How to Hire a Caregiver – Podcast

Jason Dorow 

We’re back. Welcome to another episode of the Champions of Homecare Podcast. Today we’re going to tackle a task that most Choice home care clients have to navigate to get their services started. And that’s how to hire a caregiver. Depending on what services you qualify for, and what you personally are looking for in a caregiver, the questions you should ask likely vary. But David, we got some experts who are going to be here to help us out. 

David Hancox 

Well, you’re right, Jason. And first of all, let me say it’s good to see you again today. And luckily, luckily, we do have a couple of seasoned veterans joining us today to talk us through the hiring process. First, let me introduce someone who knows all about the hiring process and helping employees succeed. Accra’s very own Senior Human Resources Director, Hannah Rutt. Hannah, thanks for being with us today. How are you?

Hannah Rutt 

I’m good. Thanks for having me.

David Hancox 

Wonderful. And second, we have with us someone who personally has navigated the caregiver hiring process several times for his own home care services. So let’s also welcome Rand, who was a client of Accra. Rand, thanks for being with us today. And how are you doing today?

Rand  

Pleasure.

David Hancox 

Good. Wonderful. So let’s just start right in and maybe Rand, let’s start with you. Where should people look for prospective caregivers? How do you go about finding caregivers to fill your schedule?

Rand  

Well, I’ve been looking for caregivers for 46 years now. And I guess I started going through the papers, I’m sure that they’re still valid, probably not as much these days. But the Minneapolis Tribune, the Sun Country, not Sun Country, but Sun Current Times, the local newspapers, that kind of things. What I’ve been using last few years is, it’s been successful, has been Care.com. And Care.com, as you know, it has all the templates out there and how to create job postings, and it has all that kind of information. And it’s, unfortunately, $75 a quarter. So it’s, you have to really buy into a premium membership. And that’s worked really well. I’ve also used Indeed. And Indeed is also, price goes with that, so they don’t really offer the means to write successful job postings, or how to interview or any of those kinds of things. But it’s $5 a day or $150 a month, something like that for Indeed. And I’m relatively new, actually less than probably six months new to Accra, and I think that you guys have a Accra Portal posting site that I haven’t been able to utilize. I’ve looked at it, but I haven’t been able to utilize it yet. I see there’s some people on there very close to where I live. But at some point, I’ll definitely, that’ll be my first free choice. 

David Hancox 

Well, Hannah, in hearing what Rand was just saying there about the Accra site, can you talk to that for a little bit about the job board that we have, and so forth? 

Hannah Rutt 

Yeah. So this past fall, we relaunched our Accra Job Board. And so what’s really nice about this is that all of the caregiver postings that you’ll see, they’re actually Accra employees. So they’ve already gone through the background study process. And depending on what service you need, they may have already completed all the necessary paperwork, so that you can search through those postings you’re able to customize a posting, and search for caregivers based on what type of experience you’re looking for, where they’re at in the state of Minnesota, and kind of some of their different experiences that they’ve had. And you don’t have to worry about them having to complete a new background study. All of those employees are in good standing with Accra. So we really hope it’s a much better resource than what we’ve currently had or what’s available out there.

David Hancox 

And if if Rand or another Accra client entered that portal and found somebody on that list that they wanted to interview or start working with, how would they go about initiating that process? 

Hannah Rutt 

Yep. So within the the job board, which is in your Accra Access Portal, you can contact an employee or caregiver who’s looking for that job, and email them and then once you guys have decided, hey, this is good, it sounds like it’s going to work out, then you just have to call Accra and let us know. And we’ll let you know if they have any additional paperwork that they need to complete or when they can get started. So we try to make it pretty easy for everyone.

David Hancox 

Well because they’ve already gone through the background study, and all that, and they’re already an approved Accra employee, it really cuts that turnaround time for someone like Rand to be able to get them started, you know, on their first shift, correct? 

Hannah Rutt 

Yeah. Correct. Yep. 

