The Contribution Of EU Workers In The Social Care Workforce In Scotland 2022

5. Qualitative findings

The qualitative research comprised ten in-depth interviews with care service managers. The findings of the interviews are discussed in this chapter to provide a fuller understanding of the survey results and of managers' perspectives and experiences of recruitment and retention challenges – including those in relation to the UK's decision to leave the EU.

It should be noted that the coincidence of the UK's official withdrawal from the EU and the emergence of COVID-19 in early 2020 meant that much of the discussion around the challenges of recruiting and retaining staff was within this context. Before looking at each of these challenges in turn, we briefly summarise managers' experiences of the impact of COVID-19 on the social care sector.

Impact of COVID-19

The impact of COVID-19 was spontaneously mentioned by managers as the most pressing challenge currently facing their service. Largely this was because of staff shortages caused by higher than normal levels of staff absence, due to infection or self-isolation due to a close contact. While this issue had been ongoing since the emergence of the virus in 2020, some also said that these challenges had been more marked in early 2022, due to an increase in infection rates across the country.

As a result, staffing issues were common, with healthy staff having to work longer hours to cover the shortfall. This was having an impact on the wellbeing of employees, with managers saying that staff were struggling physically and mentally as a result of working through the pandemic.

"[Our employees] are suffering from what we like to call 'Covid fatigue'. They have been asked to work beyond what they've ever done in their working career."

Nursing agency manager (private sector), East

Alongside working longer hours, other aspects of care work were said to have become more demanding, particularly in care homes, as a result of the health and safety procedures staff were having to work to.

"[Covid] has affected us massively. From not being able to allow visitors in the early stages, people been kept away from their families, to staff having to be split up and work in different wings and not being able mix with their teams. It caused [service users and staff] stress and depression."

Care home manager (public sector), North East

COVID-19 had also impacted on some services ability to train and deploy new staff. For example, restrictions to accessing or carrying out practical, in-person training meant it was taking longer for some trainee practitioners to get the training and experience they needed to take up their posts.

"Training is a bit of an issue because of Covid. It's more online and we're not getting a lot of the practical elements done... Some staff have not been able to start or complete their SVQs because they need to be observed and assessed while they're working in a care home, and because of Covid a lot of care homes have not been allowing this type of thing."

Nursing agency manager (private sector), South West

Findings from both the qualitative research and the open-ended comments in the survey also highlighted how some EU staff had given COVID-19 as a reason for leaving the UK (often coupled with concerns over the future of Brexit).

"The main reason for EU staff to leave has been the changing political climate and a desire to be closer to family during the pandemic."

Day care of children manager (private sector), East (survey participant)

Ultimately, the impact of COVID-19 exacerbated staff shortages and heightened difficulties in recruiting and retaining staff. These are discussed in turn below.

Recruitment

In line with the findings from the qualitative research in 2018, difficulties recruiting or retaining staff remained a significant challenge for the sector. Once more recruitment was one of the main challenges spontaneously cited by managers, alongside staff shortages caused by COVID-19, and a lack of (or uncertainty around) funding.

The main issues managers faced with regard to recruitment were similar to those reported in 2018 – an overall lack of applicants for posts and a shortage of suitable candidates for specific roles. In regards to the low number of applications received, while it was noted this had always been a challenge in the social care sector, some managers said they had noticed a significant reduction in applications over recent years.

"I remember in 2020 we had eighteen people to interview [for a childcare practitioner post], now we're lucky if we get any."

Day care of children manager (voluntary sector), South West

Many of the applications received were from applicants who did not have the relevant qualifications or experience of working in the social care sector. Again, some managers said this had become more of an issue over recent years. In particular, vacancies for nurses or SVQ qualified care workers or practitioners were mentioned as difficult posts to fill due to a lack of suitable applicants.

"We've encountered problems with recruiting nurses [since 2020] because there just aren't enough of them out there."

Nursing agency manager (private sector), East

"We're looking to recruit staff at practitioner level, but we've only managed to recruit one person [with those qualifications] in the last year."

