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In early fiscal 2007, Japan's mass media reported on several important problems that occurred at companies involved in both the home nursing care and nursing home industries. Although the most important source of the problems was the ethical stances and approaches of the individual nursing care operators, it is also clear that there are three issues which are structural in nature, and in principle, they must be addressed by the industry as a whole.
The first of these issues relates to employment conditions in the industry. When the long-term care insurance system was first introduced in 2000, a large number of people were interested in working in this sector. However, the industry is still very immature, and no basic standards have been established with respect to working conditions or the general labor environment. The reality is that many prospective employees who enter the industry with high aspirations and good intentions become discouraged after working for just a few years, and leave their jobs in disgust.
A second problem relates to the nursing care market itself. Not only is Japan's population aging, but the needs of nursing care patients are becoming increasingly diverse, while their perceptions of value are becoming more demanding. Increasingly, customers are seeking conditions that allow them to live in an environment of their choice, while receiving certain care and services. Japan, however, still does not have many nursing care facilities which are flexible enough to allow each individual to “live well,” on their own terms.
A third problem involves the nursing care operators. Nursing homes and other facilities face both regulatory and personnel-related risks that prevent them from expanding for structural reasons, even if the businesses themselves are well run.
Because of these three issues, the nursing care industry in Japan faces the worst of all possible scenarios. Due to the structural and environmental conditions, nobody is really happy – not the operators, not the employees, and certainly not the elderly people who the industry is supposed to serve.

As we have noted, the nursing care industry faces three structural issues which can only be addressed by adopting solutions which make a break with past industry norms. As one of the leaders in this industry, Benesse Style Care has recognized that basic structural reforms are needed that will fundamentally change the industry, and its business model. The company has begun working to implement these changes, in order to attract highly motivated workers, and provide them with working conditions, responsibilities, and compensation/benefits that will allow them to provide quality services with a high degree of personal contact.
In October 2007, the company introduced a new personnel structure. Thereafter, it began to make related changes in the business model, work responsibilities, and the company's in-house training structure. The revisions to the business model placed primary emphasis on ensuring that nursing care patients will receive stable and reliable services. The company redefined work duties, revising the scope of responsibilities for nursing care staff. By increasing the amount of time that caregivers spend with each patient or resident, an “activity plan” can be drawn up and put into practice for each patient individually.
Benesse Style Care has made a particularly concerted effort to train nursing staff, to ensure that they can implement the “activity plan” for each patient. This program covers not only newly hired employees, but veteran staff as well. It is essential to make sure that everyone is thoroughly familiar with the basic guidelines of operations. Since the industry suffers from a very high rate of employee turnover, the training activities are also intended to help reduce turnover. When an employee leaves their job, this can be a serious blow to patients and a source of stress, particularly if they had developed a personal bond with the caregiver. It is also a major loss to the company when it loses a trained and experienced employee.
The company is focusing particular attention on the training of employees who join Benesse Style Care in mid-career. Regardless of the facility to which they are assigned, all employees receive a nine-day training course when they enter the company. They then receive one-day follow-up training after their third month, and after their sixth month on the job. Once they have been assigned to a facility or nursing home, they receive continuous on-the-job training which is adjusted according to their needs. This system has also had a very positive impact on the ratio of employee turnover.

• Although I had experience, we were taught entirely new ways of doing things, and I was amazed that there could be such easy ways to get the job done. I expect that the old ways of doing it were difficult for the patients as well.
• Although I felt a bit uncertain at first, I was able to make friends even outside the home where I work, and I feel like I am part of a team effort. Despite my uncertainties, I still want to try to do my best.
• Through this training program, I think I began to understand the corporate philosophy of Benesse. I am really thankful to have taken part in such a thorough training program.
• Everything was entirely new, and I don't think I could possibly remember everything we were taught. However, I think I gained a lot of confidence and I want to do my very best.
• Regardless of what happens, I want to try to do my best as I look forward to the next time I meet the people who were with me in the training program.

After a few months, as new employees become fully absorbed in the work they are doing at their nursing home, they begin to remember the processes they learned and the nervousness they may have felt initially starts to dissolve. At that point, they are able to take an objective view of the work they are doing. By the time they have been on the job for six months, some may begin to perceive a gap between the requirements of the work setting and their own skills and interests. They may be so focused on the situation at their own nursing home that they have difficulty taking a broader view. It is at this point that the company needs to step in and provide follow-up training and support. That is why we provide repeat training sessions three months after the employee joins the company, and again when they have been working for six months. Meanwhile, on-the-job training projects are conducted regularly, on a regional basis. We are constantly analyzing the training methods and tools, and trying out new techniques, in an effort to further improve quality, and we are constantly expanding this effort to carefully train the new personnel who join the company.

One aspect of the future in Japan is indisputable: it is destined to become a nation of old people. This can be a positive force for the country if we work to create a society in which the elderly – not only those who require nursing care, but also those who are self-sufficient – are able to live happier and more rewarding lives with each passing year.
To this end, Benesse is maintaining close communication with the regions and communities in which it operates. Even after people enter a Benesse Style Care facility as patients, they still retain connections to the local community, and we need to provide services that allow them to truly “live well.”
Our efforts are not restricted to the nursing care industry. We are developing systems of training employees that allow them to provide service with a high level of personal contact; this requires both a strong structural base and an effective education program. We are striving to become a company that makes valuable contributions to Japanese society, and is an indispensable part of the communities in which it operates.

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	Benesse is working to improve personnel policies and business models in the nursing care industry in an effort to help people “live well.”