HRM Strategy: Agency Carers’ in London

Abstract

In organizations operating in the Agency care industry in London, their employees are allocated jobs in homes of individuals to ensure the clients live conformably within their local communities. To retain the clientele, the capacity of the services delivered by these employees to satisfy the clients is essential. This challenge prompts organizations to emphasize service quality as an essential organizational differentiation strategy. The work environment is such that managers cannot control or monitor employees to ensure compliance with service quality standards established by the organizations. This poses problems of continuous improvement in the service quality of the organizations. This research uses a sample size of 385 respondents to conduct interviews on the impacts of HRM approaches in London care PLC, Allied healthcare, Metro London healthcare, and Care International on the turnover of employees that affect the turnover of employees. The aim of the research is to study variables such as nurses, working conditions, career growth, remuneration, age, and the duration of the workforce on their impacts on the turnover. This aim is rested on the platforms of research findings in the discipline of human resource management showing that organizations, which are successful in the competitive marketplace, deploy HRM approaches to gain competitive advantage. The findings of the research indicate the HRM strategies deployed by London care PLC, Allied healthcare, Metro London healthcare, and Care International are different. Their applicability in any organization depends on the characteristics of the organization and strategic decisions for gaining a competitive advantage. However, the roles of nurses, working conditions, career growth, remuneration, age, and the duration of workforce influence agency care industrial organizations studied in the research.

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Introduct the Ion

Over the last three decades, the economy of the UK has shifted from being based on manufacturing to placing more emphasis on the development of knowledge-based industries it’s favoring the development of service sector firms. This implies that companies are shifting to relying on the employees as the source of competitive advantage to survive in a dynamic marketplace. Indeed, several organizations based in London invest very little intangible assets. Their operational success depends on the people they employ. Such organizations include the agency care organization providing services ranging from housework to patient care within the homes of the patients. Consequently, in such organizations, HRM approaches are essential.

Objectives of HRM

Several studies support the assertion that HRM has positive impacts on organizations in the services industry. For instance, a study by Huselid showed that HRM “practices can be leveraged to improve employee skills, increase motivation, and foster commitment to a company by linking certain types of HRM practices to lower voluntary turnover, higher financial performance, and increased market share” (635). The impacts of HRM are also found valid on the foodservice industry (Wright and Gardner 412), organizations having high employee’s diversities (Crook et al. 445), organization involved in general manufacturing,(Youndt 836), an organization specializing in the automotive assemblage and manufacturing (Takeuchi and Wang 1071).

In this research dissertation, it is held that organizations in the service sector need to consider various HRM approaches, which may help to influence positive outcomes. For Agency care organization based in London, HRM practices are important since they mainly rely on the services delivered by their employees to the clients for the derivation of their competitive advantage. The roles of HRM in such organization are significant in consideration of the argument that people working for any organization act as the source of competitive advantage and they cannot be optimized using economic theories in the same manner as other factors of production such as capital and land (Ollapally and Bhatnagar 455). This argument forms the basis of this dissertation research paper.

Different HRM approaches are effective to different degrees depending on the nature of the organization and industry in which the organization operates. Hence, the objective of this dissertation paper is to set a theoretical paradigm, which helps to provide the basis of making a recommendation of appropriate HRM practices, which can be instrumental in agency care organizations in London by helping them gain a competitive advantage. To realize this aim, research will be conducted in four London-based agency care organizations. The organizations are London care PLC, Allied healthcare, Metro London healthcare, and Care International. These organizations provide home care service and individual l assistance to the person of different ages.

The focus of the organizations is to ensure that people enjoy their lives while living within their local communities at the comfort of their own homes. To achieve this focus, organizations employ people from diverse backgrounds. For the case of London care PLC, Allied healthcare, Care International, and Metro London health care, it is incredible that the management for the organizations deploy appropriate human resource management approaches. The goal of this dissertation paper is to determine whether variables that are associated with HRM practices such as supervision, working conditions, career growth, remuneration, age, and duration of the workforce have impacts on the turnover for employees in the four-agency care organizations operating in London. The results of the research are useful in the proposition of the appropriate HRM approaches to reduce turnover. Direct interviews are used to collect data from employees. A simple sampling technique is used to generate the sample used in the research.

Literature Review

HRM as a Core Competency

The human resource arm of an organization has an immense responsibility to ensure that top talent within an organization is retained. HRM is a core competency for an organization whose objective is to handle issues related to employees. Such issues include enhancing motivation, enhancing job satisfaction, laying remuneration structures, giving advice on promotions, and aiding an organization to acquire top talent through the selection and recruitment (AbuKhalifeh and Ahmad 42). The department also ensures the proper induction of employees. Training of employees also follows induction. Moreover, on-the-job training and workshops enhance employees’ skills. As a core competency for an organization, HRM also engages in tasks such as training and development and managing conflicts within organizations’ conflict resolutions (AbuKhalifeh and Ahmad 42). Conflicts that HRM enhances their management are between an organization and employees or between employees and other employees.

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Labor turnover in many organizations is deployed as a measure of performance (Beecroft 41). It measures the decisions of the worker to remain committed to the work of an organization. Devir and McMahon define labor turnover as “the movement of people into an out of employment within an organization” (143). Labor turnover is controllable or unavoidable in some situations (AbuKhalifeh and Ahmad 42). In the service industry, turnover comprises one of the major challenges that influence organizations. Devir and McMahon agree with this assertion by further claiming that high turnover in the service sector organizations results in increased costs of recruitment coupled with training of new employees to fill the gaps left by the outgoing employees (144). Several studies conducted on the impacts of turnover on the service sector organizations contend that turnover is one of the issues that organizations seeking to exploit cost competitiveness as a strategy of success should address proactively (Khilji and Wang 377). Scott and Snell amplify this argument by adding that in case few people remain employed within an organization for a period less than five years, labor costs increase tremendously through high costs of replacement of the people leaving their employment (875). Many of the studies in the service sector turnover address cause together with the impacts of the labor turnover.

Job Satisfaction and Employee Retention/Turnover

Organizations conduct studies on turnover at an individual level as a means of evaluating the effectiveness of the HRM in conducting its organizational role of enhancing job satisfaction. According to Khilji and Wang, some organic nations conduct an analysis of their turnover as a routine for executing business (379). Many scholars in human resource management contend that people quit their jobs in case they are not satisfied to look for other jobs existing within the same industry (Hom and Kinicki 975). Addressing issues of labor turnover in human resource discussion is important since “HR programs designed to reduce turnover can result in tremendous bottom-line improvement” (Phillips 180). The literature on human resource management identifies several factors such as lack of job satisfaction among other aspects, which may influence turnover in the service sector organizations.

Others include organizational socialization processes, the procedure deployed for the employee’s recruitment and development, styles deployed by leaders and managers to direct and control employees (Hom and Kinicki 975). Other factors include burnout and organizational stress, and labor shortages (Devir and McMahon 149). Socialization is a great factor in determining the rate of employee retention and satisfaction. High turnover can demoralize the current employees and/or deter potential talents from seeking jobs in an organization. Investors can also be scared of investing in a company that has a high turnover. An organization that socializes its employees is likely to win them hence retaining them for a longer period because they are satisfied at work. Socialization involves a close and open interaction between employees and the administration. A good relationship between employees is also a great reason for employees to remain in an organization. Poor socialization results in enormity and grudges between employees and their supervisors. Organizations plan for interaction forums that bring their employees together for a particular purpose. Such forums include annual general meetings, luncheons, and open forums.

