Care Home Recruitment, Care Management, CQC Inspection, Future of Care, Leadership & Management, Real life, Social Care & Society, Social Care Strategy, Workforce Intelligence

Examining the social care workforce in England

Examining the social care workforce in England - Peverel Court Care

 

As Skills for Care launch their annual ‘State of the Adult Social Care sector and Workforce’ report, we take a look at some of the key findings and how they impact staff recruitment and retention for care businesses in England.

 

Skills for Care are the Sector Skills Council for Adult Social Care in England. They collect workforce data from thousands of care-providing organisations across the public and independent sectors through their National Minimum Dataset for Social Care (NMDS-SC) programme. This data gives us a unique insight into how care businesses are staffed, both regionally and across the country.

Their annual ‘State of the Adult Social Care Sector and Workforce’ report is quite a long read, so we’ve picked out some of the key insights that impact recruitment and retention of staff for care businesses.

 

Turnover of care staff

The turnover rate of staff working in the Adult Social Care sector of 30.8%. This equates to approximately 440,000 leavers in the previous 12 months. It was also shown in the report that Care Workers had the highest turnover rate of direct care-providing roles, at 39.5%; a huge increase of 11.1 percentage points since 2012/13.

Registered Nurses also had a high turnover rate of 34.0%, especially when compared to other regulated professions, such as Social Workers (13.7%) and Occupational Therapists (12.6%).

Around a fifth of Registered Managers left their role in the previous 12 months (22.0%); this was high compared to other managerial roles and equates to around 5,600 leavers in the previous 12 months in total.

 

New starters in care roles

Skills for Care estimates that the rate of new starters in posts over the past 12 months was 39.3%. This equates to around 560,000 workers. Care Workers experienced the highest starter rate, at 48.1%, followed by Registered Nurses at 35.6%.

It should be noted that the starters rate reflects staff that are new to their role. This includes both those who are new to the Adult Social Care sector (34%) and also churn within the sector – which accounts for 66% of the total. This includes those moving between roles or employers; meaning that the sector as a whole has retained the skills and experience of these workers.

However, it also means that a large proportion of employers were going through the recruitment process at any one time, with workers moving between employers with high regularity, and at considerable cost to the sector.

 

Vacancies in the care workforce

There was an estimated increase of 16,500 jobs between 2017 and 2018 in the independent and local authority sectors combined, from a total workforce of 1.36 million to 1.38 million.

Skills for Care estimates that 7.8% of roles in the adult social care sector were vacant at any given time. This represents an average of approximately 122,000 vacancies. The majority, around 77,000, of the vacancies were for Care Worker jobs, with the average vacancy rate for the role 9.0% of the total workforce.

The increase in vacancy rates for direct care-providing roles over recent years could in all probability be linked to the fall in unemployment rates in the UK over that period. Office for National Statistics (ONS) data shows that the unemployment rate was 7.8% in 2012/13, but had fallen to 4.1% by 2018/19. Pay may also be a factor; Retail Assistants earned 13p per hour less than Care Workers in 2012/13, but in 2018/19 earned 10p per hour more on average. This may shift in pay levels may also be contributing to rising vacancy rates within the Adult Social Care sector.

The Registered Nurse vacancy rate was particularly high at 9.9%. This role also had relatively high turnover and starter rates, which is likely a contributory factor to this high vacancy rate. Nurses were added to the UK Shortage Occupation List in 2015 and have remained listed ever since. The Shortage Occupation List is an official list of roles for which the domestic labour market cannot meet the demand to fill vacant posts. Listing is intended to make it easier for employers to recruit migrant workers to fill these vacancies and help reduce skills shortages.

Registered Manager vacancies at 11.4% were double the average of other managerial roles in the sector and equivalent to around 2,900 vacancies at any given point in 2018/19. Skills for Care analysis of Care Quality Commission (CQC) ratings data shows that services without a Registered Manager in post at the time of inspection (or in the year leading up to inspection) were less likely to achieve ‘good’ or ‘outstanding’ CQC ratings.

The overall vacancy rate has risen by 2.3 percentage points between 2012/13 and 2018/19. This rise in vacancies, in the context of a wider workforce that has grown at a slower rate in recent years, suggests that the sector is struggling to keep up with demand as the Adult Social Care sector continues to grow, coupled with the effects of an ageing population.

 

Social and political influences on the care workforce

At present, Brexit does not appear to be a major contributory factor to the high vacancy rate. The number of people with an EU nationality in the Adult Social Care workforce has continued to rise since the referendum. However, according to Skills for Care, Brexit continues to have the potential to cause future supply issues for the Adult Social Care workforce, depending on the immigration rules applied post-Brexit.

Around 84% of the Adult Social Care workforce in the year 2018/19 were British. Around 8%, or approximately 115,000 workers, were of an EU nationality, and 9%, or about 134,000 workers, were of a non-EU nationality. Therefore, on average, the Adult Social Care sector had a slightly greater reliance on non-EU workers than EU Workers. As a whole, the overall nationality of the Adult Social Care sector was more diverse than the population of England, which is 8% non-British. However, there are regional variations: for example London had the highest proportion of non-British workers, followed by the South East. Care businesses in these regions are, therefore, more sensitive to future changes to immigration policy than those in other parts of the country.

