Balancing family life and work in the care sector - Experiences from the UIA project “home and care” in Landshut/Germany

With the demographic development, the increasing number of very old people and the associated growing number of chronically and multi-morbidly ill people, the topic of 'care' is gaining in importance both on the individual and on the societal level in Germany. This increase in importance, the new challenges and the rising demands on the care system require answers as to how care can be organized in order to be fit for the future. Today, working conditions in the care sector are often characterized by high physical and psychological stress, time pressure and unfavorable working hours, which leads to high levels of sick leave and low retention rates. Moreover, the stress on employees has a direct impact on the quality of care. On the one hand, the challenges in the care sector require a societal solution; they must not be individualized. On the other hand, the players in their fields of practice should and must recognize and use their scope for action in order to be able to master the challenges of today and tomorrow.

As an interim status in the project, the current findings with regard to the compatibility of family and work in care companies are presented here. They are by no means the final results of the project. Rather, they are a mixture of insights already gained and expectations that have not yet been met.

LAKUMED

The Landshut Municipal Enterprise for Medical Care (LAKUMED) is the largest medical service provider in the Landshut region. The three hospitals Landshut-Achdorf, Vilsbiburg and Rottenburg are united under the umbrella of the LAKUMED clinics. In total, the LAKUMED clinics have more than 630 beds. Every year, more than 85,000 outpatients and inpatients are treated in the LAKUMED hospitals. LAKUMED employs 1,600 people.

The participation in the UIA project is aimed at expanding the company's family-friendly offering and to provide better options to employ care workers.

Among the 345 health care workers at the Landshut site, there are only twelve single parents, all of whom currently do not work regular shifts. Of these single health care workers, nine have access to childcare. Looking at this number, at first glance there is no need for special projects for single parents or flexible models of childcare.

However, a closer analysis reveals that single parents in particular are leaving the profession due to inconvenient duty hours or lack of flexible childcare options. Due to the poor conditions (especially the lack of childcare), single parents are not only not interested in working shifts in a hospital, they have no opportunity to do so. They prefer working in mobile care services or in doctors' practices with regular working hours. In this respect, the clinic has an interest in the UIA project in attracting more professionals who may consider flexible childcare.

However, like all other care providers, the clinic faces the challenge of attracting sufficient numbers of suitable care professionals. Key approaches to this include

•  recruitment of skilled workers from abroad,
• more flexible training by means of new time models for part-time training,
• better pay, especially in the form of supplements for weekend and night work,
• greater incentives to prevent staff from leaving for more attractive areas of care, and
• greater attractiveness of the profession through better working conditions.

The UIA project is seen as a small chance to attract care workers or bring them back into the profession through new forms of housing. The preference is for a residential model in which well-trained care workers live next door to each other and their children are cared for in a high-quality childcare facility with flexible hours. It is important not to lose sight of the recuperation needs of care professionals when they work night shifts and the need to rest during the day. This presents a particular challenge for the housing project.

Heilig-Geistspitalstiftung [Holy Spirit Hospital Foundation]

The foundation has found that with regard to recruiting and retaining care workers who work in shifts and at weekends the balancing of family life and career plays a key role. The biggest challenge for single mothers is, of course, balancing shift and weekend work with the care of their children in kindergarten and at school. Of course, the need to be able to fill in at short notice in the event of staff shortages is not without its problems. If there is a possibility, the company tries to adapt the shift work times to the needs of the single-parent employees (e.g. start of work at 7:30 a.m. instead of 6:00 a.m., etc.). However, this is only successful to a certain extent. In addition, there has been a childminding service in the foundation for about 6 years, the "Villa Kunterbunt" in the Magdalenenheim, run by ZAK (an NGO and UIA project partner), which has adapted its opening hours to shift times for the most part and responds very flexibly to the requirements of single-parent professionals. This childminding service usually provides the joint care of more than 5 children by two or more daycare workers.

With the project "home and care" the expectation is to further supplement the childcare which is already provided by the "Villa Kunterbunt". In addition, it is hoped that newly hired single parents will have the opportunity to obtain an apartment at a reasonable price and in the immediate vicinity of their place of work. Due to the well-known shortage of skilled workers, the company will have to continue to try to adjust working hours to the needs of employees as far as possible, although this naturally also has its limits in terms of ensuring care for the residents.

Companies in the health and the care of the elderly sector will only be able to survive if they can continue to find and retain enough well-trained care workers. It is clear that there are serious differences between care for the elderly and health care. The difficult working conditions in both fields are compounded by low pay in the care of the elderly. The establishment of an alternative form of housing thus offers only a small solution in terms of both the numbers and the solution to the existing problems. However, in many cases, the alternative form of housing identified by the project could give single parents the opportunity to take up shift work in a care company. To verify this, however, one would have to inquire about the actual need, e.g., at the job center.

For the companies, in addition to better pay and working conditions, the main issue seems to be attracting foreign skilled workers. Strengthening family awareness and establishing a family-friendly family policy for care workers seems to be a challenge that every care company has to face   and requires an enormous effort.

For example, Ms. Anzinger, the care service manager of the LAKUMED clinics, speaks

of 160 different working time models for all the employees in the clinic and 20 models for the care workers. Reconciling the personal conditions of the staff with the requirements of a clinic seems to be the greatest challenge.

With this small scale trial the UIA project may be able to help to support single parents in an emergency situation and thus prevent them from leaving the profession. It remains to be seen whether this model seems attractive enough to make single parents rethink their decision to work in care.