Recent events have plunged the adult social care sector into a deep recruitment crisis.
The sudden scarcity of candidates, on top of the longstanding challenges of sourcing suitable care workers to meet demand, which I explored in my recent CMM article, has seen the vacancy rates for all social care roles increase by 63% from March 2021 to February 2022. With almost 10% of roles now going unfilled, rising to 12.8% in home care, we have a serious challenge ahead of us just to meet care demands today, let alone in the future. It is likely the vacancy rate will continue to climb through 2022 as exiting staff aren’t replaced and pressure builds on those remaining.
The scale of this shortage means that we must quickly identify very large groups of people who are not only keen to take on a paid care role and all it entails (such as unsocial hours and hard work) but who have the right values, will stay long term and will fulfil the basic requirements of the role (like having access to transport). They must also be willing to work for low pay, since there is no sign of a meaningful across-the-board pay rise that recognises the contribution of care workers. And we need to find them urgently. This means we can’t expect to have addressed the systemic challenges I explored in my last piece, aside from low pay: how care workers are valued and changing workplace attitudes.
As a longstanding observer of social care labour markets, it is my view that we must focus most attention on three pools of labour, which are both big enough to supply what we need and contain enough people with the key characteristics employers should seek. Let’s look at each one in turn.
Before the pandemic and Brexit, foreign nationals made up 16% of the social care workforce. The huge populations of potential migrant workers living close by in EU countries mean that much of our shortfall of labour could, in theory, be made up from this group alone. At the time of writing, there is also the potential for large numbers of refugees to settle here from Ukraine – there have been about 60,000 applications so far – some of whom might join the sector. There are many uncertainties around the practicalities and a much smaller number of visas has been granted. It may be some months before the impact becomes clear.
But it is not just the sheer numbers of potential migrant care workers that make this group attractive, it is also their renowned work ethic. Foreign-born staff work longer hours in care (about 16% more on average) than their UK-born colleagues and employers regularly tell me of their greater flexibility and willingness to pick up night and weekend shifts compared to the domestic workforce. They are often over qualified for the job they do and represent a committed, valuable and flexible workforce.
But Brexit, exacerbated by COVID-19, has effectively closed off the EU labour pool. Adding care workers to the Shortage Occupation List, as has been implemented recently, is nowhere near to being a remedy as it currently stands. To qualify, sponsored workers must be paid the equivalent of £10.10 an hour, where most domestic care workers will be paid the national minimum wage of £9.50 per hour for over 23 year olds from April.
A return to full and free movement of EU migrant labour is the minimum requirement to see meaningful numbers make the choice to join our sector. This should be combined with incentives to bring in nurses and care workers from other non-EU countries. These incentives should be both focused on the employer – simpler paperwork and cost subsidies – as well as financial support for workers to settle in the UK. Employers, particularly in South East England, are concerned that, after the effort of bringing in an overseas worker, there is the risk of them seeking new sponsorship from an employer in a lower cost area of the country, or moving to the higher-paying NHS.
If we can get this right, there is the potential to go beyond the pre-COVID, pre-Brexit figure of 16% EU-born care workers. In Australia, 37% of the workforce are migrants. Were we to boost our workforce and halve the gap with Australia by adding a further 10% of immigrant workers, that would be enough to fill all our current vacancies. But first we must become much more welcoming.
My long experience of identifying the traits of high-performing care workers has highlighted family care experience as by far the best predictor of success in the role. Research undertaken for the Department of Health and Social Care in 2018 also discovered that those who know someone receiving care are over three times more likely to consider working in the sector themselves than someone who has no contact with social care.
Are there enough of them? Family carers in the UK numbered almost seven million adults before the pandemic. Studies suggest 4.5 million people were forced to become family carers during COVID-19. This means that perhaps one in eight adults in the UK now has direct experience of care and so represents a high potential pool of future paid carers. There is also evidence from other countries that suggests a large minority of those who previously cared for a loved one would consider paid care work. With increasing financial pressures on carers, more may be looking for flexible local work which directly utilises their skills and experience. In the US, programmes such as ‘Cash and Counseling’ allowed family carers to be paid to provide care, especially where there was no other paid care available. After that caring requirement had ended, usually through bereavement, studies discovered that 47% continued in paid care roles. Amongst the 53% who left care work, over 40% said they would consider paid care work again, even for someone not related to them.
The challenge with converting people with unpaid care experience to paid care work is identifying and reaching them in sufficient numbers. There are few channels available to recruiters – hospice support groups and families of those being cared for by the provider being the most obvious two. So, whilst this remains a prospective pool of the right size and quality, conversion at scale would require a major targeted outreach effort with the support of carer charities, local authorities and central Government.
The untapped potential of the personal connections of our existing care workforce is, in my view, the pool of labour with both the most promise and the easiest potential to convert at scale.
There are approximately 900,000 care workers in the social care sector in England alone. Based on sample polling, 69% of them would be willing to recommend a care role to their friends and family connections. Despite this widespread willingness to encourage those they know to join the sector, we estimate that less than 7% of new starters in adult social care each year currently come via an employee referral scheme. This gap represents a significant potential recruitment opportunity, especially when you consider that candidates referred by the existing workforce are 10 times more likely to convert to employees than applicants from an internet job board – a conversion ratio that could become even more important given the paucity of job seekers reported by employers across the country.
The reasons referred candidates have such a high conversion rate is primarily because they are picked for their values by someone who both knows them well enough to identify it and understands the job role better than most recruiters, but also because they can sell the role very convincingly. Adult social care has long had an attraction challenge that can be most effectively (or some might argue, only) overcome by a direct approach from a trusted source on a one-to-one basis. Traditional recruitment advertising neither has this impact nor the ability to target suitable, high-potential people, hence the much poorer conversion rates.
What potential is there to increase the flow of new starters from this source?
Our experience from digitising and gamifying this channel at Care Friends is that there can be a three- or more-fold increase in hires. Generally speaking, for most employers, it seems to top-out at between 25% and 30% of all new starters in a 12-month period. So, a very welcome boost of high-quality, long-staying care workers from a single digit baseline, but numbers can be very much influenced by how well valued staff feel by their employer. Another reason to make every effort to be an employer of choice.
Most new starters don’t help the sector grow
Currently, only 37% of the over 490,000 people who start a new role in social care each year are coming from outside the sector. Care workers moving from one care employer to another do nothing to grow care workforce capacity. In order to fill our vacancies, we must encourage new people to join the sector. All three of the pools of labour above will perform better than the current average for bringing in what I call ‘new to care’ candidates. By definition, any migrant worker who is not already employed as a care worker here will be new to care. By pitching a role to family carers, we can expect that the vast majority won’t already be in paid employment as a care worker and employee-referred new starters are typically 33% more likely to be from outside the sector than those from dominant recruitment sources such as internet job boards.
It is my view that, in order to stand any chance of filling our growing vacancies, we must not waste time and money trying to compete with other employment sectors for job seekers who are primarily motivated by finding local work which pays the most money. Rather, the sector should focus our resources where research tells us the largest pools of high-potential, high-converting future care workers are. That means all three of the above.
Have you explored any of Neil’s recruitment strategies and what challenges does your organisation face in tapping into new talent pools? Share your comment below.