social care workforce studycareassociationalliance.org.uk/wp-content/uploads/... · the social care...

The Care Association Alliance © Copyright. All Rights Reserved.

Social Care

Workforce Study

by Charles Taylor

The Care Association Alliance | Registered Number 9893184 | Suite H15A, Leatherhead Enterprise Centre, Randalls Way, Leatherhead, KT22 7RY

1

CARE ASSOCIATION ALLIANCE

Care Association Alliance Social Care Workforce Study

Introduction With the recent Brexit decision, dramatic increases in the National Living Wage and Skills for Care projecting a need

for 500,000 new workers over the next decade, it seemed appropriate to look at some of the recent trends in

workforce recruitment. With Brexit on the horizon, are social care employers increasingly dependent on EU workers?

With the recent rises in national living wage, what affect has this had on wages? And Finally, if we need 500,000 more

workers, where will they come from?

Executive Summary

The adult social care workforce is one of the lowest paid groups of employees within the UK. Over the next decade

with the increase in the elderly population this workforce will need to expand rapidly. With the recent Brexit vote

there is a real possibility that employers will struggle to fill these new roles. The effect of Brexit will not be felt equally

across the country, workforce issues are extremely regional with the South of England much more dependent on

foreign workers than the north. There is also variation between roles with nurses being the role that is most commonly

filled by foreign workers. These trends are highlighted by some of the key statistics below:

Care assistants earn an average of £350 per week, £200 per week lower than the average

for all jobs across the UK.

Recruitment is slowing, in 2009-10 there 65,000 new workers were recruited into our

sector, in 2015/16 this had dropped to 20,000.

27% Average turnover per annum, one of the highest rates of all sectors in the UK. Turnover

is highest in those with the least experience, lowest pay, and in younger employees.

33% of all nurses and 16% of all care assistants are foreign nationals, which is 200% and 45%

higher than the national average for all job roles, respectively.

65% of care assistants in London, the area most reliant on foreign nationals, have been

recruited from overseas and a staggering 84% of nurses were not born in this country.

23% of the total workforce working within the adult social care sector, 305,000 workers, are

over the age of 55.

9% of nurse jobs are currently vacant. Vacancy rates are highest in the most senior positions

with 11.3% of registered manager roles currently vacant.

AVERAGE PAY<

RECRUITMENT ¯


2


We also look at the wages paid to social care assistants. Over the past 5 years

wages for all roles have increased. With the introduction of the National

Living Wage these increases have become much more dramatic, with some

areas of the North seeing wages rises of over 10% in a single year. In 2017

Care assistant wages rose by 7%, senior care assistants wages by 6% and

nurses’ wages rose by 7% across England. Given that staff costs represent

65-80% of running costs for care providers this is a significant increase in

costs across the sector.

One of the key findings to come out of our study is that productivity levels of workers within our sector vary across

roles. Our sector is very reliant on part-time workers, particularly within the Care Assistant role, with the number of

hours worked per week much lower than the national average. The average number of hours worked by a Care

Assistant is 18 hours, much less than the national average of 30 hours per week. This means that one of the potential

methods of meeting future demand might be to find a way to support and incentivise more staff to become full time

workers.

Turnover is a major problem within the sector with almost one in three

workers leaving their role each year. There are also high vacancy rates across

all roles in the sector. Across the sector 6.6% of all roles are currently unfilled

and this rises to 9% for nurses and 11.3% of registered manager roles

currently unfilled. The number of new individuals employed into the sector

has also dropped in recent years with only 30,000 new individuals joining the

sector between 2013 and 2015. In 2009-10 this number was 65,000. This

suggests that rather than struggling to meet increased need social care

employers may already be struggling to fill the number of roles currently

required. We also highlight the lack of government initiatives to assist employers in generating an adequate workforce.

Care Assistant and

Nurse wages rose

by 7% in 2017

1 in 3 Workers Leaving

EACH YEAR


3


Section 1 – Sector Overview

Sector Demand The sector is well aware that the elderly population within our country is

growing significantly faster than the younger population and we are

expecting the number of individuals over 65 to increase to 13.25 million by

2030i. According to Skills for Care “forecasts show that if the adult social care

workforce grows proportionally to the projected number of people aged 65

and over in the population between 2016 and 2030, an increase of 31%

(500,000 jobs) would be required by 2030.”

One additional factor to consider for demand is the number of individuals leaving the sector each year. There are

currently 305,000 workers over the age of 55ii working within the adult social care sector. By 2030 it is extremely

unlikely that this age group will still be working full-time within this sector and these retirees will need to be replaced

within this time.

Skills for Care also estimate that there were a total of 350,000 individuals that left their jobs across adult social care in

2016ii. Looking at the NMDS dashboard for 2017iii, we can also look at the destinations of individuals that are leaving

the adult social care sector. This shows that 13.7% went to healthcare jobs, 3.3% went to retail jobs and 3% went

abroad. These figures represent an estimated 70,000 individuals leaving the social care sector in 2016 alone.

Combining these three figures together suggests that we will need to recruit

just under 36,000 workers to account for increased demand for social care

services; 22,000 workers to replace those retiring and 70,000 workers that

leave the sector every single year. This equates to a somewhat staggering

target of 128,000 workers per annum who will need to be recruited into the

social care sector. Importantly, however, this figure could be considerably

reduced if we, as a sector, were able to either keep hold of the workers that

we have already recruited or were able to increase the productivity of our

existing workforce.

There is, however, one key driver within the sector that is currently overlooked, that may well significantly increase

this demand figure. The figure for the number of employees required calculated by Skills for Care above assumes that

the social care sector will remain the same make-up as it currently is, i.e. the same split between community based

and residential based care. But, if we look at any Market Position Statement produced by Local Authorities they all

include the mantra “Individuals prefer to remain in their own home as long as possible”. Consequently, across the UK,

we as a society are trying to funnel more individuals into receiving community- based services. This has a dramatic

effect on workforce productivity and therefore the number of employees needed to fill roles. The UKHCA use an

estimate of 19% of a domiciliary care assistant’s time being spent in traveliv. This travel time is not present within

residential services and means that for every 4 residential workers, employers would need to recruit 5 community

workers to meet the needs of the same number of service users. If our society truly wishes to continue to expand into

more community services, this would dramatically increase the 500,000 workers that Skills for Care are already

estimating we require by 2030.

31% More Jobs Needed by 2030

Est. 128,000 New Workers Needed

EVERY YEAR

to meet need.


4


Sector Supply So, we understand that our sector currently needs around 128,000 employees per annum to meet the future demand.

To give a flavour of the magnitude of the challenge facing social care, in 2017 there will be 126,642 female individuals

leaving secondary schoolv [NB the current social care workforce is 80% female which is why we have focused on female

graduatesvi]. Assuming that the sector remains 80% female dominated then to meet the future workforce needs,

purely from school leavers, it would require the Adult Social Care sector to recruit 102,000 or 81% of females leaving

school. Furthermore, this would need to be continued every single year for the next 14 years! The above scenario is

obviously not possible but graphically underlines the magnitude of the problem that social care employers face.

Of course, there are also other sources of recruitment across the country. Firstly, social care employers could target

the unemployed within the UK. There are currently 1.44 million people unemployed in the UKvii, or 4.3% of the working

population. The lowest unemployment rate recorded since 1970 is 3.4%. Were we to reach this level again, this would

mean 288,000 additional Britons are available for work. Were our sector to recruit unemployed workers so successfully

that the unemployment rate within the country dropped to a new record low, and these individuals did not get jobs

in any other sector, then we would still be 200,000 people short of the 500,000 Skills for Care state we need by 2030.

This is also ignores that major fact that unemployment is substantially regionally biased without realistic real incentives

or initiatives encouraging individuals that are unemployed to move to areas with higher employment.

