Factors on workforce retention in aged care: Reasons why staff stay or leave

This section outlines the key factors identified in the review, prioritised with input from the ARIIA Sector Reference Group and expert guest members, as crucial to retaining talent within aged care organisations.

• Each factor contains a brief description and summary of the review results, including workforce type and settings
• Implications from the evidence are noted in the section ‘Key findings and implications’
• Practical tips are provided in the section ‘What can be done?’.

Where possible and if there is evidence and a resource available, each factor is linked to a relevant strategy or a resource that may help in improving the factor and consequently improve retention. 

Understanding the factors that influence workforce retention is essential for developing effective strategies to improve staff retention, reduce turnover, and foster long-term organisational commitment. By examining possible influences, a better insight can be gained into the complex interplay of factors that drive staff members’ decisions to stay or leave.

Job control and autonomy refers to staff having the ability to use their professional judgment and make decisions about their daily tasks. [1] In the aged care sector, this might involve a staff member deciding how best to respond to a resident’s needs to suit specific preferences. It also includes autonomy over how shifts are organised and how workload is managed. In a recent Australian study, staff in larger, for-profit aged care organisations often feel they have less autonomy due to strict routines or lower staffing levels. [2] For instance, care workers in such settings reported lower job satisfaction and higher turnover intentions, partly because of lack of autonomy and heavy workload. Conversely, work environments that encourage autonomy can empower staff to act in the best interest of residents, make real-time decisions, and contribute their skills to positive work culture. 

The job control and autonomy theme included the following indicators reported in the reviewed literature: 

• Choice of clients and locations/freedom of choice 
• Flexibility 
• Independence in work 
• Schedule control
• Work latitude; selection, optimisation and compensation strategies 

Summary of results 

Better job control and autonomy was consistently linked to better retention overall (including higher intention to stay, higher job satisfaction, lower intention to leave). 

• Workforce type reported in the reviewed literature: nurses, personal care workers, allied health professionals, managers, home support workers.
• Settings reported in the reviewed literature:  long-term aged care residential settings, mixed settings, home care settings.  

Key findings and implications

Our review findings show that when staff in aged care sector have more control over their schedules and have flexible working conditions, they are more likely to stay in their jobs and less likely to think about leaving. Studies by Gleason and Schwendimann found that staff who felt trusted to make decisions reported more satisfaction and a stronger connection to their work. [3, 4] Similarly, the results from a study by Ruotsalainen show that greater autonomy in daily care tasks contributed to higher job satisfaction among long-term care staff. [5] These findings show that when aged care workers have control over how they deliver care, they are more likely to stay in their jobs. Other studies, however, show that when workers had little or no control over shift scheduling or task planning, they felt more burnt out and unhappy in their roles. Also, controlling supervision was linked to higher intention to leave, as workers felt unsupported, undervalued, or unfairly treated. Controlling supervision refers to closely monitored or rigid leadership style, where staff have little autonomy or input in decision-making, resulting to frustration and low job satisfaction.  [6, 7, 8]. 

What can be done? 

• Managers can open discussions with staff about preferred work times. A practical guide to support these conversations is available in the NSW Health Rostering Resource Manual, which can be adapted for the aged care context.
• Give staff more choice and control over their rosters by allowing them to choose, change, or swap shifts. Talk with staff about the work hours that suit them best, as this can improve work-life balance. When rosters match people’s needs, it can make them more likely to stay.  
• Check examples of strategies to improve job control and autonomy here. The flexible working arrangements in residential aged care program, collaborated with staff to adjust shift patterns, allowing for greater autonomy and control over work schedules. This approach led to higher job satisfaction and better retention.

Job satisfaction reflects how positively staff feel about their work overall, and it goes beyond simple enjoyment. [2] It is shaped by a combination of factors: whether staff feel they are doing meaningful work, whether their efforts are recognised, and whether the work environment supports their wellbeing. It also involves having a manageable workload, a sense of safety, fair pay, and opportunities for professional development. Just as importantly, it includes elements such as time for connecting with residents and colleagues, a sense of belonging in the team, and pride in the care service. Job satisfaction is an ongoing indicator of whether the workplace enables staff to thrive and grow in their roles. In broader workforce, job satisfaction has consistently been linked to reduced turnover, better performance, and improved wellbeing. [9]

The job satisfaction theme included the following indicators reported in the reviewed literature:

• Job satisfaction
• Self-satisfaction from caring

Summary of results

Job satisfaction was consistently linked to better retention overall (including intention to stay, lower turnover and intention to leave).

