We’re Home Care Pulse, a leading provider of experience management & surveys, caregiver/CNA training, and online reputation management.

Orientation is a critical piece of a caregiver’s onboarding experience. These tips and tricks will help you seal the deal and reinforce the choice that your caregivers made – to work with you, instead of the agency next door.  

Then I worked for my first home care agency as a caregiver, even though I had prior caregiving experience, I went through an 8-hour orientation class that went over the fundamentals: dementia training, cooking, ambulation, etc.

Following this orientation, I was offered the opportunity to take a personal care class. It was an 8-hour course that expanded my client pool to work with those that require personal care. The class was on my radar upon hiring; however, the class was on Tuesdays during the day when I had school.

Luckily, the agency I was working with had other caregivers in the same boat, and the clinical team was training a new nurse who would lead a Saturday personal care class.

Before taking this course, I was restricted to only working with companion clients. I was only getting 20-30 hours a week, while there were many open shifts for personal care clients. This class doubled the pool of clients I could work with and increased my base pay rate.

It’s important for all caregivers to have the same access to training, regardless of their experience levels.

57% of caregiver turnover occurs during the first 90 days of employment. That doesn’t have to be a reality for your home care agency. Turnover happens for a variety of reasons. Many of these can tie back to orientation as well. The top 5 causes of turnover include:

  • Lack of communication and transparency: Make sure your caregivers know how well you communicate and keep them in the loop. Also, set them up with a realistic idea of what each client needs and how to best care for them.  

  • Pay is too low: Be transparent about your pay range and communicate these clearly throughout the hiring process 

  • Lack of consistent schedule with enough hours: Reassure caregivers of your ability to attain clients by giving them a consistent schedule that meets their hourly goals. If your caregivers are looking for full-time, try to have your scheduler book them as close to 40 hours as they can. 

  • Lack of support and training from office staffExplain how you support your caregivers and introduce them to all office staff so that they know who is handling what department. Make sure that your caregivers are properly educated and trained before they begin working with your clients.  

  • Management is disorganized and operates last minute: Take time to organize and streamline your processes and see where tasks can be delegated or restructured to optimize office staff productivity. Have your caregivers’ schedules completed before they leave orientation, or schedule them to come back before they start their first shift.

     

Not all these causes of turnover will apply to your agency. Each of these factors can be traced back to caregiver orientation. If you can master these five things in your orientation, you can significantly improve your overall retention.

How can orientation be improved?

Because the needs and circumstances of every agency are different, there’s no single way to do orientation. However, there are common mistakes; one of the most common is rushing through it in attempt to get caregivers to their first shift.

This mistake is understandable; all too often, new caregivers fail to show up to orientation or their first day, so many agencies rightly feel a need to hurry through orientation so as to not lose caregivers before the first shift.

This thinking, however, is flawed; a (paid) caregiver orientation that reinforces the feeling that they’re working for a caring, employee-centric company and leaves them feeling fully prepared for their first shift is going to do much more for early caregiver retention than rushing through the experience.

You should also think about what brought them to their current caregiving position with you. Why did they leave their last position? Common reasons include feeling unsupported, isolated, or unprepared. If you address these topics head-on, you can prevent similar problems with your agency.

You’re probably familiar with what your caregivers think about your training, but it’s always beneficial to have a reminder. Here are some quotes from our caregiver surveys giving a snapshot of some common thoughts on orientation and training:

  • “I didn’t get training. I went in for a three-hour orientation then they sent me to my first job without anyone else.” 

  • During my orientation, I watched some videosI personally don’t learn well from watching videos. They had me shadow some caregivers for one day and those clients were easy. I wasn’t prepared at all for the client I’m with now.” 

  • “During the orientation, there is a sheet that you check off for your skills. There were quite a few skills that I needed help with and was sent into the job.” 

  • “They would benefit from having better structure like an orientation checklist and be profession-specific. They need to start on time.” 

  • “They need to have more than one training or orientation day.” 

  • “They can have more hands-on training and not have us not through it. Orientation just had people talking throughout it.”

     

How many of those may be applicable to the orientation your caregivers are receiving?