David Hancox 

Fantastic. Fantastic. Well, Rand, back to you for a second. I mean, I know that, as you mentioned in your opening remarks that you’ve been doing this for 40 plus years, you know, interviewing and hiring caregivers, and Rand and I are close personal friends as well, so I’ve gotten to know several of his caregivers. And I’ve actually been his caregiver on a few occasions as well, when we’ve traveled together and things as friends. But Rand, when you’re entering into that hiring process, when you’re thinking about or scheduling interviews with someone, what kind of questions, what kind of information are you looking for, or would you advise others to kind of think about asking, when they are preparing those interview questions?

Rand  

Well, I mean, they need to be able to describe their past experience. And in that kind of when they’re describing their past experience, it gives me, it’s kind of a window into what they’ve done in the past. And the good thing about Care.com is that it gives you a – they’ve already provided you like a resume so you know what their level of experience is. Well, you don’t know for sure, you know what they wrote as their experience. And you know how many years they’ve been doing it, what their skill levels are, what certifications they might have? With Care.com, they do a basic background check. Not enough, but they do a basic background check. But I just asked them about their previous experience. If I could call their previous employer. If they have a car, if they’re able to drive, if they’re willing to find replacements, if they’re going to be gone for any point of time, if there’s, of course, if they’re a citizen, if they’re able to work and all those kinds of procedures, lots of those kinds of things.

David Hancox 

 Well, Rand, do you get as specific with your interviews, in asking the prospective employee their capabilities of lifting and transferring, and their ability to use a Hoyer lift or, you know, get as specific as that with your interviews?

Rand  

I’ve learned that these specific items are best put in the job description itself. So that, you know, like a, probably the most important part is just the job description title itself. And probably, I’ve given a brief history of myself, but I mean, really brief, just, you know I’ve been disabled for so many years. And what my condition is. And I’ll give a description of the skills that I’m looking for, you know, whether it requires lifting, if it requires toileting, also what the exact times are that I need somebody to fill in, or to work. So I think that, you know, that’s pretty much it.

David Hancox 

Hannah, would you I mean, hearing what Rand just said in terms of the kinds of questions that he prepares to ask interviewees, what additional questions would you recommend that our listeners think about asking prospective employees as they’re applying for an interviewing for the job?

Hannah Rutt 

Yes. So I think a really good place to start is by identifying what’s important to you, and what are you looking for in a caregiver and trying to model those questions around that. As Rand said, starting with the job posting, that’s a great place to start and putting those specifics in so that as people are reading those postings, they can go and kind of decide, is this something that I’m capable of doing? Is this something I’m interested in? So that by the time you get to that interview, you’re ready to go. Sometimes it’s nice to think, you know, do you want someone who has common interests with you? Do you want someone who has specific experience with your age range or your care needs? Or is that something that you’re willing to help them train on? But then you can also think about situations that might come up in your day to day life or during the course of their job, and ask them how they might handle that. So for example, how would you handle an emergency or what would you do if you woke up and didn’t feel well? How would you, you know, communicatethat with me. And that the caregiver’s response is gonna give you kind of an idea if this is someone that you can trust and you can rely on.

Jason Dorow 

And once you’ve done the interviews and you’ve evaluated some candidates, perhaps you’ve narrowed it down to a couple or one that you really want to hire. What’s the next steps that you take then, for Hannah or Rand?

Hannah Rutt 

Yeah, so if you’re ready to make that hire, the first thing that you’re gonna want to do is call Accra. And let us know that you have a prospective caregiver that you want to go through the hiring process. We’ll check to see if they’ve already been hired with Accra. And if so, if they have any additional paperwork that they need. If they’ve never worked with Accra, we’ll start by having them complete an application. And they’ll likely need to be fingerprinted for their background study. So once they’ve submitted all that necessary paperwork, we’ll help the caregiver through the fingerprint process. And then once we get that eligible background study, we’ll reach out to you with their start date.

