The latest size and structure report offers much needed insight at a time of turbulence

Professor Shereen Hussein, Professor of Care and Health and Policy Evaluation at the University of Kent talks about the importance of the findings in the recently released size and structure report.

The COVID-19 pandemic, Brexit and a predicted economic downturn add enormous pressure on an already stretched social care sector. The sector has long-standing challenges in recruiting and retaining enough workers with the right training and skills to meet the escalating demands on the sector. With these considerable uncertainties, accurate data and analysis to inform a dynamic policy decision-making process is essential.

The latest Skills for Care size and structure of the adult social care sector and workforce in England, 2020 report uses its vast database of information on the workforce collected by the Adult Social Care Workforce Data Set (ASC-WDS) from around 20,000 care providers in England.

Effective policy formulation and decision-making require accurate information and detailed analysis. The report provides critical insights into the workforce that are vital for policy formulation as we leave the European Union and end free labour mobility in January 2021. The analysis shows a steady increase in the size and diversity of this workforce with significant contribution to the overall UK economy. It also highlights the considerable share of private and charitable organisations, with local authorities employing a declining small minority of adult social care jobs.

Trend analyses reflect a dynamic sector responding to various policies over time. For example, it shows the increase in the share of non-residential care reflecting policies specific to ageing in place, enhancing independence and cash-for-care implemented through direct payment and personal budgets. The report includes a useful analysis of individual employers who employ personal assistants. A topic we are investigating in detail at the PSSRU as part of the ‘Retention and Sustainability of Social Care Workforce’

Findings indicate a steady increase in non-residential, micro organisations and jobs in the independent sector. These findings are likely reflections of trends in the marketisation of care, including new emerging forms of home care such as live-in carers. The report also indicates a staggering 32% of social care establishments to be non-CQC regulated. These findings concur with our analysis as part of the Sustainable Care programme of work, where we investigate the impact of Brexit on the sustainability of home care workers. In our recent policy brief, we discuss the increasing use of migrant live-in carers, mainly from Eastern and Central Europe, many introduced to this work through non-CQC regulated employment-platforms. Such observations combined with findings from this report identify a real risk of a rising grey care-market post-Brexit.

While the majority of the analysis in the report is based on data pre-dating the COVID-19 pandemic, Skills for Care has made an acknowledged effort to provide some comparisons of key indicators for the period at the peak of the pandemic. Such comparison highlights a stark increase in staff sickness, reflecting some of the direct impacts of the pandemic as well as indirect implications related to delays in the availability of personal protective equipment across the sector. On the other hand, the initial analysis shows a decline in vacancy rates, which might reflect a reduction on demand during this period or the increased use of volunteers who have joined the sector as a result of the national volunteering drive for the NHS and social care observed during this period.

Workforce projections confirm the expected increase in demand for social care jobs over the coming years. Existing evidence shows the sector continues to rely on migrant workers, more recently predominantly from Eastern and Central Europe. This is particularly the case in large cities and within direct care jobs. Without specific policies aiming at creating new supply channels or other forms of workforce substitution, there are significant risks the sector will not be able to meet the projected demand post-Brexit. A clear set of policies are needed to fulfil such gaps; these can range from sector-specific immigration policies to innovation in care delivery and professionalisation of the workforce. The challenge remains especially for the short term as January 2021 is literally around the corner. The concern that the sector will not be able to immediately meet the needs post-Brexit is shared by many of the sector’s experts responding to a recent Delphi Survey on this topic as part of Sustainable Care programme of research.

While the report provides insightful information on various aspects of the social care workforce, it also highlights significant gaps in knowledge. A prime example is the lack of information on self-funders, workers’ wellbeing indicators and workers’ mobility across and between sectors. Direct care workers constitute the vast majority of this workforce, yet they are some of the least paid and remain unregulated in England. There are considerable implications on their wellbeing and consequently, potential impacts on the quality of care provided. We are working with partners in the sector, including Skills for Care, to understand, and develop a measure of the work-related quality of life that is specific to direct care workers in the UK.

The Adult Social Care Workforce Data Set (ASC-WDS) is a unique and comprehensive source of information on the social care sector in England. We have been using this dataset extensively in our research to inform policy and practice. We are proud to have Skills for Care as a partner in many projects including our current RESSCW study funded by the Health Foundation. We have been able to extend this work to investigate the impact of the COVID-19 pandemic on the social care workforce in more detail, conducting several workforce surveys and interviews with key stakeholders.

The latest size and structure report, infographic and interactive visualisations can be found on our website.

If you would like to know more about ASC-WDS please visit our dedicated webpage

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