Day care of children manager (voluntary sector), South West

Others still thought some applicants were not actually interested in a role at their service and were applying solely because the job centre required them to apply for a certain number of jobs per week to qualify for Jobseekers Allowance. In some cases, this meant managers were spending unnecessary time reviewing applications and contacting applicants, who often failed to turn up for an interview.

"We find a lot of people don't even show up for interviews… I do question whether some people just apply for jobs for the sake of [it]. If the job centre is like, "We want you to apply for ten jobs a week", you just apply for anything."

Care home manager (public sector), North East

Mangers attributed these recruitment challenges to a number of different factors. Consistent with the 2018 study, the main factor was low pay along with wage competition from other employers. Brexit was also mentioned by some managers as a factor which had impacted on recruitment, owing to a reduction in the number of suitable applications received for any vacancies.

In general, managers admitted that the pay their services could offer staff were not in line with the demands of the job. In addition, managers highlighted a more competitive job market over recent years and higher number of job vacancies. The current situation was described as very much a "job seekers' market", which meant that it could be difficult to attract people to work in the care sector, when they could find less demanding, and often better paid, work elsewhere.

"The expectation of childcare workers versus how much they earn is ridiculous."

Day care of children manager (private sector), East

"If anyone is qualified and looking for jobs [in the social care sector], it's their market at the moment."

Day care of children manager (private sector), South West

"We recently increased our hourly rate of pay, but it's still more or less equivalent to working in [a supermarket] stacking shelves, as opposed to taking on a lot of responsibility caring for someone."

Housing support / care at home manager (public sector), East

The COVID-19 outbreak was also thought to have made the care sector less attractive to job seekers. Some managers felt that the negative press associated with the sector at the start of the pandemic, due to high levels of infection within care homes, had put people off working in the sector and to apply for other jobs elsewhere.

"It's hard to find staff to work in the care homes, obviously due to high incidences of Covid and the bad press in the beginning that wasn't great. People are a bit frightened of working in care of the elderly and in care homes, which is a shame."

Nursing agency manager (private sector), South West

Competition within the sector was also mentioned by managers of services in the private and voluntary sector, who attributed some of their recruitment challenges to applicants applying for and accepting jobs with better pay and benefits in the public sector, such as jobs for local councils or the NHS. These managers said they were simply unable to compete with the public sector on their current levels of income and funding.

"Everyone wants to work in a council nursery, which is fine, but it's making it almost impossible for private nurseries to survive."

Day care of children manager (private sector), South West

"[The NHS] have a distinct advantage. We can't complete with them in the third sector, for example with pensions and the pay. We haven't got all the advantages that are available to an organisation that's got a bigger infrastructure and always gets a bigger piece of the pie."

Housing support manager (voluntary sector), South West

One manager cited the time it took to register new recruits on the PVG scheme, before they were approved to start work, as a particular problem. The delay in getting clearance meant that some recruits had withdrawn their application because they had successfully applied for and taken up another job in the meantime.

"It's not easy to fill vacancies at all. What we find is people apply, we interview them, but it takes such a long time for the PVGs to come through, by the time you phone them to confirm [their appointment], they have found something else."

Care home manager (public sector), Highlands and Islands

Views on the impact of Brexit on recruitment varied. While some managers said Brexit had not had a noticeable impact, others, particularly those whose service comprised a high proportion of EU nationals prior to Brexit, said they were now receiving far fewer applications as a result.

"Before Brexit we had a high proportion of applicants [from the EU] … We're just not getting them any more."

Housing support / care at home manager (public sector), East

"There are no people available. After Brexit, everyone went back to their own home, and they make more money at home. The only people now are British citizens, and even they're leaving to pursue nursing. There's no attractive wages to offer them."

Care home manager (public sector), North East

Some managers also spoke of how EU applicants in the care sector often had better qualifications and/or more experience than those from the UK, and that since Brexit they were struggling to recruit to some positions due to a lack of suitable applicants. This was a particular problem for nursing agency managers who, prior to Brexit, said they had relied on EU nurses to meet the demand of care services.

"Our nursing numbers haven't increased since we lost our EU nurses.... We've not had anyone [from the EU] apply for these jobs since Brexit."

