Abstract

Objective: Ageing population requires an increasing number of long term care workers. Japan’s Ministry of Health, Labor and Welfare estimates Japan needs some seven hundred thousand more care workers by 2025. The current strict budgeting control of Long Term Care Insurance expenditure, however, prevents care service providers from improving working conditions. As a result, care workers are among the lowest-paid workers in the country and the care industry has long been suffering from a high level of turnover. MHLW recently took emergency measures to provide supplemental grants for the sake of wage hikes and the turnover rates of care workers are gradually decreasing. The current turnover rate of 17.7% is still chronically high compared with 15.6% for all industries. Workforce shortages are likely to persist without actions that address the underlying factors causing the shortages, including increase of low-skilled care workers. This presentation thus explores care workforce retention strategies in Japan, mostly focusing on their training and education.

Data and methods: The recent trends in supply and training and education of care workforce are analysed based on Care Worker Support Center Foundation’s Long-term Care Working-condition Surveys and relevant official reports on training and education of care workers.

Semi-structured interviews were conducted at six care service providers with fifteen care workers to find out employers ‘retention measures as well as employees’opinions about working conditions, relationship with management, job training opportunities in their organisations and the work itself. The interviews are complemented by a Kyoto Prefecture-wide quantitative survey.

Results: The statistical analysis shows well over half of care workers have joined the long term care workforce from other sectors, while care workers fresh from school constitute about ten percent of workforce. This illustrates care service providers have a large number of new employees with insufficient care knowledge and skills.

While relatively large providers interviewed tend to feel no shortages of care workers, other providers report shortages, albeit temporarily. Although all providers interviewed provide induction training, small providers do not assign specific staff for on-the-job training. The prefecture-wide survey looks into assignment of training staff, employees’ self-assessment of care skills, intent to continue working and analyse their relationships.

Policy implications: Lacking of training and education opportunities for inexperienced care workers may likely to heighten their anxiety and hinder their motivation, possibly resulting in higher turnover. The retention strategies, therefore, should pay more attention to quality of care workforce in terms of training and education. Support measures are essential, especially for small providers, so that they may retain skilled care workers to provide quality care.

Slides