Last week we reported on the Care Quality Commission’s (CQC) annual report “The state of health care and adult social care in England 2022/23”. We identified that it made grim reading not only for providers of health and social care, but also for service users and patients.
We saw that the headline features of the report were the growing backlog of patients waiting for treatment with the financial pressures on social care adding to the difficulties faced in discharging patients from hospital. We also saw that social care providers are saying they are struggling to pay staff wages as well as with recruitment and retention despite reported vacancy levels falling by over a third, to 7%, since the last report.
Various elements of the CQC report resonate with Skills for Care’s (SfC) "The state of the adult social care sector and workforce in England”, also published in October, especially as the SfC report has much more detail around staffing issues.
With the number of providers closing in the last year because of resource issues, mainly to do with staffing and costs, this blog will consider what these reports means for staffing in social care across the board.
The adult social care workforce
It appears that once again social care is at a point when we seriously need to consider the long-term shape of the workforce. Professor Martin Green of Care England makes the worrying and poignant observation that despite the recruitment of 70,000 new staff from overseas into social care, the workforce has grown by only 13,000. What this means is that 57,000 UK staff have left the sector during 2022-2023; a situation which is wholly unsustainable.
Skills for care make the troubling observation in their report, that turnover in the sector runs at about 29-30% with almost 50% of all workers having been in ASC less that three-years. What this suggests is that there is a dearth of experience within ASC at a time when the demands placed on it are continuing to grow. It also suggests that many people see social care as a worthwhile career choice, but that the realities of the sector are driving people out.
Pay has always been contentious and challenging in ASC. With SfC presenting the statistic that the median care worker pay is £10.11ph which in real terms is 35p less per hour than a year ago. It is little wonder therefore that social care is not seen as a career choice by many. This figure suggests that care staff are grossly undervalued and perhaps explains why the average carer has been in the role a mere five years.
Despite being the safety net qualification for carers, SfC’s report identifies how more than half of all carers have not completed the care certificate with a similar number having no relevant qualifications at all. This talks to the fact that too many employers are not investing in their staff perhaps because they do not have the confidence that staff will stay in post and therefore their money and time investment would be wasted.
We know that training both improves the quality of care and in professions which require qualifications for entry, e.g. nursing, professionalisation is one of the keys to regulation on the one hand and better pay and defined career progression on the other. This does beg the question as to whether part of the way out of the current situation is better, more consistent education and training across the sector.
What does this mean?
Sadly what all this means is that the care sector remains on a downward spiral at a time when the demands being made of it are increasing not only in numbers but also complexity. It suggests that carers feel undervalued and uncared for and that they are seeking to realise their worth elsewhere, e.g. in the retail sector where pay and conditions are often better.
The lack of any real vision for social care is a real concern, with many commentators identifying the unsustainable nature of overseas recruitment to fill the staffing gap. It means that carers do not see care as a realistic career choice because pay, conditions and personal and professional development are at best hit and miss. It means that social care remains the Cinderella service when compared to health which is itself in crisis.
The state of care and state of staffing reports highlight yet again that there is a need for a consistent and realistic workforce plan which covers the whole of social care. Such a plan needs to span the breadth of provision including public and private provision and the multitude of settings in which ASC takes place.
The current lack of consistency in training, status and pay makes the sector unnecessarily volatile. Care staff do not know where they stand with regards to their career path and employers are often left confused by mixed messages from professional groups, local authorities and regulators regarding staffing requirements such as numbers as well as skills and training requirements.
There are clear messages emerging from both reports around the need for an urgent review of social care staffing, pay and training which is non-partisan and which considers the wellbeing not only of people in receipt of care, but also of the burgeoning 1.635m social care workforce.
As a quality consultancy, Bettal cannot solve your recruitment and retention woes, but what we can do is provide solid policies and procedures, including on recruitment and retention as well as staff development. This in turn frees up time for you to concentrate on the things that matter to you.
To find out how Bettal’s can help your business with our CQC-compliant quality management system, browse our website, or get in touch:
Peter Ellis MA MSc BSc(Hons) RN
Bettal Quality Consultancy