Implications of labour markets for the social care workforce: report

7 Conclusions

Introduction

7.1 We are at a crucial stage in the development of social care and social services in Scotland. This is coupled with an ageing population and an increasing dependency ratio which place additional pressures on social care. This has to be seen however, alongside a push for ‘fair work’ in social care; a planned reform of adult social care, and emphasising human rights. Not only has the Scottish population been ageing through increased life expectancy (although this increase has recently stalled), lengthening healthy life expectancy is lagging, meaning that more people are living longer but with more health and support needs^[154]. The sector is likely to face considerable challenges over the next decade as the workforce seek to recruit additional workers and replace staff as they leave to move onto new roles or for other reasons such as retirement.

7.2 It is a fast changing sector, with new ways of working and new ways of delivering services which has meant that roles and tasks undertaken by staff are developing and in many cases becoming increasingly complex. Key policy changes - including the integration of Health and Social Care, and the expansion of the funded ELC entitlement to 1,140 hours per year from August 2020 for all three and four year olds (and eligible two year olds) - have, and will continue to have, significant implications for the workforce. The projected fall in Scotland’s working age population, by 4% between 2016 and 2041^[155], coupled with the potential impact of EU exit means that competition for staff is likely to increase across the Scottish economy which has implications for all sectors, including social care.

7.3 Against this backdrop there is no doubt that there will be continuing and increasing pressure on employers to recruit and retain an adequate and skilled social care workforce to meet need. All of these factors mean that it is critical to have clear sight of the workforce and the skills required to provide high quality care across all of the social care sub-sectors. We must ensure that the mechanisms are in place to understand demand and the impact of different types of labour markets in order to equip workforce planners with the evidence-base they need to develop a sustainable workforce for the future.

7.4 Local data and intelligence along with an understanding of local labour market dynamics, will be crucial. The workforce requirements and issues need to be understood and planned for at national, regional and local level and appropriate and timely responses must be planned and implemented within an overall strategic approach. “The development of a first Integrated National Workforce Plan for Health and Social Care (in draft at summer 2019) aims to provide a strategic national approach and context to support workforce planning in these sectors. It also provides initial guidance for workforce planning in local integrated settings.” These responses must be evidence based in terms of the likely demand for skills, driving the skills pipeline, and the education and training that will be required. They must also be mindful of wider political drivers.

7.5 The sector requires a strategic approach to planning the workforce that takes account of current and emerging policy such as the ongoing integration of Health and Social Care services. The approach also needs to take account of other key drivers such as changing demographics, the development of roles in the sector, the need for qualifications, the debate around ‘fair work’ in social care, and competition from other sectors. To be useful, data and intelligence should be available at national level, but could also inform work at local authority, integration authority and locality levels.

7.6 Alongside this workforce planning activity there should be an agreed set of outcomes and performance indicators to monitor, manage and drive performance. This 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 and then monitor the difference it is making. Careful consideration will need to be given to this by the range of partners.

7.7 This report provides valuable insights in to what motivates people to join and remain working in social care, and the reasons why people may leave the social care workforce. By understanding this, workforce planners can communicate messages more effectively to attract and retain staff and take appropriate steps to help address the reason why people leave.

Conclusions

Workforce Planning Data

7.8 This report brings the evidence together from across the social care sector rather than focusing on particular parts of it, providing a comprehensive picture of the sector and the workforce planning implications. The employee and employer surveys conducted as part of this research study appear to be the largest surveys undertaken of the social care workforce in Scotland to date. The number of responses has ensured that findings are generally representative of the sector’s workforce as a whole.

7.9 The secondary data sources provide very useful information and intelligence. For example, our report refers to findings 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 of course some areas which published data doesn’t 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. For example, sources such as ‘Burning Glass^[156]’ may help to give workforce planners real-time job market analysis for example of vacancies within the social care sector and in sectors that social care may compete with for workers. Also through Skills Development Scotland, Oxford Economics data provides one source of workforce projections for key sectors, including social care, detailing expansion and replacement demand. This information will be helpful in on-going workforce planning because it also shows the projected needs of other sectors that social care employers may be competing with for staff. Enhancing the data going forward, there will be more comprehensive analysis, for example of workforce movement, as the SSSC Register is extended to cover 80% of the social care workforce.

7.10 There is a wealth of data available but more co-ordination and coherence between the various data sets would enhance their strategic value to workforce planning and might reduce the need for large scale survey work of the type carried out for this research. However, the value of this kind of primary research cannot be under-estimated in terms of the specific and depth of information it can generate. The ongoing development of a national Integrated Workforce Plan for Health and Social Care, accompanied by local workforce planning guidance for Health and Social Care Partnerships and a national Health and Social Care data platform, offer the opportunities for more informed and co-ordinated approaches to workforce planning.

