Train
Everyone working in social care should have the chance to develop, learn and grow in their role. Learning and development supports good quality social care and retention.
In this section we identify the priority actions needed to support the provision of quality learning and development:
The Care Workforce Pathway, launched in 2023 by the Department of Health and Social Care (DHSC) and Skills for Care, aims to set up a career development framework for social care roles. The next stage will focus on registered managers, deputy managers and personal assistants. This will be expanded to create one pathway for adult social care, enabling career progression and potentially pay scale alignment. It is a very important part of the infrastructure needed in adult social care and will be aligned with the other development frameworks that exist.
Regulated professionals operating across adult social care have career development frameworks including the Career Development Framework for Occupational Therapists, the Professional Capabilities Framework for Social Workers and the Professional Framework for Nursing.
Recommendations
- Regulator signposting to what good looks like in learning development (2024, ongoing): Based on published best practice (including this Strategy), Care Quality Commission (CQC) will work with Skills for Care to support care providers and system leaders to understand what good looks like in learning and development, signposting to published best practice including Skills for Care materials and resources.
- Expand skills (starting 2024): DHSC and Skills for Care should roll out the Care Workforce Pathway in 2024-25 and, in 2025, review with changing needs (mental health, digital skills and dementia care). All workers should have dementia training aligned to the Dementia Training Standards Framework and roles within the Care Workforce Pathway.
- Delegated healthcare activities (2024, ongoing): DHSC should work with the sector and across the system to continue to support person-centred, safe and effective delegated healthcare activities, ensuring that funding flows to recognise increasing expectations of care work. All healthcare activities should have appropriate governance, training and clinical oversight to ensure competency, that is overseen by registered healthcare professionals, including registered nurses.
- Fund new skills (annual): DHSC should continue to fund training for the workforce and newly identified skills.
- Develop directors of adult social services (2025): Skills for Care and ADASS, with partners, will create a development framework for directors of adult social services. DHSC should continue to invest in the leadership programme for principal social workers, principal occupational therapists and approved mental health professional leads to ensure there is a strong talent pipeline for director of adult social services roles.
- Streamline training (2025): Skills for Care will streamline statutory and mandatory training requirements. CQC will signpost and share appropriate guidance.
A level 2 Adult Social Care Certificate qualification has been developed and is due to be launched imminently, targeted at people starting in social care.
We have looked at the Ofqual qualification level descriptors and we should expect people working in social care to develop quickly to a level 2 competency and then on to a level 3 within three years of starting work in the sector.1
Level 2 and 3 qualifications
| Level | Knowledge descriptor | Skills descriptor | Occupational competence | Autonomy and accountability |
|---|
| 2 |
Knowledge and understanding of the facts, procedures and ideas in the occupational field to complete well defined tasks and address straightforward problems. Aware of a range of information that is relevant to the area of work or study Interpret relevant information and ideas. |
Select and use relevant cognitive and practical skills to complete well defined, generally routine tasks and address straightforward problems. Identify, gather and use relevant information to inform actions. Identify how effective actions have been. |
Occupational competence which involves the application of knowledge, skills, procedures and ideas in a significant range of varied work activities and contexts which are generally well defined. Some of the activities are complex or non-routine. Address straightforward problems. |
Take responsibility for completing tasks and procedures. Exercise autonomy and judgement subject to overall direction or guidance. May collaborate with others perhaps through a work group or team. |
| 3 |
Factual, procedural and theoretical knowledge and understanding of the occupational area to complete tasks and address problems that while well defined may be complex and non-routine Interpret and evaluate relevant information and ideas. Aware of the nature of the area of work or study. Aware of different perspectives or approaches within the area of work or study. |
Identify, select and use appropriate cognitive and practical skills, methods and procedures to complete tasks and address problems that are well defined, may be complex and non-routine. Use appropriate investigation to inform actions. Review how effective methods and actions have been. |
Occupational competence which involves the application of knowledge and understanding, skills and methods in a broad range of varied work activities, performed in a variety of contexts most of which are complex and non-routine. Address problems that, while well defined, may be complex and non-routine. |
Take responsibility for initiating and completing tasks and procedures including, where relevant, responsibility for supervising or guiding others. Exercise responsibility, autonomy and judgement within limited parameters. |
We are not proposing that everyone needs a level 3 qualification within three years, but they should have this level of competency. This links with proposals on pay scales because using pay to recognise development would help us recognise and retain people.
