The Impact of Staff Absenteeism on Service Users: The Case of Charlotte House

This research project examines the impact of staff absenteeism on service users in Charlotte House, a care giving organization. The study highlights the problem of habitual absenteeism and provides recommendations for improvement.

Running head: RESEARCH PAPER
The impact of staff absenteeism on service users: The case of Charlotte House
Name of the student
Name of the university
Author note

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ACKNOWLEDGEMENT
First and foremost, I would like to thank my supervisors, Prof. …, who supported me
through this research with their patience, knowledge, and understanding. I could not
have wished for better, highly qualified and approachable supervisor. He is so
patient and supportive throughout our session, particularly his one-to-one support.
I would like to thank my family, my wife in particular. They were always supporting
me and encouraging me with their best wishes.
I would also like to thank my lecturers, non-academic staffs and my distinguished
classmates for their kind support and appreciation toward me throughout this
program.
God bless you all.

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ABSTRACT
This research project had examined the impact of staff absenteeism on service
users. The research had highlighted the problem of habitual absenteeism among
care giving organization. Charlotte House had been chosen as the case for analysis.
The house had been facing issues with staff absenteeism due to various issues such
as low compensation package.
The research had been conducted from the perspective of the pragmatism where
mixed method analysis had been conducted. The study had collected data from
patients’ families and management level employees of the organization. This
consisted of 40 respondents for the survey and 3 respondents for the interview.
The data had been analysed using respondents survey response and coding. The
results had shown that the patients’ health conditions deteriorate due to the lack of
staffs and it compromises safety of the patients. Moreover, patients became more
aggressive and are not able to make decisions which affected their cognitive ability.
The research had provided significant conclusion and recommendations which could
help Charlotte house in dealing with their current issues.

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Table of Contents
Acknowledgement........................................................................................................1
Abstract.........................................................................................................................2
Glossary of terms..........................................................................................................6
Glossary of Abbreviation..............................................................................................6
Chapter One.................................................................................................................7
Introduction...................................................................................................................7
1.1 Project Overview.....................................................................................................7
1.2 Background of the study.........................................................................................7
1.2.1 Problem Statement and Organizational Significance..........................................8
1.2.2 Study purpose......................................................................................................8
1.3 Aims and Objectives...............................................................................................8
1.4 Research Questions...............................................................................................8
1.5 Rationale.................................................................................................................8
1.6 Scope and Limitations............................................................................................9
1.7 Summary................................................................................................................9
Chapter Two...............................................................................................................10
Literature review.........................................................................................................10
2.1 Introduction...........................................................................................................10
2.2 Definition...............................................................................................................10
2.3 Concept of staff absenteeism in healthcare.........................................................11
2.4 Problems of Staff absenteeism on patients..........................................................11
2.5 Conceptual framework..........................................................................................13
2.6 Literature gap........................................................................................................13
2.7 Summary..............................................................................................................14
Chapter Three.............................................................................................................15
Research methodology...............................................................................................15

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3.1 Introduction...........................................................................................................15
3.2 Research Paradigms............................................................................................15
3.3 Research approach and strategy.........................................................................15
3.4 Data collection......................................................................................................16
3.5 Ethical Consideration............................................................................................17
3.6 Summary..............................................................................................................17
Chapter Four...............................................................................................................18
Data Analysis and Findings........................................................................................18
4.1 Introduction...........................................................................................................18
4.2 Quantitative analysis............................................................................................18
4.2.1 Demographic Questions....................................................................................18
4.2.2 Questions on staff absenteeism and service users...........................................19
4.3 Qualitative analysis...............................................................................................25
4.3.1 Coded data........................................................................................................25
4.4.2 Generalizations..................................................................................................27
4.5 Summary..............................................................................................................27
Chapter Five...............................................................................................................28
Conclusion and Recommendations............................................................................28
5.1 Introduction...........................................................................................................28
5.2 Key findings and Conclusion................................................................................28
5.3 Recommendations................................................................................................28
5.4 Future research directions....................................................................................28
5.5 Reflection on own learning...................................................................................29
5.6 Summary..............................................................................................................29
References.................................................................................................................30
Appendices.................................................................................................................34
Appendix 1..................................................................................................................34

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Appendix 2..................................................................................................................36
Appendix 3..................................................................................................................37

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GLOSSARY OF TERMS
Alzheimer- Alzheimer's is a type of dementia that causes problems with
memory, thinking and behaviour
GLOSSARY OF ABBREVIATION
CCG - Clinical Commissioning Group
SPSS - Statistical Package for the Social Sciences