Well-socialized employees also act as informers of the management. Such employees feel obliged to report and/or give opinions on better management of their jobs. This fosters teamwork and cooperation within the firm. Consequently, employee satisfaction is achieved. Human resource development induction is also crucial in ensuring employee satisfaction and retention. The initial induction and orientation that new employees receive when they first come into an organization determine the image they form in their minds about the firm. During HRD induction, an employee forms a frame of reference about the management, supervisors, and employees of an organization. First, opinions are therefore developed during induction. Proper induction also means low wear and tear, scrap, and even errors. The leadership style that organization practices also determines the level of employee satisfaction and retention. An organization that practices dictatorship leadership may not perform as well relative to the one that practices laissez-faire or democracy. Some leadership styles make employees stressed and overworked.

This results in job burnout. Exhausted employees have low morale in their jobs. The absence of sabbaticals and leaves makes employees turn to absenteeism. Most of the employees in such organizations experience demotivation and hence low performance. Employees do not enjoy their working environment and/or their work. Low input results in low performance. Turnover is preceded by the perception of leaving given employment. Khimji and Wang argue further, “Labour turnover is not an isolated occurrence, where multidimensional aspects include low staff morale, substandard ,work performance and absenteeism” (380). In the service sector, the impacts of labor turnover are categorized as indirect and/ or direct costs. The sphere of direct costs involves all financial challenges that an organization encountered accruing from increased incidences of turnover such as training coupled with recruitment costs. This suggests that the differences in the management of the workforce may contribute to increased turnover within an organization following the different factors that the management may put in place to influence job satisfaction.

HR Retention Strategies in Organizations

The realization of the need to retain employees within an organization prompts management scholars to explore various retention strategies that can provide a guide on how to accomplish the task. Some of these ways are developed by organizational theory. They include fostering motivation, mentoring, and even choosing a balance between X and Y theory as discussed later in the paper. By deploying effective approaches to human resource management, turnover can be managed effectively. Recruitment followed by successful retention of personnel in an agency care-nursing organization such as Metro London health care is an incredible challenge especially in the business environment characterized by shortages. As a result, an emerging body of literature on human resource management practices indicates that different HRM practices can be grouped into bundles to have the desired impacts on the employees’ turnover. According to HayGroup, this means that individual HR practices may not have the capacity to produce different attitudes on the employees of an organization (1).

This implies that employees consider the HRM practices approach as constituting one holistic system. Consequently, individual strategies for managing people as developed by the human resource department within an organization do not produce different behavior among the employees in terms of altering their behavior coupled with attitudes. Programs for employees’ treatment are enacted by the HRM to ensure that employees are treated with fairness without disc discrimination along with diversity differences. The practice also sets mechanisms for rewarding employees whose performance exceeds the preset standards. Fairness in the distribution of resources and equitable remuneration is equally important. There should be fairness in pay and reward systems. In terms of job design, different components of a job that are related are brought together to form one complete job description. An employee is therefore assigned a well-organized the d and spelled out the job. Completion of such a job becomes easier. This makes employees creative, hence having goodwill towards their job. Employees’ goodwill also makes them practice complete engagement in their jobs.

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Performance anticipation policies are adopted in the bid to raise the performance of employees through the development of skills. Sub-categories of this bundle include training, hiring, and rewards systems. Reward systems ensure that job performance is consistent with the rewards and sets mechanisms for promoting employees based on their performance as opposed to seniority (Hom and Kinicki 981). A good reward system from HR makes it possible for employees to develop themselves and/or compete for the best rewards. In the process of competition, employees become more creative and committed to their jobs.

The organization also benefits from increased production and goodwill. Employees will remain in an organization in a bid to ensure that they are present during the end of year reward moment. Recognition of employees who perform well after job appraisal also makes them committed to the organization. Training programs also help to provide ways of enabling the HRM to deliver feedback on employees’ capabilities on a regular basis and in a consistent manner. Training is essential in ensuring that poor performance associated with a lack of sufficient knowledge on the job is mitigated (Shaw and Fang 1017). Human resource development is a key factor in employee retention. Arthur insists that for HRM to yield results in effectively managing people, HRM approaches deployed should be classified in to different categories and then strategies developed to ensure that best results are achieved for every practice (673).

Types of Employee Turnover

Employee turnover is divided into two main types: voluntary and involuntary turnover. Voluntary turnover occurs when employees decide to quit from employment out of their own will to engage in other activities such as self-employment, but not because the job was dissatisfying. Voluntary turnover is considered in the service sector industry as a management problem, requiring an urgent solution (Devir and Mthe McMahon 145). In the case of involuntary turnover, people are compelled by circumstances to quit their employments. Such circumstances include poor pay, perception, of exploitation, and work-personal life conflicts among other reasons (AbuKhalifeh and Ahmad 42). Examples of the HRM bundles that yield the ding results in the effective management of employees include inducement practices and programs for performance expectations.

For inducement practices bundle of HRM practices, sub practices include employees’ treatment, job, design, fair pay, and motivation among others (HayGroup 2). The categorization yield bundles of different practices, which Shaw and Fang maintain the lips to increase the commitment of employees to an organization (1016). With good job designs, employees are satisfied with doing jobs that they are well qualified in and/or that are not strenuous. This results in specialization and creativity. Through the provision of training coupled with aiding in the provision of incentives to employees, some HRM practices bundles aid in increasing the performance of employees (Shaw and Fang 1017).

Role of HRM in Health Care Organizations

HRM ensures that retention strategies like organizational fairness to the employees, equality, and the rewarding of every employee are upheld. HRM also develops job designs that ensure that various components of a job are fitted together and that every employee is aware of all his duties. This ensures efficiency and accountability. The impact of good turnover management is increased innovation, creativity, goodwill, and full engagement of the employees. As a result, productivity is enhanced as conflicts and losses are lowered. For nurses, scholarly research in recruitment identifies several factors that may influence nurses to accept nursing jobs within different agency care organizations coupled with factors that influence their decisions to stay on the job they have accepted.

For instance, Jones claims that recruitment and subsequent retention of the nurses are influenced by factors such as salary, the reputation of the health facility or agency care, nature and the status of unions and, more importantly, the autonomy of work (p.43). It is also the duty of the HRM department to ensure proper leadership methods and strategies in the organization. Poor leadership style results in job burnout, low employee morale, absenteeism, and low productivity. From the paradigms of the factors that may influence the decisions of a given nurse to stay within a given facility, the retention of nurses may be influenced by several factors. They include recognition and inclusion of an individual nurse in the decision-making process of a health facility, nature of the workload, and the interrelations of a nurse with fellow workers within the departments and even n the entire organization (Jones 44)

Recruitment, as a function of HR, and retention often overlap. In the nursing sector, Sourdif (59) confirms this assertion by arguing that the concerns of recruited nurses overlap with the decisions to remain employed. Sourdif concludes that factors, which encourage registered nurses to have driven for joining a health facility followed by their subsequent desire to remain in the employment, need to be given central consideration by any organization, which seeks to attract and retain sufficient nursing staff (66). However, although it is important to conduct thorough scrutiny of nurses before they are recruited to an organization in the attempt to find whether they would be retained and remain motivated while working under existing working conditions within an organization, it is important to note that recruitment is an expensive affair.

For example, Jones approximates that it requires about $62,100 to replace an existing registered nurse within a health facility (p.45). Arguably, this is an immense cost especially by noting that a single turnover of a single nurse creates a vacuum in terms of workload, which must be taken up by other nurses. From the perspective of human resource management, increasing the workload implies that the nurses who are left are likely to get lowlily motivated due to increased works loads, which they consider unfair. In fact, DiMeglio and Piatek (2010) find a single turnover as having the capacity to truncate into multiple turnovers. The only most practical way to deal with this self-replicating problem is to seek mechanisms of employee retention (115). Motivational theory is essentially ingrained in the perspectives of human capital management (Pfeiffer and Gellar 7). Its focus is looking for mechanisms for maintaining the work morale of both new and existing workforce within an organization.