In New Zealand, they are aiming to match assessment of people’s need with workforce skills requirements and pay which should help to progress detailed workforce planning. Implementation has not been straightforward and there is much we can learn from other countries.2
Recommendation and commitments
- Continue the Care Certificate (2024, ongoing): DHSC should keep rolling out the Care Certificate qualification to support new starters to achieve a level 2 qualification within three years. Employers should aim for 80% of new direct care staff to hold the Care Certificate qualification in the next five years.
- Level 3 competence for direct care staff (2025, ongoing): DHSC and Skills for Care should develop a suite of pathways and programmes to sit alongside qualifications, to support employers to ensure that, within the next five years, 80% of direct care staff are competent to level 3 within their first three years in role.
There is a strong case for investment to make apprenticeships work for adult social care, helping attract a younger workforce, but this requires reform as the current model is not working. Given the changing needs and increasing complexity of care and support work, adult social care needs a system of education and training that delivers a high-quality experience and impact. The workforce needs more adaptive and multi-disciplinary skills. We have set out the issues with apprenticeships in the workforce in adult social care today section, including a 75% reduction in the numbers of people doing apprenticeships, high dropout rates and low provision.
Recommendation
- Overhaul Apprenticeships (2025): Department for Education (DfE) should commission an overhaul of the apprenticeship system in social care, looking at funding and content, from the Institute for Apprenticeships and Technical Education, DHSC, the Adult Care Trailblazer Group and Skills for Care, including the regulatory bodies Social Work England, the Nursing and Midwifery Council and Health and Care Professions Council.
The learning provider market in adult social care is struggling, with many providers closing and, post-COVID, a growth of online learning which does not always have the highest level of quality or impact. We are seeing a lack of capability of training providers and assessors to meet the changing needs of social care, including being able to assess digital skills. Until 2024, Skills for Care ran the Endorsed Learning Provider scheme, with around 136 learning providers having met the quality assurance standards, this has now ceased and so we will need to be aware of the risk of quality reducing even more in the learning sector.
Care providers, often lacking learning and development specialists, find organising training confusing, time-consuming and costly. Additionally, training recognition or portability between providers is limited because providers worry that the training will not meet regulatory requirements. DHSC is currently developing a skills passport which should help with this issue of portability.
Until 2024, approved and accredited training in the sector was supported with government funding through the Workforce Development Fund, due to be replaced by the Adult Social Care Training and Development Fund. This has been vital to support employers to invest in recognised training and qualifications for their workforce and to help meet backfill costs.
In 2023 DfE introduced local skills improvement plans (LSIPs) and a local skills improvement fund (LSIF). LSIPs are designed to provide an agreed set of actionable priorities that employers, education and training providers and other stakeholders in a local area can use to drive change. There are opportunities for adult social care which should be considered as part of the implementation of this Workforce Strategy because currently the LSIPs awareness of and engagement with social care is variable.
Recommendations
- Ensure high-quality training (2024 and 2025)
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Skills for Care, CQC and the Care Provider Alliance will signpost and share NHS England’s free functional skills offer3 (2024).
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The Association of Colleges and the Association of Employment and Learning Providers should support the higher education sector to offer programmes on the use of digital, data, technology and AI in social care (plans should be developed early 2025).
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Skills for Care should consider how to improve quality in the learning market, including how we support training provider staff to keep their skills up to date in a changing market (2025).