• Workforce type reported in the reviewed literature: nurses, personal care workers. 
• Setting type reported in the reviewed literature: long-term aged care residential settings and mixed care settings.

Key findings and implications

Our review findings suggest that job satisfaction in the aged care sector is closely tied to whether staff are given the right conditions to provide high quality care. Employee satisfaction increases in environments with clear and open communication and strong support. It also stems from feeling like a valued team member and building meaningful relationships with both colleagues and residents. They become more confident to deliver the care that residents deserve. [10,11] When employees are rushed, excluded from decisions, or unable to do their jobs properly, even supervisor support will not make them stay. [10] To improve satisfaction and retention, organisations must focus on the everyday experience of care work by creating the conditions that allow staff to feel capable, valued, and proud of what they do.

What can be done? 

• Celebrate small wins and everyday efforts. A thank-you board and/or simple acknowledgments from managers can build a positive atmosphere where people feel proud to stay. 
• Remove frustrating tasks that don’t add value. Job satisfaction drops when staff feel restricted by paperwork or rules that interfere with proper care. 
• A range of strategies can be implemented to improve job satisfaction: 
  1. Offer training in communication, conflict resolution, emotional support, and rostering; encourage team leaders to notice staff efforts, not just outcomes, 
  2. Empower care workers with knowledge and confidence about their role, 
  3. Support staff to manage challenging behaviours in care, 
  4. Involve care staff in team decisions or service planning; this increases the sense of value and control, which are key for job satisfaction, 
  5. Give staff more control over their schedules; flexible scheduling options such as self-rostering and flexibility to swap improve work–life balance, 
  6. Help staff manage emotional fatigue with simple self-care strategies. 
  Details of these strategies can be found here. 

Effective leadership in the aged care sector means that managers and senior staff can build trust, create a safe workplace, and help employees feel that they are working towards a shared goal. [12] It involves clear and respectful communication, being consistently supportive, and treating staff fairly. Leadership style that focuses on good relationships, open communication, and mutual respect leads to better work experiences and higher morale. [13] Wong and colleagues describe a leadership style known as ‘authentic leadership,’ where leaders act consistently with their values and communicate openly. [14] Good leadership also means listening to staff concerns, providing the resources needed, and creating a safe and supportive place to work. [15, 16] So, being a good leader is not only about being in charge of a team but about building strong relationships and making sure staff have what they need to do their jobs well and feel good about staying. [17]

The leadership theme included the following indicators reported in the reviewed literature:

• Leadership quality/style 
• Participative leadership 
• Resonant leadership 
• Staff perceptions of management 
• Transformational leadership

Summary of results

Strong and supportive leadership was consistently linked to better retention overall (including intention to stay, job satisfaction and lower turnover). 

• Workforce type reported in the reviewed literature: personal care workers, nurses, managers, allied health professionals.
• Setting type reported in the reviewed literature: long-term aged care residential settings, mixed settings, and home care settings. 

Key findings and implications

Our review findings show that strong and supportive leadership consistently contributes to higher staff retention in aged care. Across the studies, staff were more likely to stay when leaders helped them manage the emotional demands of the job, work well with others, and cope with heavy workloads. The literature emphasised that it is not about the tasks leaders perform, but the way they treat their staff. What made a real difference was how leaders responded when challenges came up, whether that meant listening to staff concerns, stepping in to resolve conflict, or making sure workers felt capable and valued in their roles. For example, a study by Goel found that workers felt encouraged to stay in their jobs when they experienced fair treatment and recognition of their efforts, particularly among migrant staff. [6] In a study by Dys, mentoring and clear guidance from supervisors helped reduce frustration and confusion, whilst a study by Xie suggested that good leadership buffered the impact of understaffing. [18, 19] Together, these studies showed that supportive leadership does not remove all the pressures of care work, but it makes staff feel less alone and encourages them to stay in their job.

What can be done?

