What impact are workforce issues having on the adult social care sector?
The first very tangible impact of these workforce issues is that lots of people are having to go to agencies. Not only are agency costs now astronomical - one of my members recently offered £60 an hour for a nurse and he still couldn’t get one - but many workers in the sector are deciding that they want the higher wages and flexibility that agency work provides. There needs to be some concerted government action to form a cap on agency fees, because they are becoming prohibitive.
Another element is that some care providers are reducing their occupancy levels because they haven’t got the staff to deliver at that agreed occupancy level. That not only reduces system capacity, but it also has a knock-on effect in the NHS and reduces the income level to the care provider at a time when we have seen spiralling costs of living impacting the care sector.
These challenges are compounded by other really serious financial challenges, the key one being the withdrawal of COVID-19 funding, yet providers still having to implement COVID-19 procedures. In some large providers this is amounting to an extra million pounds a month of expenditure.
Given the high rate of zero hours contracts within the sector, are more full-time contracts needed to improve staff retention?
I think that we have now the combination of different contracts to attract different people. At the moment, people who go to agencies are quite happy to go to those roles, which are effectively zero hours contracts, because you only get paid for what you work, and that pay is currently very high.
I think there are a lot of people who would like the zero hours contract if they had proper terms and conditions, and if people pay them what they’re worth. I don’t think it is necessarily the issue of the contract, I think it is a fundamental issue of underfunding and no proper approach to how we train and reward our very dedicated and highly skilled staff.
As long as people in this sector are being paid the minimum wage that is what the problem is, not the contract. If we raised care worker pay to to £40 an hour, there would be a lot of people saying, “I’ll be on a zero hours contract if I was on £40 an hour”.
Should the Care Certificate be re-examined to improve staff retention rates within the sector, given the report raised questions over the impact of how a lack of training has made staff feel underprepared for the job?
What we've got to do first is have a ten year workforce strategy which aligns to the NHS strategy. Then what we’ve got to do is we’ve got to have very clear skills and competency frameworks and a series of portable qualifications where when you get the qualifications throughout your career you are upskilling yourself, but also getting reward commensurate with that.
The way in which the care system works at the moment, some employers are quite happy to accept that a person has done a care certificate if they know their previous employer and are confident that they have delivered care to a high standard. However, if they don’t know they will re-run the care certificate to get the person up to their own standard of quality. What we need is a centralised approach, just as we see in teaching or nursing for example. It doesn’t need to be a degree qualification, but what it does need to be is a portable and recognised qualification.
Has making care workers eligible for the Health and Care visas helped to alleviate labour shortages within the sector?
Undoubtedly they have helped and what we've seen is some of our members have decided to engage in overseas recruitment, mainly because they can’t get particularly specialist staff like nurses in the UK. But there are also quite a lot of senior care roles, for example, where people are recruited from overseas.
Of course, some of the challenges though are again relating to funding. The overseas visa sometimes requires you to pay more to an overseas member of staff than somebody who has been in the organisation for a while who just happens to be a UK member of staff. So it’s not without its problems, but it has made a difference. Increasingly, people are going to look to overseas recruitment if they cannot recruit from a pool of people from home.
What needs to change to improve how social care staff are perceived relative to their health service colleagues?
The real issue is that we are trying to get our status aligned to the NHS. If you align the terms and conditions to the NHS, people will start seeing social care as a valid part of the system.
One of the ways that could happen is if you pay people properly, that will absolutely help improve status. Another way is improving the wider public’s understanding of what the sector does.
Everybody lives with a myth that the NHS will diagnose what is wrong with you, take you to hospital and then cure you and then you go along with your life. On the other hand, social care looks after people with long term conditions who require specialist support, which people don’t like to talk about.
Something I would like to do is to get every single person who works in social care to start championing it. People are delighted to tell you they work for the NHS, no matter their role. But you don’t get the same sort of engagement from people who work in social care, and we need those in social care to start promoting what they do.