Movement in the workforce

7.11 SSSC analysis shows that the stability index within social care employers is around 20%, with one in five social care employees registered with SSSC moving jobs in 2017. Research undertaken by XpertHR indicates that the average staff turnover rate in the wider UK economy is around 15%^[157]. The SSSC research identified a strong tendency for people to remain in the same type of service, for example adult or children’s services, and re-registrations in some cases indicating promotion and upward progression within the sector.

7.12 Where staff move within the sector, they tend to join a similar service type but for many, this movement appears to be from independent or third sector services to the public sector. The SSSC will be exploring this area as part of its analysis of the Register. There is a clear perception that there are more training opportunities in the public sector which can encourage people to join, and undoubtedly, where the public sector can offer more attractive pay and conditions, then this is a motivator to move from third and independent sectors.

7.13 The research undertaken for this work shows that staff have a tendency to move to jobs within the same services (i.e. from children’s services to children’s services) meaning that people who work in adult services are very likely to remain working in adult services, and move around within it, and the same is true for children’s services. The research shows that 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.

7.14 Whilst this reflects the SSSC findings, its analysis did not include care at home and housing support services, which is the largest sub-sector in adult social care. The expansion of ELC by 2020 is very positive, any flow of workers from adult to children’s services may be exacerbated by the steep increase in the need to recruit staff in to ELC. The key will be to attract new people in to the social care sector (including ELC) as required, rather than solely relying on moving people around within it and so displacing and creating pressures within parts of it. That is why it is so important to understand what motivates people to join and stay in the social care sector.

7.15 Employees who have ambitions to leave social care are most likely to seek employment in the health and education sectors. In rural areas in particular, the tourism sector is a key competitor for staff, offering a wide range of job opportunities with similar or better pay and more flexible working conditions.

7.16 People who are currently working in children’s services and have been trained in early learning are more likely to move into the education sector than their counterparts in adult services. It means they can continue to use their skills of working with children but have more flexible working and better pay and conditions. Staff in adult services are more likely to move into jobs in the health sector where they can transfer their skills and potentially gain more attractive terms of employment. This supports anecdotal evidence provided by stakeholders.

7.17 Whilst staff move around the sectors, they also join from a range of other parts of the economy, notably office-based roles and retail jobs.

Recruitment and Vacancies

7.18 The most substantial recruitment difficulties being experienced by employers are in relation to support workers and other types of care staff. Given the potential for staff to leave the social care sector, it is imperative that employers are able to better understand what motivates their staff and work towards improving those aspects of the work environment and job role that they can influence.

7.19 Employers with hard-to-fill vacancies (30% of those who are recruiting) are looking for support workers and residential care workers in particular. Employers anticipate that they will continue to face these recruitment challenges over the next 12 months with more of these being in the third and independent sectors, and in remote or island locations. We anticipate that the Care Inspectorate and SSSC will publish an updated version of their vacancies report in 2020. A report could provide a comprehensive snapshot of vacancies in the sector as of December 2018

7.20 The high levels of both expansion and replacement demand means that the majority of employers are planning to replace staff that are due to retire or are anticipated to leave, and half of employers are expecting to recruit to expand their workforce. There is an increasing body of evidence which includes the findings from this study and evidence from key stakeholders such as the SSSC, Care Inspectorate, Scottish Care and CCPS. The findings are helping to shape our understanding of the sector’s workforce and significant challenges such as the challenges around recruiting staff and filling vacancies. There is a need to continue and accelerate progress to tackle these challenges to support the ongoing delivery of these vital services. .

Motivations to stay and leave the sector

7.21 Encouragingly, only one in ten social care employees want to leave the sector. Whilst the varied and practical nature of social care work can be attractive to some people, there are some more challenging aspects that present barriers to entry and progression. Although there are a range of factors influencing people’s decision to pursue a career in social care, most people join and stay in the workforce because they are motivated to make a difference to people’s lives and because they have a passion for the work. It shows that for many people, social care is more than just a job, it is a vocation. This passion and drive to make a difference is as true for those who at the time of the survey were in their first social care job as it is for those who have joined the workforce from a different sector.

7.22 There is also no discernible difference between those who live in urban areas and their counterparts who live more rurally. It is clear then that job satisfaction is a major attraction for people joining and remaining in social care which is a key message for workforce planners, education and training providers and employers to convey in order to attract people to work in social care. It also demonstrates how important it is that employees can be proud of what they do and are supported to continue to undertake a job that is high quality, valuable and valued. This is a key message for employers and other partners involved in planning a sustainable social care workforce.