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Reasons for Home Care Turnover

Home care turnover and intents of such turnover cases are normally common amongst recruits. Beecroft supports this line of argument by claiming that the turnover rate among first-year nurses is in the range of 35 the o 60 percent in the US (45). Cognition of these outstanding rates calls for the deployment of imperative and effective employee retention strategies. A particular focus of human resource management is on the management of the diverse workforce of home care organizations. In the era of globalization, physical boundaries between nations have been made porous so that home care organizations employ people from diverse nationalities and cultural backgrounds (Dessler 87). The impacts of free movement of people, goods, and services across different nations have seen agency care organizations based in London employ people from across the globe. This introduces the challenges of minimizing workforce challenges and hence turnover attributed to differences in workforce cultural diversities.

These causes of high turnover intents among the recruits are explained by Beecroft as being instigated by delegations of responsibilities to new recruits yet such people do not have experience (47). This implies that even though delegation is an incredible strategy for enhancing the work morale of people as developed by studies in human resources, it fails to work well in situations involving a new workforce due to work pressures while operating in an unfamiliar environment. Chu and Price evidence that attitudes coupled with work pressures incredibly influence nurses from the basis of job satisfaction and their commitment to organizations (179). Problems encountered by agency care organizations are related to the ability of HRM to control employees. The nature of the work environment and work pressures that people working for an organization is susceptible to affect retention. This implies that in case of people are exposed to a bad working environment, the intents of turnover are higher (Firth, Mellor and Moore 175). This evidence is rooted in the theory of human resource management.

Managing effectively turnover in the service industry requires home care organizations to deploy various strategic initiatives geared towards enhancing workforce motivation. Research evidence in the hotel industry shows that human resource management is pivotal in helping a health care organization to gain a competitive advantage. These findings are consistent with earlier research findings in other industries in which HRM has been found as playing an incredible role in enhancing the performance of home care organizations (Ragburam and Arvey 56). In the home care service industry, the utilization of people in the most effective way enables organizations to gain a competitive advantage. For agency care organization in London, focusing on strategies of effective management of the employees can aid the organizations to foster their retention.

Successful HR Talent Management: Impact of talent turnover or retention in the organization

Indirect impacts of turnover include low productivity associated with the unfamiliarity of new employees within an organization, dwindled quality of service due to overstretching of few remaining employees, low work morale, and compromising of standards set by organizations (Bowles and Gintis 74). These factors affect employee satisfaction as discussed above. Brockbank argues that different organizations, even though working in the same industry, exhibit different levels of turnover (341). London agency care organizations operations are unique in comparison with other industries. Similar to the hotel industry, agency care organizations render services to customers via employees (Lewis 42). This means that the employees are the representatives of the agency care organizations within areas where they are allocated duties. Consequently, the success of agency care organizations in London is a function of effectiveness in talent management by HR.

Experience and the ability of employees to satisfy the needs of the customers are developed with time. Therefore, although it is important for HR in organizations offering agency care services in London to focus on recruitment of the most talented and qualified people, it is important that such people are not lost to competing organizations over time by ensuring that turnover intents are significantly reduced. People are important assets of an organization. HR’s recognition of the value of people in an organization prompts organizations to invest in human capital management with the chief objective of “responsibly attracting, developing and managing a firm’s biggest asset, people” (Bowles and Gintis 75). The value of service delivery within an organization depends on the extent of the motivation of the employees who deliver services to clients. Hence, it is crucial that the agency care organizational management ensures that people remain motivated by handling various situations that may render them experience low self-esteem and low attitude towards their work. This makes the concepts of talent management relevant in the agency care organizations established in London.

Amid valid theoretical approaches to the concepts of talent management and its applicability in agency care organizations, Alan Erskine, a management consultant, argues that human capital management cannot be implemented by an organization without collaboration between IT, human resource and operations management arms of an organization (Erskine 12). According to him, human capital management entails the mechanisms fo the r ensuring that the organizational workforce remains motivated and productive in the effort to realize organizational goals (Erskine 12). According to Erskine, human capital management can be simply defined as the “holistic approach to contracting and optimizing the time of employees” (Erskine 12). From the basis of this definition, human capital management arguably entails an essential component of achieving the goals and objectives of an organization through people. Hence, to realize organizational goals through people, efforts need to be made to ensure that recruited employees are retained within an organization for a long-term through retention strategies such as motivation to enlace job satisfaction.

Relationship between HR Policies and Employees

The intents of employees’ turnover can be reduced by putting in place policies for ensuring employees are satisfied with their work. Although turnover has been shown by research as having unhealthy implications on organizations, some critics maintain that turnover in an organization cannot be avoided especially for growing organizations. For instance, Mount states, “an organization that is choosing to thrives and grow must expect a higher turnover rate than companies that settle for the status quo” (109). This research seeks to seal this gap by studying the supervision, working conditions, career growth, remuneration, age, and the duration of work, HRM policies employed at London care PLC, Allied healthcare, Metro London healthcare, and Care International in influencing employee turnover decisions and the actual turnover. Price argues that the service sector organization tends to have high rates of labor turnover and have to depend on the external labor available in the market to fill various vacancies often created (47).

Nevertheless, Mullin insists that labor turnover cannot be considered a problem that afflicts all service sector organizations. For instance, Brown and Cheng research on the roles of the man resource in the reduction of turnover indicated that in both Australia and Singapore, in the hotel industry, there are clear HRM policies desire and to enhance the motivation of employees in the effort to reduce their actual turnover and turnover intents (136)a. There is also a substantive effort by HRM to enhance retention of employees through the “recruitment, selection and inductions process” (Brown and Cheng 136). The researcher further found out that HRM policies despited to enhance the retention of employees within Australia and Singapore hotel industry were coherent irrespective of differences in the labor policies (Brown and Cheng 147).

Many organizations seeking to ensure they are successful in the long-term through the strategic initiative of focusing on the employees as their most important resource for gaining competitive advantage endeavor to ensure that occupational hazards are reduced coupled with ensuring that labor loss is minimized. Pfeiffer and Gellar support this line of argument and further notes that ” today, because of the recognition of the crucial importance of people, HRM in an increasing number of organizations has become a major player in developing strategic policies and facilitating changes within the organization” (8). One of such policies is looking for mechanisms of enhancing the motivation of employees such as enhancing safety in working environments. In the context of agency care organizations, safety policies not only refer to freedom from situations that may harm people physically but also emotionally. A situation that may prejudice an agency worker’s emotional safety includes conflicts with the customers while within their premises of residence. Unfortunately, the HRM has no direct control of these working environments.

Factors affecting Turnover and Retention

Any organization seeking to attain high performance using people must strive to invest in programs that will enhance the retention of employees. Lack of such programs increases the rate of turnover as employees are persuaded in their work. Many organizations do not recognize employees who perform well. They should be rewarded fairly. Such rewards make them want to remain in the organization. Fair pay is aimed at ensuring that employees are remunerated commensurately to the efforts put at work and consistently with the current, market rates with an industry in which an organization operates. Job design is also another factor that many organizations do not consider. Job design ensures that employees’ are directed and controlled in such a manner that they become innovative and creative in their work (HayGroup 2). It also entails the allocation of tasks that are reasonable depending on the role that is played by a given employee or workgroup in aiding to yield the success of an organization.

Management of people to enhance their successful recruitment coupled with their retention is a crucial factor that requires the possession of skills in human resource management and capital management (Dess and Shaw 446). This underlines the significance of proper handling of employee’s issues, which entangles the provision of services, which make it possible for the workers to execute their work effectively to the clients. Low job turnover can result from the provision of a better working environment. Employees would want to remain with an employer who offers them the best working conditions. Most of the agency employees prefer to remain with their employers due to various intrinsic factors. Low turnover is also associated with high levels of employee job investment. Kim (2005, p.137) observes that employee investment into the business enhances their attachment and connection with the company. Employees invest time, knowledge, and identity in the company that they work for. For instance, an employee who works for a company for a long duration of time will be reluctant to turn over since he or she has a time connection with the institution. One of the elements that affect turnover is organizational customs.

