Realities of adult social care recruitment and retention
World Social Work Day 2024
Professor Lee-Ann Fenge - lfenge@bournemouth.ac.uk
Dr Andy Pulman – apulman@bournemouth.ac.uk
Social Work Week is an opportunity to celebrate the value that social work brings to society as well as acknowledging the challenges the profession faces. The theme of World Social Work Day is ‘Buen Vivir: shared Future for Transformative Change’, calling for social workers to adopt innovative, community-led approaches that are grounded in indigenous wisdom and harmonious coexistence with nature. This is an important focus as we recover in a post-COVID world, where budgets continue to be constrained and social workers increasingly draw on their creativity and innovative practice to provide excellent support for those they work with.
To transform practice, it is important that we build an evidence base of what works and why, developing social work and social care research that evidences the value of the approaches taken. To date social work has lacked an established culture of research within social care organisations, resulting in limited high-quality research evidence alongside a limited culture of staff development focused on research opportunities. Practitioners may wish to develop a practitioner-researcher focus to their work, but this is often not supported or developed by their employer. This results in a missed opportunity to develop ground-up inclusive research practice driven by the insights and priorities of practitioners and service users which is essential to underpin high quality care.
Within the Wessex region, we have been working to support the development of social care research over the past few years. In 2022, we completed a year-long study examining social care research enablers and barriers which might prevent or limit a positive research environment for practitioners (Pulman and Fenge, 2023). This built the foundation for four projects across Wessex funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex – which all aimed to build research partnerships across local authorities (LAs) and universities in the region. As part of these projects, separate funding was available to support research champions embedded within local authorities, to support activities such as lunch time research discussions, journal clubs and the development of practitioner focused research. To encourage buy-in from the LAs we developed research in partnership with them to respond to key priority areas.
One such project explored local recruitment and retention issues in adult social care (ASC) from the perspective of four populations of interest collecting data from n=131 participants across the four populations of interest:
(POI 1) Social care practitioners - social workers, allied health professionals, unregistered and other social care practitioners - currently working in adult social care at two local authorities (LAs)
(POI 2) Social care staff with responsibility for performing exit interviews with LA staff currently working at the two LAs
(POI 3) Students currently enrolled in social work undergraduate and postgraduate programmes within the Wessex region
(POI 4) Service users with lived experience of receiving services in either LA and advocates drawn from Wessex Region LA contracted services
Realities of retention
So what does our data tell us about the day-to-day realities of people currently working within adult social care? What pressures are they currently experiencing and what might make them question whether they want to stay working within the profession?
Within POI 1, n=97 practitioners working in adult social care at two local authorities completed our online survey on recruitment and retention with n=25 subsequently being interviewed.
We found:
Within next three years, n=17 (17.5%) were planning on leaving social care
Career change decisions included changing area of practice, independent working, moving sectors to the NHS/Third Sector and leaving the profession to go to other employment – the biggest response at n=7 (41.2%)
The most important reasons for those wanting to leave social care within the next three years were ranked by number of responses and the highest ranked themes were then corroborated within the data collected from all participants as being ongoing issues of concern for LAs. Below we reflect on a number of the challenges, pressures and demands on ASC at the moment.
Demands of administrative tasks
Participants described support posts being reduced, causing them to spend more time on administerial processes. Additionally, more time-consuming paperwork was required and constantly changing processes created ongoing frustration.
Workload demand The increasing demands on roles in terms of a rising number of cases within LAs and subsequent increased caseloads caused immense pressure on being able to process work in a timely manner.
Inadequate staffing levelsStaffing levels in some teams was not deemed to be adequate.
Inadequate pay and benefits Pay was often equated to a lack of value in the profession when compared to other health professionals. Pay was viewed frequently as being less than equivalent to what could be obtained in the retail sector (with a view of that work also being less stressful in comparison). Concerns were also raised about the use of agency staff by LAs and the pay discrepancies between agency and permanent posts, alongside additional impacts on continuity and team stability.