Nursing agency manager (private sector), East

Retention

Managers' experience of staff retention was mixed. While some reported quite low levels of turnover, others had noticed a marked increase over the last two years or so. Managers who reported lower levels of turnover tended to have a workforce mostly comprising older staff, who had been with the service for a long time (more than 10 years). These staff were generally content in their roles, settled in the local area and did not have further career aspirations, and so were happy to work for the service for the long term. Meanwhile, younger recruits tended to stay in their role for a shorter period, before moving on to something else.

"The staff we retain are usually middle-aged women, who are generally happy and enjoy the work, and aren't really, you know, looking to develop their career or profession. You find that for younger staff, the job's a stop-gap, they give it two years and then they move on."

Housing support / care at home manager (public sector), East

Several managers mentioned high staff turnover, driven by the buoyant job market and greater availability of other jobs. They also highlighted how the COVID-19 outbreak, and the increased stress, hours and levels of responsibility that staff in the care sector had found themselves working under as a result, had caused some staff to leave to find work in other sectors.

"We've had a huge turnover compared to previous years. Because of Covid, staff going to [council] nurseries, getting more hours, more pay… There was a huge recruitment drive by local authorities to increase the numbers of nursery staff and we lost some really good staff members. That had a really huge impact on our sector."

Day care of children manager (private sector), South West

"People who have worked with us throughout Covid are saying to us they just need a break and want to try something different."

Nursing agency manager (private sector), South West

Among managers who reported higher levels of turnover, the most common reasons were staff moving on to jobs with better pay and benefits, or to jobs perceived to have less demanding working conditions. Nursing agency managers also noted that staff often left agency work to take up jobs with permanent contracts or fixed hours.

"For the amount of money [care workers] are paid, they can work in the hotels and [tourist shops] here for basically the same money and with less hassle and less worry. It's such a demanding role. Staff get burnt out."

Care home manager (public sector), Highlands and Islands

"Some of the challenges we face are because care homes are also struggling for staff. When we send our staff to them to work, they take our staff from us, by saying, 'Rather than working for your agency, when you don't know when your next shift is going to be, why don't you stay here and work for us permanently?'"

Nursing agency manager (private sector), East

Furthermore, managers of services who typically recruited students to fill part-time roles reported a higher level of turnover, because once these staff had completed their studies they would move on to another job and career elsewhere.

In terms of the retention of EU staff, managers described how, since the UK decision to leave the UK in 2016, many EU nationals had left their service. Indeed, in one extreme case a nursing agency manager reported having lost all of their EU staff.

"Before Brexit we had quite a number of EU staff, approximately 40%. At the moment we don't have any."

Nursing agency manager (private sector), East

Managers said that the main reasons EU staff gave for leaving their job were largely the same as those given by non-EU staff – to take up a job with better pay and/or conditions elsewhere. However, some EU staff had left as a direct result of Brexit, and had returned to their home countries either because they could not obtain a visa to work or study in the UK, or because there was too much uncertainty over the future and security of their residency status in the UK.

"We've only lost one member of staff from the EU and that was because of Brexit and because they couldn't extend their visa."

Adult day care manager (voluntary sector), East

"A lot of [EU staff] told us before they left that there's no future for them here anymore. They thought this was going to be a new home for them, and they could stay, invest, work and contribute to the economy. But then after the uncertainty of Brexit they felt it's better to go home. There was no incentive for them to stay here."

Nursing agency manager (private sector), East

Some services had also lost EU staff due to the COVID-19 outbreak. Managers recounted occassions where EU staff had returned to their home country to care for family at home during the pandemic, or due to concerns about the infection rate in the UK. In many cases these staff had not returned to the UK following their departure.

"The majority of [EU staff who left] took up a permanent job elsewhere. Though some said it was because of Covid and a family illness."

Nursing agency manager (private sector), South West

"[We have] a staffing crisis that's for sure. There are a lot less Europeans. I had so many staff leave because during Covid they want to go home, but then [because of] Covid and Brexit, that's it, they're not coming back."