David Hancox 

Can I circle back? Great question, Jason, I’m glad you asked that, because I think it’s oftentimes that next step where people kind of stall on sometimes. But I want to go back to the interview process for just a second as well. Because, you know, at Accra, we’ve expanded our client base into different communities. And I’m just wondering, what’s the best way in the interview process? And Rand and Hannah, either one of you, or both of you can certainly respond to this. But getting into those areas and those questions that deal with cultural competencies. How do you how – what would you advise is the best way to approach those kinds of questions that deal with that cultural competency?

Rand  

I’m not sure I understand what you mean by cultural competency?

David Hancox 

Well, I mean, you know, I know that there are – if you’re interviewing individuals from a different culture than your own. How do you go about interviewing or asking the questions that help you identify whether or not there’s going to be a cultural comfortability between you and your potential caregiver? I mean, maybe they celebrate different holidays than you do. Maybe they have different religious practices than you do. Maybe they have different cultural activities that they engage in on a regular basis, than you do, does that enter into the interview process? Or not? And if so, how do you address that during the interview?

Jason Dorow 

And David, this is kind of within the realm you’re talking about, too. But we also talked about even just personal qualities, right? So yeah, are you a morning person, for example, or needing an afternoon rest, I’m just coming up with examples. But we’ve talked about a lot of the experience that you need, or that you’ll be examining while you’re evaluating potential caregivers, but there’s also those personal qualities, right? Because this is such an intimate position and relationship that you develop with a caregiver where you kind of want to know that person before you hire them.

David Hancox 

Yeah, exactly. And does that enter into the interview process? And if so, how do you address it?

Rand  

Well, frankly, the shortage of workers has put us in a situation where, you know, you don’t know if it’s addressing it or not, but it’s, you know, that becomes a very secondary issue. My first my first goal is to find someone who’s capable and willing and interested in doing the job and if I’ve had, as you know, Dave, because you know me so well, that I’ve had a huge variety of different people working for me and it’s as long as I can find someone who’s capable, like I said, and interested in doing the job, I have never had an issue with that. I’m sure they exist, but I’ve been lucky, I guess. 

David Hancox 

Well, and you know, I don’t want to make this about me, but I’ll use myself as an example. I mean, you know, as a middle aged gay man, if I suddenly found myself in this circumstance of needing a caregiver, understanding that caregivers comfortability with the fact that I’m a gay man might be important to me. And that seems like, and I’m sure that some of our clients identify in the GLBTQ+ community as well. It would seem reasonable. And I just wonder, you know, Hannah, maybe you can address that better. So how does one go about addressing those kinds of cultural competency issues that are important to the client for comfortability sake? Maybe I’m asking a ridiculous question. I don’t know.

Hannah Rutt 

No, I think it’s the tough part is, again, as Rand said, you know, the workforce shortage, it’s so hard, because if you find someone who’s capable, you want to get them and get them hired. But I think it kind of goes back to setting those expectations in the interview process. And just, you know, even starting by like, this is what a day in my life looks like, I’m going to need you to be here at this time. You know, here’s the things that are important to me throughout the day. And you can always say, like, you know, this is what we, you know, this is what I like to do. And these are the communities that I’m a part of. And I’m going to need someone that kind of supports that. So instead of asking the question, you know, are you comfortable with that? It’s more so this is the expectation, and this is what’s important to me, I’m looking for someone who respects those choices. 

David Hancox 

I like that. I like that approach. And because I think it also establishes simultaneously, some of those boundaries, as well, that are so important in that caregiver relationship. So what a great answer. That was really good.

Jason Dorow 

I have another like, interviewing logistical question, which probably seems obvious to people who have done this before, but to someone who’s doing it for the first time, I guess it’s my choice, but now in this digital world, I’m sure lots of people are doing interviews on Zoom or on Teams, or maybe they’re doing on the phone, maybe they’re doing it in person, do you have a recommendation to first time people who are hiring caregivers, and whether they should meet in person? Do it on the phone? Should they do two rounds of interviews? Or is it just up to them and what they’re comfortable with?