The proportion of Registered Nurses who cited British as their nationality increased from 60% in 2012/13 to 64% in 2018/19. Over the same time period, the proportion of Registered Nurses with an EU nationality has risen from 8% to 18%. Non-EU Registered Nurse numbers have therefore fallen considerably in this time.

Following the Government’s white paper on ‘The UK’s future skills-based immigration system’ in December 2018, the specifics of immigration post-Brexit remain unclear. There could be a significant impact on the supply of workers to the Adult Social Care sector in the future.

 

Preparing the care sector for an ageing population

The ‘Projecting Older People Population Information System’ (POPPI) uses figures taken from Office for National Statistics data to estimate the composition of our future population based on age bands. POPPI shows that the number of people aged 65 and above is projected to increase between 2018 and 2035 from 10.2 million to 14.1 million people in England, an increase of around 38%.

Between 2012 and 2017, the population aged 65 and over increased by 2.1% per year on average. This was faster than the population aged 75 and over, which increased by 1.5% per year on average. However, between 2017 and 2018, the population aged 75 and over grew at a faster rate (2.1%) than the over 65 group (1.5%) for the first time. The population aged 75 and over is projected to increase at a faster rate up to 2025, with the highest growth expected between 2020 and 2025 (an 18.8% increase).

Using models, the number of Adult Social Care jobs in each Local Authority area in England were compared with the corresponding number of people aged 65 and over, or aged 75 and over, in the population there. These two factors were found to be strongly correlated. On average, the more people aged 65 and over, or 75 and over, in an area, the larger the Adult Social Care workforce was found to be. The ‘Aged 65 and over’ model shows that, on average in 2018, for every seven people aged 65 and over in the population, one Adult Social Care job was required. The ‘Aged 75 and over’ model shows that, on average in 2018, for every three people aged 75 and over in the population, one adult social care job was required.

These models were then applied to POPPI estimates of the number of people aged 65 and over, and 75 and over, in 2020, 2025, 2030 and 2035 to create a forecast for the number of Adult Social Care jobs required going forward. The models project that if the Adult Social Care workforce grows proportionally to the projected number of people aged 65 and over in the population, then a 36% increase (580,000 new jobs) will be required by 2035. If the workforce grows proportionally to the number of people aged 75 and over in the population, then a 50% increase (800,000 new jobs) will be required by 2035.

 

Successful recruitment and retention leads to successful care businesses

Skills for Care published research in which employers with a staff turnover rate of less than 10% were asked to consider what they believe contributes to their success, in relation to recruitment and retention. Results included:

      • investing in learning and development (94%)
      • embedding the values of the organisation (92%)
      • celebrating the organisation’s and individual achievements (86%)
      • involving colleagues in decision making (81%)

At Peverel Court Care we have taken a number of measures to aid us with retaining our fantastic staff, including our learning and development programme and the introduction of career pathways for a number of roles. We have also implemented a Recognition and Rewards programme for our team, so we can constantly remind them how valued they are by our management team.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire: Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business, providing personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

Best Care Practices, Business, Care & Technology, Care Management, Future of Care, Leadership & Management, Tech, Training & Development, Workforce Intelligence

Transitioning to Digital Care Plans

Transitioning to Digital Care Plans - Peverel Court Care

 

We are always looking for opportunities to improve the way we deliver care services to our residents. Our next big step forward comes with the introduction of digital care plans.

 

Digital transformation has been a common strategic goal across almost all business sectors over the past decade. Yet largely due to scale, budget and regulatory requirements, the UK Health and Care sectors have struggled to keep pace. However, that is now beginning to change. While more than 75% of care providers are still using paper records, the transition to digital care plans has begun; and it is quickly gaining momentum.

The increased levels of transparency brought by digital care plans is highly correlated to the provision of higher quality care. In a 2018 report released by The Kings Fund, an independent charity working to improve health and care in England, it was recognised that use of digital technology in social care can help improve efficiency, quality, and support more integrated care.

 

Benefits of digital care plans

In fact, there are many benefits. The Care Quality Commission (CQC), have outlined the five key areas in which they believe the innovative use of technology can support the delivery of outstanding person-centred care:

  • Safe: helping ensure key information is accurate and easy to share with caring professionals in real time.
    Staff can access digital care plans and records more easily. They can record information in real time. This can be quickly and accurately shared to help keep people safe, and highlight key information, such as up-to-date medical and allergy information.
  • Effective: supporting effective communication and more efficient use of resources, including finances
    Staff, family and other providers can share digital records more easily and quickly. Staff can use handheld devices to record support given as it happens. This avoids having to complete paper records after the event.
  • Caring: supporting person-centred care and helping staff to spend more time on the things that really matter
    Technology can support staff to make their processes more efficient. This means that their time isn’t taken up by administrative work. Digital care records can make information easier to access and quicker to share. This reduces the number of times people who use services have to give information or repeat themselves.
  • Responsive to people’s needs: supporting providers to be more proactive and responsive to changing needs by helping to identify developing risks or needs more quickly
    Communication aids (such as tablet based apps) can be tailored to an individual’s needs, preferences and activities. Or a computer based app can be also used to deliver tailor made treatment/recovery plans for people.
  • Well-led: supporting more effective quality assurance through more effective communication, information sharing and improved data analysis
    People who use services and their families can use online platforms to access and contribute to the information that is important to them. They can also communicate with those involved in their care and treatment. Anonymised data collected can be shared, compared and analysed to identify risks and themes, providing a bigger picture.

