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The care worker crisis
It is already hard to fill care jobs with skilled workers, and growing demand as the population ages will only worsen the situation. Julie Penfold reports on how care providers are responding
Source: Alamy
Recruiting and retaining skilled care staff is a sector-wide challenge. And it is set to become even more difficult – and important.
The latest report by the UK Commission for Employment and Skills (UKCES) revealed that more than 500,000 additional care workers will be needed by 2022. This represents a 27% growth in the frontline care workforce, according to the report, Sector Insights: Skills and Performance Challenges in the Health and Social Care Sector. The sector currently employs about 4m people with an average employee age of 50 to 65. So there is a need to replace staff as they retire.
“We’re fighting an uphill struggle”
Nigel Howlett, chief executive of the CHS Group
But a huge demographic change is the real driver. As we live longer, the sector expects to see a 44% increase in the number of people aged 65 or over by 2025, to reach 11.6 million people (see box).
Health Education England, a public body providing training for the care workforce, projects the number of people aged 85 or over will increase from 1.4 million to 2.4 million by 2027 and then to 3.6 million by 2037.
In numbers: The crisis
- There are currently 1.3 million people receiving state support for care services in England
- The social care workforce is dominated by women (82%)
- A significant proportion of care workers earn less than £7 per hour
- 37.2% of care workers have no relevant qualifications
- Sector staff turnover is relatively high at 19% (compared to a UK average of 11.5%)
- 18.2% of the care workforce is made up of non-British workers
(Source: Future Care Workforce/Future Care Workforce Synopsis reports – ILF/Anchor)
Coming to terms
But what is happening is not simply a struggle to meet demand. The sector has begun to realise that it needs to break down barriers to recruitment, by making sure working in care is an attractive job – and career. A 2014 report by the International Longevity Fund (ILF) and Anchor, a housing association and retirement provider to 35,000 people, found care work needs to be made more appealing to a wider range of people. The Future Care Workforce report illustrated that the sector is currently dominated by a largely female workforce and part-time working. It stressed the importance of addressing the imbalance.
In the current climate, finding skilled care staff is tough. The UKCES report identified a number of barriers to recruiting younger care workers and retaining skilled staff. These included low pay, limited time spent with service users, zero-hours contracts, a negative image of social care (due to scandals such as Winterbourne View and Orchard View) and outdated ideas around care worker roles being viewed as ‘low-skilled’.
‘The skills shortage does makes it hard to recruit good staff,’ says Nigel Howlett, chief executive of the CHS Group, a 2,336-home social landlord and care provider in Cambridge. ‘There’s a steady need to recruit new people, especially in high-cost areas like Cambridge, where it’s difficult to rent on care salaries. This is an enormous national problem that we have to face up to as the demand for care is going to grow considerably. We’re fighting an uphill struggle.’
To work as a care assistant, employees require an NVQ Level 2 qualification in health and social care (equivalent to four or five GCSEs at grades A-C). For those wanting to progress to a senior care assistant role, a qualification of NVQ Level 3 (equivalent to two A-levels) is required.
The dominant issue of low pay across the sector is a big recruitment barrier, says Bernie King, director of homecare services at Making Space, a national charity and leading provider of adult health and social care services. ‘If a candidate is well qualified, they will expect to be earning more. Unfortunately, there’s just not the money in the market at the moment to be able to financially reward prospective employees for the qualifications they have.’ Other providers don’t see this as a barrier, however (see box: A different approach).
This is something that also resonates with Jane Ashcroft, chief executive at 22,500-home Anchor. ‘We’re starting from a negative perspective as the role of a care worker is not seen as having a particular status in society and it’s not a particularly well-paid role either. It’s a very high-profile issue at Anchor. The frontline workforce is so important. What we hear from our residents is that they really value the relationships they have with our frontline care staff. Having the right people with the right skills and the right attitude is essential.’
In response, Anchor has taken action to make sure it is better placed to appeal to jobseekers. In April 2014, the organisation moved to paying a living wage for all its care staff. Training is another attraction for jobseekers, says Ms Ashcroft. Anchor has invested in providing an interesting programme of training both for new recruits and existing staff.
CHS has also taken steps to offer better rates of pay. The organisation regularly monitors its rates and tries to offer the market median. Some care staff may see pay rises as a result of the recent government announcement that a ‘living wage’ will be rolled out, rising to £9.35 an hour by 2020. However, this remains an issue that is difficult to tackle for many providers.
