The workforce is also not growing fast enough to meet the country’s increasing care demands. Demographic forecasts suggest that more people will need care in the future, and their needs will become more complex.
This is already having a negative impact on the quality and continuity of essential care and support for around 1 million people with care needs, so what is the government doing to address this challenge?
The National Audit Office on Thursday published a report on The adult social care workforce in England. We conclude that the Department of Health and Social Care is not doing enough to support a sustainable social care workforce and needs to take action before the situation worsens. Social care cannot be treated as subsidiary to the health service, as often appears to be the case, and the department must respond quickly by giving the sector the attention it deserves and needs.
The department estimates that the workforce will need to grow by 2.6% every year until 2035. Yet the turnover rate of care staff has been increasing since 2012-13 and in 2016-17 reached 27.8%, meaning providers must spend funds on recruitment they could otherwise have spent on providing quality care. The vacancy rate in 2016-17 for jobs across social care was 6.6%, well above the national average of 2.5%-2.7%. In particular, the vacancy rate for nurses working in care more than doubled between 2012-13 and 2016-17.
We have been reporting for several years on the slow progress being made to develop the care sector and improve support to adults with care needs. In our 2014 report Adult social care in England: overview, we described how need for care is rising while public spending is falling. We now find that local authorities, which commission most care from 20,300 independent providers across England, spent 5.3% less on care in 2016-17 than in 2010-11, and spending is expected to remain tight due to continued financial pressures.
Around two-thirds of independent providers’ income comes from local authority arranged care. The vast majority of local authorities pay fees to homecare providers below the recommended minimum price for care, putting some in financial difficulties. Furthermore, local authorities are not paying the full cost for care home placements. If this continues, there is a risk that providers will not invest in areas with high numbers of people receiving local authority funded care.
Our latest report highlights how providers are experiencing increasing difficulty recruiting and retaining staff. Providers and commissioners have told us that low pay is one of the biggest causes of this. In 2016-17, around half of care workers were paid £7.50 an hour or less, equivalent to a full-time annual salary of £14,625. This, along with tough working conditions, lack of prestige compared with working for the NHS and a lack of career and pay progression, puts off workers from joining and remaining in the sector.
We are, however, encouraged by the department’s plans – with its delivery partner Skills for Care – to launch a major national campaign to inspire people to work in care. Such a campaign needs to be underpinned by action to address the issues that make working in care unattractive.
In our 2015 report Care Act first-phase reforms, we reported on widespread support across the care sector for the act, yet the government has dropped key reforms on delivery and pay. The government intends to publish a green paper on reforming care for older people by summer 2018, and there is a parallel piece of work being developed on care for working-age adults.
The care sector eagerly awaits the proposals, which have been postponed several times. This is the government’s opportunity to recognise the vital role of care workers and urgently address the challenges we, and many others across the sector, have highlighted. Without a sustainable and valued workforce, the government cannot ensure consistently safe and high-quality care to elderly and vulnerable people.
Source: The Guardian