How Do I Find The Right Staff For My RAL?

It takes a special kind of person to become a caregiver. Not only does it require a compassionate heart and a temperament that is prone to patience, a caregiver must also meet specific standards and possess skills unique to the medical care industry. Caregiving requires excellent communication skills, a dedicated commitment to resident’s health and safety and the ability to be continually flexible in an unpredictable environment. Being an effective caregiver takes training and the right mindset.

The truth is most of us are not innately equipped to take up the great responsibility of caring for others in such a continuous and intimate manner, so finding people who have these important qualifications is critical to being successful in the residential assisted living space. So, if you are looking to secure qualified staff for your residential assisted living home, or if you are a manager or caregiver and are looking for tips on how to become more effective, the following information might be helpful to you.

Making the Initial Connection

The key to hiring staff for your RAL is not just getting a caregiver or a manager, but finding the best ones, the right ones, attracting them, training them and retaining them. There are so many potential employees out there, and because the people that you choose will become the voice and face of your organization, sifting through the masses and finding the gems is critical for success. With most elements of society moving more toward online activity, being able to do initial interviews over Skype can save you time and increase the number of potential caregivers that you can filter through. There are numerous placement agencies and online resources to help find potentially qualified employees near you and most of your initial evaluation can be done online. You will, however, want to hold interviews in person as you near the latter stages of the interview process in order to get a better sense of the individual and how they interact with others.

During the preliminary and latter stages of employee interviews, you’ll want to be prepared with more than just standard interview questions and delve into inquiries like, “how would you handle this particular situation? What would you say to this? What do you see as your biggest strength and what do you see as your biggest weakness?” These questions should be gleaned from your experience in the residential assisted living environment and what concerns and issues you have seen in your time working with residents. What you are looking for is how they respond, as you are looking them in the eye and getting a feel for them, you don’t even need to be in the same room. Do they understand what I’m saying?  Do they really have a genuine response or are they just saying what they think I want to hear?

What Qualities Should a Manager Have?

You are looking for somebody who is in control, who can take a system and implement it. Somebody who is genuinely nice to their family, to their spouse, their coworkers. If they are the manager, they need to be fair, but firm with their caregivers underneath them. The manager is responsible for managing the caregivers, doing things like hiring and firing, scheduling, giving somebody a day off when they need it or requiring them to take a day off when they need it.

Managers need to be personal. Those interpersonal relationships are the hardest thing of all to teach and train. At the RAL Academy, we actually provide a whole training course on how to hire a manager, exactly what to look for and exactly what to avoid. If the caregivers are the heart of your organization the manager is the head and overseas the caregivers, providing vision and direction. The manager needs to have experience in human resources as they are responsible for finding, training and retaining caregiving staff. they also need to have the ability to fill the home by attracting new residents, giving tours and developing relationships with prospective residents and their families. When they interact with potential residents they need to have the interpersonal skills to help the seniors and their families feel at ease and comfortable with the living situation that is provided, as well as fostering a comfortable relationship between residents and caregivers. Ultimately, the manager is continually dealing with people, whether communicating with residents, caregivers, the families of residents, outside contractors or suppliers, the ideal candidate needs to be a real people person.

In addition to the relational aspects of the job, the manager also needs to be fairly detail oriented, making sure all the i’s are dotted and the t’s are crossed. They are responsible for keeping records, keeping stock of all necessary products and supplies, contracting maintenance and other services, as well as many other important details. While it is not always easy to find someone who excels at interpersonal communication as well as being extremely detailed, these people do exist and it is just a matter of finding them. Although, it is worthy to note that if, in your search for qualified candidates, you had to error on one side or the other, the far more important skill would be to have excellent interpersonal communication skills.

What Qualities Should Caregivers Have?

Caregivers are the heart and soul of any quality residential assisted living home. Depending on the state, there will be certain qualifications and training that caregivers must have. In some states these qualifications are minimal and in others the requirements are more rigorous, so it is important to know what regulations exist in your state. And remember, as a RAL owner you are entitled to holding your staff to a higher standard if your states regulations are minimal. After all, your reputation in this industry is critical for success. You want your RAL to be known as a place that employees the best caregivers who provide superior care to your residents. Regardless of what the state requires, we want to make sure that they are the right person for us, how they treat the resident, how they look for solutions when problems arise, how they work with and take direction from the manager.