• Equip leaders with short, actionable resources (e.g. conversation guides, reflection templates) to help manage team dynamics and prevent issues from escalating. This Reflective Practice Tip Sheet for Supervisors and Workers from NDIS may be useful. 
• A range of strategies can be implemented to help improve leadership: 
  1. Provide regular leadership training focused on effective communication, conflict resolution, and staff support skills, not just task management
  2. Ensure supervisors conduct check-ins with staff at least monthly to identify concerns early and build trust. 
  3. Introduce team building practices, such as end-of-week team reflections or huddles that may be adapted to facilitate reflective practice. 
  4. Involve staff in small decision-making groups, giving them shared ownership of goals and outcomes. 
  5. Encourage supervisors to track and act on workload concerns. A leadership program that builds this skill can help prevent burnout and turnover.
  Details of these strategies can be found here. 

Salary refers to how much aged care workers are paid, how their pay is set up, and whether it feels fair. It includes base pay, bonuses, allowances, and how wages are calculated (such as hourly versus salaried, or accounting for experience). [6] In the context of aged care sector, salary is not only about the amount earned but also what workers think about their pay in relation to their workload, responsibilities, and colleagues. If employers believe their compensation is unfair, not reflective of their efforts, or inconsistent with others doing similar work, intention to leave may increase, even if they value other aspects of their job. [7]

Recent data reflect this concern. The 2024 Aged Care Worker Survey found that 40% of workers were dissatisfied with their total pay, despite 64% being satisfied with their work overall. [20]

The salary theme included the following indicators reported in the reviewed literature:

• Compensation system
• Financial stability (having a job) and job availability
• Pay/wages/low pay
• Unfair wage system

Summary of results

Higher pay, regular wages, or improved pay systems were consistently linked to better workforce retention overall (including higher intention to stay, lower turnover and lower intention to leave). However, the link between salary and job satisfaction was less consistent, as two studies found that better pay improved job satisfaction, but one review reported no relationship.

• Workforce type reported in the reviewed literature: nurses, personal care workers, allied health professionals, managers/administrators, home support workers, academics, aged care volunteers.
• Setting type reported in the reviewed literature: long-term aged care residential settings, mixed settings, community aged care settings, and home care settings.

Key findings and implications

Our review findings show that low or unfair pay contributed to higher turnover and difficulty retaining staff, especially when wages did not reflect workers’ responsibilities or experience. However, the connection between salary and job satisfaction was less direct. [6, 7] The results suggested that whilst fair pay is essential for keeping staff, it may not be enough on its own to ensure they feel satisfied in their roles. A worker can be paid well, but if the workplace is stressful or staff do not feel respected, the pay is not enough to keep the workers long-term. [6, 8] Many studies showed a link between a higher salary and job satisfaction. However, some aged care workers reported feeling satisfied in their jobs even if they were not happy with the pay. [3, 7] This can be because other parts of the job are fulfilling, for example, building strong relationships with residents, feeling part of a supportive team, or knowing they are making a real difference in people’s lives. For some workers, these emotional and social rewards may matter more than money. Factors that may make the staff satisfied include flexible hours, a good work-life balance, and strong support from managers. [21, 22]

What can be done?

• Be transparent about how pay is structured. Workers are more satisfied when they understand how their wages are determined and whether there are opportunities for increases.
• Offer consistent hours and income stability. Predictable rosters and reliable shifts can reduce financial stress and help workers stay longer.
• The Australian Government Pay and Conditions Tool is a useful resource for both employers and employees to understand and calculate minimum pay rates and entitlements under the Fair Work system.

Skill mix refers to the combination of different types of professionals working together in aged care sector, for example: registered nurses, enrolled nurses, supervisors, care assistants, or allied health professionals. It refers to having the right mix of qualifications, training, and expertise to meet the complex needs of aged care residents. [4]

A well-balanced mix of skills and staff allows for better coordination, more specialised care, and safer decision-making, especially when workers from different disciplines can contribute their strengths as part of a team. For example, the presence of nurses or multidisciplinary teams can reduce the strain on care staff. Our findings reveal that when staff feel supported by qualified team members, job satisfaction tends to improve, and turnover is reduced. [8]

On the other hand, a poor skill mix can lead to stress, burnout, and reduced care quality. This issue is especially pressing in aged care facilities that rely heavily on care workers without enough clinical supervision. Creating the right skill mix is essential to the sustainability of the sector. [23]

The skill mix theme included the following indicators reported in the reviewed literature:

• Multidisciplinary care
• Presence/absence of a nurse practitioner

Summary of results

Having a mix of staff skills was consistently linked to better intention to stay overall (including higher job satisfaction and lower turnover).