Care home manager (public sector), North East

As is evident from the above quote, for some managers the coincidence of the UK's official withdrawal from the EU and the emergence of COVID-19 in early 2020 meant that it could be difficult to discern if challenges recruiting and retaining EU nationals were as a direct result of Brexit, COVID-19 or a combination of the two. This issue was also evident in the open-ended comments provided in the quantitative survey.

"The impact of the pandemic has been difficult. Staff are moving back home to be with family. EU Settlement Status changes have also made this more difficult."

Day care of children participant (private sector), East (survey participant)

"EU citizens have returned to their own country due to Brexit and also the pandemic as no one wanted to work in care as the risk was too high.."

Housing support / care at home manager (private sector), Highlands and Islands (survey participant)

Responding to recruitment and retention challenges

Difficulties recruiting and retaining staff meant that services were experiencing ongoing staffing pressures and staff shortages, which compromised their ability to provide high quality care to service users. As described above, this issue was being exacerbated by COVID-19, which was causing high levels of staff absence. As a result, care staff were having to work longer hours, which was having an negative impact on their wellbeing.

"Not having staff available means that since our current staff are committed to supporting their [service users] they're working more hours, doing overtime. But they get tired, start to burn out. They're more stressed."

Housing support / care at home manager (public sector), East

"[Recently] we've been working 12 hour shifts. It's worse just now [because] there are more Covid cases. The staff are so tired but we have to keep the service going."

Care home manager (public sector), Highlands and Islands

In terms of specific types of staff, staffing shortages were most commonly mentioned in relation to nursing staff and care staff. Managers spoke of a lack of available qualified nurses, an issue also raised in the 2018 study, which they attributed to the current competitive job market, but also to Brexit, since a high proportion of the nurses employed by some services in the past had come from EU countries.

"The EU nurses have gone back home because they don't see any future for themselves here."

Nursing agency manager (private sector), East

Nurse agency managers highlighted that they were currently struggling to recruit and meet the demand of care services for both qualified nurses and care workers (partly due to high levels of COVID-19 absences). This meant that both agency and care home staff were having to work longer and more demanding hours.

[Care homes] will ask for maybe nine nurses or carers in a shift and sometimes we can't cover that request. So care home managers are coming back to us and saying they are working short staffed because even the agencies can't meet the demands that there are at the moment."

Nursing agency manager (private sector), South West

While managers reported that they were now receiving significantly fewer applications from candidates from the EU, compared to prior to the UK's decision to leave the EU, some reported an increase in non-EU applicants over recent years, largely from Africa and Asia. These applicants tended to fill part-time care worker and auxiliary roles.

"I would say about 20% of our staff are British born… The rest now are mostly from India, Pakistan, different parts of Africa."

Nursing agency manager (private sector), East

"We've seen a lot more young African [candidates] applying over the last couple of years."

Housing support / care at home manager (public sector), East

Most of these applicants were students, who were suited to part-time care work with flexible hours. However, some managers noted that a knock-on effect of this was that their staff turnover had increased, as these types of staff would leave the service once they had completed their studies.

"With our care workers, we've got a slightly higher turnover because when they [finish their studies] after about two or three years they tend to move on."

Nursing agency manager (private sector), East

Managers also reported that, since they were currently receiving a smaller pool of applicants for any new vacancies, they were now more likely than they had been in the past to recruit people with no experience of working in the care sector. Consequently their service was having to spend more time and money on training. This could also put pressures on staffing overall, since senior staff were having to spend a higher proportion of their time training and shadowing new staff.

"Because of the staffing crisis I'm having to pick up and train people who have never worked with children in their life and it's a harsh learning curve, but I don't have a choice."

Day care of children manager (private sector), East

"Some of the care workers that come to us have no experience, so we are doing all the training from scratch… It's something that we've had to do more of since Brexit, because before then the EU care workers were quite experienced in care, so we didn't do as much training as we're doing now."

Nursing agency manager (private sector), East

"You have to spend the time mentoring [new staff] and it costs us more money too."

Day care of children manager (private sector), South West

Managers who were experiencing recruitment and retention challenges had taken a number of different approaches to address these, with varying levels of success. Many of these approaches were similar to those mentioned in the 2018 report.

