A Description of Board and Care Facilities, Operators, and Residents. 5.3 Experience

12/01/1995

5.3.1 Work Schedule

More than half of the direct care operators (54 percent) reported working around the clock with an additional 9 percent working more than 60 hours per week (Exhibit 5-7). Only 11 percent worked 40 hours per week and another 11 percent worked part time. The mean number of hours worked per week specified by those operators who did not work 40 hours per week or around the clock was 54.

Direct care operators of small facilities were much more likely to work around the clock than operators of large facilities (64 vs. 6 percent), perhaps indicative of a small family-run facility. Conversely, operators of large facilities were more likely to work 40 hours per week than those in small facilities (27 vs. 6 percent) (Exhibit 5-8).

On the other hand, board and care staff members usually worked 40 hours per week or less with almost the same percentage working part time as full time (39 and 34 percent, respectively). Only 10 percent reported working around the clock. The mean number of hours worked per week by staff who did not work 40 hours or around the clock was 37 (Exhibit 5-9).

In large facilities, 45 percent of staff worked 40 hours per week compared to 20 percent of those in small facilities. On the other hand, 33 percent of staff in small facilities reported working around the clock as opposed to only 1 percent of staff in large facilities. In addition, 19 percent of the staff in small facilities reported working more than 60 hours per week as opposed to virtually none in large facilities.

5.3.2 Length of Employment

Relevant experience of direct care operators varied immensely. While half of direct care operators had more than 5 years of board and care operating experience, 15 percent of these operators were relatively new to the board and care field with less than 2 years of experience (Exhibit 5-7). In contrast to these operators, other board and care staff had a much greater turnover rate. Over one-third of staff (35 percent) had worked in their current facility for less than 1 year (Exhibit 5-9), perhaps indicating a rapid turnover of board and care staff and little change from the trends observed in previous research. In looking at board and care facilities that served a primarily elderly population, Dittmar and Smith (1983) reported that the mean length of employment was less than 1 year in about one-third of the facilities. It is important to note that, since Dittmar and Smith reported average staff length of employment as a facility characteristic and this study measured length of employment as a characteristic of each staff respondent, we cannot make direct comparisons between the two measures but can only use them as indicators for a similar trend.

EXHIBIT 5-7. Experience of Direct Care Operators in Board and Care Homes
  Direct Care Operators
  %     SE  
Length of time as operator of a board and care home
<2 years 15 4.2
2-5 years 35 4.3
5-10 years 26 3.7
>10 years 24 3.0
Mean length of time in years 7 0.5
Hours worked/week
40 hours/week 11 3.0
Around the clock 54 6.7
Other (see below) 36 7.9
“Other” hours worked/week
1-39 11 5.6
41-60 17 5.8
61-80 3 5.1
81-100 3 2.5
100+ 3 2.2
Mean “other” hours worked/week 54 2.0

Although many staff members remained within a facility for relatively short time periods, a substantial proportion of staff and direct care operators reported a longer tenure in their current home. Almost one-fifth of all staff had worked for their current home for more than 5 years and one-fourth of direct care operators had over 10 years of experience.

About half of the staff in small facilities had been working at the same home from 1 to 5 years, compared to 40 percent of the staff in large facilities. Conversely, 40 percent of the staff in large facilities were relatively new (i.e., worked in facility for less than 1 year) as opposed to 34 percent of small facility staff (see Table B-2).

EXHIBIT 5-8. Work Schedule of Direct Care Operators by Facility Size

EXHIBIT 5-8. Work Schedule of Direct Care Operators by Facility Size

 

EXHIBIT 5-9. Experience of Staff in Board and Care Homes
  Staff
  %     SE  
Length of time worked in this home
<1 month 3 1.0
1-6 months 14 1.9
6 months-1 year 18 2.7
1-5 years 45 1.4
5-10 years 13 2.1
>10 years 7 1.1
Mean length of time in years 3 0.2
Hours worked/week
40 hours/week 39 3.3
Around the clock 10 3.4
Other (see below) 51 5.1
“Other” hours worked/week
1-39 34 5.7
41-60 14 4.6
61-80 2 0.9
81-100 1 1.3
100+ .5 0.5
Mean “other” hours worked/week 37 1.9

5.3.3 Duties

Personal care of residents, assisting residents with social and recreational activities, and medication supervision and management were the duties most commonly performed by board and care home staff members, with 93, 81, and 81 percent of the staff members, respectively, indicating they did so. Over two-thirds of the staff members (70 percent) reported passing medications to residents, and about two-thirds (65 percent) said that assisting residents in getting to places outside the home was one of their duties. Over half of the staff members included housekeeping and laundry in their duties; half cooked; and over one-fourth did maintenance, repairs, or yard work. Only 17 percent of the staff members reported giving shots or injections to the residents (Exhibit 5-10).

EXHIBIT 5-10. Duties of Staff in Board and Care Homes
  Total
  %     SE  
Percentage of staff who...
Give shots 17 3.2
Pass medications 70 6.2
Percentage of staff whose duties include...
Housekeeping 61 9.7
Cooking 50 8.4
Laundry 61 7.3
Maintenance, repairs, yard work 28 5.3
Assisting residents with social/recreational activities 81 1.3
Driving/escorting residents outside home 65 3.4
Medication supervision/management 81 2.7
Personal care of resident 93 1.1

Staff members in licensed facilities were more likely than those in unlicensed facilities to have certain duties in the homes, namely medication supervision and/or management (82 vs. 65 percent) and personal care of residents (94 vs. 74 percent).

Staff in small facilities tended to have a wider range of responsibilities. The vast majority of staff members were responsible for many of the duties in the home including medication supervision and/or management (93 percent), housekeeping (92 percent), cooking (91 percent), assisting residents with social and recreational activities (90 percent), laundry (88 percent), and passing medications (85 percent). In large facilities, these same duties are the responsibility of only 70, 27, 8, 69, 31, and 53 percent of the staff, respectively. In addition, over half of the staff members in small facilities (54 percent) did maintenance, repairs, and yard work as compared to only 6 percent of those large facilities (Exhibit 5-11).

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