• Workforce type reported in the reviewed literature: nurses, managers, personal care workers, allied health aged care workers, aged care volunteers, policy and planning employees.
• Setting type reported in the reviewed literature: long-term aged care residential settings, mixed settings, community care settings, and home care settings. 

Key findings and implications

Our review findings show that having a good mix of skills and roles in the aged care team helps staff feel more supported and satisfied in their jobs. When teams include people with different levels of training and areas of expertise, it can ease pressure on individuals, improve care for residents, and create a better working environment overall. A study by Rao showed that when roles are clearly defined and teams work well together, such as in multidisciplinary care models or where nurse practitioners are present, staff felt more confident, valued, and less overwhelmed. [24] This was true across various settings, including aged care homes, community services, and home care. The right skill mix is not only about qualifications; it is about creating a supportive team where everyone knows their role and can rely on each other. This kind of team environment helps keep people in the job.

What can be done?

• Ensure work roles are defined, and tasks are clear, to avoid mistakes and frustrations in the team. Use visual tools like skill mix dashboards or role maps to clarify who is doing what. For more information, read the section on ‘work role and clarity’. 
• The Australian College of Nursing Position Statement discusses key issues about skill mix and provides recommendations to address the issues. 
• A range of strategies can be implemented to maximise a mix of different skills:
  1. Assign tasks by skill level. Ensure enrolled or registered nurses are focused on clinical responsibilities, whilst care workers handle personal care tasks — this acknowledges everyone’s qualifications and avoids role confusion.
  2. Ensure handovers and shift planning are conducted in mixed teams. Having senior and junior staff collaborate on daily priorities strengthens knowledge-sharing and helps new staff feel supported.
  3. Pilot 'buddy systems' where experienced staff are paired with newer or less-qualified workers once or twice a week, especially during onboarding. This builds confidence and reduces early turnover.
  4. Regularly review team composition and ask staff for feedback on skill mix. Are workloads fairly shared? Are tasks being delegated to the right level?
  Details of these strategies can be found here. 

Staffing relates to having enough workers with the right skills and secure employment conditions to deliver safe and reliable care. The studies in our review examined staffing not only in terms of the number of staff rostered per shift, but also their qualifications and training. Some of the important conditions for experiencing better staffing include positions that are permanent rather than casual, predictable rosters, and good leadership showing support and communicating effectively. Therefore, in the context of workforce retention, staffing is not only about adequate numbers of staff but also about stability, continuity, and clarity in how work is organised and supported. [23, 25]

The staffing theme included the following indicators reported in the reviewed literature:

• Adequate staffing 
• Casual contract 
• Hours of work 
• Organisational slack – staff 
• Permanent contract
• Staffing shortages

Summary of results

Adequate staffing levels did not contribute to better retention overall (including turnover and intention to leave) but it was consistently linked to higher job satisfaction.  

• Workforce type reported in the reviewed literature: nurses, personal care workers, allied health professionals, managers, home support workers, aged care volunteers, policy and planning.
• Setting type reported in the reviewed literature: long-term aged care residential settings, mixed settings, community aged care settings.

Key findings and implications

Our findings indicate that the staffing factor did not consistently lead to better retention. This means it was not clearly linked with lower turnover or fewer intentions to leave. However, it was strongly associated with higher job satisfaction. This means that even if better staffing does not directly stop people from leaving, it makes a big difference to how they feel about their work. Across the reviewed studies, aged care workers described how short-staffed shifts, casual or rotating positions, and constantly changing teams made their jobs more stressful and less rewarding. In Creapeau and colleagues' study, certified nursing assistants said they felt worn out and disrespected when there were not enough people to share the workload. They reported greater satisfaction when roles were clearly defined, and team communication was also clear. [8] The study by Gaudenz found that emotional exhaustion was more common when staffing levels were low; and this exhaustion was strongly linked to wanting to leave the job. [23] In another study, aged care homes with high turnover often had poor staffing structures, unclear expectations, and an overreliance on temporary workers, which damaged teamwork. [26] Cavanagh’s review of available literature confirmed that job security and stable team structures are very important. When staff had permanent contracts and predictable rosters, they felt more confident, satisfied, and connected to their roles. [25]

In summary, whilst good staffing may not guarantee retention, it helps create the conditions for it. Employees are more likely to stay when they feel supported by positive leadership and when their work is manageable. Offering permanent roles, keeping teams consistent, and improving team communication are all practical steps recommended for better workforce retention.