They may act to motivate or de-motivate employees (MacIntosh and Doherty 109: Whitt 237). For instance, organizations, which build their culture around the perspectives of strong interpersonal and intrapersonal communication, enjoy reduced incidences of labor turnover (Moore and Burke 74: Labov 117). This suggests that HRM has noble roles within organizations to put in place effective strategies for retention management. Such strategies require a continuous diagnosis of various causes of labor turnover. Successful diagnosis is accompanied by the deployment of employees’ retention initiatives that are well formulated and targeting specific industry needs. This underlines the importance of researching specific turnover initiatives that are effective in the context of the agency care organizations operating in London. Although Jones discusses the above factors in the context of hospital settings, their applicability is also confirmed by other disciplines such as human capital management and human resource management as essential factors, which contribute to the enhancement of workers’ motivations.

For instance, Erskine (2012) argues that workforce motivation is an essential element in any organization seeking to use the employees’ talents’ potentials to yield organizational success (Brockbank 338). Within agency care organizations, managers are charged with similar responsibilities. This implies motivation may be a significant element for enhancing retention of employees within the agency care organizations established in London. For instance, in nursing settings, DiMegl, io, Padula, and Piatek (2010) provide evidence that 13 percent of newly recruited nurses alter their principal jobs within one year. For a sample of 1000 nurses studied, 37 percent of the nurses held that they could change their jobs if given an opportunity. This means that retention is a major issue in the management of nurses. Many of the nurses studied DiMeglio, Padula, and Piatek (2010) argued that they could easily switch their careers due to poor job satisfaction. This implies that leaders for nurses within the agency care organizations in London have to deal with two main important factors to be effective in their works. These are recruitment and also maintain or retain newly recruited employees.

Cost of Turnover

The purpose of retention is particularly significant when there are high rates of employee turnover. Turnover results in increased costs for any organization. Leena and Lissy support this argument by stating, “Turnover is an immense potential source of organizational losses” (79). The literature on the reason why people consider leaving their organizations concurs that irrespective of the industry in which an organization operates; the reasons for turnover are similar. For instance, consistent with the reason why people leave their jobs in nursing and the hotel industry, in the IT industry job stress, job dissatisfaction, and poor organizational commitment are major contributors to labor turnover in the Indian IT sector (Leena and Lissy 80). Several factors contribute to job dissatisfaction. For instance, personal dissatisfaction occurs due to “compensation issues, job security, job autonomy, relationships with nurses and other colleagues among other reasons” (Vaiman 175). Organizational factors are also major contribute tutors to the intents of turnover.

Rewards and Recognition

Organizations that offer recognition and reward to their employees are also able to retain employees for a long period. Employees would like to identify themselves with agencies that recognize their input and reward them. All human beings would want to be appreciated. Agencies that have high employee recognition score low on job turnover. Employees in such agencies wait for their work to mature so that they can receive rewards. Other employees would avoid job turn to overdue to their working environment. Kim argues that in case the working environment is not conducive, employees would want to turnover (257). For such employees leaving the organization would mean a great loss of time investment. Yurtseven and Halici affirm that employees also invest their knowledge and identity into an organization (72). The longer the period that an employee serves in an agency the more knowledge they employ in their duties. In search of mechanisms of making people-oriented to their work’s demands and realize organizational objectives, McGregor developed Theory X and Y. Theory X proposes that people are normally lazy and often avoid doing work (Lorsch and Morse 92).

Consequently, managers must supervise their employees closely and ensure that they can control every activity executed by them. The theory advocates for a hierarchical structure of management of staff. This is meant to ensure direct control while leaving very little room for delegations of responsibilities. Indeed, according to Lorsch and Morse, realizing organizational goals form the basis of this theory calls for managers to deploy coercive and threatening management techniques (93). However, applying this theory in agency care settings leads to mistrust between the employee and managers. Hence, it acts as a magnificent catalyst for the turnover of employees.Theory Y presumes that employees are essentially self-motivated, exercise personal control, and/or highly ambitious to get things done within an organization (Lorsch and Morse 96). The theory holds that employees enjoy their work particularly if it is physically and mentally satisfying. Such employees are great problem solvers.

Managers inclined to this school of thought believe that people are always ready to accept responsibilities and deploy self-control coupled with self-direction to ensure that they can achieve their organization’s duties. Given opportunities, from the context of theory Y, people have an eagerness to do well (Lorsch and Morse, 103). Hence, satisfaction accompanied by doing well in a given job acts as an enormous source of motivation, which also helps to foster employee retention within an organization. No research exists on the best HRM practices in the agency care organizations operating in London. Every task that employees face poses a particular challenge to their profession. Job challenges only make the employees more devoted to searching for answers to many questions related to their field of specialization. It is such challenges that result in skills investments in place of work.

Employees of such agencies will therefore have a big attachment with their work. Wang, Chyan, and Wang observe that the pleasure and satisfaction that comes with one being associated with having perfectly done a particular job makes them want to identify with it (557). For example, Yurtseven and Halici affirm that an employee would want to be associated with a great achievement like being the agent of the year, holding the best marketer award, having supervised the building of the tallest building in the land, and so on (72). There are pride and satisfaction that come with awards and recognition. Kim (137) observes that employees who have scored high in performance rating and appraisal would want to stay longer in the organizations. Successful organizations are likely to have low turnover. Most of the employees from such organizations enjoy being identified with their success. Takeuchi and Takeuchi affirm that success enhances low job turnover (928). Success is also an investment that employees count on. Every employee in an agency would want to be identified with great achievers.

Context

Turnover in the care organizations is reflected by the rate at which caregivers get into and/or leave the employment. According to Churintrm, labor turnover indicates the employee traffic into a care agency and out of it (64). The employer gains the employees and loses them or others. The rate of turnover also indicates the duration in which employees would tend to stay in a certain agency or industry. It labors therefore important to calculate the rate of turnover for individual agencies or industries since there are dynamics in every industry. A high turnover means that employees of a particular care agency have a low tenure of work compared to those of other agencies or industries. Kwon et al. observe that low turnover indicates that employees of a certain care agency have a longer tenure of labor compared to those of other similar car agencies (47).

Human resource theorists are for the idea that a high rate of turnover is detrimental to an agency. High turnover results in a decrease in the productivity of any care agency. For instance, Buffington et al. affirm that in case nurses who turn over to new jobs either internally or externally are experienced and trained employees, the care agency is likely to suffer the loss of important skills (273). The agency will also have many new nurses who may not have the required experience to ensure high production efficiency. Kwon et al. observe that although the turnover rate varies by industry, industries that require certain specific skills for employment experience low turnover (47). For example, between 2001 and 2006, the United States health care sector experienced a 23.6 percent turnover. During the same period, the hospitality and relaxation sector in the US had a heightened loss of employed with the record standing at 74.6 percent. This indicates that turnover varies by industry. Kumar and Ravindranath observe that the fact that the leisure and hospitality industry requires less specialized skills compared to the health care sector makes it have a higher turnover (32). Replacement, unemployment, and cost of turnover are also high in most of the care organizations in London. The sector is also able to do a quick replacement of employees who leave the job or industry. The implication of labor turnover can be far-reaching for any care agency. Buffington et al. affirm that various costs are also likely to be incurred in case of high turnover (273).

