Implications of labour markets for the social care workforce: report

Executive Summary

Key Findings

The aim of this study is to better understand the influences that national and local labour markets have on the social care sector, how different parts of the social care sector interact and the implications for workforce planning.

The methodology comprised five main stages. We conducted a detailed review of literature and data and to supplement this, primary research with added depth and detail. The primary research comprised consultations with key stakeholders, online surveys of social care employers and people working in social care (with the exception of social workers). A total of 1,553 employers and 8,055 employees responded to the surveys.

Perceptions of Social Care

• The desire to do a job that makes a difference is the main reason why people are motivated to take up a career in social care and this is particularly true for people working in children’s services.
• The fact that it is a practical job, and that the sector offers flexibility in working hours are also important motivators.
• The perception is that the main reason why people leave the workforce is for better terms and conditions, particularly pay levels and another driver is to do a less demanding job for similar or better rates of pay.
• Employment opportunities in social care are reported as being good, rated more highly by respondents than career progression opportunities.

Recruitment and retention

• Social care employers face difficulties in recruiting and retaining staff, particularly staff that provide direct care and support.
• Almost two-thirds of employers in the study were recruiting at the time of the research and around a third of these reported having hard-to-fill vacancies.
• Half of employers who expect to recruit in the next year report that they will do so to expand their workforce and 71% expect to recruit to replace staff who might leave.
• Replacing staff is expected to be more common in more urban settings and remote island communities, while workforce expansion plans are greater in larger cities.
• Around half of all employers responding to the survey anticipate recruitment challenges going forward.
• Oxford Economics employment forecasts (commissioned by Skills Development Scotland) suggest that the social care workforce will grow by 5%, or 8,000 jobs, between 2019 and 2029^[1].

Social Care workforce movement

• SSSC analysis indicates that the stability index within registered social care employees is around 71% meaning that the majority of people remained in the same position between 2016 and 2017.
• Of those who did move, some can be accounted for by movement within the sector (including career progression) meaning that the sector has retained the skills and experience of these workers.
• The research shows that people who change jobs within the social care sector tend to join a similar service type. The SSSC analysis of movement also suggests there is a strong tendency for people to remain in the same type of service, for example adult or children’s service.
• The survey analysis points to a slightly greater propensity for staff to move from adult to children's services, but it is still more likely that adult services social care staff will remain in this sub-sector.
• The main exchange of social care employees is with the business services and health and education sectors. The latter reflects the synergies between these sectors in terms of skills and experience needed by the workforce.
• Social care competes for staff with health, hospitality, retail, education and cleaning
• One in ten social care employees indicate they would like to leave the sector in the future. This is mainly due to the stress and workload of their current job.
• The sector faces competition from the health, hospitality, retail, education and cleaning sectors, reflecting that people appear to be attracted to work opportunities in what they consider to be less demanding jobs for the same or a better rate of pay.

The aim of the study is to better understand the influences that local labour markets have on the social care sector, how different parts of the social care sector interact, and the implications for workforce planning.

Contributing £3.5bn to the economy, social care is a very important sector for Scotland. It provides employment and acts as a driver for research and innovation, and a purchaser of goods and services. It enables participation in the workforce by supporting the health and well-being of the population and providing care that enables parents to work and participate in training and education.

Sitting within the broader social service sector, which includes social work services (including all local authority social work services)^[2], social care covers a number of subsectors – including Early Learning and Childcare (ELC), adult day care, adult residential care, and care at home. Across the sector there are a wide range of settings, roles and occupations. A detailed definition of the subsectors and service types are detailed in Appendix A of the main report. The scope of the study extends to Early Learning and Childcare (ELC) reflecting the significant level of investment that has been committed to the sector and the increase of funded entitlement to 1,140 hours per year from August 2020. The scope of the study does not include social workers working for any type of employer.

There have been significant changes in the context and delivery of Health and Social Care and a number of drivers are impacting on the skills required to provide social care. Scotland’s ageing population and lengthening life expectancy (although this has stalled recently) has implications, particularly as healthy life expectancy has not been increasing at the same rate. The integration of Health and Social Care requires staff to work in different ways and, along with Self-Directed Support, provides the opportunity and expectation for reforming how social care for adults is delivered.

The Scottish Government and COSLA have been working with people who use social care support, unpaid carers, the social services sector, local and national organisations and Health and Social Care partnerships to develop a national programme to support local reform of adult social care. In 2017 and 2018 the Scottish Government published a series of national Health and Social Care workforce plans (NWP) for Health and Social Care as part of a new process for improving planning. Parts 1 and 3 focus on health and primary care respectively^{[3] [4]}. In December 2017, the Scottish Government and COSLA jointly published the ‘National Health and Social Care Workforce Plan Part 2: a framework for improving workforce planning for social care in Scotland’^[5] which relates to the social care workforce. It sets out a number of recommendations and actions to address key priorities which include recruitment, retention and improved opportunities for career progression. The second recommendation in Part 2 focuses on the need to develop an improved understanding around national and local labour markets for social care and this work was commissioned to deliver the recommendation.

