Creating a Culture of Care

Health Care




United States


“We didn’t have a staffing crisis.  We had a culture crisis.”
-Kevin McKay, Tockwotton President and CEO


Tockwotton on the Waterfront is a non-profit, high-end senior living community with a rich history that dates back to 1856.  However, like many in their field, they have continually struggled with attracting and retaining caregivers.  

This challenge was only exacerbated when they more than doubled in size with a new campus –  jumping from 66 to 156 residents and from 85 to 210 employees.  The familial and intimate feel of Tockwotton was changing.  During that time, it was common to hear staff and residents say:

“We don’t know what’s going on like we used to” and “It doesn’t feel like the small family anymore.”  Tockwotton was experiencing 56% turnover, 75% call outs on daily shifts, and spending monthly $20,000 on overtime and $30,000 for a staffing agency.

To address their staffing and growth challenges, the leaders of Tockwotton reached out to Drive, a consulting company that specializes in helping senior living and healthcare organizations build high-performance cultures, to attract and retain the best talent and support their mission of providing patient-centered care.



Drive conducted focus groups with staff, residents, and their families to learn what was going well within Tockwotton to strengthen and build upon as well as areas for improvement.  Some of the stories shared emphasized that beyond the bottom line, their culture was impacting lives.  

A new resident named Ruth disclosed that over the course of three months she had been given a shower by 27 different staff members. “That’s 27 unfamiliar faces. 27 different sets of hands.  Not only was Ruth one overwhelmed new resident, but she said that is not what they told me would be the case. ‘They told me consistent care by a small number of staff,’” said Kevin McKay, CEO. 

A staff member shared, “We’re losing good people because they are burned out and frustrated.”  

With so many people calling out on a daily basis, others needed to work longer to pick up the slack. 

Clear trends emerged among the various voices, which were presented to leadership along with an action plan to support leadership development, employee engagement, performance management, and retention.    

The action plan started with a leadership retreat to build connections and explore possibilities.  From there, Drive conducted monthly interactive visits with leaders throughout the organization on foundational areas such as building trusting, accountability, how to have difficult conversations, and coaching. There were also sessions for staff to support communication and how to make decisions with residents’ top of mind.   

To find out how they were doing with their plan, they conducted a Culture Assessment first with the leadership team and then the whole organization, including residents and their families.

We finally had the data to show exactly what we needed to focus on.  Instead of throwing solutions at a problem that we didn’t truly understand, we could move forward with a strategic approach to addressing our culture issues which were having an impact on residents, staff, and the bottom line,” Kevin explained.  

Overall, the assessment results showed that Tockwotton’s culture was very healthy.  They had only 11% Cultural Entropy® and seven matching values between the Current and Desired Cultures.  There was remarkable consistency among the personal values of the various stakeholders of Tockwotton.  These were people who were caring and compassionate, demonstrated respect and accountability, and wanted to make a difference.



“Our leaders are doing more coaching, mentoring, and leading instead of just staying in their offices getting their work done.  We are all committed to move in the same direction focused on ensuring we are modeling the way and working together collaboratively to support each other and our teams,” said Kevin. 

In an incredibly short period of time, Tockwotton experienced: 

  • 43% decrease in annualized turnover accomplished in a year 
  • 60% decrease in 90-day turnover accomplished in nine months
  • 11% decrease in overtime
  • 37% decrease in agency usage, resulting in an annualized savings of $226,800. 

Most importantly, Tockwotton’s focus on culture and values has had a positive impact on residents. “Remember Ruth who was showered by 27 different people? One year later, when asked in a focus group what could be improved upon, the room was silent.  Ruth broke the quiet with, ‘The silence says it all,’” said Kevin. 

Learn more about Tockwotton’s journey by watching this webinar with Barrett Consultants and Healthcare Culture Experts, Denise Boudreau-Scott and Arleen Smith of Drive.