One such approach was the more widespread advertising of job vacancies. Managers mentioned that in response to recent recruitment challenges they had started to use recruitment agencies or, for managers of public sector services, advertise jobs online through local government websites, such as myjobscotland. Other offline channels such as local newspapers, university recruitment days, posters in doctors' offices and libraries had also been used. Others still said they had success through word of mouth recruitment, often boosted by 'refer a friend' incentive schemes offered to existing staff.

"Word of mouth has got us a few in. And everything goes to myjobscotland now – but not everybody has a computer or looks at [that website] so we've asked the Council to put jobs in the local paper... It seems to be working, we are getting applicants."

Care home manager (public sector), Highlands and Islands

"We put out adverts in universities, job centres, doctors' offices. And [African staff] let people know about any vacancies through their church communities. We've got some [recruits] through that."

Housing support / care at home manager (public sector), East

While some managers reported greater success with some channels in comparison to others, in general it was thought that more widespread advertising had helped to increase the number of candidates applying for jobs.

Similar to the 2018 findings, other approaches mentioned by managers included offering to fund the costs of SVQ training for new care practitioners or continuing professional development (CPD) training courses for nurses, in order to attract people into the social care sector or to their service. In addition, nursing agency managers also said that, alongside the costs of any training, their service offered to pay their nurses' NMC fees, along with any uniform costs.

"Six staff members are going through their [SVQ] training at the moment and we mentor them through that. We source funding through the [local council] and then we fund the remainder of it."

Day care of children manager (private sector), South West

"We offer quite good incentives. We pay their NMC fees, and they get their uniform and don't have to pay for training. Some companies don't do that, so it's an added bonus."

Nursing agency manager (private sector), South West

A number of other incentive strategies were mentioned that had been used to help address both recruitment and retention challenges. These included employee discount schemes, such as the Blue Light Card, and refer a friend bonuses. Some managers had recently increased staff pay, though stressed they were not confident this had had any impact on improving recruitment and retention. They highlighted that the budgets and funding available to their service meant they were restricted in how much they could offer, and even after doing so the pay for some roles was still on a level with less demanding jobs in other sectors.

"We pay above the minimum rate [of pay], but you can work in a supermarket for more an hour. And while the government provided funding to increase support workers salaries there is no room in margins to increase the rates of pay of other [staff]."

Housing support / care at home manager (voluntary sector), East

Largely consistent with the findings in the 2018 report, managers who said they were not experiencing any retention problems attributed this to factors such as a supportive and open working environment (for example, holding regular team meetings, and providing staff mentoring and counselling), ongoing training and development opportunities, offering flexible working hours, and incentives, such as end of year bonuses.

"Everyone gets really good support and supervision, and managers have weekly team meetings with staff. And I think it's just having time and space for [employees'] personal needs, supporting people if they are going through a stressful time."

Housing support / care at home manager (voluntary sector), South West

"We give our staff bonuses at the end of the year. It's not much, but we do give them something. And we have quite a lot of jobs that come through, so our staff tend to work the hours they want to every week."

Nursing agency manager (private sector), East

Brexit and the contribution of EU workers

The impact of Brexit on recruitment and retention was largely determined by the level of reliance on EU nationals services prior to the UK's decision to leave the EU. Managers held different views on how important the contribution of EU workers was / had been to their service depending on the number of EU staff in their organisation. One view expressed by managers was that the availability of EU workers was important to their service, particularly in the context of staff shortages across the sector and high demand for care services. For nursing agency managers, having more EU staff (or staff from any background) available to recruit would mean they were better equipped to meet client demand for care staff.

"[EU staff] are very important. They allow us to have a bigger pool of workers."

Nursing agency manager (private sector), South West

"We can certainly see a massive difference [since Brexit]… Because [EU staff] made up quite a high proportion of our staff. They stayed longer."

Nursing agency manager (private sector), East

Other managers said that while EU workers had been important to their service in the recent past, now that they no longer made up a significant proportion of their workforce, the service had adjusted to that loss. Others still, whose services currently employed a small number of or no EU workers, said that their contribution was less crucial (although still valued).