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CHAPTER ONE
INTRODUCTION
1.1 PROJECT OVERVIEW
This research project has aimed to examine the impact of staff absenteeism
on service users. Researches have been conducted in the past on improving the
health care facilities in various hospitals and health care centres. Structure, process
and outcomes are key indicators of care quality (Oliveira et al. 2015). These
elements can be further divided into factors such as working conditions and human
resources which indicate the care structure. On the other hand, the patient
satisfaction is an indicator of outcome. Staff absenteeism is one of the key
components of human resource management and it affects the quality of service
provided to the patients. Studies conducted in the past three decades have been
able to develop critical standards that needs to be followed in each of these care
giving organizations. Absenteeism refers to intentional or international habit of not
turning up to work. In this given research, Charlotte House has been chosen as the
organization for analysis.
1.2 BACKGROUND OF THE STUDY
Charlotte House is a modern and purpose-built care home located at
Isleworth in Middlesex. The care home is known for their specialised service in
respite care and nursing for aged people. The care only provides service to aged
individuals having any form of dementia. The House also provides compassionate
end of life care. The organization provides customized services tailored and carefully
planned according to the needs of each of the patients (Careuk.com 2019). The
facility consists of 56 residential rooms consisting of equal number of rooms in each
of the floors. The ground floor is reserved for the privately funded patients. On the
other hand, 22 rooms are reserved for the patients being referred from Hounslow
CCG and remaining rooms are available for other Authorities in London (Careuk.com
2019). This care home has excellent facility and consists of several hierarchies for
monitoring the activities. The processes of the organization are managed by
business manager, unit managers, deputy managers and home managers. The
staffs consist of 8 registered nurses, 34 care workers, 2 lifestyle coordinators and 1
receptionist for controlling the operational activities (Careuk.com 2019). There are
various activities every day to keep the residents busy and provide them
independence at their old life.
Absenteeism at care giving organizations is one of the key issues faced by
Health care sector. Habitual evasion from work is one of the key issues faced by
various industries in United Kingdom. This effect the productivity of the employees
and shortage of staffs leads to ineffectiveness in the organizational processes.
Moreover, there is significant rise in the human resource cost and increases the

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complexity for the management as they have to arrange for replacements within a
short notice.
1.2.1 PROBLEM STATEMENT AND ORGANIZATIONAL SIGNIFICANCE
The research has aimed to highlight the problem of habitual absenteeism
among care giving organization. Charlotte House has been chosen as the case for
analysis. The house has been facing issues with staff absenteeism due to various
issues such as low compensation package. The staffs tend to leave the job without
further notice as soon as they find another job with better compensation packages.
The management has tried to cover up the shortcomings by appealing to different
specialized agencies. However, these staffs face immense stress during their work
as they are inexperienced and does not have the necessary skills to meet the daily
staff requirements. There has been significant increase in absenteeism issues in
different care giving organizations and the case study has examined the case of
Charlotte House to provide suitable recommendations for improving the experience
of the service users.
1.2.2 STUDY PURPOSE
This research investigated the impact of staff absenteeism on the service
users in Charlotte House. The research has collected data on the effect on the
service users due to the absenteeism of staffs by conducting a mixed method
analysis. Primary data has been collected from the managers working in the
organizations and patient families to understand the nature of the effect. Suitable
recommendations have been provided based on the impact identified on the
organization. Various misconceptions regarding the impact of staff absenteeism has
been addressed to highlight the real issues.
1.3 AIMS AND OBJECTIVES
 To identify and examine the impact of the staff absenteeism on service users
in Charlotte House
 To review existing studies related to staff absenteeism and service users
within UK Health and Social Care industry.
 To suggest the recommendations that can improve the performance of staff
members in Charlotte House
1.4 RESEARCH QUESTIONS
 What are the major effects of the staff absenteeism on service users in
Charlotte House?
1.5 RATIONALE
The research has chosen this particular topic as staff absenteeism is a major
issue in care giving organizations in United Kingdom and Charlotte House is one of
the best examples of this issue. The day to day operation of the organization is
getting hampered which has negative impact on the service quality. The impact of

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these phenomenon is not limited to the service users but also the other staffs. The
on-duty carers have to take up more responsibility which results in increase in stress,
dissatisfaction and mistakes. Moreover, the amount of time to be given to each of the
users are reduced significantly and the required duties are not fulfilled. This has
increased the number of complaints from the patient families to the CQC and other
authorities. This project is aimed at creating awareness among the management at
Charlotte House so that they can take immediate actions based on the
inconvenience, and issues identified and the recommendations. Absenteeism affects
productivity of the employees and the overall process efficiency.
This research provided the opportunity to develop analytical and problem-
solving skills which is required for working in the sector of Health and Social Care.
The independent learnings and experiences gained has provided knowledge for
future issues in the sector.
1.6 SCOPE AND LIMITATIONS
The main focus on the study is identify and highlight the key impacts of staff
absenteeism on patients in Charlotte House. The issues examined has been solely
based on the given case and any other issue in the Social and Health care sector is
out of scope. The major limitation of the research is the fact that direct interview with
the patients is not possible so feedback from the patient families have been taken.
Moreover, as the sample size of the study is relatively small, the sampling error is
high.
1.7 SUMMARY
This chapter has provided a detailed introduction on the problem statement,
the objective and aim of the research. This chapter has provided a brief outline of the
overall research and contribution of each into the research. The rationale, scope and
limitation of the research has been presented effectively for understanding the
aspects that has not and cannot be covered. The next chapter provide a detail
critical analysis on staff absenteeism and its impact on the service users.