Such costs include the cost of time that the agency invested in advertising, recruiting, inducting, and training employees. A low level of production that is likely to be experienced by an agency in case of high turnover is another costly venture. The agency will suffer some leaving costs after employees’ turnover. It will also be required to incur the cost of replacing the employees who leave for other jobs. Training and handing over the job to a new employee also carry some cost. All these are direct costs to the agency. In the same way, the agency also experiences low levels of production and performance whenever experienced employees leave the company. Also, the agency may be required to employ overtime employees to bridge the gap, which is likely to be more expensive. According to Churintr, whenever several nurses leave a care organization for another, the morale of their colleagues is likely to be hurt (64). This works negatively for the employer and reduces the level of job satisfaction. The whole industry may end up losing a lot of revenue due to the turnover of one or two employees for example in a health care scenario, there are increased deaths whenever there is high employee turnover.

Turnover in the agency industry can be rated as high or low. If an agency experiences high turnover, it is a direct indication that its employees are may not be pleased with the kind of work that the agency offers or/and its compensation. In other cases, high turnover may indicate that the working environment is not safe for employees or is unhealthy. Also, some employees will leave an agency in case they realize that the company is not well equipped in terms of the tools to be used when working. Other caregivers may leave the agency due to unmet demands and expectations that are unrealistic. Also, Kumar and Ravindranath argue that highly enthusiastic employees may turnover in case they realize that the agency does not offer opportunities for career growth and development (32). There are also employees who want to work in an environment that offers challenges and jobs that challenge their knowledge. For example, some agency employees will leave organizations that do not satisfy all their working needs.

In the case of extended conflict with the management, employees will tend to turn over to other jobs. Both the management and the employees would enhance the rate of turnover. Mcclean, Burris, and Detert argue that low turnover is an indicator that not all the factors that lead to high turnover exist in a certain organization (525). For example, low turnover indicates that employees of a certain agency are satisfied with its provisions. The working environment in the agency is also likely to be safe and healthy. Employees are therefore assured of their health and safety when working in and out of the organization. In the same way, low turnover indicates that the employer and the management of an agency are satisfied with the performance of the employees. Also, many employees would want to remain as employees of an organization due to salaries and other benefits. Kim argues that employees would want to remain in an organization due to corporate culture (257). For example, there is low turnover in companies that have strong excellence culture. Wang, Chyan, and Wang observe that the culture of a care agency can determine whether an employee will decide to remain in the career or not (557).

Methodology and Aims of the Research Dissertation

Aims

Studies on the roles of human resource management practices in enhancing retention of employees evidence a large scholarly contention that HRM is essential in enhancing the success of general organizations. While studies in specialized organizations such as organizations operating in the hotel industry reinforce the findings, the literature review established a gap in studies on the roles of the HRM in the agency care organization operating in London. The first aim of the research is to fill this gap by studying HRM practices, which can enhance the performance of London care organizations. To achieve this aim, variables such as nurses, working conditions, career growth, remuneration, age, and duration of the workforce will be investigated on their impacts on the turnover in three main organizations. These are London care PLC, Allied healthcare, Metro London healthcare, and Care International. The second aim emanates from the first aim. It focuses on providing evidence-based recommendations of how HRM can be utilized to reduce both intention and actual labor turnover in the organizations.

Methodology

The research is primary. This means that it will rely on first-hand data obtained from the target respondents. Direct interviews are used as the primary method of data collection. Managing people in the right way requires sharing their experiences. Interviews provide the advantage of exchanging data coupled with the sharing of the work experiences with the respondents. Hence, the data collected is also extensive. Issues about employees’ engagement through human resource management are essentially emotional. Hence, opposed to any other methodology of primary data collection, the interview provides an advantage in that it provides an opportunity to garner data on subjects, which are emotionally laden.

This increases the chances of the accuracy of the data collected in comparison to other methods of data collection. However, the method presents some disadvantages since it is time-consuming and cost-intensive, especially when large sample sizes are involved. These two challenges are overcome by the use of a relatively small sample size yielding the required confidence levels within the constraints of available financial resources to conduct research. The parameters of HRM captured in the interviews are the roles of nurses in impacting turnover, working conditions, career growth, remuneration, age, and duration of the workforce. Emphasis is placed on the roles of these factors in influencing the decisions for employees to change their jobs shortly. Turnover intention can be measure using the Likert scale having five points as used by Nadiri and Canova (33), and Seston and Ferguson (121). However, in this research, a four-point rating scale is used. The points are ‘not important, lowly important, important, and very important’.

Findings

Table 1. The percentage rate of turnover in four agencies.

Agency Employees at the beginning of the year Employees at the end of the year Employees who left the company Percentage of turnover
London care PLC 100 80 20 20%
Allied healthcare 80 70 10 12.5%
Care International 150 125 25 16.6%
Metro London healthcare 200 140 60 30%
Rate of turnover in four agencies in one year.
Graph 1.0 Rate of turnover in four agencies in one year.

Table 2. Employees not willing to turn over between the length of service in a care agency and turnover.

No of employees not willing to turnover in one year
Duration of work Health care managers out of 50 Percentage Nurses
Out of 220
Percentage Other employees out of 115 Percentage
0-5 yrs 0 0 0 0 45 40%
5-10yrs 20 40% 93 33% 35 30%
10 and above yrs 30 60% 127 77% 35 30%
Employees not willing to turnover between the length of service in an agency and turnover.
Graph 2. Employees not willing to turnover between the length of service in an agency and turnover.

Table 3. Reasons for turnover.

Duration of work Health care managers out of 50 Percentage Nurses
Out of 220
Percentage Other employees out of 115 Percentage
Uncompetitive pay 18 40% 90 33.5% 58 56%
Low opportunities for growth 18 37% 85 31.5% 23 16%
Harsh healthcare managers 0 0 15 13% 28 20%
Need to change career 0 0 0 0 6 4%
Unhealthy environment 14 20% 30 20% 6 4%
Reasons for turnover among various levels of employment in the care organizations.
Graph 3.0. Reasons for turnover among various levels of employment in the care organizations.

Table 4. Relationship between age and turnover.

Duration of work Health care managers out of 50 Percentage Nurses
Out of 220
Percentage others employees out of 115 Percentage
18-30yra 25 50% 134 66% 86 82%
30-35yrs 20 40% 60 20% 20 16%
35-40yrs 5 10% 26 14% 9 2%
40 and above 0 0% 0 0% 0 0%
Relationship between age and turnover.
Graph 4.0. Relationship between age and turnover.

Table 5. Relationship between turnover and job level.

Level of management whether planning to turnover in future
Yes
whether planning to turnover in future
No
Care managers 20% 80%
Nurses 33% 77%
Other employees 60% 40%
Relationship between turnover and job level.
Graph 5.0. Relationship between turnover and job level.

Table 6. the Ratings of the importance of pay in determining turnover rate on a four-scale rating.

Rating in a four scale Not important Lowly important Important Very important
Health are managers 18% 23% 50% 9%
Nurses 0 16% 82% 2%
Subordinate staff 0 20% 62% 18%
Ratings of the importance of pay in determining turnover rate on a four-point rating scale.
Graph 6.0. Ratings of the importance of pay in determining turnover rate on a four-point rating scale.

Table 7. Ratings of the importance of career growth in determining the rate of turnover on a four-scale rating.

Rating in a four scale Not important Lowly important Important Very important
Health care managers 0 0 40% 60%
Nurses 0 16% 80% 4%
other employees 0 16% 60% 24%
Ratings of the importance of career growth in determining the rate of turnover on a four-scale rating.
Graph 7.0. Ratings of the importance of career growth in determining the rate of turnover on a four-scale rating.

Table 8. Ratings of the importance of hospitable nurses in determining the rate of turnover on a four-scale rating.

Rating in a four scale Not important Lowly important Important Very important
Health care managers 10% 30% 40% 20%
Nurses 13% 13% 66% 8%
Other employees 0% 16% 24% 60%
Ratings of the importance of hospitable nurses in determining the rate of turnover on a four-scale rating.
Graph 9.0. Ratings of the importance of hospitable nurses in determining the rate of turnover on a four-scale rating.

