Liz Jones, Deputy Chief Executive and Policy Director at the National Care Forum, explores how strong leadership and an investment in staff can strengthen recruitment, retention and care, drawing on insights from Reena Devi, Chief Investigator of the REACH Study.
Our not-for-profit members tell us consistently that leadership matters in their organisations and that this comes from the top down, informing every area of operation and care delivery, particularly in terms of the recruitment and retention of care and support staff. Intrinsic to the not-for-profit model is an important ethos – to invest in, reward and recognise staff. Baking this into organisational culture not only creates better quality care but also reduces the high cost and resource burden of constant staff churn.
Looking across the wider not-for-profit provider market, available research studies and surveys in the UK and abroad indicate that not-for-profit care and support settings are more likely to have improved staffing levels, and staff terms and conditions. These may include access to beneficial training opportunities, increased overall staffing levels and favourable contract terms.
More favourable terms and conditions in not-for-profit settings also appear to be sustainable in the context of economic pressure and challenge. During the first year of the Covid-19 pandemic, frontline care staff reported better pay, terms and conditions when working in not-for-profit care organisations. Staff were more satisfied with their sick pay, experienced smaller increases in their workloads and hours, and were more satisfied with the support they received from their manager.
In addition, the 2025 Personnel Survey Report, produced as part of our Social Care Reward survey, showed that among National Care Forum (NCF) members the average rate of staff employed on zero-hours contracts was 13%. This compares favourably with the wider sector, where, according to Skills for Care, 29% of the adult social care workforce – or 330,000 filled posts – were employed on a zero-hours contract.
The REACH study (REcruiting and REtaining nurses, and carers in Care Homes: what works, for which staff, under what circumstances, and at what cost), in which the National Care Forum were co-investigators, sets out strategies that can help employers be more successful with recruitment and retention. NCF members were integral to the research, from the design stage through to participating in the testing of the findings.
What Works in Practice
The study identified five practical and evidence-based ways of improving staff recruitment and retention strategies, summarised by its Chief Investigator, Reena Devi, Associate Professor in Applied Health and Care Research at the University of Leeds:
Effective job interviews which involve assessing applicants’ suitability, their values and motivations, and setting realistic expectations around what the job involves.
Providing staff with career opportunities. This starts with comprehensive inductions for new starters, continued formal and on-the-job learning for early career staff, and, for experienced staff, opportunities to mentor early career staff and courses to refresh competencies or advance learning on specific topics.
Rewarding and recognising staff through being relational – for example, positive feedback and encouraging staff – supporting staff wellbeing, and providing financial incentives such as paid time off, perks and salary increases.
Promoting work-life balance through offering flexible working options to help accommodate personal circumstances, such as caring responsibilities outside of work.
Supporting staff with caring conversations through regular informal conversations between managers and frontline staff to share concerns and seek support, with managers in turn responding to and acting on feedback.
These strategies work together to improve staff recruitment and retention. Retention starts early, at the recruitment stage, while career development opportunities, rewards and recognition, flexible working options and caring conversations help staff feel listened to, respected and valued. This in turn helps to build job satisfaction and a belief in the organisation’s culture.
NCF and our members believe culture isn’t defined by policies or mission statements, but by the everyday behaviours, standards, values and relationships that shape how care is experienced. For our members, this belief forms an intrinsic part of their everyday operations, which they strive to embed throughout their organisational culture and ultimately shape better care, giving people who draw on their services the best chance to live their lives to the full.
The research findings described in this article are based on a research study called The REACH study, led at the University of Leeds. The REACH study was funded by the National Institute for Health and Care Research, Health Services and Delivery Research (reference NIHR131016). The views expressed here are those of the authors and not necessarily those of the NIHR, NHS or Department of Health and Social Care.
