This is the second article in a two part series, exploring findings from new research by Dr Simon Williams on public attitudes to and experiences of social care two years on from the start of the pandemic.
The first article looked at public perceptions, access to services and the consistency and quality of social care. This one considers views on the social care workforce and addressing staff shortages, as well as social care reform.
The full Swansea University research report is available here.
Addressing workforce shortages
The pandemic has compounded existing problems of recruitment and retention of social care staff, and the sector is now facing an unprecedented staffing crisis.
Before the pandemic it was estimated that 95% of care in Wales is provided by unpaid carers. The study notes that the challenge for social care services is to ensure unpaid carers are choosing to provide care out of preference, and not necessity due to a lack of formal social care provision.
On the paid care workforce, the research found:
- nearly all respondents agreed that social care should be valued in the same way as health care (95%), and that social care workers should be seen as equal to health care workers. Most participants agreed that social care staff should have comparable pay, working conditions and career progression opportunities relative to equivalent career stage NHS staff.
- respondents felt that a career in social care was not very attractive – both to them personally or to others in general.
The top reasons given for this were unsatisfactory pay and working terms and conditions; lack of career security and progression pathways; burn out/excessive work; lack of recognition or value given to the profession; better opportunities in other sectors; and the added strain of the pandemic on the workforce.
“it struck me it's almost the employer of last resort”; “You get paid more work at Lidl’s.”
Others argued that, despite their commitment to the role, people were leaving care roles because of the low pay and long hours, for work that was emotionally demanding, and risky during the pandemic:
“My dad’s partner, she had to give it in because she would do a 15-hour day [and] she might see 20 people, providing personal care and up and down the M4 [motorway] caring for somebody that had no family and there was that emotional guilt …
Going into the pandemic, they were asking them to put their own lives at risks with inadequate PPE [personal protective equipment], not enough money and no respite, and fear that they were going to bring it [the virus] home”. (Alys, Female, 30s)
Overall, participants felt that social care careers should be transformed. The study concludes based on the evidence that the Welsh Government and stakeholders should consider “enhancing the recognition and attractiveness of social care work”, with:
- further improvements to the pay and job stability of social care workers;
- improved working conditions and career development opportunities for social care workers; and
- substantial reform in the training, accreditation, and professional development of social care workers.
The Welsh Government recently announced further funding to increase pay and meet the real living wage in Wales and to fund a national recruitment campaign. It also says it is “taking steps to professionalise the sector and improve career progression opportunities”.
Social care reform
It’s widely accepted that fundamental reform of social care is long overdue, but, as yet, significant transformations have failed to materialise.
The vast majority of survey respondents felt that the care system in Wales is in need of reform (86%), and that reforming the social care system should be a priority for the UK and Welsh Governments (94%).
Participants in the focus groups generally felt that social care needed more funding and investment, and most felt people should not have to bear too great a cost for their care.
“It's not getting a big enough bite to the cherry, but will it ever change?” (Gareth, Male, 60s)
A significant majority of survey respondents felt that reducing the costs of social care for those that need it should be a priority for the UK and Welsh Governments (85%).
Dr Williams concludes that proposals and discussions for social care reform would likely be welcomed by many within the Welsh public. In particular, there was considerable support for the idea of a more integrated and ‘joined up’ health and social care system, with social care less reliant on private funding (e.g. via the incorporation of social care into the NHS, or the establishment of a ‘National Care Service’ for Wales).
The Welsh Government has established an expert group to make recommendations to support the ambition to create a National Care Service, free at the point of need. It previously stated that the expert group would aim to provide recommendations by the end of April 2022, and an implementation plan would be developed by the end of 2023.
Promoting wider interest in social care
This study suggests there is a considerable public appetite for social care reform. However, it also notes that a broader challenge may be to address the perception that adult social care is mainly “for the elderly”. The reality is that around 25% of adults receiving state support are under 65 (e.g. younger adults with disabilities or learning difficulties).
Although focus group participants argued that health and social care were (or should be) inexorably linked, they also suggested that many people don’t really start thinking about social care, or don’t see it as important “until you need it”.
This point is supported by the fact that while there was a wide age range of survey respondents, the average age of the sample was 64 years old. Dr Williams says this likely reflects the fact that older adults have more experience of and interest in social care.
A challenge ahead is to promote broader interest in, and appreciation of, social care to the wider public, including younger adults. After all, for most working age adults, the effectiveness of the care system is directly relevant to our loved ones now, and ourselves in the future. We are all ageing and hope to live a long life, so it’s likely that the majority of us will need to access care and support services in later life.
Article by Amy Clifton, Senedd Research, Welsh Parliament
