Social care sector is facing ‘greatest workforce crisis in history’

A damning report by the Health and Social Care Committee has found that the NHS and social care sector are facing “the greatest workforce crisis in their history”.

• Further reading: Social care is not ‘done’ despite government promises, new coalition says

In September 2021, there were 105,000 vacant posts in social care. With demand expected to grow exponentially, it is estimated that there will be 490,000 jobs needed in social care by the early part of the next decade.

With one in three care workers leaving their job in 2020/21, the Committee is calling on the government to increase annual funding for social care by £7 billion. This will help to improve recruitment and retention problems and protect people who face catastrophic social care costs.

Paying care workers a fair wage

The average annual salary of a care worker in the independent sector is £17,900. This is around £3,500 less than similar roles in the NHS. Yet, social care’s primary competitor is not the NHS, but retail and hospitality, where staff can have “better pay and less responsibility”.

While a substandard salary is not the only reason for the workforce crisis in social care, Rachael Dodgson, Managing Director and incoming CEO of Dimensions says it is “the fundamental issue” that “we cannot ignore”.

Anchor highlighted that 44% of those who leave the care sector do so because of pay, while UNISON found that there is “widespread poverty pay” in the sector, with “three-quarters of care workers paid less than the real living wage”.

A lack of career progression was also identified as a key issue. Lara Bywater, Registered Manager and owner of LDC Care, told the Committee that “managers and senior staff are paid very small amounts more than new-to-sector people.” Indeed, a social care worker with over five years of experience will earn on average just six pence more per hour than a social care worker on their first day in the job.

In order to improve recruitment and retention in social care, the Committee states that care workers should earn at least the same rate as equivalent NHS roles. Band 3 Health Care Assistant roles start at £20,330 per annum, or approximately £11.50 an hour.

Boosting salaries to this level would deter care workers from leaving the sector and moving into retail or hospitality roles. But in order to do this, the Committee says the government must commit an extra £7 billion by 2023/24. This should be used to increase wages and improve pay progression, professional development, training and career pathways.

Improving continuity of care

People who have complex needs, including autism, learning disabilities and issues with their mental health, need continuity and consistency of staffing, according to Ms Bywater.

“It can take months for people to become used to a new face if they have additional needs”, and a lack of trust in the people looking after them “can make people less keen to participate in their normal activities, and perhaps more worried about going out into the community,” she explains.

It can also cause “huge anxiety” for family members if their relatives are not cared for consistently by the same person.

Both Ms Bywater and Ms Dodgson emphasised the importance of staff being able to recognise non-verbal communication, particularly when supporting people with autism and complex needs: this is particularly difficult without continuity of staff.

For this reason, the Committee states that the value of continuity of care in social care settings, (particularly for people who rely on non-verbal communication) is “undeniable”. They are now calling on the government implement the findings of the report to improve retention in the sector.

Better training and career development pathways

The Committee report that while training is available to care workers, the reality is that “time and funding constraints make it difficult to access.”

Without adequate training, staff feel “ill-equipped for their role”, according to Dr Carolyn Downs. The report suggests introducing base-level and specialist qualifications, as this is something that social care can offer that their competitors in retail and logistics cannot.

Dr Carolyn Downs added that care workers are “very aware that if they worked in the NHS, they would be able to access comprehensive training, higher status and wages”. The Care Association Alliance is therefore calling on the government to reinstate free access for social care workers to the same NHS training as community health colleagues.

The report also found that some care home managers lack the training and support they need to stay in post. The Committee therefore welcomes the government’s commitment to fund Level 5 diplomas for those who need them, and urge the Government to publish a fully costed plan for doing so by the end of the year.

Government unable to give a breakdown of spending in social care to demonstrate how extra £1 billion was spent

The Committee would also like to see the government give a breakdown of spending for social care to demonstrate how the extra £1 billion committed annually was spent on additional social care staff, better infrastructure, technology, and facilities. So far, it has been unable to do so.

As well as this, the Committee would like the government to make the following changes:

• End the practice of “by-the-minute” commissioning of homecare and offer care workers a choice of contract after three months of employment.
• Re-examine sector-specific guidance to address complexities in national minimum wage and national living wage guidance for the care sector, and reissue new, clarified guidance to employers and employees.
• Introduce a new, mandatory Care Certificate by 2023 which is i) subject to a formal assessment process, ii) externally offered and accredited, iii) offered at no cost to providers, and iv) portable between social care providers and between social care and the NHS.
• Designate social workers as key workers on the same basis as public sector employees so they can access affordable rented housing from local authorities and registered providers.
• Pass recruitment and retention funds directly to providers to be invested in local recruitment campaigns.
• Report on how many care workers have been issued with Health and Care Worker visas since the scheme was launched.

“Investment in social care is one of the most impactful ways that the Government can support an NHS under pressure”

In light of the report’s findings, Dimensions are calling on the government to pay social care workers at a level that reflects their contribution to society and the skillset required to perform their role.

Rachael Dodgson, Chief Executive of Dimensions, said: “Social care work is highly skilled. It is not just about providing personal care, although that is one important aspect. It is about supporting individuals in all areas of life, from their health to finances to social relationships.

“Service providers already know all this. Based in local communities, they are best placed to understand the issues facing the sector. Government should heed the report and grant providers more resource to address these issues, which have been allowed to fester for far too long.

“A well-staffed, motivated social care workforce reduces pressure upon the NHS. Great support for people in their communities reduces hospital admissions and the length of stay for those who do need to access those facilities. Investment in social care is one of the most impactful ways that the Government can support an NHS under pressure.

“Hopefully, the publication of this report will be a turning point. Lives depend on it.”

Lauren Nicolle

Lauren is a qualified journalist who writes primarily across the health and social care sectors. She is passionate about exposing the injustices faced by people with a learning disability, with a particular focus on equal access to healthcare.

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