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CHAPTER TWO
LITERATURE REVIEW
2.1 INTRODUCTION
This chapter puts some lights on the role of the staff absenteeism on service
users or patients in the healthcare industry. In this regard, it can be stated that
dementia is a serious threat to the UK society and increasing at a rapid pace. Critical
symptoms like memory loss or Alzheimer is a common type of dementia. Therefore,
it requires rigorous medical treatment and close observation so that the patients can
get well positively. Based on this understanding, this chapter is trying to get a close
investigation on the impact of staff absenteeism in healthcare facilities that affects
the service users specifically the dementia patients.
Therefore, this chapter is offering an introspection into the theme of the
research and helps out the researcher to analyse a better understanding of the aims
and objective of the research related to the topic of impact of staff absenteeism on
patients or service users. In this regard, the chapter has been divided into a number
of sections in order to conduct a deep-down analysis on the empirical evidences.
Moreover, the relationship between the staff absenteeism and the condition of the
patient is also going to be discussed into the chapter in order to understand the
direct and indirect impact of the staff absenteeism on the service users.
2.2 DEFINITION
According to Baxter et al. (2015) staff absenteeism is a habitual practice that
influences the staff to take a leave in random basis. In this regard, Hallman et al.
(2014) argued that the habitual non-presence of the staff during the time of doing job
is labelled as staff absenteeism. In this regard, there are some possible factors that
are responsible to push the staff to take unexpected leave. As per the research of
Onikoyi, Awolusi and Ayodeji (2015) enough work pressure in workplace is
considered to be one of the major reasons behind staff absenteeism. It creates a
negative impression on the employee or the staff to do job enthusiastically and take
load of pressure while the financial benefit is limited. In course of this, the role of
financial benefit as a key feature for encouraging the employee to get focused.
Moreover, lack of responsibility is also referred as another important aspect that can
drive the staffs to take unexpected leave in a random manner. Lambert et al. (2015)
opined that due to the lack of understanding about the role and job position the
employees are very often took unauthorized leaves and as a result of that it
becomes a grave problem for the organization to continue a flawless production or
service. Furthermore, the unscheduled leave can also be occurred due to the clash
of shift work timing.

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2.3 CONCEPT OF STAFF ABSENTEEISM IN HEALTHCARE
Absenteeism in healthcare has become a growing practice among the
medical staffs nowadays. It is associated with huge workforce pressure and lack of
trained medical staffs. As a result of that the existing staffs are facing severe
workload in medical facilities as there is shortage in trained nurses and medical
staffs in hospitals. According to the research of Van Buynder et al. (2015) it can be
argued that the relationship between the staff absenteeism in hospitals is related to
their organizational commitment. As a matter of fact, Mercer et al. (2014) articulated
that typical classification of the staff absenteeism in healthcare facilities can be seen
in intensive care units, medical or surgical departments and specialization. There are
both the planned and unplanned absence in work and both types of work affects the
organization and the patient care differently. In this context, Johnson et al. (2018)
mentioned that planned absences in terms of scheduled leaves and vacations are
easier for the organizations to cope with because the medical organization has
already chosen an alternative to continue the healthcare practices. However, in case
of the unscheduled leaves or unplanned absenteeism of the staffs it becomes a
critical problem for the organization to keep the pace of the operational activities
(Frederick et al. 2018).
As a result of that loss in the productivity or service and poor quality are the common
feature of the staff absenteeism. Besides this, the research of Howlett et al. (2015)
confirmed that the role of the safety issue regarding the health condition of the
patients and the damaging the image of the healthcare organization are considered
to be the best possible effect that the organization has to deal with. Moreover, the
morale of the organization as well as the rest of the employees can also be affected
due to the random absence practice of the staffs (Daouk-Öyry et al. 2014). In
response to this, the organizations are trying to recruit new and contractual staffs.
However, the organizational expenses will be raised to a great extent and it can pose
serious threat for the organization (Bargas and Monteiro 2014).
2.4 PROBLEMS OF STAFF ABSENTEEISM ON PATIENTS
In this context, it is important to understand the adverse impact of staff
absenteeism over the patient conditions. There are several impacts based on the
empirical evidences formulate that the role of the staff absenteeism leads to patient
safety and lack of patient health condition. As per the research of Pieterse and
Lodge (2015) vulnerability to the safety of the patient is a significant result due to the
staff absenteeism. As the medical facilities suffer from lack of trained medical staffs
therefore it is not possible for the organization to overcome the absenteeism of the
staff within a short period of time (Duclay et al. 2015). Therefore, the patients face
severe threat as they are unattended by trained medical staffs. It turns out to be a
fatal situation for them to get proper care and medical attention.
Besides this, Oliveira et al. (2015) also pointed out that in a medical facility is
the part of the job of medical staffs to get adequate attention to each individual

