Continuing care operators have traditionally retained a pool of part-time or casual staff to fill shifts during short-term staffing shortages or peak absence periods, such as summer vacations.

However, the COVID-19 pandemic caused such sudden and unexpected staffing shortages — largely due to worker isolation and quarantine — that the pools of casual staff were virtually depleted. As a result, almost all continuing care homes were compelled to use agency staff during the pandemic as a stop-gap measure to meet required staffing accountabilities.

As below normal staffing levels persisted across the sector past the three- year mark, and operators continued to report below normal staffing levels, the sector’s reliance on agency staffing evolved into semi-permanent solution to workforce challenges.

Benefits of agency staffing

Agencies can be contracted on an ongoing basis to round out both expected and unexpected shortages within certain staffing groups or during certain shifts, such as evenings and weekends. They can also be commissioned on an emergency basis to fulfill last-minute shift gaps on short notice. For a care home with a sudden, unexpected absence of staff — usually due to illness — agencies are a lifeline to ensure regulated staffing accountability are met.

Agencies can also be instrumental in providing staff in certain geographic areas (e.g., rural) or professional roles (e.g., registered nurses) that are experiencing chronic shortages.

Challenges of agency staff

Many operators struggle with the risk-benefit tradeoff with using agency staff. For example, using an agency may cost the care home 25% to 100% more than in-house staff, which can quickly lead to financial pressure on care centres that have ongoing shortages in essential staffing groups.

As sporadic or episodic workers, agency staff are also less connected with the employer and their colleagues within the work unit. They may have limited history and knowledge about residents in the care home. They may not have the same depth of professional development and training as in-house staff, or they may not be as familiar with longstanding worksite practices. Some agency workers may also be seen as accepting less than their fair share of shift rotations such as weekends and statutory holidays. And the introduction of agency staff into a unionized worksite can cause tensions within work teams.

For these reasons, most continuing care homes are uncomfortable relying on agency staff as a permanent or long-term solution. Most would prefer to return to days of using agencies on an exception basis rather than as a permanent resource to augment their in-house workforce.

CHAA operators have committed to collaborating on addressing agency staffing challenges and advocating for system-wide solutions. We’re also continuing to work with funders on understanding the financial impact of over-utilization of agency staff.

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