Job separation of long term care frontline staff in England

Staff turnover in the long-term care (LTC) sector in England is perceived to be relatively high. Most job leavers do not leave the sector, but rather move to other LTC employers. Nevertheless, there are concerns that the high ‘churn’ has a negative impact on continuity and quality of care, care providers’ recruitment and training costs, and the remaining staff workload and motivation. This study aimed to provide missing quantitative evidence on the drivers of LTC staff retention in England, with a focus on job quality. We used yearly data (2016 to 2019) from a large, employer-employee dataset covering about half of England’s LTC market: the Adult Social Care Workforce Dataset. After controlling for observed individual, organisational, and local market characteristics as well as unobserved worker and employer heterogeneity, we found that, everything else being equal, wages and employment conditions (i.e. full time contracts and contracts with guaranteed working hours) significantly reduce job separation. For example, a 10 per cent wage increase from the sample mean would have reduced the job separation rate by about 3 ppt. Our results also show that the wage effect was substantially downward biased (i.e. closer to zero) when not accounting for unobserved effects: the estimated reduction in job separation rate of a 10 per cent wage increase was only 1 to 1.5 ppt. Our findings show that improving pay and employment conditions for LTC staff can improve staff retention in LTC and stress the importance of accounting for unobserved variable bias.