Migration Advisory Committee Call for evidence - impact of ending freedom of movement on the adult social care sector: Scottish Government response

Section 4: Scotland's Adult Social Care System

Workforce profile

At the end of December 2020, the social care sector employed 209,690 whole time equivalent (WTE) staff, an increase of 1.6% since 2019^[15].. This is the highest level recorded since official statistics began. The social service workforce makes up approximately 8.0% of all Scottish employment^[16] and, with an ageing population, there is likely to be increased upward pressure on the size of the workforce

This increase has been driven mainly by increases to the housing support/care at home sub-sector, although in the public sector it was in day care of children^[17]. The three largest sub-sectors continue to be by far, housing support/care at home, care homes for adults and day care of children; together these account for almost 79% of the workforce^[18].

The largest absolute increase in the workforce headcount was in housing support/care at home, with an increase of 3,600 from 2019 to 2020 and up 16.5% since 2011^[19]. Almost half of private sector staff work in care homes for adults and in the care home for adults and housing support sectors a significant proportion of younger workers are employed (mainly in the private sector).

There were 6,049 social workers in local authorities in December 2020, an increase of 1.5% since 2019. The number of social workers in local authorities has increased by 6% since 2011, and is now the highest level recorded^[20].

Social Care Professionalisation

The Scottish Government, in partnership with providers and other stakeholders, are committed to improving social services and the quality of care, and are clear that attracting and retaining the right people, developing them in their roles and raising the status of the sector as a valued workforce is key to delivering this.

Although people starting a social care role in Scotland do not need to be qualified, they must register with SSSC within 6 months of starting a role with a 'condition' on their registration that they achieve whichever qualification was set out as the requirement for the job (usually Scottish Credit and Qualifications Framework – SCQF - level 6 or 7) within 5 years of starting the post. This effectively means that Social Care workers in Scotland are required to reach the equivalent of RQF 3 or 4 within 5 years of starting a post. We understand this enhanced professionalisation of the social care sector is not a requirement in England and should be recognised in the immigration system. This difference highlights one of the challenges of seeking to impose a single UK level system in areas where devolution has enabled the Scottish Government to take a different approach. Any changes to the immigration system therefore need to reflect the differential approach in Scotland.

It is essential to address recruitment and retention issues and attract new people to the sector to ensure the sustainability of services through any future waves of the pandemic. The Scottish Government is currently working with key partners to support and respond to workforce pressures (including current pressures around care at home services). For example, The Scottish Government works with a range of partners, including SSSC, to deliver our policies on up-skilling and developing this important workforce. This includes the development of foundation and modern apprenticeships and resources for those providing careers advice. The Scottish Government has invested around £50 million over the last three years to support regulation and development of the social services workforce, a long standing focus of Scottish Ministers' policy to raise the quality of the workforce, improve outcomes for service users and increase public protection.

Social Workers with a qualification obtained in a non-UK country can apply to the SSSC to have their qualification assessed against the SSSC's qualification criteria. Other social services workers with non-UK qualifications who are working in a job that requires registration with the SSSC can apply to have their qualification assessed against the SSSC's qualification criteria if they have EEA mutual recognition rights.

Social Care Pay

Since 2016, the Scottish Government has had a joint policy with COSLA to ensure that all adult social care workers are paid at least the real living wage (£9.50 at the time of writing). During 2018/19, this commitment was extended to include those undertaking overnight social care support. It covers adult social care workers providing direct care and support to adults in care homes, care at home, day care and housing support. Earlier this year, the Scottish Government provided funding of £64.5 million to deliver the Real Living Wage commitment to ensure at least £9.50 per hour for direct social care staff. The Scottish Government also provided additional funding that enabled providers to distribute uplifts across their wider workforce.

On 5 October 2021, the Scottish Government announced a £300m package to support a range of measures to maximise capacity in our hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care. Important, this fund will ensure that all care workers in Scotland receive at least £10.02 per hour. This is significantly higher than the National Living Wage of £8.91 which applies to many social care workers in England and Wales.