"[EU staff] are not as important to the care sector here as they are to tourism, you know the hotels and that... But they're good workers. They have a better work ethic [than UK staff]."

Adult day care manager (public sector), Highlands and Islands

As highlighted in the above quote, and in line with the 2018 study, managers said that EU workers often had a stronger work ethic than their UK counterparts, and a more of a positive attitude to their work and greater desire to receive training, work longer hours and progress in the role.

"They've come here because they want to work hard, make a better life for themselves and their families so that tends to impact on their work ethic and their commitment… The way they worked was different, their commitment to work was different. They were quite happy to work, you know, longer hours for instance."

Nursing agency manager (private sector), East

"Some of them are just more positive. Because they're over here, it's a new country, they just feel more enthused about getting a job. And usually in interviews they're more open and honest."

Nursing agency manager (private sector), South west

When asked about the skills, qualifications and experiences of EU staff, while some managers thought there were no real notable differences between EU staff and staff from the UK, others felt that EU staff brought different skills and perspectives with them to their work in the UK, along with the ability to speak different languages.

"Being able to speak different languages helps because service users aren't always from the UK. And they can bring different skills from their country because things are always different elsewhere."

Nursing agency manager (private sector), South West

"They bring different cultural experiences. It increases the diversity [in the organisation] doesn't it, and by doing that it's a two-way learning thing. They bring experiences of what works in organisations in different countries."

Housing support / care at home manager (public sector), South West

Managers did report that, aside from an overall lack of applicants, they thought it would be more difficult to recruit staff from EU countries as a result of Brexit. Although they did not cite any specific UK government policies that made it more difficult, managers reported concerns that it would now be more bureaucratic to hire staff from the EU – for example that it took longer to get staff work permits, check visa requirements, and for applicants to attain PVGs. However, those with experience of hiring staff since Brexit did say that the recruitment process for them had been fairly straightforward and had not caused any difficulties.

"We're still getting EU staff applying… The recruitment process is more or less the same, though there's another couple of checks we've got to do but it's not really that much different than before."

Nursing agency manager (private sector), South West

"We had to go through a wee bit of extra bureaucracy to make sure they were able to work in the UK, to get a work permit."

Housing support / Care at home manager (voluntary sector), South West

"One concern would be that it will take longer for them to get their PVG clearance and to get a work permit."

Day care of children manager (private sector), East

Although not a result of Brexit and something that had been an issue prior to this, managers also noted there could be issues with qualifications from abroad not being recognised by the UK social care sector. This could be a source of frustration for managers, where applicants had qualifications equivalent to, or more advanced, than those required for working in Scotland, but they did not meet UK social care requirements.

"Nurses coming over here have to do an OSCE exam before they can be placed on the NMC register."

Nursing agency manager (private sector), South West

"We would have people [applying] who were qualified, but under SSSC they are not… EU workers sometimes have different qualifications – we had someone applying who had done a Masters in Childhood Studies and they wouldn't hire her here because she's not qualified under SSSC. "

Day care of children manager (private sector), East

Managers did not report any reservations around hiring EU staff in future because of these issues. No managers reported any specific policies on recruiting staff from the EU but most managers stressed that they welcomed applications from people of all backgrounds, providing they had the requisite skills and the right to work in the UK.

"We're happy to employ anyone who meets our standards – who works hard, interacts well with the services users and can work well with the team."

Housing support / care at home manager (public sector), East

Information and support needs

In terms of the types of information and support managers said they received about staff recruitment and retention, managers raised a number of sources, including:

• The management team of their organisation
• The HR department of their organisation
• NHS online training
• Online support from SSSC
• Local authorities

Access to this support varied by the type of organisation – for example, larger services were more likely to have access to an internal HR department, who dealt with HR policy, the advertisement of job vacancies and the paperwork involved in recruiting new staff. Meanwhile managers of voluntary services mentioned grants from local government. There were also managers from small organisations who reported that they did not receive any support from any sources.

"I get no support whatsoever… I've had to teach myself what works and what doesn't. I feel very let down by the government, especially considering how much I pay to the government to have a registered service."

