Whilst the care sector in Wales and across the UK already struggles to recruit staff, the rise in the number of old and very old adults, will increase the need for personnel coming into the sector dramatically. However, the sector suffers from a number of factors which make recruitment difficult. Pay rates are generally low, hours can be unsocial, responsibility and accountability is high. High profile scandals involving mistreatment or neglect stigmatise the work, and the personal and intimate nature of care work is off-putting for many. Men in particular often feel that the work is low-paid, low-skilled and low on desirability – seeing it dismissively as ‘women’s work’.
Retaining care staff
Staff retention is also a problem for Welsh care services, as it is in other parts of the UK. Other employment sectors can offer better-working conditions, generous staff discount schemes, or better pay, leaving the care sector struggling to recruit and retain the skilled and motivated workforce that it needs. Pay rates, in particular, appear less generous than the retail sector or hospitality where tips can often incentivise loyalty. Mandatory training programmes such as the Social Care Induction Framework have attempted to upskill new recruits, and QCF training can assist with career development, but the retention problem remains a potentially destabilising one. An often heard refrain from employers who invest in training, is that they oversee staff development through in-house training, only then to see staff poached by other services.
Brexit is another unstable factor in the recruitment equation. Many services have employed workers from Eastern Europe in the past decade, recognising that these workers see the sector as more attractive than many locals. But of course, with Britain negotiating to leave the EU, no one knows what the status of these and future EU migrants will be. Consequently, estimating the availability of EU nationals for availability in care roles is beyond speculative.
New Funding
In recognition of the multiple difficulties facing the care sector in Wales, an extra £10 million a year of new Welsh Government funding has been identified to help ensure the Welsh care sector is fit for the future. The new investment forms part of a three-way partnership between the Welsh Government, local government and social care employers, to create a more stable social care workforce. This is in addition to funding to support the integration of health and social care through a £60m “Intermediate Care Fund”.
The Welsh Government funding will help meet the extra costs associated with the introduction of the national living wage. It is in addition to the extra £25m for social care, which was announced in the draft 2017-18 Budget in October. Further funding to support social care in 2017-18 will be available as the maximum weekly charge for domiciliary care rises from £60 to £70.
Minister for Social Services and Public Health, Rebecca Evans, said:
“In Wales, we have prioritised social care as a sector of national strategic importance, we know that the sector is crucial to the effective running of the wider healthcare system and we have engaged with our social care partners to understand the issues facing the sector – the financial impact of implementing the UK Government’s national living wage has emerged as a primary concern… the Welsh Government will provide a further £10m a year to help manage the impact of the national living wage. This will also support work to create a fully registered workforce by 2022. This investment underpins a joint commitment between partners – we will provide funding, local authorities will invest in service provision and employers will create a more valued workforce, reducing the high turnover in staff currently experienced.”
The Minister added:
“Alongside our recurrent £10m investment, I have also been considering the maximum charge for domiciliary care. I believe the time is now right to uplift it. Taken together, these announcements will mean millions of pounds more are invested in social care every year. This will ensure we all benefit from a strong, sustainable sector that is fit for the future.”
According to the minister, the uplift in domiciliary care rates will complement the extra £10m-a-year investment, ensuring care across Wales continues to be of good quality, reflects the need to invest in domiciliary care and takes account of inflation over the two-year period that the current £60 maximum charge has been in place.
Responses to The New Funding
The response has been mixed. Councillor Huw David, Welsh Local Government Association Spokesperson on Social Care and Health, said:
“We warmly welcome the additional £10m to assist with funding the implementation of the national living wage for care workers. Equally, the decision to raise the maximum charge for domiciliary care from £60 to £70 is a beneficial step in the right direction and it is the view of the WLGA that it will need to increase further in future years to help cover some of the extra costs.”
Estimates suggest the rise in domiciliary charges will raise more than £4m a year in additional income for local authorities to use, to tackle pressures in the social care sector, including financial pressures caused by the introduction of the national living wage. However, underlying or ‘structural’ problems remain within the system. The funding model is under extreme pressure and looks difficult to sustain even in the short term. Furthermore, there was no suggestion that the income generated would have to be ring-fenced, leading other commentators to be more cautious.
Mario Kreft of Care Forum Wales – an organisation representing care providers said:
“Any extra funding to a sector in meltdown is to be welcomed, but in reality, it is a sticking plaster which will fail to plug the massive funding gap… since October 2015 we will have seen the minimum pay rates of our care workers increase by 12 per cent. We estimate the cost of this to be at least £80m…We are pleased that the Welsh Government has prioritised social care as a sector of national strategic importance, but there needs to be recognition as the sector remains under pressure. The on-going demands of the national living wage increases and registration mean that the value we place on the sector and the funding it receives will need to be revisited with our partners in Welsh Government, local authorities and health boards to make it sustainable.”
The new money is undoubtedly a significant initiative on the part of the Welsh Government at a time when budgets are tight and there are so many competing demands. They have shown themselves to be responsive to concerns from providers regarding the cost of implementing the living wage and providing domiciliary care, whilst not making any commensurate increase in funding for residential care packages.
The sector needs new thinking, and now that it sits within a devolved portfolio, the Welsh Government must follow through on the commitments made to date and make further strides towards stabilising the sector. It is something we no longer need to wait for England to take the lead on.