Another source of potential new recruits is the projected increase in the English population. Currently the English

population is predicted to increase by 5.7 million by 2030. This however will only correlate to an increase of 3.1 million

new workers entering UK employment. But this figure comes with a significant note of caution, as it was predicted

pre-Brexit, and 63% of the new 3.1 million workers are predicted to be migrants to the UKviii. Under current UK

immigration laws, post Brexit social care employers will only able to recruit registered managers or nurses from

overseas. This means that the majority of this potential population increase and pool of employees (if migration still

occurs at predicted rates post Brexit!) is inaccessible to our sector without significant changes to immigration rules.

Removing immigrants from the new entrants to the workforce means that there will be an increase to the English

working population of 1.15 million, or c.80,000 new workers per year. This is not enough to meet the number of posts

currently required by the social care sector each year

[even assuming that 100% of these new workers join

the social care sector and no other areas of

employment].

The next potential source of workers is recruiting

from other sectors within the UK workforce. There

are currently 32.2 million peopleix in work in the UK.

This means that finding an extra 500,000 workers

would only represent enticing 1.6% of the working

population away from other jobs across the country.

This might seem a plausible scenario, however our

sector represents the single lowest paid segment of

working society in the UK (shown in the graphic

below from the ONSviii). It is extremely difficult to see

a scenario where the care sector manages to tempt

large numbers of workers from alternate sectors

without significant investment in recruitment drives

across the sector, or significant changes in the pay

+2.5%

+2.9%

+1.0%

+2.4%

+2.6%

+1.1%

+2.0%

+3.8%

+4.3%

+2.5%

300 400 500 600 700 800

All employees

Managers, directors and senior

officials

Professional occupations

Associate professional and

technical occupations

Skilled trades occupations

Process, plant and machine

operatives

Administrative and secretarial

occupations

Elementary occupations

Sales and customer service

occupations

Caring, leisure and other service

occupations

£ Per week


5


structure and national recognition of the importance of the sector to make our employment more attractive.

The last, and often unexplored, target for recruitment within the UK are the “uncounted unemployed” within the UK

population. ONS statistics show 1.44 million people are currently unemployed, however there are in fact 8.73 million

people that are “economically inactive”. These are individuals of working age that are not actively looking for work.

Of these 2.3 million are students, 2.1 million are looking after the family or home and 1.15 million are retired (but

below the age of 65). It may well be possible to recruit from these sources, however this would require a national

strategy and understanding of the drivers for each of these groups so that we could encourage them to join our sector.

They do however represent the single largest proportion of the native population that could potentially be recruited

were foreign immigration to continue to be seriously curtailed post Brexit. Interestingly, this is also the part of the

population that is currently receiving the least attention from Government workforce initiatives and plans.

Finally, we come to recruiting from foreign countries into the UK. Over recent years, as shown later in this paper, we

have been increasingly filling roles within the social care workforce by recruiting from EU countries. With Brexit

looming this is becoming increasingly difficult, and at this stage the British government seems incapable of coming up

with any post-Brexit plans to outline how immigration will be managed. Foreign recruitment is a viable source of

potential workers into the UK and could easily provide the required workers. However, such foreign recruitment will

only be possible if a wider range of care sector job roles of differing skill levels were placed on the Shortage Occupation

List. Additions to the Shortage Occupation List have been a highly political issue and barrier frequently obstruct these

additions, particularly for low skilled workers such as Care Assistants. Whilst an easily implemented strategy, it would

be more sustainable in the long term for Britain to be able to produce our own workforce in sufficient quantities. That

being said, without major changes in the way that the UK, and in particular the social care sector recruits and retains

staff, immigration may remain the only accessible source of recruitment to meet the short to medium term need for

social care staff.

DISCUSSION As it currently stands the social care sector will need to employ a huge number of workers to meet growing demand.

As with most issues in social care, it is this authors position that there are no meaningful government plans to meet

this demand. The National Audit Office analysed the number of new-starters joining the adult social care workforce

over the past decade. This shows a worrying trend with only 30,000 individuals recruited into the sector in the previous

two years analysed. This represents less than half of the number recruited in 2009/10 at the start of the data set.

Estimated annual increases in care jobs, 2009 - 10 to 2015 - 16

Data Rounded to the nearest 5,000 Includes employees of local authorities and independent providers, personal assistants and NHS staff working in care.

65,000

30,000

60,000

35,000 35,000

10,000

20,000

-

10,000

20,000

30,000

40,000

50,000

60,000

70,000

2009 - 10 2010 - 11 2011 - 12 2012 - 13 2013 - 14 2014 - 15 2015 - 16

Incr

ease

in Jo

bs

Year


6


Source: Skills for Care, National Minimum Data Set for Social Care (NMDS-SC), 2016-17 workforce estimates

Currently the government’s plans to meet the upcoming demand is a draft workforce strategy published by Health

Education Englandx, which sets out a proposed government strategy to solve the adult social care workforce issues.

This paper dedicates 6 pages of its 142 to the social care sector. This section states that:

1. Skills for care will “improve the skills of the ASC workforce and support employer’s recruitment and

retention through the £12m Workforce Development Fund”. 2. “Health and care has more apprentices than any other sector, with 420,000 starts in the last six years, with

social care apprentices up 37,300 or 42% from 2010.” 3. “employers need to have the right offer to keep the staff they need and reduce turnover”. “Values based

recruitment can help ASC employers with an evaluation by Skills for Care showing that employers using it

have turnover rates 5.6% lower than the overall sector average.”

4. Professional regulation supports the delivery of safe and high-quality care through setting standards and

ensuring continuing fitness to practise. Greater regulatory oversight of social care assistants might be an

option. A regulatory framework could also support the development of clearer roles linked to competencies,

building on the Care Certificate.

The draft workforce is extremely disappointing as it has no meaningful plan to assist employers in recruiting the

additional half a million workers that will be required. In their report on the adult social care workforce the National

Audit Office described the workforce strategy as “mainly concerned with the health sector, and coverage of the [social]

care sector is short and lacking detail”. In addition, the suggestions made are not properly thought through.

• The workforce development fund has been in place for many years and over this time retention within care

has worsened dramatically.

• Whilst there are more “apprentices” than any other sector in care this potentially valuable source of recruits

has been hijacked to make political gains. Apprenticeships within our sector are used as a method to fund

QCF/ NVQ courses and the majority of these are carried out by individuals that are already employed within

the sector. This means that whilst there are many hundreds of thousands of apprentices over the past 8

years, # only a tiny fraction of these have been genuine new-recruits to the sector.

In addition to the draft workforce strategy the adult social care workforce has been the subject of several other

government sponsored reports over the past year. The national audit office has written a reportxi analysing the social

care workforce. This report highlighted that our sector has a high vacancy rate with 6.6% of all jobs unfilled and an

extremely high staff turnover rate at 27.8%. Vacancy rates were also highest in the most skilled positions with 9% of

nursing posts vacant and 11.3% of registered manager posts empty. It also highlighted that working in our sector is

considered low skilled and there is limited career progression available.

The House of Commons Committee of Public Accounts has also published a

report on the adult social care workforcexii. The first sentence of the report

provides an accurate summary of the pressures faced by employers – “The

adult social care sector is underfunded, with the care workforce suffering

from low pay, low esteem and high turnover”. The report summarises the

effect of lack of funding to providers from local authorities as one of the key

factors driving the workforce problems within the sector. The Department of

Health responded to these criticisms by committing to looking at how they

can oversee the activities of Local Authorities in the future. Whilst helpful

these reports merely highlight the problems that we are facing. What is required is a robust, well thought out plan to

support employers to meet the future care needs of English population.

Underfunded,

Low Pay,

Low Esteem, and

High Turnover


7


Section 2 – Our Existing Workforce

Key positions within the Social Care Sector For a detailed analysis of the social care workforce, we have split the workforce into

three key roles that make up the clear majority of the workforce and will look in

more detail into each of these positions. These three roles are Care Assistants,

including Senior Care Assistants, Nurses and Registered Managers. For each of

these positions, we will look at the demographic make-up, nationalities, work

patterns and pay rates over the last 5 years.