- Maintain training funding (2024, ongoing): DHSC should have a three-year funding plan for training (including backfill) to allow the sector to plan. This should support training for the sector and target new skills that are needed. It should include funding for personal assistants which allows flexibility for individual employers and is built around the needs of the person they are supporting. (£50m per year is currently committed to fund the Care Certificate in the white paper 'People at the Heart of Care').
Adult social care employs 33,000 registered nurses, 25,000 registered managers, 23,500 social workers, and 3,800 occupational therapists. These roles are crucial for quality, safety, leadership, prevention, and meeting clinical needs, even though they only make up 6% of the workforce. Regulated professionals in adult social care also carry out professional oversight, for example increasing healthcare activities must be assessed, planned and overseen by regulated professionals. We set out some of the issues with high turnover and vacancy rates for these roles earlier.
The benefits of creating pathways and opportunities for registered nurses working in social care and social care occupational therapists to develop into advanced practitioner roles have been modelled for this Strategy. The results show that creating advanced roles would mean that, for every £1 spent, the sector would generate £2.50 in socio-economic benefits. Moreover, it will produce higher benefits than costs in year one.
Many of the recommendations in this Strategy relate to the workforce, including the regulated professional workforce. However, we have identified some additional specific recommendations.
Recommendations relating to training and developing social workers
The DHSC, the DfE, Social Work England (SWE), the British Association of Social Workers (BASW), the Local Government Association and Skills for Care should work in partnership with local authorities and the Principal (Adults) Social Worker Network to:
- Invest in Social Work development: DHSC, DfE, SWE, BASW and Skills for Care should collaborate on new role categories such as social work assistants or consultant social workers (scope in 2025).
- Create a Community of Practice: SWE, BASW, ADASS Professional Workforce Group and Skills for Care to foster opportunities for sharing good models of multidisciplinary working across regulated professions in adult social care and, where appropriate, health to support integration (set up by 2025).
Recommendations relating to training and developing occupational therapists
- Invest in the development of occupational therapists: DHSC, the Royal College of Occupational Therapists, the Health and Care Professions Council and Skills for Care should work in partnership with local authorities and principal occupational therapists to:
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- Develop a national career and skills framework for adult social care occupational therapy (2025) including advanced practitioner roles to support career progression, transferability of knowledge, skills and capability across integrated care systems (ICSs).
- Develop a strategy to improve continual professional development (CPD) and supervision to grow the workforce (2025 scoping) - through degree, enhanced and advanced apprenticeships and maximise the benefits and impact of assistive technology, data and AI through innovation, leadership and training. This could be leveraged through the Health and Care Professions Council’s standards.
Recommendations relating to training and developing registered nurses working in social care
- DHSC and partners (including ICSs) should develop and implement a career framework for registered nurses working in adult social care (2025 scoping with five-year plan): this should be aligned with a clear pay structure equivalent to comparable roles in the NHS and include the use of apprenticeships to develop nurse specialists, nursing educators, consultants and advanced practice roles, maximising opportunities to support people to be well at home and reducing the need for admission to acute care. A strategy should be developed in partnership with DHSC to improve and fund continuous professional development and clinical supervision to grow and develop the workforce.
- DHSC should encourage employers to develop employer-funded preceptorship programmes for newly registered nurses and nursing associates transitioning into their roles (2025, ongoing): preceptorship programmes should be alongside regular clinical supervision with clear channels for raising concerns. They should continue to offer some funding to support. (Five-year programme.)
- The Council of the Deans of Health (CoDH) should promote adult social care in higher education (2025, ongoing): the CoDH should encourage universities to ensure adult social care is reflected in the knowledge and experience of their teaching faculties and, where it isn't, work to establish hybrid roles that reach into the expertise of the sector.
- DHSC and the National Institute for Health and Care Research (next round of priority setting) should build into their research programme registered nurse-led research opportunities.