What can be done?

• Prioritise permanent roles over casual or agency staff to improve job security and build a more committed team.
• Avoid chronic understaffing by actively monitoring workload pressure and creating systems for relief. 
• A range of strategies can be implemented to address staffing concerns:
  1. Strengthen communication and role clarity by making expectations clear, listening to staff concerns, and providing supportive leadership.
  2. Use short, structured team huddles to help staff manage busy workloads and avoid feeling overwhelmed.
  3. Offer flexible but fair rosters with input from staff. 
  Details of these strategies can be found here. 

Training and opportunities refers to providing aged care staff opportunities to improve their skills and grow in practice. This can include learning how to care for clients with complex needs, improving communication and teamwork skills, or getting support to move into leadership roles. There is evidence showing that training opportunities help employees to feel more confident, valued, and supported. [27, 28] According to the 2021 Home Care Employee Retention Survey, training and development was seen as the most important way to improve staff retention, with over 40% of employers saying it was their top priority. This was followed by improvements in scheduling (26%) and communication (22%). [29] It also shows that the organisation is willing to recognise its staff's potential and invest in their future. This in turn, can increase commitment and job satisfaction.

The training and opportunities theme included the following indicators reported in the reviewed literature:

• Career advancement/development or lack of
• Opportunities for further study
• Promotion opportunities
• Training or lack of training opportunities

Summary of results

Training and career opportunities was consistently linked to better retention overall (including higher intention to stay, higher job satisfaction, and lower turnover).

• Workers in the reviewed literature included: nurses, personal care workers, allied health professionals, managers/administrators, a home support worker, and an academic.
• Settings in the reviewed literature included: long-term aged care residential settings, mixed settings, community aged care settings, and home care settings.

Key findings and implications

The findings across the studies reviewed show how much aged care staff value access to training and skill-building opportunities. A study by Lim and colleagues showed that when staff lacked proper training and supervision, they did not feel equipped to manage complex client needs, which led to feelings of stress and insecurity. [7] In a study by Creapeau and colleagues, aged care workers emphasised that ongoing development was not only about learning and improving skills, but it also made them feel recognised and increased their willingness to stay. [8] Similarly, in Rao’s study, nursing leaders who received mentoring, coaching, or guidance felt more supported and were more likely to remain in their roles.  Many said they lacked formal leadership training and needed help building their confidence and skills. [24] In another study, allied health workers in aged care reported that training and development opportunities made their jobs more rewarding and helped them see a future in the role. [30] When those opportunities were missing, especially in rural areas, workers were more likely to consider leaving. Together, the studies consistently show that learning opportunities help staff feel more confident, motivated, and committed to staying. In Goel’s study, immigrant care workers expressed frustration when training was unavailable, particularly when language and communication support were lacking, making it harder to perform their jobs well and feel included. [6] In summary, the results show that offering development opportunities can strengthen staff capabilities as well as reinforce that they are worth investing in. 

To improve retention, aged care organisations could provide regular, supported training in everyday work, ensuring staff feel valued, equipped, and able to grow within their roles.

What can be done? 

• Support on-the-job learning by pairing less experienced staff with experienced mentors and encourage team leaders to give feedback and recognition.
• A range of strategies can be implemented to improve training and opportunities:
  1. Make learning and professional development part of the job, not an added burden. Integrate regular, paid training time as part of the roster.  
  2. Create clear development pathways by offering short courses, mentoring, or step-up roles that show staff how they can grow within the organisation.
  Details of these strategies can be found here. 