We have also split our data into the different regions of England to give a more local

picture of the workforce across the country. The regions used are shown in the map

to the right:

The National Audit office report on the adult social care workforce provides the

below summary that highlights the roles that the 1.34 million workers currently

employed within our sector.

Numbers of jobs in the care workforce in England, 2016 - 17 Most roles are jobs that involve providing direct care to users

Managerial Number of jobs

NOTES: 1) Number of jobs, including totals, rounded by

Skills for Care to nearest 500, 1,000 or 5,000 depending on the number of jobs.

2) ‘Other’ roles include chefs, cooks, cleaners and maintenance staff.

Source: Skills for Care, National Minimum Data Set for Social Care (NMDS-SC), 2016-17 workforce estimates

Senior management 16,000

Registered manager 22,500

Other managerial 78,000

Total managerial 115,000

Regulated profession

Social worker 17,000

Occupational therapist 3,000

Registered nurse 43,000

Other regulated prefession 2,000

Total regulated profession 64,500

Managerial

Senior Management 85,000

Registered Manager 815,500

Other Managerial 60,000

Other Managerial 23,000

Total direct care 985,000

Other Jobs 175,000

Total Jobs 1,340,000


8


Key Role 1 - Care Assistants and Senior Care Assistants The positions of Care Assistants and Senior Care Assistants account for the majority of the social care workforce. These

individuals carry out many of the day to day tasks that care work requires. These duties include attending to personal

care, assistance with feeding, providing activities, cooking and cleaning to name a few. Currently, being a Care Assistant

or Senior Care Assistant is an unregulated profession and has historically been one of the lowest paid in our society.

Job vacancies At present, Skills for Care estimates that 8%xiii of all Care Assistant roles across the country are unfilled and a further

6% of Senior Care Assistant roles are empty.

Retention One of the key factors that affects recruitment within the sector is our ability to retain existing workers. Using data

from Skills for Care, we can see that the average turnover rate within the social care workforce is 27.8%, suggesting

that almost 1 in 3 workers will leave an employer each year. There are several different factors that will affect this

rate. According to Skills for Care data, those most likely to leave are those with the lowest pay, those with the least

experience and those that are younger. These factors may well be linked as the youngest, least experienced workers

tend to be the lowest paid. These graphs are included below:

Care worker turnover rate by years of experience in role

Source: NMDS-SC unweighted data between March 2016 and March 2017

In reality, this relationship could be even more pronounced because some care workers that leave the sector soon

after joining could have left before their employer has chance to record them in the NMDS-SC.

Care worker turnover rate by average hourly pay bands


32.60%

25.20%

20.30%16.60%

13.50%11.60% 11.10%

0.00%

10.00%

20.00%

30.00%

40.00%

Less than

1 year

1 to 2

years

3 to 4

years

5 to 6

years

7 to 10

years

11 to 20

years

More than

20 years

29.80%27.10%

24.70%22.30% 21.30%

17.90% 17.90%

0.00%

10.00%

20.00%

30.00%

40.00%

£7.20 to

£7.49

£7.50 to

£7.79

£7.80 to

£8.09

£8.10 to

£8.39

£8.40 to

£8.69

£8.70 to

£8.99

£9.00 and

above


9


Care worker turnover rate by age bands


Care Assistant Key Facts Skills for Care collect a wide selection of information on the workforce within social care. We have collected some of

the key facts together in the following infographic to highlight some of the key characteristics of this role.

37.00% 37.00%34.00%

31.00%28.00%

25.00%23.00%

21.00%19.00% 18.00% 19.00% 20.00%

0.00%

10.00%

20.00%

30.00%

40.00%

Under

18

18 to

19

20 to

24

25 to

29

30 to

34

35 to

39

40 to

44

45 to

49

50 to

54

55 to

59

60 to

64

65 to

69


10


England Social Care Workforce Datasheet: Care Workers

Care Worker Pay Rates

Q1 2012 Q1 2013 Q1 2014 Q1 2015 Q1 2016 Q1 2017

£6.86 £6.94 £7.03 £7.13 £7.31 £7.85

Care Assistant Pay rates (per hour)

Care Worker Nationality

Nationality Country of Birth Average Age

7% EU Nationals

9% Non-EEA Nationals

80% Born in Britain

20% Not Born in Britain 40.7

Nationality of Newly Recruited Care Workers in England, 2012 to 2016

Care Worker Productivity

Full vs Part time Average Hours worked per week

Care Worker Full-time and Part-time split by nationality

Care Workers Average per nationality

2010 2011 2012 2013 2014 2015 2016

NO

. O

F N

EW

CA

RE

WO

RK

ER

S

British EU Non-EU

52%

71%

59%

48% 29% 41%

0%

20%

40%

60%

80%

100%

British EU Non-EEA

Full time Part time

18

21

19

16

17

18

19

20

21

22

British EU Non-EEA

1% 1%

ΩΩ

1%

ΩΩ

3% 7%


11


Care assistant Pay Rates Care assistant pay rates across England have been historically depressed across the country due to inadequate

investment within the system by Local Authorities in a drive to lower the cost of care provision across England. This

trend has been reversed in recent years with 3% and 7% increases in the carer wage in 2016 and 2017. This was

predominantly driven by the introduction of the National Minimum (living) Wage and shows the dramatic impact on

employers and employees that this national agenda has had.

Care assistant Nationality In total across England, 16% of workers are currently non-UK nationals and in total 20% of the workforce were not

born in Britain. The % of the workforce that is currently non-British shows how many foreign workers are currently

employed. Under immigration rules, an individual can usually apply for British nationality after 5-10 years. Therefore

the % of the workforce that were not born in the UK includes these individuals who are foreign workers but now have

British nationality.

For comparison, the Migration Observatory at Oxford University collects data on foreign nationals within the

workforce across the UK. Their data shows that 11% of the national workforce is made up of foreign nationals and in

total 16% of the UK workforce are non-British bornxiv. This means that the Care Assistant workforce has 5% more non-

English nationals and 4% more individuals not born in the UK than the average across all industries. This highlights the

dependence that our workforce has, now and historically, on foreign workers to fill roles. The Care Association Alliance

(CAA) have also collated data on the nationality of recruits each year. This shows that the number of new care

assistants recruited each year has been increasing for the last 6 years. This increase has however been fuelled by an

ever-increasing percentage of foreign workers, from both inside the EU and outside the EEA.

Care assistant Productivity Due to the demand for new recruits across social care, the CAA have collated data on the productivity of the social

care workforce. We have also looked at the productivity across different nationalities as, anecdotally, providers have

informed us that foreign workers tend to work longer hours. This is borne out by our analysis of the Skills for Care

data, with British workers on average working only 18 hours per week and EU workers working an average of 21 hours

per week. This is also mirrored in the working arrangements of the nationalities, with only 52% of British care assistants

working full time vs 71% of EU workers.

Across England, the average number of hours worked per week is 31.9, suggesting that care assistants with an average

of just over 18 hours per week are significantly less productive per head of workforce than other industries.

Historically, this has been exacerbated by government policies. For example, benefits rules in place over the past

decade have meant workers were worse off if they worked more than 16 hours per week and therefore capped their

hours to prevent a drop in their benefit entitlement. Considering the requirement to recruit hundreds of thousands of

new workers, an alternative solution would be to explore in more detail the reasons why individuals within our sector

work fewer hours than in other employment sectors. Simply increasing the average hours worked by our existing

workforce by only a few hours per week, would significantly increase the number of hours of care that can be provided

with no extra employment effort required.

