Why any long term plan for social care must start with the workforce
Today, the narrative around social care is centred on the question of funding; namely, how do we find a sustainable model to pay for a population that is living longer with ever greater care needs. Whilst these funding challenges are an important consideration, this blinkered thinking misses the point. Our social care system is built on people and they seldom feature in the headlines.
More than 1.49m people work across adult social care. That is more than 1 in 25 people of working age in the UK. This massive cohort is fragmented and lacks a unifying voice. They do not have the social panache that comes with working in the NHS and they certainly can’t produce their ID cards to get discounted pizza or cinema tickets.
Today, there are 122,000 vacancies across social care and more than 1,100 people leave their job every day. By 2035, there will be double the number of people requiring full time care. Estimates by Skills for Care say that we’ll need a minimum of 650,000 more care workers to match this demand.
Rebuilding social care is a significant infrastructure project and will not happen if our workforce strategy continues to regress. There are three things that need to happen to halt the slide backwards: change the narrative, professionalise the workforce and agree a sustainable funding solution.
Change the narrative
The media has a responsibility to ensure that the social care narrative is front and centre of the national conversation. The tone of that story needs to be extremely well considered.
Stories about the NHS are coloured by the undertone of a glorious institution that needs rescuing. Compared to this, social care is seen as a sick dog where the elderly trade in their homes to receive substandard care. This is not true and the sector suffers as a result of these negative headlines.
Social care is tainted with a significant branding problem. We will not attract people into the sector whilst this is still the case.
Professionalise the workforce
In order to deal with the 31% annual turnover in the care workforce, we need to develop a robust national training plan and professional development scheme.
Clear career pathways in social care will lead to an upskilled workforce, improved care for end users and a better reputation for the sector at large. New Zealand has a relatively mature model for a professionalised care workforce and the results have been remarkable.
Wales and Scotland have mandatory registration of people that provide care and in England, Skills for Care is leading the charge with the introduction of the Care Certificate. But these schemes are still relatively immature and need more funding if they are to scale.
Agree a sustainable funding solution for providers
The collapse of care home providers is an almost daily occurrence that is most acute in homes that rely on local authority funding. Predictably the pain of these collapses is felt most by those without the resources available to fund their own care. Inequality is distressing at any point but when it is applied to the elderly and vulnerable it is particularly galling.
With local authorities paying care providers a fraction of the real cost of providing care, there is no wiggle room for staff to be properly remunerated. In 2019, the median hourly rate across the sector was £8.10 which was below the National Living Wage of £8.21. By comparison, the median starting salary on the shop floor of Aldi is £10.
Looking after our loved ones is an important job and we have a duty to ensure that those people are appreciated, developed and remunerated appropriately. We do not need a short term sticking plaster for the adult social care workforce and need to be looking so much further into the future than the term of a single parliament. Taking a year to build the plan for the social care will be acceptable only if the plan is bold and workable. I am decades away from my old age but I suspect that we’ll be having the same conversation when it is my turn to be looked after.
CEO, Co-Founder of Florence
Pay in the Adult Social Care Sector. Skills for Care 2019. https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/documents/Pay-in-the-adult-social-care-sector.pdf
The Health and Social Care workforce gap. The House of Commons Library, 2019. https://commonslibrary.parliament.uk/social-policy/health/the-health-and-social-care-workforce-gap/
Health and Social Care Workforce: Priorities for the New Government. The Health Foundation, 2019. https://www.health.org.uk/news-and-comment/blogs/health-and-social-care-workforce