Work and role clarity describes how well staff understand what their job involves; what they are responsible for, what tasks they need to do, and where their role begins and ends. When duties are unclear or overlap, (especially between nurses and care workers) it can lead to stress, mistakes, and frustration. However, when people know exactly what is expected of them, they tend to feel more confident, less anxious, and more satisfied with their work. This clarity also helps teams work more smoothly together because everyone understands their place and purpose. Studies show that clear roles reduce confusion and make staff more likely to stay in their jobs. [31]

The work and role clarity theme included the following indicators reported in the reviewed literature:

• Role conflict 
• Role heterogeneity
• Task identity 
• Unclear scope of work

Summary of results

Better work and role clarity was consistently linked to better retention overall (including higher job satisfaction, lower turnover, lower intention to leave).

• Workers in the reviewed literature included: nurses, personal care workers, and managers/administrators.
• Settings in the reviewed literature included: long-term aged care residential settings, mixed settings with home care included.

Key findings and implications

Whilst the studies were scarce (and a US study focused only on nursing home administrators’ perspectives), the message is still important: clear roles help prevent confusion and support a more stable workforce in aged care sector. Results from a study by Rahnfield confirm this and show that clearly defined work structures make employees feel more confident and secure. [32] This is especially important in multidisciplinary teams, where coordinated roles are essential. On the other hand, Nelson and Lim found that staff reported higher stress and a stronger desire to leave when job expectations were not clear. [7, 33] In Lim’s study, unclear job responsibilities and role boundaries were linked to emotional exhaustion and lower job satisfaction, which increased the likelihood of staff wanting to leave. The results from the study by Nelson showed that when job roles were poorly defined, staff felt overwhelmed and disconnected from their work. These insights suggest that role clarity not only supports performance but also protects staff wellbeing and retention. [7, 33]

Unclear or conflicting job expectations contribute significantly to emotional exhaustion, stress, feeling of being incompetent, and higher intentions to leave, particularly in high-demand care settings. Clear role definitions, consistent communication, and supportive leadership are recommended for better retention over time. [34]

What can be done? 

• Set clear role boundaries and manageable expectations to reduce emotional overload and confusion, which are key drivers of turnover.
• Make sure every staff member knows exactly what their responsibilities are and who to ask for support. For instance, use simple job descriptions, team briefings, and clear reporting lines to avoid confusion and promote role clarity.
• Check examples of strategies to improve work and role clarity here. The 'Empowerment Program for Certified Nursing Assistants' was a 10-month program that supported nursing assistants in understanding their roles more clearly within the organisation. It included training on communication, organisational systems, and sector developments. Participants reported better understanding of their responsibilities and how to work effectively within their teams. 

Workplace culture is shaped by how people interact, how safe and respected they feel, and how well they work together as a team. In aged care, a positive workplace culture isn’t just about having good policies, it is about fairness, open communication, and being able to speak openly without judgement. Studies show that staff are more likely to stay when they feel genuinely valued. [5, 35] A study by Perreira found that emotional comfort (feeling cared for, understood, and treated with kindness) is just as important as practical support. [10] As one worker shared, 'It’s not just about doing the tasks, it’s about feeling like someone sees you and cares.' In aged care, a positive workplace culture lays the foundation for keeping staff and improving job satisfaction.

The workplace culture theme included the following indicators reported in the reviewed literature:

• Communication/effective communication 
• Fairness 
• Respect 
• Voices being heard 
• Workplace characteristics
• Workplace culture/environment
• Work effectiveness
• Workplace safety

Summary of results

Good workplace culture was consistently linked to better retention overall (including higher intention to stay, higher job satisfaction, and lower turnover and intention to leave).

• Workers in the reviewed literature included: nurses, personal care workers, allied health professionals, managers/administrators, one home support worker, an academic.
• Settings in the reviewed literature included: long-term aged care residential settings, mixed settings, community aged care settings, and home care settings.

Key findings and implications

The studies reviewed show that staff are more likely to stay when they feel respected, included, and supported at work. A positive culture, with approachable leadership, a friendly atmosphere, and adaptable work practices, was consistently linked to higher job satisfaction and retention. For example, a study by Gao found that aged care staff were more likely to stay in their jobs when they felt listened to and genuinely valued by supervisors and colleagues. [30] The results from a study by Goel highlighted the importance of respectful communication and inclusive environments, especially for immigrant care workers. [6] And in the study by Perreira positive relationships with residents and staff and working in home-like environments increased staff retention. [10] Together, these findings suggest that positive workplace culture – meaning recognising staff contributions, improving communication, offering flexible scheduling, and building a warm, respectful environment – can directly strengthen workforce stability in aged care.