Senior Care assistants Many care assistants that have been in post for several years and shown promise within the role will be promoted to

the position of Senior Care assistant. These roles differ across the sector but predominantly involve some form of

training and mentorship for junior staff and line management of other care staff, along with taking responsibility for

managing certain aspects of care within their setting. We have again pulled out some of the key facts for this role,

shown in the infographic overleaf.


12


England Social Care Workforce Datasheet: Senior Care Workers

Senior Care Worker Pay Rates

Q1 2012 Q1 2013 Q1 2014 Q1 2015 Q1 2016 Q1 2017

£7.37 £7.52 £7.63 £7.80 £7.99 £8.51

Senior Care Assistant Pay rates (per hour)

Senior Care Worker Nationality


5% EU Nationals


81% Born in Britain


Nationality of Newly Recruited Senior Care Workers in England, 2012 to 2016

Senior Care Worker Productivity


Full-time and Part-time split by nationality

Senior Care Workers Average per nationality

2010 2011 2012 2013 2014 2015 2016

NO

. O

F SE

NIO

R C

AR

ER

RE

CR

UIT

S

British EU Non-EEA

72%82% 82%

28% 18% 18%

0%

20%

40%

60%

80%

100%

British EU Non-EEA

Full time Part time

29

30 30

28

29

30

31

British EU Non-EEA

1%

2% 6%

2% 2% 2%


13


Senior Care assistant Pay Rates Senior Care assistant pay rates have historically risen slightly above that of other Care assistants, at 2% per year. As

with Care assistants, these rates have risen much more dramatically between 2016 and 2017with a rise of 6%, again

reflecting the dramatic effect of the National Living Wage on our sector. However, this wage rise is lower than that

seen in Care assistants suggesting that the National Living Wage is forcing employers to increase the lowest wages but

may be undermining pay differentials between roles.

Senior Care assistant Nationality Senior Care assistants are 14% non-British nationals, a slightly lower percentage than Care assistants however still

above the UK wide average of 11%. Again, this suggests that there is an above average reliance on foreign workers

within our sector. In total, 19% of Senior Care assistants were not born in the UK, suggesting that a further 5% of the

workforce were originally recruited from outside the UK and have since permanently settled within the UK. This

highlights that immigrants working within this sector are not a new addition to the workforce but have been a part of

employers’ workforce planning for a significant period of time. However, the author must note this is very regional, as

shown later within this report.

As with Care assistants, the number of Senior Care assistants joining the work force has increased in most years since

2010. Initially, such increase was mainly reliant on British and non-EEA workers, however the Home Office stopped

offering visas to Senior Care assistants during this period leading to a reduction in the recent recruitment of Non-EEA

nationals. At the same time, the number of EU workers recruited has increased. Non-British recruits make up a smaller

minority of Senior Carer recruitment each year compared to Care assistants, suggesting that EU workers are being

recruited at the bottom of the career ladder in our sector. This contrasts to non-EEA workers where recruitment is

higher in Senior Care assistants, suggesting that non-EEA workers are recruited into more senior roles. In all

probability, such a pattern is caused by immigration controls blocking recruitment of Non-EEA nationals into lower

skilled roles rather than any sort of employer choice.

Senior Care assistant Productivity Productivity of Senior Care assistants is significantly higher than that of Care assistants, with an average of 29 hours

worked per week. This is slightly higher in non-British workers, with an average of 30 hours worked per week. Again,

this is mirrored in the number of full-time employees; 72% of British workers work full time versus 82% of foreign

workers. This productivity is much more in line with other industries and shows a significantly higher number of hours

worked by all Senior Care assistant nationalities when compared to Care assistants.


14


Key Role 2 - Nurses Nurses are predominantly employed within the care home sector of social care and make up the largest body of

registered professionals in social care. These individuals will often oversee shifts in nursing homes across the country.

Vitally, they give the social care sector the skills required to care for patients with a higher clinical level of need.

Job vacancies Currently Skills for Care estimates that 13.9% of all Registered Nurse positions across the country are vacant. Health

Education England in their workforce planning suggest that a 5% vacancy rate is a good target level for a profession,

highlighting that there is a severe shortage of nurses within our sector.

Retention The turnover rate for nurses is currently 24.2%, slightly lower than of care staff. The position of Registered Nurse is an

anomaly in a sector where demand is otherwise dramatically increasing. Tt is one of the few positions in social care

where we are employing fewer nurses now than we were in 2012. Skills for Care show a decrease of 8,500 nurses

being employed within the Social Care sector when comparing 2012 to 2017. This is a statistic that may not surprise

employers, who have found it increasingly difficult over the past 5 years to recruit nurses into social care. As a

consequence, additional yet unregulated roles such as nurse assistants, or nurse associates have started to appear.

These roles assist in meeting the patient needs that were previously met by Registered Nurses within our sector.

Nurse Key facts Before showing the data that we have analysed from our Skills for Care, it is worth sharing some wider findings

regarding the nursing workforce. The long-term issue of nurse shortages is reaching a critical juncture. In their

2017report Christies estimate that there are 17,000 empty nursing roles within the UK, and this figure is increasing.

This worsening situation has a very simple root cause; we continue to fail to train enough UK nurses to even meet the

number of nurses leaving the nursing register each year. Furthermore, our government continues to exacerbate the

situation by placing barriers within immigration law, preventing employers from recruiting from overseas. To highlight

my point, the graph below shows the number of UK trained nurses entering the NMC register over the past 5 years,

and the number leaving:

Number of new nurses entering and leaving the NMC register from the UK over the past 5 years

This graph clearly proves the cause and continued reason for the nursing shortage. Every single year for the past 5

years, the number of nurses leaving the NMC register is higher than the number that join the register. This situation

is getting worse, not better.

We now move on to the Skills for Care information on the workforce within social care. We have collated some of the

key facts together in the following infographic to highlight some of the key characteristics of the nursing role.

0

10000

20000

30000

40000

2012/13 2013/14 2014/15 2015/16 2016/17

Leavers UK trained nurses entering the register


15


England Social Care Workforce Datasheet: Nurses

Nurse Pay Rates

Q1 2012 Q1 2013 Q1 2014 Q1 2015 Q1 2016 Q1 2017

£12.24 £12.34 £12.57 £12.96 £13.46 £14.38

Nurses Pay rates (per hour)

Nurse Nationality


15% EU Nationals


56% Born in Britain


Nationality of Newly Recruited Nurses in England, 2012 to 2016

Nurse Productivity


Nurses Full-time and Part-time split by nationality

Nurses Average per nationality

2010 2011 2012 2013 2014 2015 2016

NO

. O

F SE

NIO

R C

AR

ER

RE

CR

UIT

S

British EU Non-EEA

56%

75% 76%

44% 25% 24%

0%

20%

40%

60%

80%

100%

British EU Non-EEAFull time Part time

24

31

28

22

23

24

25

26

27

28

29

30

31

32

British EU Non-EEA

2% 7%

4% 3% 2%

1%


16


Nurse Pay Rates Nurse pay rates have increased each year over the past 5 years. These wage rises have also picked up pace with an

increase of 7% between 2016 and 2017. This is indicative of the augmented competition for a dwindling pool of nurses

over the past few years, forcing employers to offer ever increasing pay rates to attract nurses.

Nurse Nationalities Nursing has the highest percentage of foreign workers of any position within social care. This is extremely regional,

however in some areas of the country well over 50% of all nurse recruits are coming from overseas. Nationally, a total

of 33% of all nurses are non-British nationals and in total 44% were not born in Britain. This data shows that our sector

is dependent on overseas recruitment to fill this role and that the dependence on overseas recruitment of nurses is

not a recent phenomenon. An additional 11% of the nursing workforce have received British nationality since entering

the country, a process that takes many years.

