‘Who cares about skills? The impact and limits of statutory regulation on

qualifications and training in the social care sector’

 Howard Gospel and Paul Lewis

Management Department, King’s College London

 DH, 17 November 2009

Outline

• Context

• Methods

• Impact of regulatory frameworktrainingOPH, PLDH, CH

• Continuing impediments to training

• Significance and discussion

• Conclusions

Context: the social care sector

• 1990 Health Services & Community Act quasi-market in social care

purchasers and providers

• The regulatory framework2000 Care Standards Act and NMSs Inspection regime – NCSC, CSCI, CQC Registration regime – GSCC NMSs Training central – for managers and workers Training targets – 50%/80% 2005

• Classic quality assurance modelservice standardsinternal quality control proceduresexternal monitor

Context: the social care workforce

• 1.6 million, circa 5% of UK labour force

• 2/3 of whom care workers

• 85% women, 50% part-time, 65% 35+,

• High turnover and vacancy rates

• International recruitment

• Labour costs 80% of total costs

• Training limited

Research methods

• Replication study – 2003 DfES; 2008 DH

• 7 case studies4 OPHs, 1 PLDH, 2 CHs; spread of types

• Interviews with key organisations

• Examination of various statistical databases

The impact of training targets

• 2003, 1 met NMSs; 2008 all met NMSs

• All registered managers compliant

• Managers attributed higher qualifications to NMSs

• See also CO 2008 study: ‘Everyone we spoke to believes that far fewer employees would have been trained in the absence of regulation’ (16)

• Representativeness?

The impact of targets – flow measures

• Table. New registrations (levels 2 and 3) each year 2000-05; tails off in 2006

• Biggest increase in 2003 and 2004

• Same story with registered managers

The impact of targets – stock measures

1. Staff2003 20% at level 2 or aboveSfC NMD 23%CO 30%Some, but limited, progress to 50%SfC NMD registered managers 57%

2. HomesOPH 48% compliant in 2002/3; 78% in 2006/7HPLD 63%, 80%CH 46%, 70%

Significant , but still considerable work to be done

The impact of targets – other

• Induction standards – in place in all case studiesInduction training in length, breadth,

formalityBetter integrated into subsequent NVQ

• Minimum number of days training – all compliantUsed for mandatory training e.g. h&s, POVA

etc.Built into routines

• Conclusion: Significant positive effect, but still considerable scope for improvement

Impediments to achieving NMSs:employers

1. Costs of training / funding2003 direct costs covered, but not indirect2008 more state moneyConstraint

2. Assessment2003 cost and time of assessor2008 move to external assessmentConstraint

3. TurnoverFear of poaching in both 2003 and 2008But fears not well grounded – turnover not Perceived constraint continues

Impediments to achieving NMSs:employees

1. Time constraintsNVQ study 1 – 2 hours per weekStill a constraint

2. The academic demands of NVQTho’ practical, on-site, on-the-jobStill fear of ‘going back to school’2008 constraint : older workers have quit; moreof a tradition; smaller portfolio; in-houseassessment

3. Deficiencies in basic skillsliteracy and numeracyimmigrant labourStill a constraint

Impediments to achieving NMSs:employees

4. Weak financial incentivesno or very small incrementBut HPLD £1 / 15%

5. Limited career prospectsLittle scope for progression to 3 (or 4 in CH)

a. barriers to gaining experienceb. paucity of senior positions c. blocked by professional

requirements e.g. nurse, DipSW

Discussion 1: NVQs - training or certification of existing skills?

• Improvement, caused by regulatory frameworkbut still NMSs still not fully met.

• But scepticism about NVQassessment, not trainingcertification of existing competenciesformal compliance as opposed to real

commitment

• Some agreement with thisBut most think real advice and training – better underpinning knowledge, more reflective

• Would like more technical training

Discussion3: broader HRM linkages

• Is training being integrated into a broader set of HRM practices – pay, job design / team work, job security, career, better information, voice?

• None had moved much towards integrated strategies

• However, genuine training; integrated (induction, NVQ, mandatory)

• Also, job security – little use of agency work

• Also, team working

• But, only a minority had aligned qualification and pay.

Discussion: broader HRM linkages

• Only limited granting of more discretion

• Progression a problem

• Despite fact that most workers desired.

• Lessons to be learnt from NHS (Cox 2007)

• May have to change in futurea. demand for more multi-skilled workers may

domiciliary care ; older on entryb. pool of labour may shrink

higher educational and aspirational levels

Conclusions

• 2000 regime was a major development: ‘brave new world of social care’

• Some improvements under this regime.

• But a long way to go.

• Managers and employees supportive of present framework and would like to see a tightening up.

• However, re-fashioning of the system / regime - ‘lighter touch’ regulation – ‘risk-based’, ‘output-driven’

- revision of NMSs – targets likely to go - ‘personalisation’ – direct payments, individual budgets

‘Who cares about skills? The impact and limits of statutory regulation on

qualifications and training in the social care sector’

 Howard Gospel and Paul Lewis

Management Department, King’s College London

 DH, 17 November 2009