David Hancox 

Rand?

Rand  

Oh, just I never hire someone just on the phone. I always narrow it down to, in a lot of cases, recently, again, because of the worker shortage situation, I narrowed down to the one person that I really want to hire. And before I actually hire him, I have them, I meet them in person so that we can, you know, become familiar with each other. And in almost every single case, everything is good. And I move forward and hire that person.

David Hancox 

Hannah, you were going to add?

Hannah Rutt 

Iwas gonna say, sometimes doing that first kind of phone screen, and really just going over maybe the job description with them, so they understand, you know what you’re looking for. Sometimes you’ll weed people out that way, they may have said, Oh, I didn’t really realize this, or all those dates and times don’t work with me. So that can be a really good way to help make sure that someone understands the position. And then at that point, I do think meeting them, if you’re not comfortable meeting them in your home, you know, maybe finding a community place to meet such as a coffee shop or a library. But at some point, I do think it’s important that you do invite them to your home and to make sure that they’re comfortable there as well. 

David Hancox 

Sure. It makes perfect sense. It makes really good sense. So okay, so you’ve gone through the interview process, you’ve identified an individual that you would like to hire, and they begin the work process and providing services. Rand, how do you go about, and how frequently, and what techniques do you use to evaluate the quality of care that they’re providing?

Rand  

If they show up on time, that’s my number one, if they can’t show up, then they’re not gonna last so they’ve got to show up. I can work with, you know, with most anybody, if it takes them awhile to get in the swing of things and probably, you know, it’s, again, if they show up, if they’re willing to show up and willing to do the work that’s primary.

David Hancox 

Well, and you know, and I know from our personal relationship, Rand, that you’re very candid with your caregivers, and you’re very good about letting them know what they’re doing well and what they’re not doing well in the moment. And if they’re doing something incorrectly, like I’ve done a few times, you’re very good about redirecting in the moment as well and getting it back on track so that the caregiver is learning simultaneously to having their behavior redirected. And I think you know, that’s a really good way of of tracking someone’s job performance as well. Hannah, from an organizational standpoint, are there methods that you use or that Accra uses to track performance?

Hannah Rutt 

Yeah, so we do actually have some templates that we’re always happy to provide our clients and responsible parties with, I think it’s important to address and give feedback often and then timely as well. So even if your PCA is doing a great job, let them know that. And then if there’s things that they could be improving on, address it, you know, as it comes up, in the moment is, I think, probably the easiest. But sometimes it’s even if there’s little things that kind of build over time, address those things that come up. And because sometimes it might be that they just need a refresher on how to do a certain task, or they might need a little bit of different type of training, we all learn in different ways. So that if you address it early enough, it kind of gives you that opportunity. But if you do get to a point where you’re like this is a really significant concern, or it’s getting to the point where like, I’m not really sure if this is going to work out, we always suggest writing, making, you know, kind of documentation of what the concern was, when it’s occurring. And then maybe what are some things that you would like to see the person improve on moving forward? And another really great thing that you can do is have your employee be a part of that. So say, Okay, this is kind of a problem, what would help you improve upon this? Or what can we agree on that you’ll work on and work towards, and giving that employee some of that ownership. And again, kind of sets that boundary that you talked about earlier, Dave. It’s just helpful making sure that the employee feels that they’re a part of that process, as well. 

David Hancox 

Well, you know, Hannah, that kind of leads to another question. I mean, if a client like Rand is having some difficulty with their interaction, or the job performance of their PCA, or whatever, and they’re not exactly sure how to address it, or they’re feeling a little uncomfortable about addressing it, can they turn to Accra and you or HR department for some resource and assistance in addressing those issues as well? 

