COMPLETED SOCIAL CARE: Local Authority Adult Social Care Recruitment and Retention research project
Lead: Dr Andy Pulman Post Doctoral Researcher and Professor Lee-Ann Fenge
Contact: apulman@bournemouth.ac.uk
Background
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 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.
Aims
The aims of our project were:
•Explore local recruitment and retention issues in adult social care and adult social work
•Helping to inform future workforce development activities undertaken by two local authorities (LAs)
•Contributing research data to both the regional and national picture of adult social care recruitment and retention issues
How did we do this?
Data for our project was collected between February 2023 and October 2023 and explored local recruitment and retention issues in Adult Social Care (ASC) from the perspective of four populations of interest. We collected data from n=131 participants across the four populations of interest:
•Social care practitioners - social workers, allied health professionals, unregistered social care practitioners - working in adult social care at two local authorities (LAs)
•Social care staff performing exit interviews with staff working in the two local LAs
•Social work students (undergraduate and postgraduate programmes) in Wessex
•Service users receiving services in either LA and advocates drawn from Wessex LA contracted services
esPos Positive Outcomes
•Practitioner demand to participate in this study was very high and we exceeded our initial recruitment targets.
•Being able to shine a light on some of the current issues facing advocacy – a currently under-reported research area – as a part of our qualitative data collected from POI 4 was an enlightening and beneficial bonus.
•Being able to involve and co-write with both the PPI collaborator and the two research champions from a local authority to produce two separate academic articles from the project was another highlight.
•Reaching a national newspaper (both print and online in the Telegraph) with research findings from practitioners regarding hybridization and hotdesking was a very positive development in reaching an external audience.
Practioner findings - Data on Staying
Reasons for staying with LAs included:
•Flexible working – place of work and hours worked
•Love of the job and engaging with the service users supported
•Supportive management
•Supportive team
•Training and CPD - via continuing professional development or an apprenticeship.
A number of outputs from this project can be viewed below.
We have also submitted a number of journal articles describing findings from the project data to the peer review process, which will hopefully be available later this year.
Practioner Challenges
Challenges to Retention highlighted include:
Hybridisation and Hot desking
Stress and Burnout
Negative Perceptions of Social Care
Student Reflections on Social Care
•There is always focus on recruitment, but not on retention.
•Social care is hugely underfunded but money is not the only answer –a place where people want to be.
•Awareness that SW not seen as a fully sustainable career. Some already planning exit strategies before they started work - a perceived shelf life for a social work career.
•Worries about excessive caseloads/increased admin burdens and bureaucracy.
•Pay level was deemed inadequate for the demands of the job.
•On placement students noticed issues with team churn, attrition and a lack of stability – one had 8 different managers over a 12 months.
•Staff shortages – some vacancies can’t even be filled by locums.
•COVID-19 had been the prompt for a lot of staff to move on.
•Agency usage is an issue (for example, out of county managers). This is helping to create a ‘perfect storm’.
•Risk of stress and burnout inherent in profession was noted: Ethical Dilemmas / Job related / Questioning of their decision making / Resilience / Coping strategies / Travel issues
Students reflected on Cost of Linving Impacts that:
•Increased numbers seeking hardship support / more working alongside study
•Social work bursaries frozen since 2014 – more earning whilst learning
•Some HEI staff do not appreciate hardships experienced or demands faced
•Burnout - feeling stressed/lacking in energy after working full-time alongside course.
•Longer term, reductions in students entering the profession have major implications for meeting rising level of vacancies in social work.
•Cost of living issues an increasingly influential factor for prospective students when choosing route/retraining as mature student.
Service User reflections on Social Work Relationships
•Changing role - onus now on the carer more to be the lead professional though not through choice.
•Biggest issue is lack of money in the system.
•Money over empathy – it often feels like carers and SUs cost money.
•Inertia - one participant described this feeling as : “It doesn't matter how I am, you're not going to do anything about it”.
•Whole structure needs an overhaul. Social work/social care is a societal issue and priority
Service User reflections on staff turnover
•Previous continuity of same worker no longer exists. Rapid changeover / staffing issues causing upset for carers and SUs.
•Churn obliterates previous working relationships
•Depersonalisation – team rather than individual; now you don’t usually have a designated social worker. It's a group.
•Less frequent contact.
•Out-of-hours - service is overstretched and doesn’t cover the whole area effectively for time precious situations.
Impact on Advocates
·Safeguarding caseloads for advocates have increased. Crisis situations due to lack of early intervention. After discharge there is no pick-up or continuity from the community – loss of advocate, a new LA social worker or unqualified social care practitioner assigned, or the case is closed as it is classified as ‘not in crisis’.
·Increased caseloads now have greater complexity. There are more Section 21A challenges – a review under a Deprivation of Liberty Safeguards (DoLS) as SUs unable to care package in the community.
·Community advocacy - which prevents crisis in a lot of cases - has been reduced as statutory work always comes first. SUs need be in receipt of an LA commissioned service or NHS secondary care before they can get issues-based advocacy.
·Increased complexity causes settled cases to be visited less regularly as advocates now deal with more complex court proceedings and safeguarding issues.
Increased caseloads - Social work / NHS overflow
·Social work seems to be moving away from relationship-based practice to procedurally driven form-filling with advocates picking up some of this work instead.
·“Hold on, this is not actually my role” - Advocates are doing part of the social worker’s job because, for whatever reason, they are not able to.
·There is a greater expectation of monitoring conditions done by the supervising body, when actually it’s not their role as an advocate, but it has become their role.
·Less time for IMHA within hospitals as advocates now have little or no time to do it.
Further reading – blogs:
A blog for World Social Work Day (19/03/24)
Further reading – reports:
Recruitment and retention in adult social care. Bournemouth: NCCDSW, Bournemouth University.
Further viewing:
Publications
Full article: Advocacy in Practice: Who Advocates for the Advocates?
Full article: Impacts of Workplace Stress on the Retention of Social Workers: A Qualitative Study