How to safely staff your LTC home (including night shifts)

Proper staffing is essential for making sure your LTC residents are safe and given appropriate care.

In our current healthcare staffing crisis, we know this can be easier said than done, but it’s critical to stay on top of it.

This is because staffing shortages can trigger a whole range of serious issues if not dealt with – from poor patient care, to staff burnout, to damage to your facility’s reputation in the long run.

If you’re worrying about staffing at your LTC home, this is the guide for you. Here, you’ll find out how to spot and fix staffing issues as they arise and get back to healthy levels.

First things first: what does safe staffing look like?

You need the right number of people working at your home, with the right skills, day and night.

This can change depending on the number and needs of the residents living with you, so it’s something you should constantly monitor and adjust as necessary.

Safe staffing means:

  • Hiring good people to your team, and running recruitment checks before hiring
  • Putting enough of those people to work every shift, and making sure they have the experience to meet residents’ care needs
  • Making sure your team is well supported and able to do their jobs.
  • Having alternative plans in place in case you’re short staffed at the last minute.

Warning signs your staffing is unsafe 

If you notice some, or all, of the below points happening at your home, your staffing levels could be unsafe.

Signs of unsafe staffing include:

  • High staff turnover
  • Struggling to hire enough people
  • New staff leave shortly after joining
  • Staff are often off sick with stress-related illnesses
  • Your scheduling processes are disorganized or difficult to follow
  • You’re constantly changing your staff schedule
  • Staff don’t have time to ‘care’ – only to do their basic duties
  • Staff don’t have time to talk to residents, residents’ families or their own colleagues
  • There’s no consistency in the teams of people who work together day to day
  • You over-rely on agency professionals to cover schedule gaps
  • You don’t spend time on inductions for new staff
  • You give limited time to staff training and development, beyond what you’re legally required to do

How to safely staff your LTC home (including night shifts)

Note, there’s no quick fix for safe staffing: improvement often means making several changes in different areas, monitoring how these go and shifting your approach based on the results.

Fix 1: Figure out the people and skills you need

Using a single formula for safe nursing and care staff ratios – for example, one nurse for every three residents – is outdated.

So, what exactly is a safe nurse-to-patient ratio?

The answer is, there isn’t a one-size-fits-all way to plan your staffing per shift.

Instead, you should focus on your residents’ individual needs to plan your staffing.

For example, if your residents need specialized care for a condition like advanced dementia or have mobility issues, you’ll naturally want more staff with experience in those areas.

Plan your staffing with a ‘dependency calculator’ system – you can get software that does this or build it yourself with a spreadsheet.

If you’re building your own system with a spreadsheet, start by listing each area of care, for example:

  • Eating
  • Dressing
  • Bathing
  • Toileting
  • Moving and transferring
  • Communicating

Then create categories of dependency:

  • Independent
  • Needs some help
  • Needs full assistance

Categorize each resident by their level of dependency for each area of care, including what those requirements are during the night. This will give you a picture of the number and type of staff you need for each resident.

Make a list of your current staff and their individual skills, and link them to residents depending on their needs. This will help you see where you have gaps to fill.

You can then plan the best way to do this – either by training current staff or hiring new people with specific skillsets. You can build your staffing requirements for every shift this way.

Fix 2: Prioritize training

With residents’ needs constantly changing, it can be hard to know when staff training is needed.

Start by taking an inventory of what skills your existing staff already have. You can add skill requirements to your ‘calculator’. For example, if a resident needs specific care, which staff members have the right training?

This setup can highlight where your staff needs more training. If you constantly need staff trained in mobility assistance and don’t have enough, that’s a cue for more training sessions.

Your ‘calculator’ will paint a clearer picture of staff requirements for every shift and allow you to see where you need to make changes as residents come and go from your facility.

But remember, every individual is unique. Always allow for some flexibility in your system to account for varied resident care needs.

Fix 3: Build processes and stick to them

In order to make sure your team is well supported and able to do their jobs, have a process in place that shows where your staffing gaps are at all times.

If you’re using a skills calculator and have added a skill you need to it, this ‘live’ document will allow you to regularly check if you have a realistic staff count.

Check in with this document throughout the year, based on the specific needs of your home.

This helps you spot if there are consistent gaps or there’s a pressing need to train staff in a given area.

Also consider new guidelines for care and how this may impact your shift staffing. When new guidelines are released, re-train all staff to make your home continues to follow best practices.

Fix 4: Plan your night shift staffing carefully

Use the same system for matching daytime employee skills and training to residents’ needs for planning your night shift staffing too.

You may find you need fewer people on shift overall, as night time work is quieter while your residents are asleep, but it’s crucial to make sure people on shift are trained to deal with situations like resident evacuation and emergency medical responses. You must have a comprehensive plan for emergencies that all night staff are aware of.

It’s also essential your day and night staff communicate clearly and give a thorough handover during shift changes. Finally, make sure you have a fair shift rotation system in place, and that it is in alignment with your Collective Bargaining Agreement if your staff are unionized, so staff aren’t over-burdened by working night shifts too often, which can take a toll on mental and physical health and lead to burnout.

Fix 5: Sort out your scheduling

Once you’ve got a solid process in place and are regularly tracking staffing gaps and training needs, now you need to make sure you’ve got enough staff to fill those gaps. Having a backup plan for scheduling is essential. 

Florence can help when staffing is tight. Whether it’s using the app to alert existing staff via SMS that a new shift is available or taking advantage of our 5,000+ on-call network, we’ve got you covered.

Using Florence, send shifts out to your own staff in under 30 seconds. Notify all at once or in seniority and rotational seniority order if staff are unionized.

Simply set your rate, alert our network and choose the candidate that best suits your needs. Florence staff are matched to your shift based on the skills you need, so you can rest assured you’re booking the right people to care for your residents. It’s really that easy.

And did we mention there’s no hidden costs or cancellation fees? And we’ll never charge you a surprise commission bump. We’re transparent with our pricing.

If that sounds simple, it is. You can find out more great things about Florence here or book a 10-minute chat with our team to see how we can help.

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