An in-person orientation might not be realistic if you have too many attendees. There are many ways to offer online training and information sessions. However, make sure that your caregivers have time to get trained and meet with the scheduler/care coordinator in the office before starting their first shift.

Make sure to also:

Understand your caregivers’ client preferences.

  • Do they like dogs? 

  • Do they want to work with people that smoke?

  • How far are they willing to travel?

     

Understand your caregivers’ communication and learning preferences.

  • Are they texters or do they prefer a call? 

  • Do they learn by doing, seeing, or listening? 

  • Do they have the opportunity to ask questions when they need to? 

What should orientation do?

Your caregiver orientation should aim to accomplish several goals:

Reinforce that your caregivers picked the right place, but don’t make the orientation all about you. Instead, focus on culture, incentives, and programs you have in place to help with long term retention. Some of these can include: CNA scholarships, stellar training, caregiver mentorship programs, career ladders, and other benefits.

Set clear expectations for your caregivers.

  • Are there minimum hourly requirements per week/month? 

  • Show them how to clock-in, clock-out, and leave shift notes

  • Be clear about their pay rates, holiday rates, travel and mileage reimbursement

     

Allow time for filling out required hiring paperwork: I-9, W-4, job description/responsibilities, job offer letter, etc.

Prepare your caregivers to work with your clients.

Are your caregivers able to perform the skills required for their clients?

If you perform a skill evaluation with your caregivers, were you able to verify and check off every skill? If not, schedule a time for the person to be trained one-on-one. Make sure that they are competent in all skills before starting with their first client – even if those skills are not required for their current assignments.

Additionally, make the training as close to real-life as possible. See if caregivers can use each other or a staff member as a pretend client. Dolls and mannequins are not representative of the weight that they will be lifting.

Ask your caregivers if they feel prepared, and make sure to arrange initial client meetings for the caregivers with an office staff member/caregiver mentor. Having a familiar face with them when they are meeting each new client adds to a new caregiver’s comfort level. Be realistic about the time needed. If they need a whole shift of training, make sure that the person sent out with them has the necessary time available.

What should caregivers take away from orientation?

Orientation can often seem like an information overload, but it’s important to go over everything. Here are some of the main points that your caregivers should leave orientation with:

  • An employer that honors their word and employee preferences 

  • The knowledge and skills to care for all clients on their schedule

  • Tips for self-care 

  • A schedule that conforms to their availability and client preferences 

  • Confidence, and feeling ready to start working for their clients 

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Orientation is not the be-all-end-all

As we mentioned in the beginning, the caregiver turnover rate is 57% within the first 90 days. This makes the orientation and beginning part of their employment a key factor in their longevity.

It’s important to treat your orientation like a first impression. Within the first seven seconds of meeting, people generally have a strong impression of you decided. You’ve likely met your caregivers before they come to orientation, but this is a new opportunity to reintroduce them to your company in the best light possible.

It’s easy to forget a step or let one slip past you but putting together a stellar orientation for your caregivers can boost your retention rates. If you’re stumped on assembling topics, we have a blog article on suggested orientation topics that can help pull your orientation together. This will set your caregivers up for success with their clients and with your home care agency.

At the end of the day, however, orientation isn’t the only thing that matters. One agency owner said, “It’s because of them out there, that we get to be in the office.” Keeping a pulse on your caregivers, knowing how they are doing, and providing continual opportunities for upward progression is key to your success.

Don’t just give your caregivers a great orientation and turn them loose—let the orientation set the tone for the quality of education they’ll receive throughout their time with your agency.

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HCP’s Care Intelligence Platform offers RN-developed training, satisfaction surveys, and reputation management tools to help you become the best employer and provider in your area—and make sure everyone knows about it.

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2 Comments

  1. Sandra RN BSN July 29, 2021 at 4:33 pm - Reply

    This sounds very beneficial. Do you offer training?

    • Jennifer Lagemann July 30, 2021 at 10:59 am - Reply

      Hi Sandra,

      We do offer training. Home Care Pulse merged with In The Know caregiver training, here is a link for more information: https://www.knowingmore.com/ Our dementia and Alzheimer’s training is recognized by the Alzheimer’s Association, we also have specialty learning paths like: caregiver kitchen, preventing readmissions, and palliative care.

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