When (if) there is an economic upturn in England and we begin to reduce the catastrophic unemployment figures adult social care will find itself in deep trouble. There will not be enough people to take jobs to support older people or adults with disabilities.
The number of jobs in adult social care is projected to grow by between 24% and 82% between 2010 and 2025. This means there could be between 2.1 million and 3.1 million jobs by 2025, based on Skills for Care 2010 estimates (1). England got close to a workforce numbers crisis in the middle of the last decade. In some regions social care employers where struggling to recruit and retain sufficient staff, there were stories of residential homes unable to fill places due to lack of staff and home care organisations struggling to fulfill contracts. The crisis was averted then due to people coming to the UK from the countries of Eastern Europe that had recently joined the EU and by overseas (meaning from outside the EU) staff recruited by agencies that ‘sidestepped’ the work permit regulations.
Next time there will be no new countries in the EU (Turkey wants in, but there is resistance) and the UK Border and Immigration Agency have some very clear political directives to all but shut down the work permit system. As the economy recovers other industries will adjust their pay and conditions to attract staff. This seems unlikely for the publicly funded parts of social care, restricted as it is by procurement fees. In April 2011 the Low Pay Commission reported (2) that the social care workforce is among the lowest paid in the economy, with 9% of staff earning less than the minimum wage of £5.93 (as of April 2010).
People will be attracted to other employment, in part by pay, but also by intelligent human resource systems that recognise people want to work where they are respected, trained and well managed. Work in adult social care can be all of those things and more, but experience over the last 10 years has been that there is no consistent move to recognise the skills and rewards necessary to sustain the sort of workforce we need. Some social care employers are extemporary in how they manage and plan for their workforce. However they do this against the flow of government policy on service procurement, lack of regulatory attention to workforce issues and funding for education and training. As ever Government Ministers make statements about the importance of the workforce but there are few examples of any positive action and plenty of missed opportunities to directly do anything positive for the workforce.
Conferences and meetings generally resolve that the image of work in social care should be improved. Actually the problem is that there is no image of social care itself. Only at a time of family crisis do most people begin to get an understanding of the issues and support services that social care deals with. Getting people to consider employment or a career in social care is therefore difficult, but made all but impossible by the poor pay and conditions. The existing chaotic state of funding for social care services is only sustainable by staff continuing to subsidise the system by accepting poor conditions. For the last ten years this workforce have been told that registration would recognise their competence and commitment to high quality care and that inspection would require and support initial and ongoing qualifications. In England none of this is now happening. The workforce in social care continues to be ignored, cope with policy and financial failure and yet is relied on to provide high quality care.
The likelihood is that just as the numbers of people needing support increases we may have insufficient staff to do that work. The quality of support will be adversely affected there will be an increase in poor or abusive care leading to care work and workers being mistrusted and causing recruitment to be ever more difficult. With insufficient or poor quality care, relations will feel forced to stop their own work and become carers for older relatives. This has negative effects on the economy as whole and severe effects on individuals moving from employment to reliance on carer’s benefits – such as they are.
Options for government seem to be:
- Ignore the impending problem and hope that something turns up
- Blame social care provider organisations
- Move away from improvements (personalisation, dignity etc) and return to a warehousing system for people needing support
- Permit the importation of workers from somewhere who will not have had time to train for task
Or invest now in education and training as part of a concerted approach to improving the image and actual experience of working in adult social care.
Other countries use economic down turns to retrain their workforce for their best guess at the sorts of industry, skills and systems required in the future. There would be little guessing required in doing this in adult social care. We know very well how many people we will have who will need support and we know the sort of skills and services that work well (aside from a miracle cure for dementia). But in England (things are different in the other parts of the UK) the government is moving away from that sort of planning. Nothing is being done to improve the pay and conditions of the workforce. On occasion there are even attempts to misuse workforce data to pretend that pay and conditions do not matter to social care staff. While it is correct that local work, flexible working and commitment to the proper and dignified care of people is important in attracting workers they still will need to be paid properly. Employer led Skills for Care has again produced a clear strategy 'Capable, confident, skilled' May 2011. This says and plans most of the right things but it is not adequately funded and the implications for other Government responsibilities such as inspection are not taken up.
Just like the bankers with their justification for bonuses social care staff will go elsewhere if better pay and conditions are on offer.
(1) Skills for Care The size and structure of the adult social care sector and workforce in England, 2011 Researched and compiled by William Fenton August 2011
(2) Low Pay Commission National Minimum Wage April 2011