Looking at the nationality of new nurse recruits, we can see that the number of nurses joining the sector has increased

each year. This increase however has been most significant in nurses with an EU nationality, suggesting that employers

have increasingly been turning to the continent to recruit nurses over the past 5 years. However, this source of recruits

may be removed from our sector with dire consequences. A recent Christie’s report states that since the Brexit vote,

there has been a 96% drop in the monthly number of nurses joining the NMC registerxv. This drop in EU recruitment is

shown in the graph below from the National Audit Office report:

The Number of nurses and midwives Joining and Leaving the register for the EU/EEA

Only includes data from people where their initial registration was from EU/EEA – Country of Current address and Nationality may differ. Data for each period runs from April 1st to Mach 31st of the following year. Joiners only includes first time registrations. Source: Nursing and Midwifery Council

Nurse Productivity As with Care Assistants, there is a large difference in the productivity of individual nurses from different nationalities.

The average hours worked for British nationality nurses was 24 hours per week, versus 28 hours for non-EEA

nationality nurses and 31 hours for EU nationality nurses. This is reflected in the tenure of employment of the nurses

with only 56% of British nurses working full time, in comparison to 75% in non-British nurses.

0

2,000

4,000

6,000

8,000

10,000

2010/2011 2011/2012 2012/2013 2013/2014 2014/2015 2015/2016 2016/2017 2017/2018

Joining Leaving


17


Key Role 3 – Registered Managers Registered Managers represent one of the most highly trained and responsible positions within social care. Registered

Managers must pass stringent tests from the Care Quality Commission in order to take up the position and the

individuals in these roles take up regulatory responsibilities and can be held individually liable for the performance of

a social care location. Within their workplace these individuals are usually wholly responsible for the quality and

performance of the social care provided.

Vacancy rate and retention Currently Skills for care shows a vacancy rate of only 11.3% in registered manager positions within the country. This

means that over one in ten social care providers does not have a registered individual running the care service. This is

the single most important role in any care provision and is an area that will need urgently addressing.

Registered Manager positions also show one of the lowest turnover rates within social care with only 12.5% leaving

their role in the past 12 months according to skills for care data. This suggests that registered managers are much less

likely that other staff levels to leave their positions. To put this in context however having a new manager will often

have a dramatic effect on the quality of care provided within an organisation so this figure means that every year 1 in

10 providers will be suffering from substantial upheaval due to the change of registered manager.

Registered Manager Key facts Skills for Care collect a wide selection of information on the workforce within social care. We have collated some of

the key facts together in the following infographic to highlight some of the key characteristics of this role.


18


England Social Care Workforce Datasheet: Registered Manager

Registered Manager Pay Rates

Q1 2012 Q1 2013 Q1 2014 Q1 2015 Q1 2016 Q1 2017

£27,780 £28,570 £28,740 £29,210 £29,460 £29,930

Registered Manager Pay rates (per annum)

Registered Manager Nationality


3% EU Nationals


87% Born in Britain


Nationality of Newly Recruited Registered Managers in England, 2012 to 2016

Registered Manager Productivity


Registered Manager Full / Part-time split by nationality

Registered Manager Average per nationality

2010 2011 2012 2013 2014 2015 2016

NO

. O

F N

EW

RE

G.

MA

NA

GE

RS

British EU Non-EEA

94% 96% 96%

6% 4% 4%

0%

20%

40%

60%

80%

100%

British EU Non-EEA

Full time Part time

34

35

34

32

33

34

35

36

British EU Non-EEA

2% 3% 1%

2% 1% 2%


19


Registered Manager Pay Rates The average pay rate for Registered Managers across England in 2017 was just under £30,000 and Registered Manager

pay rates have shown the lowest increases of all social care positions over the past 5 years. However, rates vary

considerably across the regions, with some areas actually showing a decrease in Registered Manager pay rates over

the past 5 years. There is also huge variation within this position between different sectors and employers with some

of the largest nursing homes offering £70-80,000 per annumxvi for registered managers in the larger care homes.

Registered Manager Nationality Registered Managers are predominantly British in nationality with only 6% of managers non-British nationals. There is

however a much higher number of managers that were not originally born in the UK at 13%. This suggests that the

majority of foreign managers have been in the country for many years and achieved British citizenship before

becoming a Registered Manager. The position of Registered Manager has a huge amount of responsibility with

knowledge of the English regulatory system being a key requirement. This data suggests that employers are very

unlikely to recruit directly from overseas to fill this role. These same employers however are happy to promote

overseas workers into this position once they have been in the country and worked within social care for a number of

years and gained the relevant experience.

Registered Manager Productivity Registered Managers show negligible differences in productivity between different nationalities, working on average

34 or 35 hours per week. This is also above the British average of 30 hours per week, showing that Registered Managers

work longer hours than the average worker in the UK. This is mirrored in the tenure of the workers with only 6% of

Registered Managers working part-time. This is most probably a reflection of the responsibilities associated with the

role, which would be difficult to meet whilst working part-time.


20


Key roles - Regional Summary As alluded to in the commentary above, there is a large amount of regional variation in the make-up of the social care

workforce. The full regional breakdown can be found in the attached appendix 1,2 and 3, however we have picked out

some of the key messages in our summary.

Nationality of social care workforce – a regional picture Analysis of the Nationality data highlights a definite pattern of reliance on overseas workers. London is a stand out

region and without foreign worker recruitment it is unlikely that the social care sector in this region would survive.

The remainder of the country is not as dependent on foreign workers, however the South East and Eastern regions

gain a significant number of staff from outside the UK. When looking at the different job roles, Nurses stand out. All

regions of the UK employ significantly more overseas Nurses than the UK average. Without the employment of

overseas Nurses, our sector would only be able to deliver a fraction of the nursing care currently provided.

As with our previous analysis, we have looked at four key positions within the adult social care workforce. The

nationality of workers is extremely regional as different areas of England have found it more or less difficult to recruit

British workers. Firstly, we have looked at Care Assistants:

Current Nationalities of Care Assistants

Care assistants born overseas

Looking at the current nationality of Care Assistants, we can see that London (30% non-EEA, 12% EU) and the South

East (13% non-EEA,10%EU) have the largest reliance on foreign workers. When looking only at EU workers, there are

similar large proportions of these in the Eastern, London, South East and South West regions. To give these number

some context, the recruitment of non-EEA Care Assistants was practiced within our sector until about 2013, being

possible under British immigration rules. After this point, it was impossible to recruit into this role due to tightened

immigration rules. It was in 2013 that employers had to look for other sources of workers and increasingly started to

look at EU workers. This also coincided with the ability to recruit from Romania and Bulgaria. The data therefore

suggests that London and the South East have been dependant on immigration to fill job roles for a longer period of

time. Recently, this trend has been reflected more widely across the UK and has been aided by the easier availability

of Eastern European workers. The Brexit vote may have considerable impact, with many employers in the care sector

having a far narrower field from which to source their workers. Looking at the original nationality of Care Assistants

shows the long-term reliance that some areas have had on foreign workers. In London for example only 35% of all

Care Assistants are originally from the UK. This is followed by the South East with 71% of the work force being born in

Britain and the Eastern region with 77%. This picture of nationality suggests that without access to foreign workers,

the Social Care sectors in some areas may well be unable to recruit, with London being particularly at risk.

0%10%20%30%40%50%60%70%80%90%

100%

Eastern

East M

idla

nds

London

Nort

h East

Nort

h West

South

East

South

West

West

Mid

lands

Yorksh

ire &

Hum

ber

British EU Non-EU

0%10%20%30%40%50%60%70%80%90%

100%

Eastern

East M

idla

nds

London

Nort

h East

Nort

h West

South

East

South

West

West

Mid

lands

Yorksh

ire &

Hum

ber

Born in UK Not born in uk


21


Secondly, we have looked at Senior Care assistants:

Senior Carer current nationality data

Senior carers born inside and outside the UK

Looking at the data for Senior Care assistants, this fairly closely mirrors the situation with Care Assistants. London is

the region most dependent on foreign nationals with 30% of staff being non-EEA nationals and a further 6% EU

nationals. This is followed by the South East with 15% of staff being non-EEA nationals and a further 8% EU nationals.