Perceived rationing of/limited resources for service users
Struggles to provide adequate services to service users was a continual source of frustration in the face of current budgetary pressures. This could also be apposite to the personal ethics of working within the sector.
Isolation/too much working from home
The effects of hybrid working was viewed positively or negatively, depending upon the individual. Positives included the ability to concentrate more, better productivity with less interruptions and the inherent flexibility of choosing where and when an individual worked. Negatives included feelings of isolation and lack of support - a particular risk for new entrants. A lack of a team culture was also described in some cases. Additionally, management seemingly became more distant in some instances.
Poor support and induction for newly qualified staff
The induction process was viewed as being inconsistent across LAs. Providing initial support for new staff can be complicated by the effects of hybrid working, limiting support and team building opportunities for new entrants. Suggestions for improving consistency included mentoring, shadowing and standardising the structural induction process.
Stress and COVID-19 burnout
Stresses caused by working in the sector and lowered resilience over a prolonged period of time could contribute to burnout. Stress caused by the nature of the job was mentioned by a number of participants. COVID-19 and post pandemic effects contributing to stress were noted. This also impacted on staff working from home during and after this period. Stress was also caused by the ethical challenges of working within the constraints of the current social care system.
Office environment/hot-desking issues As with hybrid working, both the pros and cons of attending the office were discussed by participants – with travel and parking costs described as factors which might influence office attendance. There was an acknowledgement that hub office space had been lost since the pandemic, which some thought had been detrimental. Both home and work environments had their supporters, depending on working preferences. For some, the office was preferred for providing deeper and broader opportunities for networking and helping to build a positive team culture. Open plan offices could be a problem due to their nature – be it issues of noise, a lack of privacy and storage space in some cases. Also a lack of locations to debrief or chat in private. Hot-desking could also prevent a team culture from developing.
Next Steps
Social Work England’s State of the Nation report (2023) suggested that high demand for health and care services, a rising complexity of needs and increases in vacancies continues to put pressure on a system that is already stretched. Workforce challenges around the recruitment and retention of staff alongside increased reliance on agency social workers constantly proves challenging for employers. Although social workers are adaptable and innovative in the ways they deliver social work, ultimately pressure in the system can undermine the stability of relationships which can have a direct bearing on people’s care (Social Work England, 2023). Similarly, Skills for Care (2021) concluded that a well-led, supported and developed ASC workforce were more likely to stay in post and deliver consistent, high quality, personalised care. Conversely, a workforce that was under-funded, under-developed, suffering from poor wellbeing and not supported to advocate for themselves and the people they cared for was likely to result in poor care or worse. Our research highlights that unless employers, and the government, recognise the current concerns of front-line practitioners, recruitment and retention will continue to be a challenge. Addressing these concerns, alongside wider consideration of career paths that may include the opportunity for research engagement for practitioners, is essential to stem the tide.
Thanks to:
The authors wish to thank all participants who took part in the online survey and gave up their time to be interviewed. This work was supported by the NIHR Applied Research Collaboration (ARC) Wessex
More information on our project:
Professor Lee-Ann Fenge - lfenge@bournemouth.ac.uk
Dr Andy Pulman – apulman@bournemouth.ac.uk
https://nccdsw.co.uk/clusters/research/building-research-capacity-in-social-care
Further viewing:
Pulman, A. 2024. NIHR ARC Wessex Social Care Lunchtime Seminar – Realities of adult social care recruitment and retention in 2023
References:
Pulman, A. and Fenge, L. A. (2023) Building Capacity for Social Care Research - Individual-Level and Organisational Barriers Facing Practitioners. The British Journal of Social Work. bcad117).
Skills for Care. (2021). Evidence review and sector consultation to inform Skills for Care strategy: Final sector report. Available from: https://www.skillsforcare.org.uk/resources/documents/Adult-social-care-workforce-data/Evidence-review-and-consultation-analysis.pdf (accessed February 22, 2024).
Social Work England (2023) Social work in England: State of the nation 2023. Available from: https://www.socialworkengland.org.uk/about/publications/social-work-in-england-state-of-the-nation/ (accessed February 29, 2024).