Although it is one of the largest, this is not the first piece of research into the social care workforce or the first survey of the sector. Research has been undertaken and continues to be undertaken by a range of organisations including the Scottish Social Services Council (SSSC), the Care Inspectorate (CI), Scottish Care, Skills Development Scotland (SDS), the Institute for Research and Innovation in Social Services (IRISS), the Coalition of Care and Support Providers in Scotland (CCPS), the National Day Nurseries Association (NDNA) and the Scottish Childminding Association (SCMA).

The methodology comprised five main stages. The primary research stage was undertaken in order to supplement the data and literature review, and add depth and detail to the evidence. This included a programme of consultations with key stakeholders, and an online survey of social care employers and the social care workforce (with the exception of social workers). Table 1 sets out the details of the primary research and the number of responses.

Table 1: Primary research

Stakeholder Group	Approach	Number of Responses
Social care employers[6]	Online survey	1,553 responses[7]
Social care employees	Online survey	8,055 responses[8]
PA employers	Online survey	20 responses
PAs	Online survey	76 responses[9]
Key stakeholders	Telephone consultations	23 qualitative consultations

Alongside the main report, the following have been produced:

• a report focusing on ELC, reflecting the over-representation of ELC services in the survey responses
• a report on the implications for workforce planning; and
• a case study report that explores key local labour market characteristics and issues around recruiting into the social care sector in four areas with different characteristics: Aberdeen, Dumfries and Galloway, Argyll and Bute, and South Lanarkshire.

Working in Social Care

The research drew on published data from official sources about the current composition of the workforce, the forecast workforce requirements and the pipeline of skills. The SSSC is the regulator of the social service workforce and, with the Care Inspectorate, undertakes research and collects data on the Scottish workforce. Based on this it produces an annual data-driven workforce report. At the time of our research, the most recent report was published in August 2018 comprising data collected in December 2017.^[10] It shows that there were over 202,000 people employed in over 13,000 active registered services. The report indicates that, on average, employers in the public and voluntary sector are larger than those in the private sector. Childminders account for around 40% of active registered services, many of whom do not employ any staff, so excluding childminders gives just under 8,000 social service providers in Scotland.

The social service workforce comprises 18 different subsectors as defined by the SSSC^[11]. By far the largest of these in employment terms is housing support/care at home, which employs almost 71,000 people (35% of the total workforce), care homes for adults, which employs over 52,000 people (26%) and Day Care of Children which employs over 34,000 people (17%). A Scottish Government report indicates that in 2018 non-UK EU nationals accounted for 5.6% of people employed in adult social care and childcare, which equates to around 9,830 staff^[12].

The social care workforce has some characteristics that set it apart from other sectors in Scotland and the economy as a whole. It has a much higher proportion of female workers than the economy as a whole^[13]; it is, on average, slightly older than the overall workforce in Scotland^[14]; there are a greater number of social care jobs relative to other sectors in more rural and remote areas of Scotland, and they are less concentrated in cities and more urban areas^[15]. There is also a much higher prevalence of part-time working in social care than across the Scottish economy^[16]; and a substantially higher vacancy rate^[17] in social care than other sectors^[18].

Workforce movement within the Social Care sector

The average staff turnover rate in the UK economy is around 15%^[19]. The SSSC publishes stability index figures for the social service workforce which measures the proportion of staff who have been retained in the same post since the previous year. In December 2017 the stability index for social services was 77.1%.

In 2018, SSSC undertook a survey of around 1,000 people who had left the SSSC register^[20]. Just over half indicated that they were still working in the social service sector despite leaving the register, meaning they were likely in roles that do not require registration, or people who have taken up a new post but have not yet registered. Just over half of those who were no longer working in the sector had taken up a job in a different sector.

The research shows that people who change jobs within the social care sector tend to join a similar service type, and the SSSC analysis supports this by suggesting that there is a strong tendency for people to remain in the same type of service, for example adult or children’s service. The research data shows that people who work in adult services are very likely to remain working in adult services, and move around within it. In children’s services, the research evidence shows more movement from adult to children’s services but it is still more likely that people move within children’s services, rather than from adult services to children’s services. Where people do move from one to the other, it is more likely to be from adult to children’s rather than the other way round.

Going forward the key will be for workforce planners and employers to attract new people into the social care sector instead of relying on moving people around within it.

Competition from other sectors

The research explored what motivates people to join the social care workforce, and also the reasons why they leave. For adult and children’s services the main motivator is the desire to do a job that makes a difference to people’s lives, followed by having a passion for the job. The factors that employees believe encourage people to leave the workforce are to move into a job with higher rates of pay, because of caring responsibilities, and to progress their career. Employers in the survey are less likely than employees to perceive that people might leave to care for dependent children or adults. In the research there was a cohort of 418 employees who reported that they intend to leave the sector and so we asked them to indicate why. The overriding reason was that the work is too stressful, workloads are unmanageable and there is a lot of pressure. This was followed by wanting to achieve a better work-life balance, and then because they are looking for better terms and conditions.