The most staggering figures however come from the number of non-UK born staff employed. These are individuals

that were originally foreign nationals but have remained in the UK long enough to achieve British citizenship and therefore

give a measure of longer-term reliance on employing foreign individuals. London is most dependent with 65% of workers

originally employed from overseas, this is then followed by the South East (32%), Eastern (26%) and South West (18%).

The next staff group that we have looked at are nurses:

Nurse current nationality

Nurses Country of Birth

The data shows that currently the English Social Care sector is heavily reliant on overseas workers. As shown earlier, the

Oxford based Migration Observatory states that on average a UK industry on average has 11% of their workforce as overseas

nationals with a total of 16% of the workforce being born outside the UK. For nurses within that care sector, the percentage

of foreign workers is staggeringly higher. The most dependent area for overseas nationals is the South East with only 50%

of nurses employed being British nationals. London follows closely with only 45% of nurses being non-British nationals.

Across England every single region employs more overseas nurses than the UK average. Such a heavy reliance on foreign

workers highlights the failure of the UK to train a sufficient nursing workforce.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

England

Eastern

East M

idla

nds

London

Nort

h East

Nort

h West

South

East

South

West

West

Mid

lands

Yorksh

ire &

Hum

ber

British EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

England

Eastern

East M

idla

nds

London

Nort

h East

Nort

h West

South

East

South

West

West

Mid

lands

Yorksh

ire &

Hum

ber


0%10%20%30%40%50%60%70%80%90%

100%

East

ern

East

Mid

lands

London

North E

ast

North W

est

South

Eas

t

South

Wes

t

West

Mid

lands

York

shire

& H

umber

British EU Non-EU

0%10%20%

30%40%50%60%

70%80%90%

100%

Eastern

East M

idla

nds

London

Nort

h East

Nort

h West

South

East

South

West

West

Mid

lands

Yorksh

ire &

Hum

ber

Born in UK Not born in UK


22


We have also looked at the number of nurses that were born overseas. These are individuals that were originally

foreign nationals but have remained in the UK long enough to achieve British citizenship and therefore give a measure

of longer term reliance on employing foreign individuals In London only 16% of nurses were born in the UK, followed

by the South east with 35% UK born nurses and the Eastern region with 49% of nurses born in the UK. Again, the lowest

region for overseas nurse recruitment was the North East, who “only” have 21% of their workforce that were not born

in the UK.

This data is staggering in many ways and shows that for years our sector has been filling staffing vacancies through

recruitment from overseas. Anecdotally, employers have stated that UK trained nurses prefer to remain in the health

sector and this data strongly echoes that sentiment. Without major effort in this area our sector will continue to

require overseas trained staff to fill roles. Any stifling of this supply post Brexit puts our sector’s ability to care for

patients who require clinical interventions at severe risk.

The final role that we have analysed is that of the Registered Manager. Data is shown below:

Registered Manager Current Nationalities

Registered Manager Country of Birth

As with the previous job positions, the London and the South East remain the highest regions for employment of

overseas nationals. When looking at the number of Registered Managers that were not born in the UK London is the

stand-out results with over 50% of Registered managers originally coming from overseas.

Recruitment of Foreign nationals – A regional picture Appendix 3 contains the annual breakdown of recruitment in each region. This data closely follows the national picture

highlighted above and will therefore not be dissected in detail. In summary, when analysing individual regions, London

was again the most dependent on overseas recruitment, followed by the South East and Eastern areas. Nurses are the

single role that employers have had to recruit most widely form outside the UK. This dependence has grown over time

with the top three regions, London, South East and Eastern. All three regions initially recruited around 40% of their

nurses from overseas (data from 2011,) however this had grown to over 50% of all recruits by 2016. Registered

Managers were the least likely to be recruited form overseas. The roles that had the largest change was Care Assistant.

This suggests that employers have been finding it increasingly hard to recruit into entry level positions over the past 5

years and have increasingly had to turn to overseas nationals to fill these roles.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

East

ern

East

Mid

lands

London

North E

ast

North W

est

South

Eas

t

South

Wes

t

West

Mid

lands

York

shire

& H

umber

British EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

East

ern

East

Mid

lands

London

North E

ast

North W

est

South

Eas

t

South

Wes

t

West

Mid

lands

York

shire

& H

umber



23


Workforce Pay – A Regional Picture Pay levels for the workforce vary across the country. The table below shows the highest and lowest payers for each

job role:

JOB ROLE LOWEST AVERAGE HIGHEST

REGISTERED MANAGER (PER ANNUM) North East - £28,530 £29,930 South East - £30,550

NURSE (PER HOUR) North West - £13.56 £14.38 London - £15.75

SENIOR CARER (PER HOUR) Yorkshire and Humber - £8.17 £8.51 London - £9.00

CARER (PER HOUR) North East - £7.55 £7.85 London - £8.46

The table above shows the variation in pay rates across the country. Unsurprisingly, in all roles London and the South

East were the highest payers, with Yorkshire, the North East and North West all paying well below the rates in the

South. Registered Managers have the lowest pay differential with only a 7% difference between the pay in the highest

and lowest paid regions. Nurses had the largest pay differential geographically with 16% difference between pay levels

the lowest and highest paid regions. The differentials for carers were in between with senior carers having a 10%

difference and carers 12% between the highest and lowest paid regions.

Wage changes increased by their largest margin between 2016 and 2017 due to the rise in the National Living Wage.

The North East stands out with a 10% increase in average wages between 2016 and 2017 for Carers, Senior Carers and

Nurses. This was closely followed by the West Midlands that had an 8% increase for all three roles. This suggests that

the National Living Wage is having a greater effect on regions of England with traditionally lower pay. This is of grave

concern to employers within these areas, due to the inadequate levels of government funding.


24


Section 3 – The future for Social Care Employers

We have considered several factors affecting the current social care workforce over the course of this paper, all of

which will have repercussions moving forward. One of the largest changes facing employers is the upcoming Brexit

deadline. Our analysis has shown that increasingly employers in most regions of England are turning to the EU, and

more widely overseas, to fill Care Assistant positions within their organisations. What was historically a London and

South East regional reliance on overseas workers has now expanded to become a national issue. For London, the South

East and East, employers now recruit significantly from overseas to fill Care Assistant positions and they would struggle

to adapt were this source of recruits to suddenly disappear. Immigration is currently a crutch holding up the social

care sector and this will either need to continue to be available (even for unskilled workers), or, as a sector, we will

need to radically change the way that we source staff.

We have also shown that the negative impacts of Brexit could be alleviated through increased productivity. In

particular, Care Assistants represent some of the least productive workers in the UK when measured on hours worked

per week. Proper analysis of the cause of this, and incentives to encourage employees into work full time, could

meaningfully increase the capacity of the existing social care workforce. Increasing the average number of hours

worked per week by this workforce from 18 hours to the current UK average of 30 hours, would effectively add around

300,000 FTE employees to the overall workforce, almost 60% of the number that Skills for Care suggest that we require

by 2030.

Supply of Nurses to the social care sector continues to be in crisis. The number of Nurses employed within our sector

has dropped by 8,500 over the past few years. Employers have historically been, and will continue to be, reliant on

recruitment from overseas and without this many nursing homes would be unable to function. There are no major

solutions on the horizon and the situation continues to worsen. Every year for the past 5 years the number of student

placements offered in UK universities has been lower than the number of nurses leaving the NMC register, and this

deficit is growing dramatically. Steps have been taken by employers to mitigate the lack of Nurses, these have mainly

revolved around the innovative use of less-skilled workers to perform elements of the nursing role. Nurse Associate is

the role being backed by Government, which has set up training courses to meet this need. This is a two-year course

that is currently being piloted with employers. Larger employers however have been unwilling to wait the 2 years for

employees to become available and are independently recruiting “Nurse Assistants”, putting them through a much

shorter training programmexvii. This has allowed many of the lower skilled jobs traditionally undertaken by Nurses (e.g.

administering medications) to be carried out by others. Consequently, organisations have either been able to lower

the number of Nurses required to alleviate a shortage, or to alter the nursing role so that it makes better use of the

clinical skills that these individuals have.