The National Care Service will allow us to introduce a National Wage for care staff and enter into national pay bargaining for the sector, based on fair work principles, for the first time (see below).

Recruitment and retention

Working with employers and representative bodies, the Scottish Government is taking a range of actions to support recruitment and retention of the social care workforce.Delivery of a national recruitment campaign aimed at frontline workers in adult social care, 'There's More to Care than Caring' ran for eight weeks in early 2020, to support recruitment into adult social care and to promote it as a career destination. As part of that, the Scottish Government has invested over £42,000 to enable employers to advertise their jobs for free on myjobscotland. The Scottish Government is encouraging anybody who is completing their studies in care to apply for the many open positions on myjobscotland.

Consideration is being given to a further social care recruitment campaign to address the recruitment and retention issues in the sector and build up a resilient, sustainable workforce. The Health and Social Care COVID 19 Accelerated Recruitment Portal remains available. This enables those with relevant skills and experience to come forward and support health and social care services.

The SSSC delivers a range of support for recruitment and retention of the workforce including resources on career pathways and promotional materials for schools, colleges, employment services and employers; management and promotion of routes into careers (Foundation and Modern Apprenticeships); and a network of Ambassadors for Careers in Care.

The Scottish Government published the first Integrated National Health and Social Care Workforce Plan in the UK on 16 December 2019. Developed in partnership with COSLA, the Integrated Plan sets out how health and social care services will meet growing demand to ensure the right numbers of staff, with the right skills, across health and social care services.

The Scottish Government committed to implementing the Independent review of Adult Social Care in Scotland (IRASC) recommendations^[21] including establishing a National Care Service in Scotland by the end of this Parliamentary session. This will oversee the delivery of care, improve standards, ensure enhanced pay and conditions for workers and provide better support for unpaid carers. A consultation on a National Care Service was published in early August.

In the interim, The Scottish Government has continued to progress a number of key projects to take forward and improve Fair Work principles that will lead to better terms and conditions and more rewarding roles for the adult social care workforce, which will not only improve the current experience of the workforce, but also help to attract and retain new staff into the workforce.

While some employers offer employment contracts closer to the Scottish Government's fair work principles, we are aware that some employers do not have occupational sick pay policies. In recognition of these current exceptional circumstances, the Scottish Government introduced on 25 June the Social Care Staff Support Fund (Coronavirus) (Scotland) Regulations 2020 designed to ensure that social care workers will receive their expected income when ill or self-isolating due to coronavirus.

The Scottish Government has a long-standing commitment to the principles of Fair Work and are working with stakeholders to further embed fair work principles and achieve better terms and conditions and more rewarding roles for the social care workforce. An interim report of the Fair Work in Social Care Group is due in the coming weeks.

The challenges in social care recruitment have a number of potential solutions, some of which are within the devolved competencies of the Scottish Government and some of which rest with the UK Government notably the changes to the immigration system. The Scottish Government is taking a range of actions to support the social care sector and improve the attractiveness of working in the sector. However, it is important that this work is seen within the wider context. As a result of the ending of freedom of movement Scotland is facing a declining working age population^[22] .The impact of this is likely to be felt most acutely in rural authorities. The National Records of Scotland 2020 mid-year population estimates confirmed that Around two thirds of council areas (20 out of 32) experienced population decline with the worst affected areas being Inverclyde, Na h-Eieanan Sar and West Dunbartonshire^[23]. Meanwhile, the same report found that all 32 Scottish council areas have seen an increase in their population aged 65 and over in the last decade – including those areas where the total population fell. The greatest increases in the population aged 65 and over were in West Lothian (32%), Orkney Islands (31%) and Clackmannanshire (31%).

The Scottish Government has established a Ministerial Population Task Force and published a Population Strategy to address solutions to these challenges but a legacy of depopulation and out-migration throughout the twentieth century means that in-migration is crucial for future population growth.

Any recommendations for changes to the migration system must recognise the impact of the work undertaken by the Scottish Government within devolved competencies and the need for that to be matched by action from the UK Government in relation to the immigration system. Changes to the immigration system cannot be determined solely by the needs or characteristics of the social care workforce in England.