No time to wait
Another issue in the spotlight is the use of controversial zero-hours contracts in the care sector. All of the providers Inside Housing spoke to for this feature felt they do have benefits for both staff and providers. Care staff themselves may not share this view, however (see box: A frontline perspective). Zero-hours contracts are more commonly known as bank working or flexible-hours contracts within the sector.
‘Zero-hours contracts are not as exploitative as people are led to believe,’ says Kris Peach, director of extra care at Housing & Care 21, a leading national provider of retirement housing and care services. ‘At H&C21, they’re more like bank contracts as people work as and when needed. We’re introducing guaranteed-hours contracts to our care staff to counteract any uncertainty around their working hours. It’s an investment in our care staff that we feel is very important.’
Making Space has joined forces with Jobcentre Plus and Standguide, a north west training and recruitment company. They have developed a two-level course which starts with jobseekers taking part in a two-hour workshop. This explains the basics of a career in care, what it entails and details how rewarding it can be. Following the workshop, attendees are asked to commit to a two-week training course that gives them core training in social care support work.
‘It’s working really well for us,’ says Ms King. ‘We started the campaign on 25 May and 31 people have already completed the training. We’ve also filled 17 positions.’
The team also identified the key barriers to working in rural areas. The cost of the essential disclosure and barring service (DBS) check, buying work clothing and getting to and from work were major factors putting off potential employees. To combat these issues, Making Space is funding all DBS checks for applicants applying via Jobcentre Plus and the employment support service has agreed to provide grants for clothing and a bicycle.
‘It is vital work that carers do,’ adds Ms Ashcroft. ‘We’ve undoubtedly seen that investing in that frontline, paying a living wage and making sure no staff are paid a minimum wage has made a difference. What it says to jobseekers when they’re looking for a role in care is this is an organisation that’s serious about its people.’
A different approach
‘The reason we’re seeing a skills shortage in the sector is because providers are not recruiting for the attitude, aptitude and confidence of an individual,’ says Ivan Finney, training and development manager at Extra Care Charitable Trust, which supports older people in housing schemes and villages across the Midlands and north of England.
‘Instead, they’re looking for very specific qualifications. When we recruit we’re looking at a person’s competency and attitude. We’re less concerned about the qualifications they have. The right behaviours are very important as NVQ training can be given. Our approach has helped us to drive down staff turnover from 26% six years ago to 12% in 2015. It’s not an issue that applies to us.’
A frontline perspective
Working in care is associated with a lack of opportunities for career progression. However, that hasn’t been the case for the frontline care staff Inside Housing spoke to.
Asa Lehane-Johnson started his career in care as an Anchor care home activity co-ordinator. He has since progressed to a community engagement advisor role within the organisation. Mr Lehane-Johnson’s role involves supporting activity co-ordinators in Anchor care homes to organise meaningful activities for residents.
‘It’s a very rewarding role as I know the activities we’re putting in place are helping to enhance the lives of residents in our homes,’ says Mr Lehane-Johnson. He also feels the shortage of men in the care sector is another factor that providers need to address. In his role as activities co-ordinator, Mr Lehane-Johnson was the only male care worker at the home. ‘Male residents like spending time with other males and feel more comfortable receiving care from male care workers.’
Another frontline care worker that manages supported and floating housing says, ‘The most wonderful part of my job is watching a person go through a journey where they start at zero and end up at 10.’ She describes the joy of assisting vulnerable adults to live independently. The low points in her role are when tenants are unable to continue and have to go into residential care or hospital. Though contracted to work 39 hours a week, her phone is always on so staff can make contact at any time. However, she says: ‘That’s my commitment to the people I manage.’
She also feels the issue of skills shortages in the sector is driven by low pay and misconceptions around what care roles entail.
We also spoke to a senior care assistant who feels the use of zero-hours contracts is contributing to the issue of skilled people shortages in the sector. She began her career in care working as a care assistant on a zero-hours contract. She describes always having regular work. However, she agrees with calls for the use of these contracts to be abolished so everyone can move to secure hours working.
She finds her role varied and enjoyable. ‘All of the care staff I work with have been here a long time and they all enjoy what they do. I feel this is due to the supportive team environment and good management we have. Our senior manager has an open door policy and is a good listener.’