In addition to finding quality managers and caregivers, it is also important to find good independent contractors when outside help is needed for things like maintenance or a specific service you hire to for your residents. We want contractors with the right attitude, who understand the importance of what we do. Professionals who, when they’re on the job and on our premise, whether dealing with our residents or staff, that they do it with respect, high quality, the best attitude possible.

There is a lot that goes into finding the right people to work in our residential assisted living homes and because they’re play such a big role in our success we want to focus on doing it right the first time. Now that we have discussed some of the general qualifications we are looking for let’s talk about the specifics of how to go about finding and hiring the right people.

Home Care Employment Agencies

Home care employment agencies give referrals to people seeking home care nurses and health aides. Clients may contact, hire and pay caregivers directly. When you directly hire home care workers, the advantage of working with a reputable home care employment agency is that they’ve screened each person in their database. Additionally, home care employment agencies may also provide worker training and occasional on-the-job supervision. Ideally a home care agency becomes a family’s trusted partner for senior care. When you meet with the administrator, getting answers to many important questions can help you avoid choosing a mismatch or substandard care.

What is the administrator’s background? All sorts of people direct home care agencies, and some are more qualified than others. A director’s duties are important and diverse: setting the agency’s policies, managing the employees, negotiating with insurance companies, ensuring compliance with healthcare laws, and more. Many states require that two people serve as an agency’s administrators.

The most appropriate educational background for a home care agency leader is in healthcare administration or public health. Typically, an administrator has a master’s degree, but competence for the role is certainly possible with a bachelor’s degree plus work experience. Longtime healthcare professionals such as RNs and psychologists also move into administrative positions.

The best home care agencies are led by people with relevant training and a genuine commitment to human well-being. If you get the sense that money is the manager’s main motivator, then it is probably time to ease your way out of the interview.

Is the agency Medicare certified? To receive Medicare coverage for home care, a patient needs to work with a Medicare Certified Home Health Agency (CHHA).

Is the agency licensed by the state? Not all states have industry-specific licenses for home care agencies. If your state has the option, choose a state licensed home care agency for assurance that state standards are met.

Does the agency carry insurance? Choose an agency that has its caregivers bonded and insured. A well-run agency also has professional liability insurance and general liability insurance.

What services are available? Home care agencies may provide medical services, non-medical services or both. Confirm that the desired services are available. For example, not every state-licensed center has an RN on call 24/7. Some, but not all, have caregivers trained in speech therapy, physical therapy, Alzheimer’s therapy or memory care, and other healthcare specialties.

How are the caregivers trained? The best home care agencies have extensive orientations for caregivers and provide continuing education. One essential part of caregiving is effectively handling emergencies, so be sure to ask if emergency training is included in employee orientation. (Are employees trained in fire safety? Do they know the Heimlich maneuver and CPR?) Continuing education lets caregivers build their healthcare skill sets and stay up-to-date with best practices in home care.

How thorough are the agency’s background checks? Effectively vetting a potential employee involves talking with their previous employer and other references. It also involves getting a full criminal background check to be aware of any felonies, misdemeanors and driving violations.

How many caregivers are assigned to each client? The best home care agencies assign more than one caregiver to each client. Because two or three people become regular visitors, a worker familiar to the senior is available even if one person takes time off or leaves the agency.

If the senior is unhappy with a caregiver, can another worker take the shift? You might also ask the director to explain their procedure for matching clients with caregivers.

How are caregivers managed? When caregivers are treated well, their patients can benefit. Before hiring a home care agency, observe how the management interacts with staff. Ask the director how the agency motivates its workers and recognizes great work.

Also ask about employee supervision and evaluation. Directors should occasionally observe their employees in the field, preferably unannounced to help ensure quality control. The following tips and interview questions may be helpful as you hire home care workers, and remember to clarify your needs when interviewing caregivers.

1. List the specific areas in which help is needed. Some possibilities:

Personal Care: bathing, dressing, eating, dressing, using the toilet, lifting out of bed

Homemaking: preparing meals, cleaning, washing laundry, buying groceries

Medical Care: managing medication, physical therapy, intravenous treatments, dialysis, physician’s appointments

Emotional Care: companionship, conversation, enriching activities

2. Calculate how many hours of care are needed daily or weekly. How long is each shift?

3. Decide how much you will pay per hour. Also list any special benefits of the job. For help determining your pay rate, research the wages offered by local home care agencies. Also put yourself in the worker’s shoes, paying the local norm isn’t necessarily fair to the employee, and it’s doesn’t serve your best interest as a RAL owner.