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patient. As a matter of fact, the patient’s family expects that the hospitals will look
after the patients with professional and quick action that they cannot do. Therefore,
expectation of the patient’s family is too high and they are constantly believing in the
myth that the patient will get proper care in hospital. However, in reality the situation
is different (Williams et al. 2016). Due to absenteeism, most of the healthcare
facilities suffers with lack of medical staffs. Thus, the patients often do not get
medicine in time.
In addition to this, King Long and Lisy (2014) advocated that in the advanced
medical facilities the patients enjoy a number of healthcare development programs. It
is essential for the hospitals to ensure the progress in patient’s health condition.
Therefore, the medical staffs are entitled to set some program for the benefit of the
patients. Through the research of Haines et al. (2015) it can be opined that the role
of the healthcare development programs is highly effective for better treatment of the
patients. However, absenteeism creates lack of medical staffs to set separate
healthcare programs for the patients. As a result of that it causes serious problem for
the patients to get well as soon as possible. Deterioration of patient’s health is also
an important aspect that can be developed due to the lack of healthcare programs
conducted by the medical staffs.
On the other hand, the role of the medical staffs is also associated with
performing a bridge between the organizational management and the patient family.
It is easier for the patient family to communicate with the medical staffs than
communicating with the doctors. The doctors or the hospital management has
dynamic activities to play. They do not get much time to communicate with each
patient family directly (Lowe et al. 2015). As a result of that the role of the medical
staffs is highly important in order to establish a better communication and let the
patient family informed about the health condition of the patient. Henceforth,
absenteeism of medical staffs leads to the communication gap between the patient’s
family and the hospital management. Lack of communication and misinformation are
also identified as the detrimental factor that creates enough problem in the
development of the patient’s health condition.
In this regard, Ackers, Ioannou and Ackers-Johnson (2016) pointed out the
importance of the medical staffs in dementia. For the dementia patients it is pertinent
for the medical staffs to make a close monitoring process. Moreover, the research of
Jackson et al. (2014) pointed out that the medical staffs are played pivotal role in
order to develop the cognitive understanding of the dementia patients. In fact, it is
one of the major steps to develop the mental condition of the patients and generate a
hospitable situation that can help the patients to make progress in their health
conditions. As a result of that any kind of absenteeism in staffs can end the
possibility of developing the health condition of the patient and it leaves a negative
image to the service users.
As a matter of fact, the role of the staff absenteeism has a direct impact on
the security of the patient health condition. In this regard, King, Long and Lisy (2014)

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Staff
absenteeis
m
Patient safety
Timely medicine
Healthcare
development
program
Communication
Patient health quality
Insecure health
condition
Affecting
Service
users
Discouragement
figured out the role of the medical staffs is not only look after the patients but a
psychological bonding between the two is also established. Moreover, the patients
also feel relaxed and optimist in order to get well as soon as possible. Any kind of
absenteeism of medical staff hampers this healthy development process and can
create insecurity of the positive development of patient’s health condition.
2.5 CONCEPTUAL FRAMEWORK
From this point of view, it can be seen that this conceptual framework is trying
to create a relation between the staff absenteeism and its impact on the service
users or the patients. In this regard, there are several factors that can create adverse
impact on the service users. For an instance, the empirical studies argue that patient
safety is considered to be one of the major factors that leaves a direct impact on the
health safety of the patient. Besides this, absenteeism in medical staff will hamper
the timely medicine of the patients. In fact, the healthcare development programs are
also getting failed due to the lack of medical staffs. The bonding between the
medical staffs and the patients will also get halted due to the staff absenteeism.
Moreover, communication, patient health quality and insecure health condition due to
staff absenteeism is also identified as strong determinants of affecting the service
users.

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2.6 LITERATURE GAP
However, this literature review is not free from limitations. For an instance, all
kinds of health-related issues are the focal point of this discussion. In other words,
this literature review does not put any emphasis on any specific health related issues
and the impact of the staff absenteeism on the service users. Moreover, damaging
the service users is not only affected by the staff absenteeism. There are a number
of other factors that influence the service users experience in hospital and health
care institution. Therefore, it is essential for this research to put focus on a specific
health issue like dementia and try to find out the role of the staff absenteeism on
affecting the dementia patients as service users.
2.7 SUMMARY
From this point of view, it can be argued that the literature review intends to
deal with the problems of staff absenteeism on patients. In course of the discussion,
the literature review does not circumscribe the discussion into the impact of the staff
absenteeism on patients. Rather it tries to investigate the problem by finding out the
factors behind the staff absenteeism. As a matter of fact, the literature review also
puts focus on the definition of staff absenteeism in a general sense. In addition to
this, the conceptual map tries to implicate a better understanding regarding the
relationship between staff absenteeism and impact on health care service users.
Finally, the literature gap is also discussed that highlights the limitations of this
literature review that drives towards conducting this research. From that point of
view, it can be stated that the literature review is relevant and significant for
conducting this research.

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CHAPTER THREE
RESEARCH METHODOLOGY
3.1 INTRODUCTION
This chapter has provided a vivid description of the methods, instruments and
frameworks used to collect data and analyse it (Mackey and Gass 2015). This study
has followed the research onion which has unfolded the different methods in every
stage. The research methods and framework are chosen based on the goals of the
research (Kumar 2019). The main goals of the research is description of a
phenomenon, prediction and explanation of causal relationship. This research has
used a mixed method approach to use both quantitative and qualitative data analysis
to develop relevant results. The research has used an experimental research design
to evaluate staff absenteeism and its impact on the service users (Collis and Hussey
2013).
3.2 RESEARCH PARADIGMS
As stated by Antwi and Hamza (2015), research paradigm consists of sets of
values, assumptions and ideas that defines the research at different levels and
facilitates in knowledge development. Researchers make assumptions at every
stage even though they are not aware of it. The different assumptions include
assumptions on realities encountered (ontological assumptions), impact of values
on research (axiological assumptions) and assumption on human knowledge
(epistemological assumptions). The different types of research philosophies are
positivism, interpretivism, realism and pragmatism (Wolgemuth et al. 2015).
Generally, majority of the research uses positivist or interpretivist views. However, in
this current scenario, the use of both these approaches is required to address the
research questions so Pragmatism has been chosen as the research philosophy.
Pragmatism focus on the research question and uses methods based on the needs
of the research questions. Pragmatism believes in the existence of multiple realities
where there can be different ways of interpreting an issue and solving it (Shannon-
Baker 2016). Pragmatism accepts theories, approaches and framework if it consists
of data that supports them. The use of pragmatism philosophy has facilitated in
conducting both quantitative and qualitative analysis to understand the impact on the
service users due to absenteeism. Moreover, it has been understood from varied
perspective, one from the families of the service users and other from the managers
responsible for the supervisory role they play within the organization.
3.3 RESEARCH APPROACH AND STRATEGY
Research approach consists of two parts, one is data collection and other is
reasoning. Research approach is the method of selecting data and examining it.
There are mainly two types of research approaches, deductive approach and
inductive approach. As stated by Alase (2017), every layer of the research onion is