Table 9. Ratings of the importance of a healthy working environment in determining the rate of turnover on a four-scale rating.

Rating in a four scale Not important Lowly important Important Very important
Health care managers 0 10% 55% 35%
nurses 0 15% 60% 25%
Other employees 18% 40% 30% 12%
Ratings of the importance of a healthy working environment in determining the rate of turnover on a four-scale rating.
Graph 9.0. Ratings of the importance of a healthy working environment in determining the rate of turnover on a four-scale rating.

Table 10. Comparison of the rate of turnover in the four agencies.

Agency No of the employees who left the Agency No of the male employees who left the Agency Percentage No of the female employees who left the Agency percentage Percentage of total turnover in the Agency
London care PLC 18 10 56% 6 39% 18%
Allied healthcare 11 7 70% 2 31% 13%
Care International 32 16 71% 5 24% 17%
Metro London health care 72 36 61% 18 41% 30.5%

From table 1.0 and the graphical representation of the same information on graph 1.0, it is evident that turnover is prevalent in all agencies in London. Graph 1.0 indicates that turnover rates for the four agencies in London were 20%, 12.5%, 16.6%, and 30% consecutively. The average rate of turnover in agencies in London is 19.76%. Although the average rate of turnover is below average, the consequences of turnover are far-reaching for the agency. The lowest rate of turnover was 12.5 %, which was entered by Allied healthcare agencies. The highest rate of turnover was indicated as 30% by Metro London health agency. Since the agencies were drawn from different professions, the result of the research paints a wider and clearer image of turnover across the board. On investigating the relationship between the rate of turnover and length of service, only 0% of the health care managers were likely to turn over from their jobs after having worked for the agency for less than five years. From graph 2.0, it is clear that 40% of the health care managers who have worked for an agency for 5-10 years would not be willing to turn over.

On the same note, among the senior nurses who had worked for the agency, only 60% of them had worked for the agency for between 5 and 10yrs that were not willing to turn over. Stevens et al. (831) observe that as the health care managers continue working for the same agency for a longer period, they become lowly attributed to turning over. We can therefore deduce that the rate of turnover among the health care employees decreases with an increase in the length of service. The more an employee works for an organization the more the decrease in his will to turnover. We can therefore infer that there is a relationship between turnover and length of service for employees. Employees that work for a particular organization have their attachment to the organization increase with time. Agencies can therefore learn from the indication on table 1.0 and graph 1.0. Management officers should be encouraged to stick in one organization since the more they stay the more their salary becomes. Organizations should encourage their management officers to remain longer in the organization. The premise is that there are more accrued benefits to serving for a long period in one organization.

The managers would feel more secure working with an organization that they already know and have links with than working with new ones. Health care managers will therefore prefer remaining in the same organization than move to other organizations that they do not know about. On the general employees 40% of the total number of those who have worked for different agencies for 0 to 5 years would not turn over, 30% of the same employees who have worked for the agency for 5 to 10 years would not turnover from their job. Moreover, graph 2.0 indicates that from the employees who have worked for various agencies for more findings 10 years 30% of them that would not want to turnover. Pao-Ling and Min-Li (843) are for the idea that the deduction implies that more employees would contemplate turnover at their early stages of employment than nurses and managers. Rad and De Moraes (51) argue that turnover can be attributed to factors like remuneration package, working conditions, and hygiene factors.From graph 3.0 and table 3.0, the research indicates that 40% of the healthcare managers cited uncompetitive package as the major reason for turnover. Another 33.5% of the nurses also cited low growth opportunities for their need for turnover.

The remaining 20% attached their desire for turnover to unhealthy working conditions in their place of work. From the same graph, we can deduce that 33.5% of the nurses attributed their turnover to low pay, 33.5% attributed it to low opportunities for growth, 13% of them cited harsh nurses and 20% of them cited environmental conditions as the reason for the high turnover. Also, 56% of general employees attributed their need for turnover to poor remuneration, 16% of them attributed their desire for turnover to low opportunities for growth, 20% of the employees attributed their desire for turnover to harsh nurses, 4% of the general employees attributed it to a career change, and 4% of the general employees attributed their need for growth. The deductions from this graph were that there existed variation in the causes of turnover among various people. For example, graph 3.0 indicates that the nurses and managers may not be predisposed to turnover due to their desire to change their career while general employees may turnover due to a change of career. Graph 4.0 indicates that there is a relationship between age and turnover.

From table 4.0 it is clear that health care managers reduce their rate of turnover with age. For example, 50% of healthcare managers would consider turning over. However, the rates of interest in turnover decrease with time. For example, graph 4.0 indicates that this rate decrease from 50% to 40% as the health care managers continue to remain in the organization for the next phase of 30 to 35 years of age. The rate of interest in turnover completely declines from 40% to 10%. Rad and De Moraes (51) argue that after the health care managers turn 40 years of age they almost have no interest in turnover. Health care employees who have stayed in one organization for over 40years may completely avoid turning over. We can deduce that turnover is higher in younger employees. Managers that are still young for example between the age of 30 to 40 years and below 30 years are likely to be interested in turnover. Similarly, nurses also experience rates of turnover that reduces with an increase in age. For example, from graph 4.0, it is clear that 66% of nurses would think of turning over within their 25-30 years age bracket. In the same way, 20% of the agency nurses between the age of 30 and 35 would think of turnover during their tenure of office.

Consequently, 14% of the nurses would think of turnover within their 30 to 40 years. The deduction is that turnover decline in an increase in the number of years that a nurse has. For example, the graph indicates that by the age of 40 the willingness of both the nurses and the health care managers to turnover had tended towards zero. Graph 4.0 also indicates that 82% of the other employees between the age of 15 and 30 would think of turnover at some point in their lives. In the same way16 of general employees between the age of 30 and 40 would think of turnover in the course of their job. As employees grow to the age of 40 it is only 2% of them that would think of turnover. From graph 4.0, we can also deduce that the general employees were likely to quit their current jobs for other jobs at some point. More employees would turnover during the initial days of their work. However, Pao-Ling and Min-Li (843) are for the idea that turnover decreases with an increase in their age. More employees would want to move to other agencies during their initial days but would avoid doing so after having worked with a certain organization for a long period. From graph 5.0, there are several deductions that we can make concerning turnover and level of work. Employees are likely to depict varying turnover tendencies about their job positions. For example, from table 5.0 and graph 5.0, it is clear that the number of healthcare managers that would be willing to turnover is only 20% compared to 80% who would not wish to turnover from their current jobs. The data indicates that turnover is lower as one climbs up the ladder of leadership and responsibility.

The majority of the health care managers would not want to leave their lucrative positions in their current organizations for some unknown agencies elsewhere. The graph also indicates that the turnover trend in nurses is almost similar to that of the health care managers. For example, graph 5.0 indicates that 33% of the nurses would not want to turn over from their current positions. However, the majority 77% are not willing to quit their current jobs for a certain reason. The deduction is that the majority of nurses would not want to turnover. Just as the majority of the health care managers would not want to turn over the nurses would also not be willing to quit. On the general employees, the graph indicates that 60% of them would want to turn over at a certain point. On the same note, 40% of the general employees would not want to quit their jobs at a certain point. Stahl et al. (23) argue that the rate of turnover is higher in a lower position job compared to higher position jobs. The nurses and managers would have lower rates and interest in turnover when compared to their juniors. Stahl et al. (23) observe that the responsibilities that managers and nurses are accorded by the agency may restrain them from turnover. In the same way, the package that the nurses and the managers receive may be higher than that of the general employees. Therefore, the salary may be a big determinant of turnover or stay in the organization. Recognition and reward are also higher for the administrators compared to the general employees.