What can be done? 

• Build team trust by investing in regular opportunities for staff to talk, reflect, and connect across roles. Communication only at handover is not enough to build a positive workplace culture.
• Make it easy and safe for staff to speak up and share ideas. 
• Recognise staff contributions consistently and meaningfully (e.g. public praise, small celebrations, or staff-led initiatives that integrate) can help create a culture of value and belonging.

Workplace relationships refer to everyday interactions staff have with co-workers, supervisors, and managers. These relationships involve trust, mutual respect, clear communication, and the ability to work through challenges together. Strong, supportive relationships build the emotional environment in a workplace and influence whether staff feel heard, valued, and safe. A review on positive and negative behaviours in workplace relationships by Almost and colleagues found that collaborative and respectful relations contribute to lower stress, better job satisfaction, stronger teamwork, and improved patient care. [36] Similarly, a review by Fitzpatrick highlights workplace relationships as a key part of a “positive practice environment” that contributes to retention, especially when paired with good leadership and opportunities to learn and grow professionally. [37] In short, when staff feel genuinely connected to their team and supported in their roles, they are more likely to enjoy their work and stay committed to their organisation.

The workplace relationships theme included the following indicators reported in the reviewed literature:

• Collaboration and teamwork
• Co-workers
• Workplace/working relationships

Summary of results

Workplace relationships was consistently linked with better retention overall (including higher intention to stay, higher job satisfaction, and lower turnover and intention to leave). 

• Workers in the reviewed literature included: nurses, personal care workers, allied health professionals, managers/administrators.
• Settings in the reviewed literature included: mixed aged care settings including home care.

Key findings and implications

Across the studies reviewed, strong team collaboration, respectful communication, and supportive supervision were consistently linked to higher retention. These findings suggest that fostering a culture of mutual respect and positive teamwork not only boosts morale but also directly supports workforce stability. Our findings suggest that positive workplace relationships go beyond simply “getting along” with colleagues. What truly matters is the quality of these relationships, such as feeling heard by supervisors and being able to contribute and communicate openly. For example, in a study by Goel, staff working in culturally diverse aged care settings felt more motivated to stay when they were included in team decision-making. [6] In contrast, when communication was poor or staff felt excluded from decisions, intention to leave increased. [38] These findings highlight the importance of cultivating strong, inclusive team dynamics.  A study by Bethell highlighted a link between supportive supervision and significantly reduced risk of staff leaving, especially when employees felt their efforts were acknowledged. [11] Similarly, studies by Ruotsalainen and Xie showed that positive staff relationships are closely linked to job satisfaction, and that creating a caring, inclusive atmosphere can strengthen the bonds and improve retention. [5, 19] To improve staff retention, aged care providers should prioritise building respectful, trust-based workplace relationships by training supervisors in supportive leadership and encouraging open communication across all levels.

What can be done? 

• A range of strategies can be implemented to improve workplace relationships:
  1. Give team leaders a simple weekly checklist to ask staff how they’re going, what support they need, and follow up.
  2. Pair up new or less experienced staff with a consistent buddy/mentor for their first few months to build trust and confidence.
  3. Set up a short 10-minute team huddle at the start or end of shifts to raise quick concerns, share small wins, and boost team connection.
  Details of these strategies can be found here. 

Factors that did not make it in the priority list but are equally important are detailed in the report, which will be available soon. These include benefits, burnout, commitment, organisation characteristics, physical health problems, infection control, job demands, job fit, job market factors, personal drivers, psychological load, recognition, resources, social capital, societal factors, staff perceptions, stress and support. 

This summary draws on a review of the existing literature, where evidence around the most definitive factors is still being explored. No formal assessment of study quality was undertaken. Whilst the research team carefully compared findings across studies to identify common patterns and themes, the results should be interpreted with caution. 

The identified factors and associated findings provide a broad overview of possible influences on outcomes. It is important to acknowledge that the decision to stay or leave a job cannot be attributed to a single factor but to various factors at play across the individual, organisational and environmental levels.

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