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related to each other and is linked to its previous steps. Pragmatism requires the use
of both inductive and deductive approach to develop essential findings in the
research. The deductive approach facilitates in testing the existing theories
discussed in the literature review section. On the other hand, inductive approach
facilities in developing new generalization and tentative theories. The use of both
these methods has assisted in providing different dimension to the research (Quinlan
et al. 2019).
According to Lewis (2015), research design is the developing the overall plan
for conducting the research. Exploratory, explanatory and descriptive research
design are three of the research designs chosen in this type of researches. However,
this study has used explanatory research design where sequential explanatory
research design has been used to validate the data analysis of the quantitative
analysis with that of the qualitative analysis (Creswell and Poth 2017). This research
has used the experimental method to address the causal relationship between staff
absenteeism and its impact on service users. The case study method has been used
to examine the different consequences the service users face due to staff
absenteeism.
3.4 DATA COLLECTION
Data collection consists of two methods, primary data collection and
secondary collection. This research is based on collecting primary data collection
method where survey questionnaires has been used to collect the data for
quantitative analysis (Palinkas et al. 2015). The survey questionnaire consists of
close ended questions which address the relationship between staff absenteeism
and its effect on service users. These questions have been asked to the patient’s
families and have been selected randomly using simple random sampling (Palinkas
et al. 2015). In the survey data collection, 40 respondents have been chosen from all
the patients. On the other hand, the qualitative data has been collected using semi
structured interviews which has used non-probabilistic sampling to collect data. The
research has used convenience sampling to collect interview data. The deputy
manager, home manager and business manager has been interviewed to gather
information on the problem faced by the patients by conducting a cross sectional
study. Therefore, in case of the qualitative study the sample size of the research is 3.
The data collected for the qualitative required two persons where one of the
persons have been asking the questions where another individual has been
documenting the answers. The study used pilot testing where 3 respondents were
asked about the sequencing, language and relevance of the questions (Heale and
Twycross 2015). On the other, the data collected for the quantitative analysis has
been tested by using Cronbach’s alpha which measured the scale reliability of the
data. However, as the sample size for the quantitative analysis is small so their
chances of 25% sampling error. However, the study has tried to use an effective
research design to reduce the sampling error.

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The data collected from the mixed method analysis has been analysed
separately using both quantitative and qualitative analysis. The quantitative analysis
consists of using statistical tools and techniques. SPSS is the tool used for
developing inferential statistics in the current research (Morse 2016). The survey
data has been represented in forms of graphs and frequency table. On the other
hand, the data collected from the qualitative analysis has been analysed using
coding. Coding is the method of identifying key phrases and terminologies based on
the patterns in the interview data from different respondents. This is executed in two
phases, open coding and axial coding. Open coding has been used to examine the
pattern and develop keywords (Collis and Hussey 2013). On the other hand, axial
coding has been used to form generalisations based on the information assessed.
3.5 ETHICAL CONSIDERATION
This research has followed all the given ethical guidelines in this research
process. The research has conformed to the major principles of conducting an
ethical research where plagiarism, fabrication and falsification has been avoided.
The authors have been credited for their contribution to the research by citing them
where ever used. The data collected has not been fabricated or falsified to fulfil the
purpose of the research (Silverman 2016). Informed consent is another key aspect
of the research and research has been sure that the participants have knowingly and
voluntarily participated in the research. Moreover, the research has adhered to the
data protection act of 1998 where anonymity and privacy of the respondents have
been maintained (Silverman 2016). The research data has not been used for any
other purpose and the data will be destroyed as soon as the research is completed.
Verbal and written consent from the respondents have been taken and they have
been provided choices to leave at any point. The research has also made sure no
abusive or discriminatory language has been used which would hurt the sentiments
or offend any participant.
3.6 SUMMARY
This chapter has provided a detailed description of the data collection method
and analysis plan. The different research methods and instruments adopted in the
research has been described in detail to provide valuable insights on the way the
different research methods has been used to achieving the given objectives and
goals of the research. The next chapter has developed findings and analysis based
on the methods and instruments developed in this chapter where both semi
structured interviews and survey questionnaires has been used.

