Over the last few months, members of The Homecare Association have expressed growing alarm and concern about inadequate workforce capacity to meet rising demand for home-based support and care.
Many employers say they have never experienced such difficulty in retention and recruitment and fear for the wellbeing and safety of older and disabled people who are unable to access the care they need.
In July 2021, we reported results of a member survey highlighting a shortage of home care workers. We conducted a further survey in August 2021. Responses were received from 843 home care providers, large and small, state-funded and private-pay funded, across all regions of England. This was a record number of responses, indicating a high level of concern among employers.
Key findings were as follows:
- 95% of home care providers said that recruitment was harder than before the COVID-19 pandemic, with the majority (78%) saying that recruitment was ‘the hardest it has ever been’. There were not substantial regional differences.
- Providers serving predominantly the private-pay part of the market reported similar challenges to those serving predominantly the state-funded part of the market.
- 65% of home care providers said that more care workers were leaving their jobs than before the pandemic, including 29% who said that more care workers were leaving than ever before. Just 4% said that fewer care workers were leaving than before the pandemic.
- 89% of providers stated that demand for their services had increased or significantly increased over the previous two months. Just 2% said that demand had reduced or significantly reduced.
Care workers’ pay and available terms and conditions of employment were said to be the greatest challenge to recruiting and retaining home care workers, with 46% of employers describing that as the most significant issue. This is, of course, closely linked to how the home care sector is funded by the state, and what private individuals arranging their own care are willing and able to pay. Consistent patterns were seen across regions, with some variation.
Other key reasons for care workers leaving their roles were competition with other business sectors; care worker exhaustion and low morale; Brexit or migration policy; and COVID-19-related policies, such as self-isolation, PPE, vaccination and quarantine.
- 38% of providers said they were unable to take on new work, with 57% saying they could take on some but not all new work.
- 29% of providers said they were handing some work back, with 1% saying they were handing all work back. 70% were continuing to meet existing need.
ITV News reported on these findings and filmed care workers and managers talking emotionally about the challenges they are facing. Lord Bethell dismissed our research as ‘anecdote’. Whilst the Government is apparently in denial, some NHS hospitals are reporting critical incidents due to the inability to discharge people to community and social care services. A new survey from ADASS states that 13% of people are being offered care and support, such as residential care, that they would not have chosen, due to recruitment and retention issues.
Vaccination as a condition of deployment is on the horizon for home care. The Government has issued a consultation on whether to extend requirements for vaccination against COVID-19 and influenza to other health and care settings.
As strong supporters of vaccination , we remain keen to ensure that as many home care workers as possible receive both COVID-19 and flu vaccines, as there is good evidence these protect the recipient from serious illness.
To this end, we are working with colleagues in NHS England and Public Health England to try to persuade vaccine-hesitant staff to accept vaccination voluntarily.
We have repeatedly raised concerns about the risk of older and disabled people being left without care at home, if vaccination rates among the home care workforce do not increase above current average levels of 81.8% for the first dose and 69.8% for the second dose, and care workers lose their jobs. At least 20% of home care workers could leave or be dismissed at a time when supply of care workers is already inadequate to meet rising demand.
Disappointingly, the Government’s plans for funding reform of social care make no provision to address the long-standing workforce issues affecting home care.
The Homecare Association continues to call on the Government to:
- Fund social care adequately so that home care workers are paid fairly for the skilled roles they perform, and at least on a par with equivalent public sector roles.
- End the practice of councils and the NHS purchasing home care ‘by-the-minute’, alternatively focusing on achieving the outcomes people want.
- Support development of an expert-led workforce strategy for social care and a 10-year workforce plan, aligned with the NHS People Plan.
- Create a professional register for care workers in England, covering all paid social care workers in both regulated and unregulated care services. Registration of care workers needs to be adequately funded and carefully implemented.