Background The health and social care sector (HCS) is currently facing multiple challenges across Europe: against the background of ageing societies, more people are in need of care. Simultaneously, several countries report a lack of skilled personnel. Due to its structural characteristics, including a high share of part-time workers, an ageing workforce, and challenging working conditions, the HCS requires measures and strategies to deal with these challenges. Methods This qualitative study analyses if and how organisations in three countries (Germany, Finland, and the UK) report similar challenges and how they support longer working careers in the HCS. Therefore, we conducted multiple case studies in care organisations. Altogether 54 semi-structured interviews with employees and representatives of management were carried out and analysed thematically. Results Analysis of the interviews revealed that there are similar challenges reported across the countries. Multiple organisational measures and strategies to improve the work ability and working life participation of (ageing) workers were identified. We identified similar challenges across our cases but different strategies in responding to them. With respect to the organisational measures, our results showed that the studied organisations did not implement any age-specific management strategies but realised different reactive and proactive human relation measures aiming at maintaining and improving employees’ work ability (i.e., health, competence and motivation) and longer working careers. Conclusions Organisations within the HCS tend to focus on the recruitment of younger workers and/or migrant workers to address the current lack of skilled personnel. The idea of explicitly focusing on ageing workers and the concept of age management as a possible solution seems to lack awareness and/or popularity among organisations in the sector. The concept of age management offers a broad range of measures, which could be beneficial for both, employees and employers/organisations. Employees could benefit from a better occupational well-being and more meaningful careers, while employers could benefit from more committed employees with enhanced productivity, work ability and possibly a longer career.