Pay rates have climbed dramatically over the past 2 years, fuelled predominantly by the rise in National Living Wage.

These changes have been felt most acutely in the North of the UK, which is coincidentally the area that is least able to

absorb these changes. Linked to this cost increase social care providers have been subjected to, ever increasing, real-

term reductions in fee levels paid by Local Authorities. This is beginning to take its toll, with 1380 care homes closing

in 2016 and a further 1353 closing in 2017xviii. Over the same period, numerous domiciliary care agencies have handed

back contracts to Local Authorities en-masse. Ours is a sector that is in financial crisis and the imminent further

increases to the National Living Wage will only exacerbate this. If Local Government, as the single largest purchaser of

care, does not take a more realistic stance on funding then we will see many more care provider closures across the

country.

In addition to these financial difficulties, the future direction of our sector may also be in jeopardy. Increasingly,

commissioners across the country are encouraging the provision of care in people’s own home. This is however a less


25


efficient use of staff than placing people in an institutional setting, and if staff availability becomes the key driving

force for our sector, then this policy to encourage people to stay at home may stutter and reverse.

This summary paints a bleak picture for the future for our sector and there are major workforce challenges that our

sector will face in the upcoming years. However, there are also employers and organisations that are “bucking the

trend” and are able to attract and retain staff exceptionally well. Employers are continuing to find innovative ways to

keep and attract staff in an ever more difficult environment. Further study of these employers is merited as there will

be many areas of good practice that could be shared across the sector to improve our performance in the areas of

staff recruitment and retention. Skills for care have started this research in their “Recruitment and retention in adult

social care: secrets of success Learning from employers what works well” study. There are also a number of authors in

both the UK and the US that have published books on this subject, with Neil Eastwood being one of the current

favourites.

In conclusion the social care workforce is in a troubling state, particularly for a sector that will need to grow

substantially over the coming years. Retention levels are extremely high and mean that for many employers effort

that should be spent enticing new individuals into the sector is simply spent replacing individuals that have left. The

number of individuals employed is not the only factor however, as a sector the situation could be improved if we had

a better understanding of why our work force is largely part-time and were able to entice more individuals into full-

time work. We have also shown that immigration plays a key role in providing enough individuals to fill our job roles

and this needs to be seriously considered by Government ministers when making policy decisions, particularly post-

Brexit. We have also shown that the cost of employing staff continues to rise, in large part due to the introduction of

the national living wage. This needs to be recognised by commissioners across the country as their current stance of

ignoring pleas for increases in fee levels is leading to the financial collapse of businesses across the country at a time

when the need for them is increasing. Finally, we have also shown that the government has no realistic plan to grow

the social care workforce. This means that it will be increasingly up to individual employers to come up with solutions

to workforce issues. This is an area where Care Associations across the country can assist individual employers to gain

a wider perspective on the local workforce through data sharing and can provide a forum for employers to network

and share good practice. The Care Association Alliance will continue to support Care Associations across the country

so that they can provide this much needed support to individual employers.


26


References

i POPPI elderly population predictions ii Skills for Care, State of the adult social care sector and workforce in England, 2017 iii NMDS-SC dashboards, https://www.nmds-sc-online.org.uk/reportengine/GuestDashboard.aspx?type=Leavers iv UKHCA Briefing, A minimum Price for Homecare, Jan 2018. v Schools, Pupils and their Characteristics: January 2017 - National Tables, Department for Education vi Size and Structure of the adult social care sector and workforce, 2017, Skills for Care vii https://www.ons.gov.uk/employmentandlabourmarket/peoplenotinwork/unemployment/timeseries/mgsc/unem viii See appendix 1 for calculations of working population ixhttps://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/uklabourmark

et/january2018 x Health education England, Facing the Facts, Shaping the Future, A draft health and care workforce strategy for England to 2027,

March 2018 xi National audit Office, The Adult Social Care Workforce in England, 8th February 2018 xii The adult social care workforce in England, House of Commons Committee of Public Accounts, 30th April 2018 xiii Skills for care NMDS-SC dashboard accessed March 2018. xiv BRIEFING: Migrants in the UK Labour Market: An Overview, dec 2016, The Migration Observatory, University of Oxford. xv Christie and Co. 2017 Market Insight Report, ADULT SOCIAL CARE 2017, Funding, Staffing & the Bed Blocking Challenge, July

2017 xvi Indeed.co.uk adverts for “Registered manager” accessed March 2018 xvii https://www.scie.org.uk/care-providers/hc-one xviii https://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2018-

02-07/127148/

The Care Association Alliance © Copyright. All Rights Reserved.

Social Care Workforce Study

Appendix

by Charles Taylor


27


Appendix 1 – Nationality of Social Work Staff by Region

Care Workers Current Nationalities of Care Assistants

Care Assistants Born Overseas

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern East Midlands London North East North West South East South West West Midlands Yorkshire &HumberBritish EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern East Midlands London North East North West South East South West West Midlands Yorkshire &HumberBorn in UK Not born in uk


28


Senior Care Workers Current Nationalities of Senior Carers

Senior Carers Born Inside and Outside the UK

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

England Eastern East Midlands London North East North West South East South West WestMidlands

Yorkshire &Humber

British EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

England Eastern East Midlands London North East North West South East South West WestMidlands

Yorkshire &Humber



29


Nurses

Nurse current nationality

Nurses Country of Birth

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern East Midlands London North East North West South East South West WestMidlands

Yorkshire &Humber

British EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern East Midlands London North East North West South East South West West Midlands Yorkshire &Humber