Hannah Rutt 

Yeah, absolutely. Our staff are definitely able to help, we can identify, you know, are there, again, some different types of trainings that are available online, if it’s more of kind of a technical issue that you’re running into, we’re also able to help kind of be that middle person, if you’re saying, hey, there’s something that I’m really concerned about and I’m not quite sure of how to, you know, approach it, maybe it’s a more sensitive topic. Or you’re just kind of getting to that point where like, it’s not really working, we’re happy to help jump in and either give you guidance to handle it, or work with the employee as well.

David Hancox 

Great. Well, you know, we know that Accra is a PCA choice provider. And the other model that’s currently available is the traditional model. Are there different responsibilities for the client and the agency between those two models, Hannah?

Hannah Rutt 

Yep. So under the PCA Choice Program, you as a client are really serving as a co employer with Accra. So your responsibility and knowing the program rules, selecting your own staff, training those staff, and then scheduling your staff, as well. And obviously, your care manager will work closely with you to help identify those resources. You always have Accra as the resource, you know, in case you have a question that comes up. But then on Accra’s side, we’re, you know, our main responsibility is making sure that we’re hiring the employee and being compliant with all of the federal and state employment laws and all the program rules. But then also making sure that we’re getting your employees paid on time. And so we’ll help kind of anything along the way. But, you know, again, as that client, you’re really double checking, making sure that the times that employees are working are recorded properly, the tasks that they’re doing are recorded appropriately, and then verifying this information. You know, when time cards are due, and at your annual visits and things like that.

Jason Dorow 

Great. Hannah, there’s also a big change on the horizon with PCA Choice becoming Community First Services and Supports starting in the fall. How is that going to change the staffing requirements for people who are hiring caregivers, and we don’t need every little piece of minutiae perhaps, but a high level as people start thinking about how things are going to change with CFSS. What do they have to be aware of?

Hannah Rutt 

Yes, I think one of the biggest changes is that Accra is now going to be able to help assist with that staffing element so we’ll be able to help source caregivers and then we’ll be able to work with you to identify if you need caregivers or even just backup staffing, and kind of what that looks like. It’s still very much client directed. And so we’ll, you know, again work with you and we’ll listen to you and say, here’s what we have available. And hopefully we can help match up employees with clients. And everything, obviously lots will change and lots more to come on that we hope too, we’ll be a better resource for that staffing challenge, hopefully.

David Hancox 

Great. And, you know, Rand, one last question for you. I mean, as we kind of begin to wrap up here a little bit. This has been great. You know, as a client, as somebody who needs and uses PCA services, in the context of hiring and supervising and evaluating staff, and the services that they provide, what do you look for as a resource from your agency that provides your care? 

Rand  

Do payroll. 

David Hancox 

And do it on time and do it effectively? And exactly right. Yeah.

I have a good question too, Dave. Maybe one of you. I’ve done a lot of reading on CFSS. And I haven’t found anything about this, but in the budget model for CFSS, which is kind of replacing the choice, PCA choice. That being there’s not a lot of expense, but there’s a decent amount of expense that goes into advertising and finding PCAs. Is that going to be part of the budget model? Or is that something that I as a client, consumer, whatever, will have to continue to pay on my own?

David Hancox 

I’m going to pump that over to to Hannah, because I think she may have a little bit more of that minute information, Hannah, is that something that could be part built into a budget – is part of the budget model?

Hannah Rutt 

I believe so. We’ve seen clients within the CDCS program, I’ve seen that written into their budget, they’ll have a line item for maybe a Care.com membership, or different ways that they advertise postings.