It’s reasonable to say that the biggest and most obvious advantage here is that records can be accessed and updated far more quickly. This will allow our staff to spend less time on administration and more on providing care to our residents. A transition to digital care plans will ultimately allow for more transparent and safe care provision. In addition, it will allow care businesses like us to make better decisions based on data and analytics. Beyond that, the ability to share information with GPs and hospitals when required – in line with Data Protection laws – will help to provide more efficient and integrated care in the future.

 

Risks of digital care plans

There are some risks involved in transitioning to digital care plans; which we are very conscious of. However, these risks can largely be mitigated by having the correct processes in place. For example, the technology provider we choose for the digital care plan solution will be carefully vetted to ensure it complies with all Data Protection and GDPR requirements, and that records will be regularly “backed up” to protect against data loss.

We will ensure strict processes are in place so that devices on which the platform operates are securely stored and password protected. Also, we will make certain that any staff who leave Peverel Court Care have their access revoked in a timely fashion. Finally, we’ll be onboarding and training our staff to make sure that they’re fully engaged with the transition to digital.

 

The transition to digital

At Peverel Court Care, we are embracing the use of technology to drive improvement in the services we deliver. We believe that the transition to digital care plans sits in line with one of our core values; Resident Focus – our commitment to putting our residents first. Associate Director Preet Shergill commented:

Peverel Court Care believe the future lies in digital transformation and data intelligence to support better decision-making and allow us to better predict, optimise and continue to improve care. Integrated care will be vital to the local community, and our digital care platform will assist in managing care between providers; supporting health and social care integration.

Having carefully weighed up and considered all of the costs and benefits, we are due to start the implementation process soon; beginning in January at Bartlett’s.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire: Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business, providing personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

Business, Social Care Strategy, Workforce Intelligence

The Care Quality Commission and their five year strategy

The Care Quality Commission (CQC) is the regulator of social care organisations in the United Kingdom. They set out what outstanding care looks like and then inspect services to make sure that they meet at least fundamental standards. They not only inspect care homes, but hospitals, dentists and other public services as well.
For our sector, the CQC was founded to make sure that care homes provide a safe and comfortable place to live for people who need care and support. Last week they released their five-year strategy, which aims to improve the quality of care services providers are offering.
In this article, we explore how Merryfield Nursing Care Home, Stone House Nursing Care Home and Bartlett’s Residential Care Home are already implementing the best practice strategy the CQC has identified for themselves.

Encourage improvement, innovation and sustainability in care

On Carehome.co.uk we are rated 9.7 and 9.8 out of ten for all three of our premises. We have a reputation for providing outstanding services in comfortable settings and giving people an excellent place to live.
But we want to be known as more than a good care provider. For our residents, our premises are their homes and we are often an extension of their family.
We provide innovative care through our activities coordinator, who is dedicated to providing new experiences to stave away boredom and look after the mental health of our residents.

Deliver an intelligence driven approach to regulation

It’s not good enough for us to form our own opinions on what makes good quality care provision, we must listen to what those receiving care are telling us makes our service excellent.
Our residents and relatives survey gives those who live with us and their families the opportunity to tell us what they think of our service. It’s a great way of discovering any alterations we might need to make in the way we deliver our care and an excellent way to see our strengths, too.
We are delighted to report that in the last one we scored above 3.4 out of 4, which is a rating of ‘outstanding’.

Promote a single shared view of quality

Across all three of our premises, all staff are working towards the same view of quality. It is a view that has been developed over time by Peverel Court Care as a result of years of learning.
All staff are fully inducted in accordance with these principles, so whichever of our care or nursing homes you’re living in you’ll be receiving the same standards of excellence from all of our staff. We think this shared view is extremely important for the wellbeing of our residents.

Improve our efficiency and effectiveness

Our residents all have different care plans and requirements, so we have to be efficient whilst still administering care effectively.

Many of our staff members have worked with us for a number of years. They are well practiced in delivering care in the most efficient and effective way, so that we can be proactive instead of merely reactive.

We’re proud

Care provision is a difficult and important sector to work in. We have the lives of people in our hands. Regulation is important, and a good, strong strategy makes sure that providers know what the best care looks like. We were very happy to recognise that we are already implementing the best practice way of working that the CQC have identified for themselves.

We plan to carry on advancing and enhancing our services, providing high quality, luxury care in comfortable residential settings and through skilled, competent and happy staff.

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