Most of the nurses and the managers would not be ready to leave their jobs for new ones. According to Koh and Goh (103), some accrued benefits like the medical cover, care, and length of service may make the health care employees reluctant to turnover. Health care managers and nurses may also fear that they may never get another leadership position in new agencies. However, according to Farooqui and Ahmed (130), for the general employee, there may be no much to lose by turning over to other jobs. New employees are also anxious to move and to change their jobs. According to Koh and Goh (103), the ambitions to get into new jobs that junior employees have may have predisposed them to have a high interest in turning over. On the rating of pay in determining the rate of turnover thought in schools graph 6.0 indicates various concepts. For example, 18% of the health care managers thought that pay is not a major determinant of turnover. Another 23% of the health care managers thought that good pay is a determinant of the rate of turnover in agencies. A larger 50% of the health care managers thought that pay was important in determining the rate of turnover in agencies. A lesser 9% of these managers thought that pay is a very important determinant of the rate of turnover that a typical company experiences. On the same note, 0% of the nurses believe that pay is not a major determinant of turnover. From graph 6.0, it is also clear that 16% of the nurses thought that pay is lowly important in determining turnover.

Also, 82% of the nurses thought that pay was important in determining the rate of turnover. The remaining 2% of the nurses thought that pay was very important in determining the rate of turnover. The third group under this investigation was the general employees. From table 6.0, it is clear that 0% of other employees thought that pay was not important in determining the rate of turnover. From the same graph, we deduce that 20 % of the employees thought that pay was lowly important in determining pay. We can also deduce that 62% of the general employees believed that pay was important in determining the rate of turnover in agencies. From the same graph, 40% of the general employees believed that pay is important in determining the rate of turnover. The deductions that we can develop from graph 6.0 are that the health care managers scored the highest on the rating of 20% above the nurses and the other employees. We can infer that the health care managers had low attribution of pay because the health care managers are the employers of the junior employees in some instances. Mcclean, Burris, and Detert (525) argue that health care employees may also be receiving many benefits hence underrate the fact that junior employees need money to feel motivated. To such health, care officers believe that junior employees can work with or without pay.

Their source of motivation is not money but other employment benefits that the nurses and the general employees may not have. On the other hand, it is also clear that the general employees scored the highest in ratings of wanting to receive high pays. Such employees completely believe that money is the main motivational factor that may determine whether they will remain on the job r not. According to Farooqui and Ahmed (130), although money is not the only motivating factor for employees to remain in an agency for a longer period, it is one of the sources of employee motivation. On the ratings of the importance of career growth and development in determining the rate of turnover, graph 7.0 indicates various variations. The graph indicates that 0% of the health care managers thought that growth and development are not an important factor in determining the rate of turnover in their agencies. Another 0% of health care managers also thought that growth and development were lowly important in determining the rate of employee turnover in various agencies. From table 7.0 and graph 7.0, it is clear that 40% of the health care managers thought that employee growth and development was an important factor in determining whether an employee will turnover or will remain in the agency. A staggering 60% of the health care management employees in the four agencies indicated that growth and development are very important.

The graph also indicates that 0% of the nurses also think that growth and development are not an important factor in determining the rate of turnover in agencies in London. Another 16% of nurses in agencies also thought that growth and development were lowly important in determining the rate of employee growth and development. From the graph, it is also clear that a larger majority of 80% of the nurses thought that employee growth and development are an important factor in determining turnover rates. A minor 4% of the nurses are indicated to have rated growth and development as a very important factor in determining the rate of turnover in an agency. From the indication on graph 7.0 and table 7.0, we can infer that most of the health care managers in various agencies in London attribute importance to growing and developing of employees in a bid a to prevent the high rate of turnover. The health care management rated growth and development from important (40%) to very important (60%). We can therefore deduce that health care managers of various agencies in London would encourage their agencies to train their managers, nurses, and employees. Rondeau and Wagar (386) observe that organized workshops and refresher courses are important in ensuring that employees grow and develop their careers. The nurses also rated growth and development from lowly important to very important.

Only 16% of the nurse thought that growth and development were lowly important in determining turnover. We can infer that since the nurses play an advisory role, they may not have a direct feel that general employees who do the actual job have. This may explain why 16% of them thought that growth and development were lowly important. In the same graph, it is also clear that most of the nurses (80%) thought that growth was an important factor in determining turnover. We can therefore infer that the majority of the nurses are for training and development of the managers, nurses, and general employees in a bid to curb employee turnover. It is therefore clear that employee growth and development are one of the highest determinants of whether nurses will turnover from their jobs or will remain. Only a few employees (4%) believe that growth and development are very important in curbing employee turnover. This percentage only adds to the importance of training employees and providing them with avenues that will ensure that they experience growth and development. On their side, the general employees also rated growth and development from lowly important to very important. Although some employees in these agencies may not yet be clear about the career path that they would want to follow, it would be crucial to train them towards specialization in specific fields. Such training makes them unable to turn over to other jobs and careers. An organization that trains its employees in certain areas also invests in itself.

With proper growth and development, employees will also have a bigger connection to their company. The quality of work that such employees deliver will also be high. Also, with proper training, there will be reduced wastage in the agency products since the accuracy of production increase with an increase in training. Adhikari argues that organizations that ensure the growth and development of their employees also score high on image rating. Rondeau and Wagar (386) observe that people would want to be associated with such employees and even their company since they keep on growing. The average employee in any organization would want to keep on acquiring new information every day. It is therefore true that many employees would want to turnover from their organization in case there is no growth and development. From graph 8.0, we can deduce that having hospitable nurses is another determinant of turnover. From the graph, it is clear that 10% of the health care managers were for the idea that nurses are not a determinant of whether the employees will quit their jobs or not. Another 30% of the health care managers were for the idea that the nurses will lowly determine whether employees will quit their jobs or not. A higher 40% of the managers thought that it was important to have good nurses in a bid to curb employee turnover. A smaller 20% of the health care managers in the agencies thought that nurses are very important in determining the rate of turnover in agencies in London.

On the side of the nurses, it was also clear that 13% of them thought that nurses would not determine the rate of turnover in an agency. A similar 13% of the nurses also thought that nurses are the low determinant of the rate of turnover in the organization. The graph also indicates that 66% of the nurses thought that it is important for an agency to have good nurses to curb high rates of turnover. The graph also indicates that 8% of the nurses thought that they are very important in determining the rate of turnover in agencies. On the side of the general employees, graph 8.0 indicates that they rate the importance of nurses in determining the rate of turnover from lowly important to very important. About 16% of the employees thought that nurses would lowly determine whether employees will turnover to other jobs or not. Another 24% of the general employees thought that nurses were important in determining whether they remain in their current jobs or they would turnover in the future. A larger majority of the general employees believed that nurses were the greatest determinant of whether they were to remain in a certain agency or they would quit from it. This was indicated by a staggering 60% of the general employees. From graph 8.0, we can therefore deduce that the health care managers may not rate nurses as a great determinant of whether their employees would turnover or not. This is because the health care managers will normally receive information from the nurses and rarely from the employees.

The nurses are also subordinate to the health care managers hence they may not clearly understand what transpires between them and the employees. This may explain the reason why 10% of the health care managers thought that nurses were not a determinant of whether the employees would turnover or not. The communication gap that exists between the two levels may explain the difference. The nurses themselves are on the ground and in touch with the general employees. The research indicates that 13% of them were for the idea that they are not the determinant of whether an employee would want to quit their job, or not. Also, another 13% of the nurses thought that if a nurse would influence the rate of turnover in an agency, then it is only in a low way. Nurses may not want to shoot their heads. Their character may affect the whole organization and even influence who works in the organization. Cox, Khan, and Armani (6) affirm that nurses may make the working conditions of an organization good or bad. It is also clear that 66% of the nurses were also cognisant of the fact that they are one of the major determinants of the rate of turnover in an agency. This is an indication that the majority of the nurses in agencies in London appreciate that their behavior may affect the way their juniors work and whether they choose to remain in that organization or not.