Day care of children manager (private sector), East

Asked about any support received in the lead up to Brexit about the retention of EU staff, some managers reported receiving internal support from their HR department (in larger organisations) or online information from the Scottish Government and local councils that they were able to share with EU staff. Others said that they had not received any information. However, no one said that this information, or a lack thereof, had caused any issues regarding the retention of EU staff.

"I think there were emails sent through from local authorities [and] support we got from the government in terms of the process and steps and ID required and all these sorts of things. And we were able to support them through the process."

Adult day care manager (voluntary sector), East

"I didn't see anything and I'm a manager so you'd think that I would have. It's not something that was discussed at any managers' meetings let's put it that way."

Housing support / Care at home manager (voluntary sector), South West

On the whole, managers were unclear about any future information and support needs to address any recruitment and retention challenges. They said either that they did not need any more information or support, or that they would welcome support but, other than financial support, did not know what this would look like.

Views were similar on information and support needs specifically in relation to any ongoing impacts of Brexit on recruitment and retention. Managers either felt that, now Brexit had occurred, they did not need support (for example, because Brexit had not significantly affected their organisation, or they had already adjusted relatively successfully to the changes), or they would welcome support and information but, at this stage, were unable to say exactly what they required – largely because they had not recruited any EU workers since Brexit.

"There's information on the [intranet] and HR would direct us as well so it's not really an issue."

Care home manager (public sector), North East

"I think that maybe we'd have to have seen more [impacts of Brexit]. I need to know more of what to be aware of – what sort of things do people need – so that we can plan to support people."

Housing support / Care at home manager (voluntary sector), South West

"It's not been an issue for us yet so it's quite difficult for me to comment because I don't really know what [the impacts on] the wider sector are going to be."

Adult day care manager (voluntary sector), East

Looking to the future

Looking towards the future of the social care sector over the next five years, managers expressed concerns about growing staffing shortages. Care home managers expressed particular concerns around the ongoing impact of COVID-19 on recruitment and retention: COVID-19 restrictions in care homes were felt to still be restrictive, making for difficult working conditions, and as noted previously there was a perception that people were more reluctant to work in care homes since the pandemic.

"It's really depressing. If care homes keep getting [bad press] people won't want to apply. There's so much publicity on the issues in homes now that restrictions have come down on us so hard. We can't breathe."

Care home manager (public sector), North East

"People are not keen to work in care homes just now."

Nursing agency manager (private sector), South West

Other concerns were around an ageing workforce in the social care sector, with a perception that the sector was not attractive to younger workers, who were less likely to apply for care jobs and pursue a career in social care, and which would intensify the staffing issues in the sector over time. Nursing agency managers also highlighted concerns about a lack of new, qualified nurses entering the sector.

"My worry is that quite a lot of [care workers] are over 50, and I think recruitment is going to be really difficult when, in the next five years or so, most of them will be looking to leave."

Adult day care manager (public sector), Highlands and Islands

"There are less student nurses coming through just now. The numbers aren't where they should be."

Nursing agency manager (private sector), South West

Other managers were more positive (or at least cautiously hopeful) about the future of the sector. There was a hope that 'once the dust settles', they might see more applications from EU workers. For voluntary services, there was also a view that funding and recognition of the sector had improved in recent years, and a hope that it would continue to do so in future.

"Maybe once people [from the EU] get use to the changes that Brexit brought, they will hopefully, in a year or two, start thinking, 'Well, actually I can go to the UK and apply for these jobs and work there.'"

Nursing agency manager (private sector), East

"The future's looking good, in terms of the government recognition of the social care sector and funding to increase the hourly rates and towards training and allowing people to get their SVQ qualifications and SSSC registrations."

Adult Day Care manager (voluntary sector), East

Looking more specifically at the future of their service, managers' views were mixed. Some were pessimistic, expressing concerns about possible funding cuts or the demands an ageing population will place on their service.

"We've not got the staff for what's needed in the future. We've an ageing population with more and more complex social care needs."

Housing support / care at home manager (voluntary sector), South West

Other were more hopeful, highlighting opportunities related to the high demand for care services or plans to expand and diversify into other areas of care.

