Recruitment and retention in adult social care services

Recruitment and retention in adult social care services
© iStock/Dean Mitchell

The crippling effects of workforce shortages are being felt across adult social care services. Oonagh Smyth, CEO of Skills for Care, discusses the key drivers behind the sector’s recruitment and retention challenges.

Staff shortages are one of the fundamental challenges facing the health sector today. Skills for Care’s recent report on the state of the adult social care sector and workforce in England revealed the number of vacant posts increased by 52% since 2020/21, totalling 165,000. Forecasts from the workforce development and planning body highlighted that if the number of adult social care posts increases proportionally to the projected number of people aged 65 and over, between 2021 and 2035, 480,000 additional posts would be required by 2035. To discuss the key drivers behind recruitment and retention challenges in England’s adult care sector, Lorna Rothery spoke to the CEO of Skills for Care, Oonagh Smyth.

Can you give an overview of the current state of adult social care services in England? How have care services been affected by increasing staff shortages, as well as soaring food and energy prices?

In October 2022 Skills for Care released its latest ‘State of the adult social care sector and workforce in England’ report providing a comprehensive overview of the current state of the sector. Key findings from this year’s report include vacancy rates having risen by over half in one year to the highest recorded rate, while the number of filled posts (roles with a person working in them) has fallen. The latest data highlights the serious recruitment and retention challenges that the sector is currently facing. While turnover remains at a similar level to the previous two years the starter rate has fallen from 37.3% in 2018/19 to 30.8% in 2021/22. This means that around the same proportion of people are leaving their roles but there are fewer people replacing them.

As with all organisations, social care providers and workers will undoubtedly have been impacted by the cost-of-living crisis – from increased costs for energy and catering in care homes to increased fuel prices for domiciliary care workers who travel between visits.

What the report did highlight was the size and significant impact of adult social care services in communities across England. We know around 1.5 million people are working in adult social care in England, and around 17,900 organisations are delivering adult social care services in England across an estimated 39,000 establishments.

Social care has a bigger workforce than the NHS, construction, transport, or food and drink service industries and there are so many opportunities in a wide variety of roles.

Recruitment and retention in adult social care servcies
Oonagh Smyth

What is behind the high level of staff vacancies we are currently seeing? What issues do care providers often come across when trying to recruit care staff?

Between 2012/13 and 2020/21, filled posts have consistently increased to keep up with the rising demand for care. Employers have not been able to recruit and keep all the staff they need so in the 2021/22 data we have seen an increasing number of posts remain vacant.

We know that social care is very sensitive to any labour market fluctuations so part of why vacancy rates have risen is because there are lower levels of unemployment across the board.

We know that some care providers have been able to respond to rising staff vacancies by increasing wages to attract and retain more staff. Some have also reported giving signing—on bonuses and other incentive payments.

In addition, care worker median pay previously rose in line with increases in the national living wage, whereas in 2021/22 pay increases were higher, on average, with pay going up 49p compared to a 19p increase in the national living wage.

However, we must recognise that despite these pay rises, average pay rates for care workers are still some of the lowest in the economy. We know that 80% of jobs in social care pay more than the median care worker pay of £9.50.

So, despite recent pay increases, the availability of higher-paid roles in other sectors, some of which may be seen as less demanding, is contributing to the high vacancy rate in adult social care.

What our report has evidenced is the importance of not only pay but also time and space to do the job properly, plus employers investing in learning and development are all key elements in getting and keeping people.

How are the aforementioned challenges impacting those people who rely on care homes or receive care at home?

Social care is a fundamental part of our communities across the country, and we need it to work. We need it to work so that people can live the lives that they choose, and we need it to work so that other sectors such as health can function efficiently. Social care is still a people business and does not exist without the professionals who work in it.

The high staff vacancy rate can impact the ability of care providers to deliver care and support consistently. If more of these posts were filled, providers would be able to deliver person-centred support to people who draw on services and maintain higher ratios of staff to people receiving care.

We also found that establishments with lower vacancy rates, on average, received better CQC inspection scores. Employers with high CQC scores had an average vacancy rate of 5% compared to a rate of 6.1% for those with lower scores. This suggests that those employers who struggle to find all the staff they need, and are carrying vacancies, can find it harder to deliver a high-quality service.

The government recently announced the launch of their annual domestic recruitment campaign, Made with Care, what are the goals of the campaign?

We need to talk more about the rewarding and fulfilling career choices that adult social care can offer, and we hope the latest Made with Care campaign will raise awareness of the value and job satisfaction a career in care offers, and the important contribution that the 1.5 million people currently working in adult social care services are making in our communities every day and all year round.

What further action should be taken at a policy level to support the recruitment and retention of care workers in the UK?

Our report highlights the need to start implementing the ‘People at the heart of care’ white paper which was published last year and to start releasing the £500m that it committed for the workforce to support skills and learning.

A workforce plan for social care which identifies the numbers, skills mix and innovations in delivery needed to meet growing demand and prioritises staff recognition, value and reward, is also required.

Oonagh Smyth
Skills for Care 

This article is from issue 24 of Health Europa Quarterly. Click here to get your free subscription today.


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