Another 16% also add to the number that appreciates their impact on determining whether the employees turnover or not. The indication from the graph is that nurses are one of the determinants of the rate of turnover in an organization. Adhikari argues that having harsh and rude nurses may result in high turnover in an agency. The nurse can make a simple task very complicated and even very hard for the general employee to do. This results in low production in the organization. Takeuchi and Takeuchi (2009, p.928) affirm that a harsh nurse or one that is not knowledgeable may also influence the turnover of his or her seniors. For example, if the nurse harasses the general employees and that they fail to deliver results, the health care managers may prefer to move on to another organization where he or she can see results. An agency may have very humble and accommodative managers, but poor nurses can bring it down. Nurses need people skills. They also need the d to be trained in the management and human resource development. The relationship between the employees and the nurses may highly determine the quality and quantity of work that they deliver. Nurses bridge the gap between general employees and management. Cox, Khan, and Armani (6) affirm that good nurses will result in a good working environment hence few employees may want to turnover from the agency.

Most of the employees have every other reason to believe that their nurses may determine whether they will quit their current jobs or they will remain in them. From graph 8.0, about 60% of the general employees would attribute their desire to turnover to harsh nurses. Employees will spend most of their working period with the nurses. It is therefore possible that if the nurses are harsh and hard on them, then they can be highly affected. Every employee would want to have the best working environment. Chen, Ford, Kalyanaram, and Bhagat (846) observe that employees will optimize their production rate when they know that their efforts are being appreciated either by their immediate nurses or by their organizations. No one would want to work hard and go unnoticed. Graph 9.0 also reflects the importance of providing employees with a healthy working environment. The graph indicates that most of the health care managers, nurses, and general employees believe that an unhealthy environment can result in high turnover in organizations. From graph 10.0 and table 10.0, we can also deduce information about the relationship between gender and turnover. The graph indicates that the turnover rate is higher in men than in women. For example, among various care agencies that were investigated on the turnover rates for men were 56% for London care PLC, 70% for Allied healthcare, 71% for Care International, and 61% for Metro London health care. On the other hand, women scored lowly on turnover. For example, their scores were 39% for London care PLC, 31% Allied healthcare, 24% Care International, 28% for Metro London health care. We can therefore deduce from graph 10.0 that the rate of turnover of men is higher than that of women in various agencies in London. For example, at London care PLC agency, the rate of turnover of men exceeds that of women by 17%. This percentage is on the higher side of the rating.

At Allied healthcare agency, the rate of turnover in men exceeds that of women by 39%. At Care International agency, the rate of turnover of male employees exceeds that of the female employees by 47%. Also, at Metro London, a health care agency the rate of turnover in male employees exceeds that of the female employees by 20%. It is therefore clear that the rate of turnover in various agencies operating in London is higher in men than in women. The high rate of turnover in men can be attributed to various factors. For example, men score high in risk-taking. Men may want to turn over to another career or organization even without being sure of the benefits that they will leap from the risky venture. On the other hand, women may want to settle down with their family in a particular area hence work for one organization for a very long period. Most of the women are also good at establishing relationships at work. Women score high in relationship forming and teamwork compared to men. The socialization level of a woman may also be very high compared to that of a man. Such factors may make the woman want to stick around one organization than a man. Ford, Kalyanaram, and Bhagat (846) observe that researches have indicated that men are more flexible than women are during turnover. Women have many attachments and responsibilities especially with themselves, their families, and other social organizations. It may therefore be very hard for women to turnover from one job to another. This may also explain why women will perform better in agencies that entail localized work than those that deal with services that require movement and traveling.

Conclusion

The aim of this research was to find out HRM strategies for managing turnover among agency careers in London. The research sought to find out whether various variables like remuneration, nurses, healthy working conditions, career growth and development, duration of service, and age affect turnover in agencies in London. The research was able to formulate questionnaires around the subject. The questionnaire method of gathering data was applied. Data was gathered from four Agencies that operate in London. A sample of 385 careers was selected from these Agencies. A clear representative sample was selected. The issue of gender was also taken into consideration in selecting the sample. Various graphs were developed to present the information in graphical form. Analysis of the data and processing of the data into useful information revealed various findings on turnover in agencies in London.

The research found that the rate of turnover in most of the agencies in London had certain influencing factors. Turnover in most agencies in London did not occur independently of both internal and external factors in an organization. Turnover was influenced by factors like age. The research indicated that health care employees had a tendency of wanting to remain in one organization until retirement. Older employees of various levels have a low rate of turnover. When an employee lives in an organization for a long period, he or she becomes attached. Older employees may attract low levels of employment interest from the employer. The employees may also want to secure their financial benefits from the organizations that they work for. Such benefits included health care, social groups’ benefits, and others. It is therefore clear that age reduces the rate of turnover. On the other hand, junior employees that are young in age may be very anxious. The high anxiety may increase the rate of turnover. Young employees are anxious to get into jobs that have higher pay and huge benefits.

The research also indicated that turnover was also influenced by pay. Most of the employees from both senior and junior levels affirmed that remuneration was an important factor in determining whether they would turnover from a job or not. Employees from all the levels appreciated that payment is a major factor in reducing turnover. Employees will tend to move to agencies that remunerate them well. Most of the nurses and managers would also turnover from their current jobs if they are assured of better pay in other agencies. However, the researchers realized that junior employees are the ones that are likely to turnover from their jobs due to poor remuneration. Heads of various agencies are also hunted for using an attractive pay package strategy. We can conclude that a company that fails to remunerate its employees well is likely to lose them to well-paying agencies. Agencies in London should therefore compare the rate of payment in other companies before they decide on their pay package for their employees. Stevens et al. (2006, p.831) observe that having a pay package and benefits that are comparable to other companies may reduce the desire to move to new agencies.

The other factors that featured prominently as influencing turnover rates are working conditions. Employees of both genders would want good working conditions. The working environment of the employee is a great determinant of whether they will remain in the organization for a long period or they will turnover. Employees need to feel free to express their worries and grievances. They also need to form relationships with their colleagues and to work with others in a team. The outer environment should also be healthy for the employees. Employees may not want to remain in an agency that exposes them to dangerous chemicals, noise, and rays.

The research also concluded that the nature of nurses also affects the rate of turnover in agencies. If an agency has harsh nurses, most of the junior employees may want to turn over to other jobs or companies. In fact, AbuKhalifeh and Som (41) argue that the relationship between the nurse and the employees affects the rate of production. A good nurse will provide a facilitating environment for employees to exploit their full production potential. On the other hand, a harsh nurse will only instill fear in the employees thereby reducing their production capacity. This may in turn affect the management and hence managers would want to turnover from unproductive agencies. People would want to be associated with success. Agencies should therefore hire nurses with good temperaments and people skills.

The research recommends various undertakings in Agencies operating in London. According to AbuKhalifeh and Som (41), the agencies should vet the nurses for interaction and people skills before according they the responsibility to supervise employees. The agencies should also ensure that they do remuneration surveys and comparisons before settling on various pay packages for their employees. This will reduce turnover. The research also recommends that the agencies develop packages and mechanisms to ensure occasional training of employees. In-service courses, sabbaticals, and workshops should be organized occasionally. Agencies that operate in London should also ensure that they develop mechanisms of harnessing young employees and retaining them in the organization. The rate of production in organizations is determined by the level of energy that employees have at their disposal. There is a need to curb and/or discourage turnover among young employees in order to ensure a high rate of production. The research also recommends that the agencies should provide a good working environment for the employees. Any health risk should be curbed. This will ensure the security of the employees.

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