7.23 Interestingly employers whilst agreeing that making a difference is a major motivator, also believe that employees are motivated by a broader range of factors including training opportunities and flexible and part-time working. These are less commonly reported by staff which may imply that employers believe staff value these opportunities more than they do in reality. It may also mean that employers are more aware of the opportunities, or they perceive the opportunities to be more abundant and positive than staff and that employers are over-optimistic about how the workforce feels about working in the sector in terms of pay and conditions.

7.24 Employees report that in their view, people who leave the sector are primarily (though not exclusively) driven by a need or a desire for better pay and conditions. Employees also cited other factors such as a lack of recognition of their role and the wider terms and conditions. These factors – particularly pay - supports previous research and is still the main challenge faced by employers, and indeed, by employees. Employers recognise that employees who leave their job with them are often looking for better pay and conditions. Employers also see a key driver for people leaving is that they are looking for opportunities to progress their career, this could be within social care or leaving to move in to other sectors.

7.25 In the study, some people noted their current intention to leave the sector and for this group, the key reason was that they wanted a less stressful job. They were also looking for a better work-life balance and the third most important driver was that they were looking for better terms and conditions. It is interesting that stress and work life balance is the reason why people report that they intend to leave, which is slightly different to the overall perception of why people might want to leave. It demonstrates to workforce planners the importance of supporting employees to ensure that the work and the work environment is not too stressful and doesn’t put too much pressure on the lives of employees in and outside of work.

7.26 Movement of social care staff from the independent and third sectors to the public sector has long been recognised as a particular issue facing providers. However, it is important to recognise that people are also motivated to move out of social care for jobs that are less demanding but may have equal or better rates of pay.

7.27 The evidence supports the fact that there are some fundamental structural issues facing the sector and whilst some progress has been made on addressing terms and conditions, the sector will continue to face challenges to meet replacement and expansion demand. These issues are also a barrier to achieving a more diversified social care workforce and make the challenges of recruitment and retention particularly acute in areas where there are a wide range of career opportunities in other sectors. Improving terms and conditions across all parts of the social care sector can’t be addressed by employers alone. It requires a greater understanding of the value and contribution of care.

7.28 Given the substantially higher proportion of female workers in the sector it is not surprising that a significant reason for leaving the workforce is childcare or other caring responsibilities. Whilst the part-time nature of the work is perceived as being a motivating factor in joining the social care workforce, it could be the case that part-time hours are determined by service user need, and do not necessarily align with when people are available to work because of their own caring responsibilities. This, compounded by pay levels can mean that working in the sector and paying for care is not a viable option for many people, forcing them to leave rather than find a work life balance solution. It demonstrates the importance of flexible working and innovative initiatives, for example supporting employers to consider how or if they can provide working patterns that are predictable and can fit around domestic responsibilities, ways of helping employees access high quality, affordable care, or looking at formalised career breaks during which workers have the opportunity to keep their skills up to date and plan their return to the workforce. Understanding this, and considering it at an area rather than provider level may help workforce planners to design solutions and take a medium to longer term approach to ensuring there is a local and skilled workforce.

Fair Work

7.29 The findings in this study should also be seen alongside the recent report by the Fair Work Convention examining fair work in Scotland’s social care sector.^[158] The report highlight the undervaluing of care and the fact that these vital services are delivered by a predominantly female workforce. The report sets out five recommendations designed to impact on the drivers of work and employment practices in social care. In summary the recommendations are as follows:

• The Scottish Government should support the establishment of a sector-level body responsible for ensuring that social care workers have an effective voice in the design, development and delivery of services.
• Key stakeholders should develop and agree appropriate minimum contract standards for the provision of publicly- funded social care services. This should cover terms such as pay as well as hours/income stability and appropriate supervision, training and development.
• Commissioning practices in social care should be overhauled to ensure that fair work drives high quality service through minimum contract standards and engagement at sector-level between social care purchasers, providers and deliverers.
• Key stakeholders in the social care sector should apply the Fair Work Framework and commit to improving pay, conditions and opportunities for progression for directly employed care workers and for PAs.
• The Scottish Government should support the preceding recommendations and incorporate them in to the Fair Work Action Plan and Gender Pay Action Plan. It is suggested that there should be a central location in the Scottish Government’s Health and Social Care Directorate to co-ordinate across the pertinent policy areas.

7.30 Our labour market study highlights a range of key findings which could support the implementation of the next steps for the Fair Work agenda.