Living on market rates can be especially stressful for entry-level home care workers. If the market rate is just $10/hr in your town, then a full-time worker would take home just $1600/month before taxes. Their annual income would be so low that they would qualify for federal assistance. If home care workers our living on such fine margins, they probably won’t be able to keep up a high level of care for long. When setting a rate, put yourself in the worker’s shoes.

Employment benefits can make your job offer more attractive. Home health care agencies typically offer health care and other benefits to their employees. A few examples of benefits you might offer:


Paid vacation days

Paid sick days

Dental insurance

Health insurance

Travel opportunities

Tuition for healthcare education

Figure out how you’ll make payments and comply with the law. When you hire home health workers directly, you need to report the expense to the Internal Revenue Service. Reporting the work may bring tax deductions, plus it gives social security benefits to the employee. For more details, visit the IRS publications page. Finally, write an employment contract to protect yourself and your employees. It’s wise to first have a trial agreement, e.g., for 30 days.

Preliminary Interview by Phone

Before meeting a job applicant in person, interview him or her by phone or over Skype. This can be a great time saver. Covering the following topics in a preliminary interview might rule out a number of applicants and save you lots of time.

Work hours

Relevant training and work experience

Access to transportation

Why the person is interested in the job

If the preliminary interview is to your liking, then arrange to meet in person. Some employers find that it is a good idea to have the initial meeting in a public place unless you already trust the individual based on a friend’s recommendation. Ask the applicant to bring a photo ID, their job history or resume, contacts for references and any other documentation that you might find useful.

Full Interview in Person

Below are ten interview questions for home health care workers. Remember that the main tasks of your interview are: presenting your needs, understanding the applicant’s skills and qualifications, explaining the compensation and deciding whether the applicant is a good match for your residents and families.

If possible, have the senior participate in the interview. This is easily done if you feel comfortable having the interview at your residential assisted living home. The following 10 questions are key to any caregiver interview. Consider amending them and adding any additional questions that you feel would be helpful to the process.

1. Why are you working in home eldercare?

2. What is your work experience as an in-home caregiver?

3. What do you like about home care?

4. What are the greatest challenges of home care work?

5. Why did you leave your previous job?

6. Are you insured to provide in-home care?

7. Can you provide documentation of your health status including immunizations?

8. Can you provide documentation of your relevant training?

9. Are you certified in CPR or willing to become certified?

10. How do you prefer to receive feedback? Would you be comfortable with a weekly or monthly check-in about progress and any problems?

After the Interview

Following a positive interview, here are steps you can take to help ensure an effective home care agreement.

Call the job applicant’s references. Previous employers and other references might confirm your impressions of the individual, or they might share “red flags” that you missed. When you speak with other employers, ask about the worker’s punctuality and work quality. Ask why the person no longer holds that job position.

Consider paying for a criminal background check. Ask your local police station for guidance to get an accurate report. Many companies offer background checks via smartphone apps or the web, but their reports can be misleading. Some RAL owners might find this step a little intimidating, but it is worth remembering that these potential employees are the face of your business and are responsible for ensuring your resident’s health and safety.

Make the job offer. If the candidate accepts, then put your agreement in writing. Include a mention of a trial period before the job position is considered permanent. A contract for home care should also include: job duties, wages, payment schedule and method, start date, termination policy, time off and other benefits.

When you are going through the hiring process consider hiring backup workers. You are hiring real people, not super humans. Make sure that you are prepared to cover all the needs of your RAL home and its residents without stressing in case an employee falls ill or otherwise needs to skip a shift.

Check in during your caregiver’s work shifts. Especially when the work arrangement is new, spend time at the home to help familiarize the caregiver with your seniors’ needs. Periodically drop by unannounced during a shift to ensure that all is well. When setting up employment, schedule a regular time to meet with employees to address concerns about job duties and to evaluate the status of your residents’ health and well-being.

These are just a few of the numerous methods and tips that we help RAL owners adopt in their businesses to help create models of success in the residential assisted living industry. We have additional training that covers every topic you can imagine concerning RAL homes, setting up and running a successful RAL business, training and managing employees and every other assisted living topic under the sun. If you would like more information about additional training, visit:


The RAL Academy is here to help you succeed, so don’t put it off any longer. Take control of your future and get involved in a unique industry that allows you to Do Good and Do Well.