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CHAPTER FOUR
DATA ANALYSIS AND FINDINGS
4.1 INTRODUCTION
This chapter has evaluated the collected through survey and interview by
using inferential statistics and coding. Triangulation has facilitated in using different
methods to collect and analyse data so that the issue can be addressed at different
levels in the organization. The statistical data has facilitated in developing a model
which has established the relationship between service users and staff absenteeism
issues. The data collected from patient’s families have been kept confidential to
protect their interest. Similarly, the data analysed from the qualitative analysis has
not used any names to protect the employees.
4.2 QUANTITATIVE ANALYSIS
4.2.1 DEMOGRAPHIC QUESTIONS
Graph 1: Gender
Source: (As created by author)
This question examines the gender of the patients in Charlotte House. The
results show that 47% of the patients are male and remaining are female.

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Graph 2: Age
Source: (As created by author)
This question highlights the age of patients in charlotte house and the results
show that 42% of the respondents belong to the age group of 70-79, 38% belong to
age group of 80-89 and 20% respondents belong to the age group of 60-69. This
shows that average age of respondents in quite high and extra care is required from
the perspective of the care institution.
4.2.2 QUESTIONS ON STAFF ABSENTEEISM AND SERVICE USERS
Graph 3: Dissatisfaction level
Source: (As created by author)
This question examines the satisfaction level of the patient’s families by the
service provided by the care institution. The results show that 40% of the patient

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families have strongly agreed to the question, 40% have agreed and 2% are
indifferent. On the contrary, 13% disagreed to the research question and 5% strongly
disagreed. This shows that majority of the patient’s families are not happy with the
respondents and the lack of staffs have affected the performance of the care giving
facility.
Graph 4: Deterioration of patient condition
Source: (As created by author)
The question evaluates whether the patient’s condition deteriorates due to the
staff absenteeism. The results show that 37% of the respondents have strongly
agreed to the question, 42% have agreed and 3% are indifferent. On the contrary,
10% have disagreed and 8% have strongly disagreed to the research question.
Patient’s suffering from different dementia diseases require care and support at all
times for development in their mental and physical conditions. However, staff
absenteeism results in decrease in attention from the available staffs which causes
deterioration in patience’s physical and mental conditions.

21RESEARCH PAPER
Graph 5: Increase in patient’s aggressiveness
Source: (As created by author)
The question portrays whether the patient’s aggressiveness increases due to
staff absenteeism. The results show that 35% of the respondents have strongly
agreed to the question, 45% have agreed and 2% are indifferent. On the contrary,
8% have disagreed and 10% have strongly disagreed to the research question. The
results show that as the patient’s condition deteriorates their aggressiveness
increases as they are not able to communicate with anyone and their decrease in
physical activities also increase their physical discomfort.
Graph 6: Reduction in patient’s physical involvement
Source: (As created by author)

22RESEARCH PAPER
The question investigates whether the patient’s physical activities decrease
due to staff absenteeism. The results show that 37% of the respondents have
strongly agreed to the question, 42% have agreed and 3% are indifferent. On the
contrary, 10% have disagreed and 8% have strongly disagreed to the research
question. This shows that patience physical discomfort and activities decrease as
they have to be kept within bounds due to safety reasons and lack of staffs in
attending to individual patients.
Graph 7: Timely medication of patients
Source: (As created by author)
The question evaluates whether the patients receive timely medication due to
staff absenteeism. The results show that 37% of the respondents have strongly
agreed to the question, 42% have agreed and 3% are indifferent. On the contrary,
10% have disagreed and 8% have strongly disagreed to the research question. This
shows that absence in staffs causes issues in keeping track of medicines of each of
the employees. The available staffs have more work to do and cover up for the
missing staffs which takes more time to address each of the patients.

23RESEARCH PAPER
Graph 8: Hindrance in patient progress
Source: (As created by author)
The question evaluates whether the patient’s progress is hindered due to staff
absenteeism. The results show that 27% of the respondents have strongly agreed to
the question, 52% have agreed and 3% are indifferent. On the contrary, 3% have
disagreed and 15% have strongly disagreed to the research question. Patients
making good progress may have a setback if they are not cared for at all times. Lack
of staffs’ causes’ compromise in attention given to each of the patients as charlotte
house has only 34 staffs to attend to around 60 patients. The increase in
absenteeism is expected to definitely hinder the daily operations and impact the
patients consequently.

24RESEARCH PAPER
Graph 9: Patient’s attachment to particular staff causes lack of cooperation in
their absence
Source: (As created by author)
The question evaluates whether the patient’s condition deteriorates due to the
staff absenteeism. The results show that 30% of the respondents have strongly
agreed to the question, 50% have agreed and 2% are indifferent. On the contrary,
10% have disagreed and 8% have strongly disagreed to the research question.
Patients become comfortable and attached to particular staffs and carer givers have
particular role in improving the physical and mental condition of the patients.
However, if a staff leaves and replaced by new staffs it takes time for the patients to
get accustomed. Moreover, various may even reject the staff due to their resistance
to change and aggressive nature.
Graph 10: Deterioration in decision making ability
Source: (As created by author)
The question evaluates whether the patient’s decision-making ability
deteriorates due to staff absenteeism. The results show that 42% of the respondents
have strongly agreed to the question, 37% have agreed and 3% are indifferent. On
the contrary, 10% have disagreed and 8% have strongly disagreed to the research
question. The decision-making ability of these type of patients are affected and are
dependent on their attendant to make some of their decisions. Lack of staff makes it
difficult for the patients to take their own decisions. Even though some patients can
be their own decision, most of them face issues with capacity as their information
processing abilities are affected. Presence of staffs helps in making decisions for
these types of patients and the staff absenteeism makes it difficult for these patients
to have attention of individual staffs at all times.