David Hancox 

Yeah, I thought so as well. But I didn’t want to be premature in responding to that. And I know that you have a little bit deeper knowledge at this point right now. So yeah, absolutely. And Rand, we do have if you visit our website, we did do a podcast previously on CFSS that provided some information about it. So you can certainly find some there. I believe the DHS website has some limited information about CFSS and its content and its intent as well. But stay tuned to us because you know now that we have an implementation date, which we’ll talk about in a minute, but now that we have an implementation date, one of the things that we’re doing internally here, is preparing to ramp up some of our communication to our clients and others about CFSS; its implementation, what the client like yourself, the recipient of services needs to start thinking about in terms of preparing for that transition. So a lot more to come, especially now that we have an implementation date from the Department of Human Services. So great question, though. Great question. Well, thank you both for being with us today. This was really, really helpful. And I think our listeners will grab some information out of the thoughts that you shared, and it will make it a little easier for them perhaps or a little more informative as they continue their interview process and trying to find and hire caregivers as well. I mean, Rand mentioned a couple of times the the workforce shortage and I know that continues to be a real challenge for Hannah and our team at HR and within Accra as a whole and this community as a whole. But, you know, we’ll continue to do our best to try to address that and be a partner and a resource in that process with folks like Rand. So thank you both for being here. Any final comments you’d like to share? Thoughts to impart? No. Okay. 

Jason Dorow 

Well, thank you both very much for joining us today and sharing your insights.

David Hancox 

Absolutely. Thank you both.

Hannah Rutt 

Thanks for having us.

Rand  

 Bye, bye.

Jason Dorow 

Well, they were both phenomenal, David. And that’s such a key part is just getting started right? It is the hurdle of finding a caregiver who is going to be well suited to your services.

David Hancox 

Right, finding that caregiver that you’re compatible with and that you have confidence in. And I can see you know, I don’t mean to speak for Rand, but I know one of his caregivers has been with him for more than 20 years. And when you find that kind of relationship you know, somebody that sticks with you for that long a period of time, that’s pretty significant as well. But it is that and when you think about the kinds of intimate care that people are being provided, finding that right person becomes just so absolutely essential. It’s just so important. But, as you mentioned, Jason, CFSS is coming. And we just recently got the start date, it’s going to, you know, the Department of Human Services, informed us that on October 1 of 2024, this fall, DHS plans to begin this CFSS implementation with consultation services. So people who receive services will begin the transition process from PCA or CSG to CFSS during their regularly scheduled annual reassessment. So not everybody’s going to, you know, they’re not going to flip a switch and everybody’s on October 2, everybody moves to CFSS. I wish it was that easy. Yeah, well, oh my gosh, that would be a calamity if we had to do it all in one day. But when their reassessment date comes due, that’s when they will enter into that transition process to CFSS. And for those who may not be familiar with it, this is a new self directed option called Community First Services and Supports or CFSS, for short. And it will offer individuals who need home services or home care services, more choice control and flexibility with their services, and supports that are required to live and work in the community. So it’s an important transition that’s really designed at its most fundamental level, to give individuals with disabilities and their families more personal control in their lives. 

Jason Dorow 

So we know change can freak a lot of people out, right, yeah. Some new things into your life, but you don’t need to worry, because Accra will provide all the services under the CFSS model. So if you are a current Accra client, you can rest assured that you can continue working with Accra, assuming you want to do so as well as your current caregiver. So that’s not going to change even when CFSS comes along. And as we approach that October 1 implementation date, we here on the podcast, and the folks at Accra will keep communicating to clients and caregivers the various updates that you need to know as those updates roll in. So stay tuned. Information will be coming your way. We’ll make sure that everyone’s prepared for this transition.

David Hancox 

Two perfect words: stay tuned.

Jason Dorow 

Precisely. All right. Well, I think that’s it for us today, David. 

David Hancox 

Wonderful. Well, I think another good podcast, I think this will be informative and helpful for our listeners. And Jason, always a pleasure to be here with you. Thank you for all the prep work you do behind the scenes. I don’t think most people realize how much prep work you do behind the scenes to prepare for these. So my great appreciation to you for that and thanks. 

Jason Dorow 

I provide so little compared to you and our amazing guests. So thank you to you to Hannah and Rand for making this podcast so helpful and informative. For the folks out there listening, make sure to follow us and review the podcast on YouTube, Spotify and Apple podcasts. And we’ll see you next time. 

David Hancox 

See you next time. Thanks Jason.