- The Nursing and Midwifery Council (NMC) should establish a standard process for registered nurses and nursing associates working in social care (including students) and their representatives raising concerns about equipment, staffing, safety, policies and processes. Nursing associates should be supported by their employers to work within their scope of practice and should not be used as a substitute in activity that requires a registered nurse. The CQC will encourage adult social care professionals to whistle blow when required and will signpost and share guidance as appropriate.
Registered managers are crucial in adult social care but face high turnover (23.2%) and vacancies (10.6%). Their numbers need to increase to meet growing needs and retirements. However, registered managers are often under-valued compared to other professionals such as nurses and social workers, despite the skill needed in the role.
The 2022 Messenger Review4 emphasised the role of strong leadership in the quality of health and social care. The NHS has a roadmap implementing its recommendations, outlining clear expectations for leaders and managers. This includes expected standards and competencies, consistent training curricula and support for meeting these requirements. It also emphasises proactive and inclusive talent management. Social care needs a similar strategic approach, aligning all the levers (funding, commissioning, support) to develop and implement a leadership development roadmap for social care.
Regulation 7 (2)(b) of the Care Act deals with registered managers and states that they must have the necessary qualifications, competence, skills and experience to manage the carrying out of the regulated activity. That is generally accepted to be the Level 5 Diploma as recommended by Skills for Care (56% of registered managers have this qualification).5 However, as the role has become more complex, the CQC ’Fit Person’ process needs to reflect this and there should be opportunities for registered managers to do a full degree or master’s degree to support their development.
We have some evidence of what works:
- 44% of registered nurses working in social care are from Black and ethnic minoritised backgrounds and only 17% of people in leadership positions are from Black and ethnic minoritised backgrounds. DHSC ran two leadership programme cohorts for registered nurses from Black and ethnic minoritised backgrounds working in adult social care which have had a positive impact. Skills for Care piloted a support programme for new registered managers, and it was impactful in terms of their confidence and skills. Skills for Care also has an Assessed and Supported Year in Employment (ASYE) programme for new social workers.
- Skills for Care previously delivered a government-funded graduate leadership scheme, for which funding ceased in 2020. There are now no programmes to attract gifted, talented or aspiring leaders into adult social care. Work undertaken by a consortium of stakeholders across the sector has shown strong support for such a programme to return.
- Skills for Care modelled the benefits of expanding the ASYE programme, currently only for social workers, to occupational therapists and registered managers. Analysis suggests that, for every £1 spent, the sector would generate £1.30 in socio-economic benefits. Moreover, the reduction in turnover would prevent approximately 3,750 workers from leaving the sector.
This evidence gives us a sense of where we should be focusing over the period of this Strategy to attract and develop good managers and leaders by developing more routes into the roles, increasing support and giving greater recognition of professional status.
Recommendations and commitments
- Adult social care roadmap to implement Messenger recommendations (2025, ongoing): DHSC should commission a Messenger roadmap for adult social care aligning all the levers (funding, commissioning, support) to develop and implement a leadership development roadmap for social care, outlining clear expectations for leaders and managers.
- Registered manager role (2025, subject to funding): Skills for Care will deliver a project to set out what would need to happen, the implications and costs for setting up a professional body for registered managers with a code of conduct, competency and development framework to include degree and master’s level qualifications.
- Support new managers, occupational therapists and social workers (2025-30): DHSC should support the rollout of the piloted enhanced support programme for new managers, similar in style to the ASYE programme for newly qualified Social Workers. The ASYE funding formula for newly qualified social workers in diverse settings, for example mental health trusts, should also be reviewed.
- Foundation degree minimum education for registered managers (2025-30): Skills for Care, supported by DHSC, will ensure that it is a requirement for care services to be led by a qualified registered manager with a minimum foundation degree qualification (level 5), and should support opportunities for registered managers to undertake full degree programmes or master’s degree programmes. The CQC should ensure that they signpost and share guidance and feed this into the ‘Fit Person’ process.
- Review ‘Fit Person’ process (2025): CQC to consider how the registration process for registered managers assures that people are equipped and competent to be successful in that role, and able to deal with the considerable responsibilities and requirements on them.