25RESEARCH PAPER
Graph 11: Communication Issues
Source: (As created by author)
The question evaluates whether the patient families face difficulty in
communicating due to staff absenteeism. The results show that 37% of the
respondents have strongly agreed to the question, 42% have agreed and 3% are
indifferent. On the contrary, 8% have disagreed and 10% have strongly disagreed to
the research question. Patients’ family gets majority of the information about the
progress from the staffs so reduction in staffs increases the work load which makes it
difficult for the staffs to communicate.
4.3 QUALITATIVE ANALYSIS
4.3.1 CODED DATA
Questions Comments Code
1. What are the problem
faced by the care facility
due to lack of staffs?
“It is difficult to manage
the patients with a smaller
number of staffs. Each
patient has their own
needs and it is difficult to
provide customized
service.”
“Staff absenteeism results
in increase in stress level
among caregivers.
Moreover, staffs leaving
without notice makes it
difficult to arrange for
it is difficult to provide
customized service,
increase in stress level,
difficult to arrange for
skilled staff, difficult to
arrange for skilled staff,
increases the work load

26RESEARCH PAPER
skilled staff within a short
period of time. Moreover,
staffs hired from agencies
are not skilled enough to
handle critical situations.”
“It increases the work
load of the present
caregivers. Staffs get
demotivated as their
colleagues leave due to
better compensation and
opportunity. It causes
inconsistency in the
operational processes
and difficult to host new
activities for patients if
there is shortage in
staffs.”
2. What are the possible
impact of staff shortage
on the patients?
“Patients conditions
deteriorate and patients
become more aggressive
when there is lack of care
givers.”
“It increases the safety
risk of the patients as it is
difficult for the patients to
process information and
make decisions on their
own. There are high
chances that patients may
harm themselves. The
patient condition may also
deteriorate”
“Patients progress is
hampered when there is
no staff to take care of
them. Patients respond to
the customized service
they receive but change
in staff makes it difficult
for the new staffs to deal
Patients conditions
deteriorate, become more
aggressive, Patients
progress is hampered

27RESEARCH PAPER
with these patients as
they lack prior
experience.”
4.4.2 GENERALIZATIONS
The findings of the qualitative data are quite similar to the data analysed in the
quantitative analysis. Patients conditions deteriorate due to staff absenteeism as
they organization is not able to provide the customized service they require. The
patients making progress face a setback due to the irregularities in the therapy. Staff
absenteeism has been considered as the prime issue for these impacts. Moreover,
the patients making progress are affected by irregularities such lack of timely
medication and therapeutic programs.
4.5 SUMMARY
This chapter has evaluated the impact of staff absenteeism on the service
users. The analysis of the quantitative and qualitative data shows that service users
face issues due to staff absenteeism. These consists of issues such as deterioration
in patients ‘physical and mental health. It makes the patients more aggressive and
due to their lack of ability of decision making, safety of the patients become
questionable. The next chapter is the final chapter and as the name suggests would
provide conclusion linking the results with the objective.

28RESEARCH PAPER
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
5.1 INTRODUCTION
This chapter has discussed the validity of the results and draws conclusion by
linking it with the objective. Recommendations have been provided based on the
results so that the management of Charlotte House can use these recommendations
to reduce staff absenteeism. The future scope of the research has also been
discussed based on the limitation of the current study. The study has concluded with
providing personal reflection on learning outcomes.
5.2 KEY FINDINGS AND CONCLUSION
The purpose of the research is to investigate the impact of staff absenteeism
on the service users. The findings of the research show that majority of the
respondents have agreed to the fact that patients’ physical and mental conditions are
affected due to the lack of customized service and activities. Charlotte house has
been unable to operate effectively and completely provide personalised service to all
the patients. Staff absenteeism causes hindrances in patient progress which in turn
affects service quality and satisfaction of patient’s family. The question on increase
in patient’s aggressiveness showed that that 35% of the respondents have strongly
agreed to the question and 45% have agreed to the question. This shows that
majority of the families are facing issues due to the reduction in staffs. Moreover, the
replacements from agencies does not have the experience and skills to take care of
critical patients. They tend to leave due to the high level of stress and lack of coping
skills.
5.3 RECOMMENDATIONS
The research has been able to develop crucial findings and this section has
provided valuable recommendations that can be used by facilities of similar and the
given Care facility. The recommendations are as follows:
 Charlotte house should increase the compensation package of the staffs to
retain them
 Charlotte house should develop training and development programs for the
new care givers so that they can handle stress situations and critical patients
 Charlotte house should increase the number of care givers so that they have
plenty of staffs to handle situations on habitual absenteeism which requires
mass hiring of staffs.
5.4 FUTURE RESEARCH DIRECTIONS
The major limitation of the research is the limited sample population which
has increased the sample error. This is the reason that the research does not

29RESEARCH PAPER
represent the majority of the population. In future, the research should use minimum
of 1000 population to check the issue of absenteeism in all the care giving
organizations in United Kingdom. This would facilitate in developing better
generalizations with minimum sampling error. Moreover, the findings and
recommendations are developed based on the chosen case and may not hold true
for other organizations. Therefore, future studies conducted using similar methods
on other organizations would facilitate providing a different dimension.
5.5 REFLECTION ON OWN LEARNING
I have learned a lot on this topic and I have gained considerable amount of
knowledge on Alzheimer’s and dementia related diseases. I have been able to
understand the way a care giving organization works. I have little knowledge on data
collection and analysis methods and faced few issues in choosing the methods
appropriate for the research. However, I have gained knowledge about using mixed
method and use of statistical tools for conducting inferential statistics.
5.6 SUMMARY
This chapter has provided a suitable conclusion and recommendations based
on the research objective. This chapter has been able to address the issues faced by
Charlotte house and the recommendations can be used by management to solve
their problems.