30


Registered Managers Registered Manager Current Nationalities

Registered Manager Country of Birth

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Yorkshire &Humber

British EU Non-EU

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Yorkshire &Humber



31


Appendix 2 – Regional Wage Increase Summary

Care Assistant Manager Hourly Pay rates 2012 – 2017 REGION Q1

2012 Q1

2013 Q1

2014 Q1

2015 Q1

2016 Q1 2017

ENGLAND £ 6.86 +1% 6.94 +1% £ 7.03 +1% £ 7.13 +3% £ 7.31 +7% £ 7.85

EASTERN ENGLAND £ 7.05 +1% £ 7.12 +2% £ 7.24 +1% £ 7.30 +2% £ 7.43 +5% £ 7.83

EAST MIDLANDS £ 6.67 +2% £ 6.78 +2% £ 6.89 +1% £ 6.97 +2% £ 7.13 +8% £ 7.71

LONDON £ 7.23 +2% £ 7.37 +0% £ 7.40 +1% £ 7.50 +4% £ 7.77 +9% £ 8.46

NORTH EAST £ 6.54 +0% £ 6.57 +0% £ 6.58 +1% £ 6.67 +3% £ 6.89 +10% £ 7.55

NORTH WEST £ 6.65 +1% £ 6.74 +1% £ 6.82 +1% £ 6.89 +4% £ 7.15 +7% £ 7.66

SOUTH EAST £ 7.02 +1% £ 7.11 +2% £ 7.27 +2% £ 7.41 +2% £ 7.57 +6% £ 8.02

SOUTH WEST £ 7.03 +1% £ 7.10 +0% £ 7.13 +2% £ 7.28 +3% £ 7.49 +5% £ 7.87

WEST MIDLANDS £ 6.61 +2% £ 6.72 +2% £ 6.84 +2% £ 6.98 +2% £ 7.12 +8% £ 7.67

YORKSHIRE & HUMBER £ 6.77 +0% £ 6.79 +2% £ 6.90 +1% £ 6.97 +1% £ 7.07 +8% £ 7.67

Senior Care Assistant Hourly Pay rates 2012 – 2017 REGION Q1

2012 Q1

2013 Q1

2014 Q1

2015 Q1

2016 Q1 2017

ENGLAND £ 6.86 +1% 6.94 +1% £ 7.03 +1% £ 7.13 +3% £ 7.31 +7% £ 7.85

EASTERN ENGLAND £ 7.05 +1% £ 7.12 +2% £ 7.24 +1% £ 7.30 +2% £ 7.43 +5% £ 7.83

EAST MIDLANDS £ 6.67 +2% £ 6.78 +2% £ 6.89 +1% £ 6.97 +2% £ 7.13 +8% £ 7.71

LONDON £ 7.23 +2% £ 7.37 +0% £ 7.40 +1% £ 7.50 +4% £ 7.77 +9% £ 8.46

NORTH EAST £ 6.54 +0% £ 6.57 +0% £ 6.58 +1% £ 6.67 +3% £ 6.89 +10% £ 7.55

NORTH WEST £ 6.65 +1% £ 6.74 +1% £ 6.82 +1% £ 6.89 +4% £ 7.15 +7% £ 7.66

SOUTH EAST £ 7.02 +1% £ 7.11 +2% £ 7.27 +2% £ 7.41 +2% £ 7.57 +6% £ 8.02

SOUTH WEST £ 7.03 +1% £ 7.10 +0% £ 7.13 +2% £ 7.28 +3% £ 7.49 +5% £ 7.87

WEST MIDLANDS £ 6.61 +2% £ 6.72 +2% £ 6.84 +2% £ 6.98 +2% £ 7.12 +8% £ 7.67



32


Nurse Hourly Pay rates 2012 – 2017 REGION Q1

2012 Q1

2013 Q1

2014 Q1

2015 Q1

2016 Q1 2017

ENGLAND £ 12.24 +1% £ 12.34 +2% £ 12.57 +3% £ 12.96 +4% £ 13.46 +7% £ 14.38

EASTERN ENGLAND £ 12.35 +1% £ 12.44 +2% £ 12.72 +3% £ 13.08 +4% £ 13.59 +8% £ 14.66

EAST MIDLANDS £ 11.91 +1% £ 12.07 +1% £ 12.16 +3% £ 12.54 +3% £ 12.96 +9% £ 14.11

LONDON £ 12.90 -1% £ 12.82 +4% £ 13.30 +4% £ 13.77 +4% £ 14.32 +10% £ 15.75

NORTH EAST £ 12.24 +3% £ 12.55 +1% £ 12.63 +2% £ 12.91 +2% £ 13.23 +10% £ 14.52

NORTH WEST £ 12.02 +0% £ 12.03 +2% £ 12.23 +2% £ 12.52 +3% £ 12.91 +5% £ 13.56

SOUTH EAST £ 12.43 +1% £ 12.61 +2% £ 12.81 +4% £ 13.30 +4% £ 13.86 +6% £ 14.74

SOUTH WEST £ 12.43 +0% £ 12.47 +2% £ 12.76 +3% £ 13.16 +5% £ 13.76 +5% £ 14.47

WEST MIDLANDS £ 12.14 +2% £ 12.35 +2% £ 12.59 +2% £ 12.88 +3% £ 13.33 +8% £ 14.38


Registered Manager Pay per annum 2012 – 2017 REGION Q1

2012 Q1

2013 Q1

2014 Q1

2015 Q1

2016 Q1 2017

ENGLAND £ 27,780 +3% £ 28,570 +1% £ 28,740 +2% £ 29,210 +1% £ 29,460 +2% £ 29,930

EASTERN ENGLAND £ 30,040 +5% £ 31,400 +1% £ 31,600 -1% £ 31,370 +3% £ 32,220 -9% £ 29,370

EAST MIDLANDS £ 28,970 -2% £ 28,530 +2% £ 29,110 +3% £ 30,030 -1% £ 29,780 +2% £ 30,390

LONDON £ 30,900 +4% £ 32,150 -3% £ 31,100 +3% £ 31,890 +0% £ 31,960 -7% £ 29,860

NORTH EAST £ 26,580 +0% £ 26,670 +6% £ 28,400 -1% £ 28,070 +2% £ 28,620 +0% £ 28,530

NORTH WEST £ 27,560 +0% £ 27,640 +2% £ 28,320 +1% £ 28,500 +2% £ 29,070 +3% £ 29,870

SOUTH EAST £ 28,080 +3% £ 28,890 +2% £ 29,330 +3% £ 30,090 +0% £ 30,200 +1% £ 30,550

SOUTH WEST £ 28,320 +3% £ 29,230 -6% £ 27,570 +3% £ 28,450 +2% £ 29,100 +2% £ 29,640

WEST MIDLANDS £ 28,110 +4% £ 29,340 +1% £ 29,740 +2% £ 30,270 -1% £ 30,060 -1% £ 29,790

YORKSHIRE & HUMBER £ 26,820 +3% £ 27,540 +5% £ 28,860 -2% £ 28,400 +1% £ 28,800 +5% £ 30,250


33


Appendix 3 – Nationalities of New Recruits

New Care Assistants by region - 2010 – 2016 Care Assistants – East region - 2010 – 2016

Care Assistants – East Midlands region - 2010 – 2016

Care Assistants - London region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

75%

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


34


Care Assistants – North East region - 2010 – 2016

Care Assistants – North West region - 2010 – 2016

Care Assistants – South East region - 2010 – 2016

94%

95%

96%

97%

98%

99%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


35


Care Assistants – South West region - 2010 – 2016

Care Assistants –West Midlands region - 2010 – 2016

Care Assistants – Yorkshire & Humber region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

86%

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


36


New Senior Care Assistants by region - 2010 – 2016 Senior Care Assistants – East region - 2010 – 2016

Senior Care Assistants – East Midlands region - 2010 – 2016

Senior Care Assistants - London region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

75%

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


37


Senior Care Assistants – North East region - 2010 – 2016

Senior Care Assistants – North West region - 2010 – 2016

Senior Care Assistants – South East region - 2010 – 2016

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


38


Senior Care Assistants – South West region - 2010 – 2016

Senior Care Assistants –West Midlands region - 2010 – 2016

Senior Care Assistants – Yorkshire & Humber region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


39


New Nurses by region - 2010 – 2016 Nurses – East region - 2010 – 2016

Nurses – East Midlands region - 2010 – 2016

Nurses - London region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


40


Nurses – North East region - 2010 – 2016

Nurses – North West region - 2010 – 2016

Nurses – South East region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


41


Nurses – South West region - 2010 – 2016

Nurses –West Midlands region - 2010 – 2016

Nurses – Yorkshire & Humber region - 2010 – 2016

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


42


New Registered Managers by region - 2010 – 2016 Registered Managers – East region - 2010 – 2016

Registered Managers – East Midlands region - 2010 – 2016

Registered Managers - London region - 2010 – 2016

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

80%

85%

90%

95%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


43


Registered Managers – North East region - 2010 – 2016

Registered Managers – North West region - 2010 – 2016

Registered Managers – South East region - 2010 – 2016

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

86%

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

0%

20%

40%

60%

80%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU


44


Registered Managers – South West region - 2010 – 2016

Registered Managers –West Midlands region - 2010 – 2016

Registered Managers – Yorkshire & Humber region - 2010 – 2016

86%

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

88%

90%

92%

94%

96%

98%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

92%

93%

94%

95%

96%

97%

98%

99%

100%

2010 2011 2012 2013 2014 2015 2016

British EU Non-EU

social care workforce studycareassociationalliance.org.uk/wp-content/uploads/... · the social care...

Documents