"Hopefully we'll get more business [in future]. There's going to be a demand from the [care] homes."

Nursing agency manager (private sector), South west

"We've lost a lot of nurses to Brexit so we're thinking we've got to diversify into care in home services, … so that our care workers can go into [service users'] homes instead of just care homes."

Nursing agency manager (private sector), East

Managers were asked what they thought would help to encourage more people to work in the social care sector. Their suggestions were broadly in line with those from the 2018 study. The overwhelming feeling was that improvements to pay and working conditions across the sector were necessary, including benefits such as time off in lieu, improved pensions, less demanding hours and, for care home managers in particular, an end to COVID-19 restrictions (when appropriate). Improved messaging and media coverage to raise the profile of the social care sector was also mentioned.

"Better salaries, pensions, job security – not having to worry about where funding is coming from."

Housing support / care at home manager (voluntary sector), South West

"If the pay was better, maybe that would be more attractive for people… Also, I don't know if the government can do an outreach thing [in the] media, to try and promote the [care] sector as something that's attractive to go into, and not something that people are fearful and reluctant to go into."

Nurse Agency manager (private sector), East

In terms of messaging to help encourage people to enter the sector, managers suggested a range of different ideas to help portray the sector in a more positive light and to encourage more people to work the sector.

• You can make a difference in people's lives
• There is job satisfaction and a feel-good factor to the work
• You will work in a playful, dynamic environment where every day is different
• There are opportunities for people from all sorts of backgrounds
• There are opportunities to gain qualifications and have a career within the sector

These are illustrated in the quotes below:

"It can be very rewarding. It's about people first and it's dynamic, there's no one day the same. You can use your skills and creativity, it can be basically, within reason, what you want it to be… And there's always a place for someone in health and social care, no matter what the background."

Care at Home service manager (voluntary sector), West

"For me it would be the qualifications, you can get your SVQs, and then decide where you want to go."

Adult Day Care manager (voluntary sector), East

"It's a chance to make a difference in young people's lives. You have the chance to make their lives very special… You can help them through social and emotional things, you can help them have fun… It's a great safe, secure and playful environment."

Day Care of Children manager (voluntary sector), South West

Summary

The qualitative research highlighted that the recruitment and retention of staff remain significant challenges for the social care sector and echoed the findings from the survey that the extent of these issues had increased over recent years.

Some of the recruitment and retention challenges facing the sector were broadly similar to those described in the 2018 study, namely a shortage of suitable applicants, particularly for nursing roles, and low pay and wage competition from other employers.

However, a number of new factors were also raised, which were exacerbating these ongoing challenges. The emergence of COVID-19 in early 2020 has had a clear impact on the sector, and added to existing staffing and workload pressures due to higher levels of staff absence and restrictive working conditions. Furthermore, negative publicity surrounding the virus and the care sector was thought to have made the sector less attractive to job seekers. In addition, managers felt that the current, competitive job market and a high number of job vacancies meant that people were more likely to apply for better paid and less demanding jobs elsewhere.

The UK's decision to leave to EU has also had a noticeable impact on recruitment and retention, particularly among services that comprised a high proportion of EU staff prior to Brexit. In the lead up to and since Brexit, managers noted a significant reduction in the number and quality of applications, as a result of the decline in applicants from the EU. They also noted that a number of EU staff had left their service, and the UK, either because they could not obtain a visa to work in the UK or due to concerns and uncertainty about their future residency status in the UK.

Despite a decrease in the number of applicants from EU countries, managers noted there had been an increase in non-EU applicants over recent years. However, they also said that since they were still receiving a small pool of applicants for any job vacancies, they more likely than they had been in the past to recruit people with no experience of working in the sector.

A number of strategies had been taken to address recruitment and retention challenges, with varying levels of success. These included the more widespread advertisement of job vacancies; improved pay, conditions and training offers; and providing a supportive and communicative working environment.

A number of other suggestions were made on how to meet current and future recruitment and retention challenges. These included:

• Improving pay and working conditions across the sector
• Improved messaging and media coverage to raise the profile of the social care, focusing on the rewarding nature of the work and career opportunitie within the sector.