30RESEARCH PAPER
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APPENDICES
APPENDIX 1
Questionnaire
1. Your Patient’s Gender?
a) Male
b) Female
2. Your Patient’s Age?
a) 50-59
b) 60-69
c) 70-79
d) 80-89
3. How far do you agree that you are satisfied with the staff service?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
4. How far do you agree that patient condition deteriorates due to lack of
staffs?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
5. How far do you agree that patient’s aggressiveness increases due to lack of
proper care?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
6. How far do you agree that lack of staffs reduces the patient’s involvement in
physical activities?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
7. How far do you agree that patients does not receive timely medicines?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
8. How far do you agree that patient’s progress is hindered due to lack of
staffs?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
9. How far do you agree that patient’s attachment to particular staff causes
lack of cooperation during his /her absence?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree

35RESEARCH PAPER
10. How far do you agree that patient’s ability to make decisions deteriorate
due to lack of care from staffs?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
11. How far do you agree that you face communication issues with the Health
care facility due to the lack of staffs?
a) Strongly agree b) Agree c) Indifferent d) Disagree e) Strongly disagree
Qualitative Questions
1. What are the problem faced by the care facility due to lack of staffs?
2. What are the possible impact of staff shortage on the patients?

36RESEARCH PAPER
APPENDIX 2
CONSENT FORM FOR INTERVIEWED PARTICIPANTS
I, the undersigned [please give your name here, in BLOCK CAPITALS]
…………………………………………………………………………………
Hereby freely agree to take part in the study entitled
The impact of staff absenteeism on service users: The case of Charlotte House
1. I confirm that I have been given a Participant Information Sheet giving particulars
of the study, including its aim(s), methods and design, the names and contact details
of key people and, as appropriate, the risks and potential benefits, how the
information collected will be stored and for how long. I have been given details of my
involvement in the study. I have been told that in the event of any significant change
to the aim(s) or design of the study I will be informed and asked to renew my consent
to participate in it.
2. I have been assured that I may withdraw from the study at any time without
disadvantage or having to give a reason.
3. In giving my consent to participate in this study, I understand that voice-recording
will take place and I have been informed of how this recording will be transmitted.
4. I have been told how information relating to me (data obtained in the course of the
study, and data provided by me about myself) will be handled: how it will be kept
secure, who will have access to it, and how it will or may be used.
Signature of participant …………………………………….……….... Date…
Signature of (principal) investigator…G ………...……… Date…
Name of (principal) investigator [in BLOCK CAPITALS please] …

37RESEARCH PAPER
APPENDIX 3
CODE OF CONDUCT
I, Student No: …, Student Name: …… undertake as follows:
1. To provide the organisation being researched with a written proposal for the
Project (with a copy to the tutor) confirming our understanding of:
a. The problem(s) to be investigated.
b. Intended methods of investigation.
c. The extent and timing of reimbursement (if any) of costs.
d. The name(s) of the primary contacts in at the organisation.
2. Whether the organisation name and financial support may be declared to
informants and other third parties.
3. To advise the organisation that the report may be seen by up to 4 examiners and
may be available to the public.
4. To protect all data lent or given by the organisation or generated during the
Project and to destroy such data after the Project is completed.
5. To operate at all times in such a way so as not to reflect discredit on the
University, its staff or students; and not to cause distress, embarrassment or
unpleasantness to any party whether before, during or following contact with same.
6. Not to use interviews to obtain basic subject understanding obtainable from
desktop research.
7. To be factually correct in all statements to, and honour all assurances made to
informants.
8. To preserve the anonymity of, and information about, informants unless they give
their express permission in advance.
9. Not to name any individuals in the report where this may be in any way prejudicial
to them.
10. To supply, should the informant require, the name of the interviewer(s), the
University and the Project tutor, clarification as to whom the results of the study will
be divulged.
11. To seek the Project Tutors’ advice and prior agreement before approaching
people under 18 years of age or anyone in circumstances which might make the
public suspicious or cause a reference to the police.

38RESEARCH PAPER
12. To respect the right of informants to withdraw their co-operation without notice or
reason at any stage.
13. Not to engage in sales approaches the compilation of lists for canvassing,
industrial espionage, attempts to influence opinions per se or inquiries about private
individuals per se.
14. Not knowingly to disseminate conclusions inconsistent with, or not warranted by,
the data and to use our best endeavours to restrain the dissemination by others of
such conclusions.
15. To ensure that it is made clear that the report was produced as part of an
educational programme and that neither the University nor its staff is responsible for
its contents, conclusions or recommendations.
SIGNED: …..
DATE: