Feature: Care staff shortage worse than before pandemic

The latest report from Skills for Care reveals the significant impact the pandemic has had on both the short and long-term challenges faced by the workforce.

The annual ‘The state of the adult social care sector and workforce in England’ report, based on data provided by sector employers to the Adult Social Care Workforce Data Set (ASC-WDS), reveals that on average, 6.8% of roles in adult social care were vacant in 2020/21.

This is equivalent to 105,000 vacancies being advertised on an average day. The vacancy rate in adult social care has been persistently high at above 6% for the previous six years.

The turnover rates across the sector remain high, at 28.5% in 2020/21. This figure had decreased during the pandemic, but since March 2021 many employers report that retention is now more difficult than before the pandemic. The rate was higher for registered nurses at 38.2%, much higher than for their counterparts in the NHS (8.8%).

In recent months adult social care employers have been raising the significant recruitment challenges they are facing.

Since May 2021, vacancy rates have steadily risen as the wider economy has opened back up. As of August 2021, vacancy rates are now back above their pre-pandemic levels.

Since March 2021, we have seen a decrease in jobs (filled posts) of around -1.8%. This is the first time on record that the number of jobs (filled posts) has fallen.

Recruitment and retention

At the same time vacancy rates are increasing. This indicates that providers are struggling with recruitment and retention, rather than a decrease in demand, which we know from our market insights. This is even more pertinent in registered nurse jobs, which have fallen by 5% to 34,000 in the last year.

Vacancies offer people opportunities to work in rewarding and challenging roles supporting people in their communities. As we develop and implement reform for our workforce, we need to make a strong case that these jobs offer highly-skilled careers where you can progress to leadership positions.

Skills for Care said we need to listen to people who draw on care and support services to understand what they want. People want to be supported by people who have the skills to support them, and people who are trained and developed who are then less likely to leave their roles.

The steady shift from care homes to care at home services continues and has been accelerated by the pandemic.

In 2020/21 the number of adult social care jobs increased by 2.8% (45,000 jobs). The vast majority of this increase was in domiciliary care services which increased by 7.4% (40,000 jobs).

The total number of direct payment recipients employing staff has remained stable (at around 70,000, and 130,000 jobs) since 2014/15.

Occupancy rates of care homes also fell during the pandemic from 86% pre-covid to 77% in March 2021.

People who draw on care services say that that they want to live in a place they call home, and we need to ensure reform recognises this desire enabling people to draw on care in the way that works best for them.

The National Living Wage (NLW) has contributed to a 6% increase in the median nominal care worker hourly rate from March 2020 to March 2021.

However, employers have found it more difficult to maintain differentials for more experienced workers, care workers with five years’ (or more) experience in the sector are paid just 6 pence (1%) more per hour than care workers with less than one year of experience.

Social care workers from a Black, Asian or minority ethnicity make up 21% of the total workforce with 82% female and 27% aged 55 and over. We must reward them and embrace the opportunity to make social care an employer for all.

man in red sweater with face mask

A growing market

The report shows social care is a growing market currently contributing £50.3bn to the English economy. The efforts of the 1.54m people who worked tirelessly throughout lockdown need to be recognised and properly rewarded.

Skills for Care CEO Oonagh Smyth said: ‘This report is a stark reminder that our recruitment challenges continue, and to help tackle that we need to properly reward and value care workers for their high skill levels and dedication.

‘We know that this is a priority for the new Government White Paper expected on adult social care this year and look forward to seeing the measures contained.

‘Social care is fundamental infrastructure in our communities, it allows people in our families, our friends and people in our communities to be supported to live the lives they choose. And the workforce in social care are the people that provide that support every day, in every single community.

‘The workforce is so important but we know from speaking to employers that the pandemic has had a huge impact on people working in social care. The rich data from this authoritative annual report confirms this pressure, as well as showing us longer term trends in adult social care.

‘We’re grateful to all the employers who continued to submit their data to ASC-WDS in challenging times, and this report is just one way we will use it to make sure we can create a sustainable workforce as we enter a period of reform for adult social care.’

Skills for Care said it is aware that the workforce is a priority for the upcoming white paper and that it is committed to working with the government and stakeholders across the sector to make a shared vision for a workforce that enables people to live the lives they want, where they want.

Anita Charlesworth, director of research and REAL Centre at the Health Foundation, said: ‘Today’s report highlights the urgent workforce challenges facing adult social care in England.

‘Many social care employers are now reporting growing concerns about recruiting and retaining enough staff. This is hardly surprising when job vacancies, which initially went down at the start of the pandemic, have risen above pre-pandemic levels.

‘There has also been a decline in the number of people from outside the UK taking up jobs in the industry at a time when the post-Brexit immigration system means providers can no longer turn to EU workers as easily as they could in the past.

‘Even before the pandemic, there were very high levels of staff vacancies and turnover in the sector. Social care work has long been characterised by low pay and poor terms and conditions.

‘The government has committed to bring forward a White Paper on reforming adult social care later this year, which presents an opportunity to better reward, recognise and support social care staff, and to improve services for people who need them.

‘Looking further ahead, the Health Foundation’s REAL Centre estimates that over 600,000 extra social care staff could be needed by 2030/31 to improve services and meet growing demand for care, over and above filling existing vacancies.

‘The government must strengthen its workforce planning for social care to ensure that there are enough staff to look after the growing numbers of people who will need care in the future.’

A Department of Health and Social Care spokesperson said: ‘We appreciate the dedication and tireless efforts of care workers throughout the COVID-19 pandemic and beyond. We are providing at least £500 million to support the care workforce as part of the £5.4 billion to reform social care.

‘We are also working to ensure we have the right number of staff with the skills to deliver high-quality care to meet increasing demands. This includes running regular national recruitment campaigns and providing councils with over £1 billion of additional funding for social care this year.’

Photo Credit – engin akyurt


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