During the COVID-19 pandemic, there was an explosion of temporary staffing agencies across the country. There remains a high number of agencies operating across the social care sector, but how do you ensure you don’t run into difficulties when using them?

Why use an agency?

Many services will proudly exclaim that they never use agency staff as part of their internal policy. Whilst a positive ambition, in the current climate of staff vacancies and as events such as COVID-19 showed us, there can be a role in any home for agency workers. The most beneficial use of agency staff is when staff have been covering additional hours and are becoming tired. A short period of agency use can allow the staff to rest and reduce sickness.

All services should develop a relationship with an agency. This allows terms and conditions to be agreed, basic checks of quality to be undertaken, and perhaps most importantly, a contract for supplying staff to be in place before emergency cover is needed. An existing relationship can often place you higher on the priority list for cover than a cold call late at night for night staff cover.

Services need to identify what the broad needs of their service users are and what duties an agency worker may be required to cover. For example, you may need an agency that can supply staff with learning disability training or medication training, or with the ability to lead a shift for example. It is quite possible that a service may need more than one agency to meet all of the potential staff coverage it identifies. Many services, for example, fail to plan for covering housekeeping staff.

Vetting agency workers

Given the CQC requirement for services to have a profile for each agency staff member, it would be natural to assume that the agency would automatically send these over when staff are booked. However, in BKRCC’s experience, this does not routinely occur.

The agency should be set clear expectations on the supply of profiles. As part of the contracting process, a sample profile should be examined by the service to check that it provides them with sufficient information to engage the individual confidently and that it is compliant with CQC requirements. There should be an image of the worker, a list of their mandatory training and the date it was completed. You should be able to see that training was not delivered in unrealistic timescales, their skills are described, there is a DBS number and so on.

Any profiles should be stored in a folder that is regularly reviewed, so it only contains the agency staff recently used by the service and items such as training are in date.

Vetting the agency

Due diligence checks should also be made of the agency. The lowest cost agency may be tempting but what is their track record? Are there reviews available? Who is using them in your area? How long have they been operating? Are they CQC registered (it should be noted there is no requirement that they are to supply to a care service)?

Any contract with the agency should include a right to examine the employment files of staff that are used by the service. Such a right is essential to exercise before problems arise.

BKRCC has seen a case where a long-term agency worker was a material witness to an event in a care home. Once the police became involved, the worker became uncontactable. The person's staff file was requested, and the identification documents provided to be examined were immediately noted to be falsified. Further exploration with the agency revealed that the worker was in fact illegally within the country and was the former partner of the agency owner.

This was not an isolated case by any means. BKRCC recently came across an agency that only employed illegal workers in the south of England.

How to use agencies

The vast majority of temporary staffing agencies are well managed, compliant companies. Many agencies will happily engage with your training when using their staff long-term and work with you to guide their staff so they can meet your needs and expectations. They are however best used, not least financially, for short-term shift cover rather than long-term use. Any service that routinely covers shifts using agency staff as part of the planned rota should be reviewing their recruitment and retention policies and procedures.

Where it is necessary to use agency staff, services need to plan ahead for predictable needs. For example, are you likely to need someone to cover a medication round or to lead the shift? If so, it is usually a good investment to nominate a small pool of agency staff who are booked to attend to shadow a medication round or shift, so they can gain insight into how your service works. Some agencies will split such costs with you.

Checklist

In summary, services should:

• Develop a relationship and contract with an agency, even if you don’t intend to use agency staff.
• Understand what you want from an agency and check they can deliver it.
• Ensure the agency understands that they must send profiles when you make bookings – and consider developing an internal audit tool.
• Where you are using agency workers, visit the office and check staff files.
• Check the DBS is up-to-date and valid.
• Develop your recruitment process. Remember that agency workers are meant to be a temporary solution.
• Get prepared and ensure the safety of the service by investing in some shadow shifts for medication rounds and shift leadership.