The research explored the reasons why, once people enter the workforce, they choose to remain. These factors largely mirror the motivations for joining in the first place. Having said that, people are more likely to identify with, and care for their service users once they are actually working with them.

Just over half of people working in adult services responding to the survey report that the desire to make a difference to people’s lives motivates staff to stay in the workforce. The corresponding proportion for people working in children’s services is three quarters which is a substantial difference. A sense of pride and job satisfaction was also identified as a key motivator to remain, as is identifying with service users, including children. The working environment was found to have an important role to play in motivating some people to join and remain the sector. It is a practical job with variety rather than being routine or desk-based and this is perceived as being attractive.

The SSSC research^[21] of c.1,000 people who had left the register shows that people who leave the register and take up a job in a different sector most commonly move into education, retail or health. In the research undertaken for this report employers suggested that the top sectors competing for social care staff are health and education, in that order. Retail and hotels and hospitality are also important competitors. The extent to which social care competes with these sectors varies by area, largely driven by the sector profile in each locality, for example hotels and hospitality are considered more important as a competitor in rural areas.

Recruitment and retention

The research evidence shows that social care employers have found it difficult to retain staff in recent times, particularly care staff that provide direct care and support. Retaining managerial and supervisory staff is reported as less of an issue. At the time of the research around two-thirds of social care employers responding the study were recruiting and it was highest amongst independent sector employers. Understandably the evidence shows that recruitment and retention can be particularly difficult in tight labour markets and where there are people who have more, and more varied employment options.

Around one-third of employers in the study report having hard-to-fill vacancies, again, most noticeably amongst independent employers. Employers are finding it hard to find staff with the skills and experience to deal with complex conditions, and people who have the required digital literacy and technology skills. Reflecting a recent expansion in the housing support/care at home sector, employers here are particularly concerned about recruitment challenges.

Social care employers in the research anticipate facing challenges in recruitment and retention in the next 12 months, particularly in islands and remote areas, and again most acutely in the independent sector.

Given the high levels of expansion and replacement demand for skills in the social care sector reported in the study, a higher proportion of employers plan to recruit in the next year to replace staff that might leave (72%) and to expand their workforce (50%). Replacing staff is expected to be more common in more urban settings and remote island communities, while expansion plans are greater in larger cities.

Skills Development Scotland (SDS) commissioned Oxford Economics to prepare employment forecasts for key sectors in the Scottish economy. These forecasts suggest that the social care sector (which includes child day care activities) will grow by 5%, or 8,000 jobs, between 2019 and 2029^[22], covering expansion demand (demand for jobs due to a growth in the sector) and replacement demand (demand for jobs due to the existing workforce leaving/retiring). This means that by 2029 approximately 42,500 workers will be required to replace those leaving and to fill new posts.

Workforce planning

The sector requires a strategic approach to planning the workforce that takes account of current and emerging policy and key drivers of change. Data and intelligence should be available at national level, but could also inform work at local authority, integration authority and locality levels. To ensure the sustainability of the social care workforce, planners must use data from a range of sources. They must have robust information to understand the current profile of the workforce, gaps and shortages, the requirements of the sector and the subsectors, and the anticipated future needs. Overarching this, an understanding of the labour market context is important as are the implications of different labour market conditions for recruitment and retention.

There is a wealth of data available, providing very useful information and intelligence for example from the Scottish Government, the Scottish Social Services Council (SSSC), the Care Inspectorate, Scottish Care and the Coalition of Care and Support Providers in Scotland (CCPS). There are some areas which published data does not currently explore in depth or regularly, such as detail about vacancies within different parts of the sector, where the social care sector recruits from, and the sectors staff move on to. Sources such as ‘Burning Glass^[23]’ may help to give workforce planners real-time job market analysis, for example of vacancies in social care. Also through SDS, Oxford Economics data provides workforce projections for key sectors, including social care. This is only one source of intelligence for understanding future demand but it is helpful for workforce planning because it also shows the projected needs of other sectors that may be competing for staff.

The Workforce Planning report that accompanies this report sets out data limitations and gaps that, if addressed, would help workforce planners to better understand and respond to the labour market conditions and the social care workforce demand and supply. These gaps should be prioritised in order to plan how available resources are best used. Addressing them may require adjusting existing research methods and tools or undertaking additional primary research, for example with employers, staff and potentially people who have left the register. A number of these activities could be considered as part of the ongoing work under the development of the National Workforce Plan for Health and Social Care.

Alongside this, it would be good practice to have in place an agreed set of outcomes and performance indicators to monitor, manage and drive performance. It will require co-production and partnership working, and organisations must be willing to make adjustments to how they might do things currently. It will require budget as well as time commitment to plan, implement and manage a refreshed approach to workforce planning.