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Is the increase in the use of agency staff keeping care homes going?

Updated: May 10, 2023

As we begin a new year, I hope that 2023 brings with it a far better outcome for the social care sector and all those who work within it. As we look forward, it is hard to see any light at the end of the tunnel. We are confronted with more strikes by nurses, the NHS in a critical situation.


The provision of social care continues to be blighted by the difficulties in recruitment and retention of staff that has led to some providers handing back their contracts to local authorities and in some cases closing down altogether.


Some encouraging news


One bit of seemingly encouraging news for the care home sector however, is that reported staffing levels in care homes appear to have recovered in 2022, after a steep fall in 2021. There were 472,500 people working in care homes at the beginning of April 2021, which dropped to a low of 454,900 by the end of 2021 but increased to around 475,500 people by the end of September 2022.


Increase in the number of agency staff


It is less encouraging however, to note that much of this recovery seems driven by a sharp increase in the proportion of agency staff, rather than directly employed staff. While numbers of staff directly employed by adult care homes has only marginally increased since the beginning of this year, hovering just under 441,000, the total number of agency staff employed in care homes almost doubled between April 2021 and September 2022, from around 17,400 to 34,700.


These trends are indicative of problems experienced by care providers in recruiting and retaining staff. While the rates of people leaving the older age care home sector remain relatively stable, there are fewer new starters replacing them. Against the backdrop of rising occupancy levels, which dipped during COVID, and an uptick, in demand, vacancy levels are at an all-time high.


As a result, employers are increasingly resorting to using agency staff to fill gaps. Although it might be necessary to fill critical gaps, it comes with increased cost to providers, as well as a potentially detrimental impact on relationships and continuity of care for residents.


Failure of government to develop long term strategy


Care homes cannot continue to absorb increased costs for the use of agency staff at a time when they are being plagued with astronomical increases in the cost of energy. Something will have to give. The Government is fully aware of the situation but has failed to develop a comprehensive and long-term workforce strategy that addresses the underlying issues in the social care workforce.


Throwing money at the problem will on its own not solve the issue. One only needs to look at the critical situation the NHS finds itself in. Despite year-on-year billion-pound increases in funding to the NHS, the fundamental operational problems remain. Despite the government being aware of bed blocking in hospitals over 14000 patients are trapped on hospital wards where their care could be provided by services in the community. This is having a critical knock-on effect on A&E and other services provided by hospitals.


Summary


In the present situation one has to search very hard for any good news in the social care sector. On a positive note, there seems to have some stabilisation of staffing numbers in care homes towards the end of 2022. But this needs to be tempered by the knowledge that the number of agency staff almost doubled over this period of time. This situation cannot continue and unless we see more action from the Government, unfortunately, more care services will be handing back contracts to local authorities.


The crises in the NHS has shown that ploughing more money into the organisation will not solve the problem. What we need is a comprehensive and long-term workforce strategy that addresses the underlying issues that has bedevilled the social care workforce for so many years.


Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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