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What about social care?

Glen Garrod, president of the Association of Directors of Adult Social Services (ADASS), outlines the challenges facing the social care workforce – which are being shouted down by Brexit.

Social care in England provides employment for some 1.5 million people (not including those working as personal assistants) – that’s more than the number of people who work in the NHS. The largest group are care workers – typically in residential settings or working in home support. The sustainability of social care is therefore founded upon this group of people who, despite their pay grade, have significant skills.

But social care is fragile, lacking the capacity to cope with more challenges than it currently has, with some parts of the country already at ‘tipping point,’ to reference previous CQC annual ‘The State of Care’ reports. In September 2012, the median pay for a care worker was £7.38 and had grown by 7% in 2018 (after six years). Compare that, though, with the increase in pay for healthcare workers and others at the lowest end of the pay scale within the NHS, who are looking at up to 29% extra in the next five years. If any one of us was faced with this differential between overlapping roles, what would we do? I think I know where we would all choose to go given this disparity.

The national living wage just doesn’t come close, and the social care precept does not cover the financial costs of implementation. In addition, the ability for councils to pay more is severely hindered by the ongoing and increasingly damaging austerity in local government and social care that began in 2010 and continues today: by the end of 2019-20, over £8bn will have been removed from social care. One effect of austerity is the increasingly worrying picture of large- and small-scale providers leaving the sector.

Another impact can be seen in the deteriorating position regarding staff turnover: in 2012-13, turnover in social care was 23.1% on average across the country. Every year since, it has deteriorated further and now stands at 30.7%, with some regions having a much higher figure. The fragility of the market becomes clear when we realise that up to a third of the social care workforce will have to be replaced next year. It is unsurprising than many in the sector see this level of turnover as having a direct and detrimental impact on the quality and consistency of services – most notably to people receiving them at home. It will also add costs to providers who need to maintain a high level of recruitment and in training new staff – a vicious circle if ever there was one.

Then we need to consider the potential impact of Brexit on this fragile public service. Some 8% (104,000) of the social care workforce are EU nationals, with the greatest number working (as a proportion of the regional whole) in London. This is another risk amongst many others that the social care sector is in danger of being overwhelmed by.

The government’s belated change of policy from charging people for applying for settled status may represent a move in the right direction, but their approach to those with salaries over £30,000pa does not help the care workforce who are nowhere near those sums. There is also an implicit assumption that valuable skills are to be found above £30,000pa when anyone who works in, or is close to, social care knows just how skilled the care workforce is. Government policy needs to consider skills needed, not salary received.    

Essentially though, without a long-term sustainable funding base for social care at the quantum necessary, then whatever else might be done to mitigate the impact of Brexit will fail miserably to address the need for the social care workforce to feel valued, appropriately rewarded, and recognised alongside others who care for some of our most vulnerable members of the community we live in.

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