A national care workers’ charter is needed that sets out what social care staff can expect from employers for wages, employment terms and conditions, training and career development, say MPs.
The Communities and Local Government Committee said such a charter, along with better pay, status and opportunities, generally, were needed to boost workforce recruitment in social care.
“It is clear there are severe challenges in the care workforce”
The committee warned that the high vacancy and turnover rates, particularly among nurses, in social care, pointed to “severe challenges in the social care workforce”.
The turnover rate for nurses working in social care is 35.9%, while 47.8% of care workers leave within a year of starting, it highlighted in a new report, published on Friday.
It stated: “Low pay, lack of status and inadequate or non-existent training opportunities, and limited career progression were significant barriers to an improvement of prospects for those working in the social care sector.”
The median hourly pay for a care worker was £7.40, and 160,000 to 220,000 care workers in England were paid below the national minimum wage.
In addition, 49% of home care workers were on zero hour contracts, compared with 2.9% of the workforce nationally.
Meanwhile, 27% of care workers received no dementia training and 24% of those who administer medication were not trained to do so.
“The government… put in place robust and long-term workforce planning arrangements”
To make the sector more attractive and to stabilise the current workforce, the MPs recommended the government work with the Local Government Association to publish a “care workers’ charter”.
It should set out what workers can expect from employers on wage levels, employment terms and conditions, training and career development, said the committee.
They suggested it should draw upon Unison’s ethical care charter – a set of commitments the union developed for councils aimed at improving homecare.
The committee also recommended the status of care work be improved across the board through better pay, commensurate with skills and responsibilities, and better terms and conditions.
A “stronger career structure” was needed as well – from apprenticeship to registered nurse – with national standards and qualifications similar to the NHS knowledge and skills framework.
Unison welcomed the committee’s call for a new “bill of rights” for care workers to try and end low pay and high job turnover rates.
“The government needs to stem the financial crisis in adult social care”
Its general secretary Dave Prentis said: “It’s good MPs have recognised Unison’s ongoing campaign to get all councils to reward care workers fairly.
“We’d now urge the government to act, otherwise the crisis in social care will overshadow everyone’s lives,” hr said.
Royal College of Nursing employment relations adviser Clare Jacobs said: “Despite playing a critical role in delivering care, nurses and care assistants have been repeatedly undervalued… The national minimum wage is not proportionate to the skilled work healthcare assistants do.
“All care staff need to be registered to support training and raise standards,” she said. “The government should heed the committee’s warnings and put in place robust and long-term workforce planning arrangements to ensure we have enough.”
She added: “Nurses are ideally placed to deliver improvements and to make the clinical decisions necessary for safe quality care. They must be included in any future plans for aligning the health and social care workforces.”
In addition to the workforce challenges, the MPs’ report called for major reform of social care funding and its provision in general.
The government needed to “urgently review” how social care was funded in the long term and address serious threats to social care provision, said the committee.
It noted the government’s forthcoming green paper and welcomed the Chancellor’s budget commitment to provide an additional £2bn for social care over the next three years, but warned it fell short of the amount required to close the funding gap.
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A “long-term fix” that worked on a cross-party basis and involved the public and social care sector was “urgently necessary to meet the ever-increasing demographic pressures on the system”, it said.
The MPs’ inquiry found that funding constraints were leading to councils providing care and support to fewer people, concentrating it on those with the highest needs, with care becoming the minimum required for a person to get through the day.
“Care workforce challenges, including the welcome national living wage and retention of staff, are creating further pressures”
Fewer than one in 12 directors of social care told the committee that they were fully confident that their local authority would be able to meet its statutory duties in 2017-18.
The MPs also found care providers were relying on their privately paying clients to subsidise local authority funded clients. Up to 96% of paying residents were being charged on average 43% more than state funded residents in the same home for the same room and the same level of care.
Councils were increasingly taking a “price first, quality second approach” when commissioning social care, with accounts of some councils paying as little as £2.24 an hour for residential care, said MPs.
Meanwhile, the committee said it found evidence of councils involved in poor consultation and unfair contracts with providers in the social care sector.
It called on councils to audit the services they commissioned annually and regularly carry out spot checks to ensure providers paid the national minimum wage, covering care workers’ travel time, travel costs and ‘sleep ins’.
Clive Betts MP
Clive Betts, chair of the committee and Labour MP for Sheffield South East, said: “During our inquiry we heard mounting concerns about the serious impact which inadequate funding is having both on the quality and on the level of care.
“We heard compelling evidence of acute threats to care providers’ financial viability and an increasing reliance on unpaid carers,” he said.
“It is clear there are also severe challenges in the care workforce, with high vacancy and turnover rates, and low pay, poor employment terms and conditions, lack of training and inadequate career opportunities the norm across the sector,” he added.
David Pearson, honorary treasurer of the Association of Directors of Adult Social Services, said: “We welcome this report which echoes the entire sector’s call for a long-term solution to providing and paying for social care, the historic underfunding of which is threatening its viability.
“Not only are people living longer and with increasingly complex needs, care workforce challenges, including the welcome national living wage and retention of staff, are creating further pressures –the need to future-proof the social care system cannot be ignored,” he said.
“The extra £2 billion for social care over the next three years is an important step towards closing the growing gap in government funding – but this is just a short-term measure,” no noted.
Professor Martin Green, chief executive of Care England, said: “The committee has done a very thorough investigation and I hope that the government will give maximum consideration to the recommendations proposed in its forthcoming green paper.
“The conclusion of this report cannot be disputed; the government needs to stem the financial crisis in adult social care,” he said. “The sector is ready and waiting to work with the government to find a resolution that focuses on outcomes.”