Workforce challenges
The Department of Health and Social Care published the Care Workforce Pathway at the beginning of the year. I’m acutely aware of the workforce challenges faced by care providers at present. It was a key theme in our 2022/23 State of Care report, and I’m pleased that it’s the ambition of this new pathway to go some way to addressing some of those challenges.
The first part of the pathway focuses on staff working in direct care roles in four categories: new to care; care or support worker; supervisory/leadership; and practice leader. The pathway sets out a defined set of behaviours, knowledge and skills for each role, helping someone working at a specific level to develop within each category and be able to provide the best care to the people who receive their support.
Learning by example
We see frequent evidence of the skills and dedication of the care workforce in our assessment activity. One of our key questions at inspection is whether a service is well led.
A recent outstanding example of a well-led service is run by Marcus & Marcus Limited in north London. The service provides specialist care and support to people with a learning disability, autistic people and people with mental health needs who are living in their own homes. We found that the leaders promoted a positive, person-centred, open, inclusive and empowering culture. They involved all staff in workshops on how to assess and improve their workplace culture, enabling reflection on practice in a supportive environment.
A well-led service, with inclusive and positive continuous learning and improvement is key to delivering good and outstanding care. Effective support and development pathways must be in place for staff if they’re to be able to provide the person-centred care that enables people to live rich and fulfilling lives. I encourage all leaders and managers to explore the Care Workforce Pathway and take opportunities to begin embedding it within your wider teams.
Policy changes
The pathway will take time to embed. And workforce pressures can be more immediate, of course. Challenges in recruiting and retaining staff are widespread, though international recruitment has gone some way to plugging staffing gaps. Changes announced by the Home Secretary in December last year may on the ways in which care staff can be recruited from overseas, with only health and care organisations that fall under the scope of CQC regulations able to sponsor care worker visa applications. This will affect organisations that deliver or co-ordinate health and care services that are not registered with us, as the services they provide fall outside the scope of our regulation.
This includes, for example, provision of personal care or nursing care in cases where a care worker or a nurse works directly for the individual receiving care, or for a third party acting on their behalf. It also includes introductory or employment agencies who help people find registered nurses, nursing associates or care workers and do not manage or direct the nursing or personal care themselves. The ongoing challenge in recruitment and retention remains – to ensure that the staff have the right values and support to deliver safe and high-quality person-centred care.
Recognising the workforce
Now, as the days begin to lengthen, it’s easier to feel as though a long winter is moving behind us. The hard work and dedication of colleagues across the sector during winter doesn’t go unnoticed. I’m proud to see the work done in services to increase capacity. And where we can we’ve accelerated inspections to release beds to support timely discharge from hospital to care homes. As we undertake more assessments of local authorities and integrated care systems under our new responsibilities, we’ll be able to build a clearer view of how services work together across systems.
Identifying local good practice and sharing it nationally will support staff and leaders across sectors in their contingency planning. Working effectively together across systems can help support the workforce and enable people to move through their local health and care system in ways that best support their needs.
James Bullion CBE is Chief Inspector of Adult Social Care and Integrated Care at the Care Quality Commission.
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