The Care Act has undoubtedly brought about significant changes in the landscape of adult social care. The Act introduced crucial reforms aimed at promoting wellbeing, safeguarding individuals and ensuring person-centred care. Its emphasis on prevention, integration and a person’s right to control their care are commendable and, a decade on, the core principles of the Act have only grown in importance.
The recognition of the duty to promote an individual’s wellbeing was a step change in what we consider the role and value of social care to be. It’s all too easy to dismiss the significance of this change in perspective.
The Care Act also placed a duty on councils to promote the integration of care and support services with health services where this will benefit patients and the quality of care.
This principle of greater integration undoubtedly represents an important step towards someone only having to tell their story once to get the health and social care they want and need. Different integrated care systems are at different stages of development, and we have some way to go before social care is properly represented at every level – but we are moving in the right direction.
The adult social care workforce plays a crucial role in translating the Care Act's principles into practice. Skilled and compassionate professionals are essential for delivering high-quality care and support.
Yet our vital workforce faces considerable challenges which can hinder the effective implementation of the Act.
Between April 2022 and March 2023, there were 152,000 vacancies in the sector on any given day – and almost three in ten people left their jobs over the course of a year, with around a third of them leaving the sector altogether. Even where people stay within social care, the turnover affects continuity of care and creates recruitment challenges for employers who tell us that they can find it hard to compete in the local labour market.
We estimate that we will need 440,000 more adult social care posts in 2035 than we had in 2023 – which is an increase of 25 per cent over a period of time that is likely to pass all too quickly."
We therefore need to address both our immediate and long-term recruitment and retention challenges. We don’t have enough people right now, so first we need to repair the leaky bucket of our workforce – addressing the factors that will improve retention such as terms and conditions, and access to learning and development, and organisational culture and leadership.
The Government reform programme is key to supporting the development of our workforce. This includes the creation, with Skills for Care, of the Care Workforce Pathway to set out the career pathway for people in direct care roles, a level 2 qualification for the Care Certificate and the investment of millions of pounds into the development of our colleagues.
Developing our people – including our leaders – will not only encourage them to stay with their employers and in the sector, but it will also drive up the quality of care and support for the people who draw on it. And it stands to reason that the Care Act’s focus on wellbeing can only be achieved if we support the wellbeing of the workforce too.
We need to find new, innovative ways to attract more people into the sector straight away. Some of the factors influencing retention will help with recruitment too – and there are others, such as appealing to more men and younger people, who are under-represented in the workforce.
We need to think about today and tomorrow at the same time, and not just have a plan for recruiting 440,000 more people into the kind of care roles that currently exist – but also consider what the roles of the future will look like.
Importantly, we need to prevent our recognition of these challenges from spilling over into a crisis narrative – or a ‘doom loop’ as I’ve heard it described – which will only hamper our efforts to find and keep people. We need to start seeing them as hundreds of thousands of opportunities to join a sector that offers valued, rewarding and wide-ranging roles."
Achieving all this will be crucial to realising the ambitions of the Care Act, which is why we need a piece of the jigsaw that is currently missing: a workforce strategy for adult social care.
This is why, in October 2023, Skills for Care announced plans to develop such a strategy, building on the reforms being led by the Government. We are doing this in partnership with the full range of people and organisations with a stake in the future of social care – as the strategy will only work if it is created by the sector, for the sector.
If the workforce strategy is to help us make progress towards some of the goals of the Care Act – especially when it comes to fostering better integration by empowering staff to work collaboratively across health and social care settings – we also need to work closely with our colleagues in the health sector. This will ensure that our strategy complements the NHS long-term workforce plan that was published in 2023, so NHS England and the NHS Confederation are both part of our steering group.
The strategy will address the most important themes for the future of the sector and workforce: recruitment and retention, training and development, integration, leadership, prevention, technology and pharmaceuticals, new service models and multidisciplinary working.
While there may be a gap between the objectives of the Care Act and what has been achieved so far, the workforce strategy provides a golden opportunity to address the outstanding challenges and ultimately guarantee the best possible care and support for the people who draw on it.
