Overview
Over the next decade, the need for social care workers is projected to grow substantially, largely due to an ageing population creating greater demand. Adequately funded, high quality adult social care is vital to support the lives of service users and their families. Adult social care workers can have a hugely positive impact on the lives of service users and their families.
Labour shortages have worsened since Brexit and the Covid-19 pandemic. These shortages have resulted in unmet care needs and delays in the acute care system as patients cannot be discharged from hospitals due to lack of community care facilities. Such problems negatively impact service users’ quality of care. The wellbeing of the workforce has also suffered where provider organisations are short-staffed over an extended period of time.
Key recommendations
Adult social care provides a vital service for people of all ages to live as independently and safely as possible in a supported environment. With demand for care services expected to increase due to the ageing of society and growth in chronic conditions it is paramount to provide the conditions for the social care sector to grow to meet the current and future demand. However, social care has long been underfunded. Despite recent increases in funding, more is required to meet the predicted demand and any additional funding needs to feed through the commissioning process to reach the social care workers in order to ultimately benefit those being cared for.
Good quality, fairly valued and rewarded jobs are essential to making this happen and to provide high quality care valued by service users. To deliver these better-quality jobs that will help deliver better quality care, we make the following recommendations:
1. Increase the wages for care workers relative to other low paid occupations and restore pay differentials between care workers and senior care workers.
The evidence has shown that relative wages in social care have declined, with the cost-of-living crisis and the rise in petrol costs for care workers supporting service users at home having reduced their purchasing power further. Restoring pay differentials to other low paid occupations is expected to reduce turnover, lowering costs for the recruitment and training of new staff. Rising wage floors over time coupled with underfunding of the social care sector resulted in reduced pay differentials between care workers and senior care workers. Restoring them would make career progression more attractive, as increased job responsibilities would be rewarded by commensurate pay with can contribute to improving retention. However, wage increases rely on increased central government funding and care providers receiving higher rates to use them to pay better wages.
2. Improve sick pay for social care workers to secure a decent living during periods of illness.
The pandemic has shone a light on the negative impact of current sick pay provision in social care leading to financial difficulties and even hardships or difficult choices to support themselves and their families. Improved sick pay from day one of employment will provide a safety net during periods of illness in a low paid job, making a contribution to improving care workers terms and conditions. This requires regulatory changes by central government.
3. Parallel to wage increases, improve working conditions, and continue to support the mental health and wellbeing of the social care workforce.
Pay, followed by terms and conditions, have repeatedly been identified as key reasons for recruitment and retention challenges in a number of studies, with one study finding that wage and employment conditions significantly reduce job separation among direct care staff. Despite it being a rewarding career, pay, terms and conditions inform people’s career choices. A key aspect to be mentioned here is the high degree of zero-hour contracts providing required flexibility while also generating insecurity for employees in terms of their actual take home pay and work schedules. Innovative workplace solutions are required to address the scope of zero-hour contracts, e.g. by exploring the suitability of guaranteed hours a few months after joining a care provider. In the meantime. more clarity is required round holiday and sick pay entitlements among zero-hours workers.
The Covid-19 pandemic had impacted social care workers mental health and wellbeing due to increased workloads and working hours and fear for their own and their families’ health and safety. While the Covid-19 pandemic has now passed, ongoing support is required to support staff recuperating and/ or affected by continued high workloads due to ongoing, albeit slightly improving, recruitment and retention challenges. This will require primarily adequate support at the workplace level, including by management via voice channels.
4. Support training and career development to help make jobs in social care more attractive.
The level and quality of training and development to address the skill gaps remain limited and patchy. There is some evidence of investment in job-related training reducing labour turnover or turnover intentions in adult social care. There is scope for encouraging shared training between the health and social care sector to facilitate movement across the health and social care system. And it stands to be argued that good training and career development opportunities send out positive signals to potential new recruits considering a career in social care.
The Government of England’s recent publication of career paths, underpinned by a knowledge and skills framework, initially for care workers, is a first step in supporting training and career development in the sector. It provides a useful framework for horizontal and vertical career development opportunities that still needs to be explored in practice, accompanied by adequate funding and attractive pay structures.
5. Create and support more effective and inclusive voice channels for the social care workforce.
Low trade union representation in the care sector often means that care workers lack channels to negotiate pay, terms and conditions or to voice their concerns effectively. There is some evidence that particularly ethnic minority workers often find it difficult to be heard, that they have a lower level of awareness of employment rights and are more affected by verbal abuse, bullying or threats than their White counterparts, leaving them open to lack of support or even exploitation. Having more effective and inclusive voice channels can help to address areas of workplace discontent and ultimately support retention of staff when the situation begins to get resolved. Options to explore could include national collective bargaining strategies, currently being pursued in Scotland, other suitable forms at local or regional level or steps to encourage social care employer recognition of unions.
6. Better support unpaid carers who provide the majority of care.
Unpaid care is an essential pillar of the mixed care system. Caring for family or friends can be rewarding, yet studies also show associations between informal caregiving roles and poorer mental and physical health. Challenges maintaining employment (levels) due to concerns about inflexibility and incompatibility with work demands, can reduce income levels, including in later life.
To address this, measures need to be put in place by government and employers of informal carers to support those in employment (e.g. through carer’s leave, flexible working and/or a carer’s network at work), to reduce the care penalty and to support the carer’s own health, e.g. by offering opportunities for breaks beyond those in crisis times. This will help to improve what could be considered the equivalent of ‘job quality’ of informal carers.
FURTHER READING