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Absenteeism And Its Impact On Quality Of Care

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This paper first discusses the issue of Absenteeism in a Private Care Home which cares for five people with Learning Disabilities.

Secondly, it looks at SSM, Cognitive Mapping and SODA I as appropriate methodologies for analysing the problem of Absenteeism why SODA I using Cognitive Mapping is best recommended.

Thirdly, a Model is built using Individual Cognitive maps which are then merged to form a strategic map which is action oriented.

Fourthly, limitations of the Model are discussed.

Lastly, a Monitoring system is suggested which helps to monitor absenteeism trends and how it impacts on the Quality of Care Provided.

Finally is the conclusion based on the findings.


Employees can be absent from work either due to Long-term sickness, short-term certified or uncertified sickness or unauthorised absence and lateness. Absenteeism will not include annual leave , maternity, compassionate or absence due to training or attending union meetings but where a worker fails to turn up at work as scheduled resulting in disruption of work schedule, added work load, increased payroll costs and poor quality service an d poor staff morale.

High levels of absence are costly both to individual organisations and the economy as a whole.

* Company Background

The home has 9 full-time Support Workers ( the manager, 4 seniors and 4 support workers) contracted 35hrs a week and 7 part-timers contracted 20 hrs per week who are mostly student giving a total of 455 hours whereas the expected care hours are (72hrs *7days) 504 hrs. The company has a pool of relief staff who can work in any home. Two seniors are on long term sickness due to injury at work hence a shortage of 70hrs a week.

Until recently the home was allowed to use agency up to a maximum of 50 hrs per week and this has been scrapped from Dec 04 (kite Update 2004) and staff are encouraged to do overtime as the clients need regular staff that understand them and know their routines. More work loads leads to stressed staff whose morale will be affected and this in turn affects their performance and absenteeism will increase leading to inefficient Quality of Care provided.

Every shift needs at least a staff who can give medication, a driver and both male and female staff due to cross -gender policy (Care Practice Manual 2004).When a key staff phones sick without notice this will disrupt activities of the day .For one, if it was the only female staff on duty a female cover must be sort and this disrupts the day's schedule. If it's the driver then client's outdoor activities have either to be rearranged or a taxi used depending on how important it is and if there is enough money. For a medication giver this is crucial and staff off duty especially the manager has to come in or a senior from another Milbury home has to come in.

In the home only seniors are allowed to administer medication hence the regular staffs don't feel empowered and this affects morale and their commitment to the job.

The company used to pay sick-pay but since April 2003 this was replaced by the Government Statutory Sick pay to discourage people phoning sick but this has not stopped people calling in sick. This shows that absenteeism may just be a symptom of an underlying problem.

The researcher will need to interview staff and management so as to find out the root problem as this affects the delivery of Quality Care.


The behaviour of human activity is soft since different people construe a problem in quite different ways hence Absenteeism is viewed as a pluralist problem. SSM Methodology is concerned with the question why? before moving on to how? Brainstorming would be a good start where the researcher will act as consultant working within a system to try and find out the root problem.

SSM compares what happens in the 'real world' that is, day-to-day human interactions &business with abstracts derived from the real world to see how the variance can be minimised.

SSM uses Rich Pictures to capture information relating to the problem including communication flows, documentation maintained and by using cartoon pictures one can express emotions, conflict/harmony between co-workers. It gives a holistic view of the problem which will be useful in expressing the problem.

Using the rich pictures one can develop Root definition which are interpretation of view-points of different people (Pidd 2003).Lack of empowerment may be the main reason give by a support worker whereas increased work load is the main reason from senior point of view.

SSM is a good approach as it helps analyse the situation and is action oriented through root definition but it represents how the researcher/consultant understands what is happening and this may lack validity as it may not be what the participants meant.

The open ended nature makes it impossible to manage and it's not easy to tell whether a SSM project is a success or a failure.


Cognitive Mapping is an interviewing technique that captures the individual's perception about an issue and is present it in a diagrammatical method, which uses the person's words to describe an experience (Eden 1988, Wright 2004).

SODA I involves merging of the individual cognitive maps to one strategic map which is action oriented. The group aims to come up with concrete suggestions on how to generate commitment from individuals. This is the aim of SODA I, which seeks ways to make the team commit to the joint actions despite any differences in perceptions.

Through merging the maps the staff are able to see others' point of view which may be similar or different and the group can decide together how to go about prioritising issues and solving the problem. Hence mapping must precede



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