Recruitment and recovery challenges in the care sector post-pandemic

Jennifer Johnston, an associate in law firm BLM’s occupational disease team in London, considers how the sector can proactively tackle the recruitment challenge and provides practical advice for care home employers.

While there is a sense of optimism within the care sector following a turbulent 18 months, there remain several challenges to contend with, particularly recruitment.

Understaffing proved a huge challenge during the pandemic: many workers who typically operated across several care homes pre-pandemic were no longer able to; changes to immigration law made non-British workers sparse; there was no real mention of social care reform in the Queen’s speech, and the decision to make vaccines mandatory in the sector from November will also provide another hurdle.  

It’s been a challenging time for everyone involved with social care, with the sector now facing several serious recruitment and recovery challenges. According to independent social work charity Skills for Care, there were 112,000 vacant roles in adult social care in England last year, and this number is anticipated to rise significantly by the end of 2021. It’s a crisis that has quickly come to a head and is the result of both long- and short-term problems that have been poorly handled, or not been dealt with at all.

The UK’s population is aging rapidly. According to the Office of National Statistics (ONS), in 1990 the median age of the UK was 35.8 years old, in 2020 the median age was 40.5 years – a huge rise in just 30 years. It’s created a society where more of us are suffering with conditions associated with old age, such as dementia, placing greater pressure on care providers to accommodate an increasing number of residents and patients.

It’s a problem that’s been mounting for some time, exacerbated by a serious lack of central support and planning from successive governments. Even with a recent hint at plans to improve funding through a tax rise, it is something that will take time to implement and doesn’t directly address how social care for today’s elderly should be funded.

In the shorter term, Brexit and its associated immigration policies have also made a serious impact over the past five years, slashing employee numbers in the UK, brought to a head by Covid-19. At the beginning of August, the government launched an open consultation on the impact of ending free movement on the adult social care sector specifically, so there are some early, promising signs that the government is taking the threat seriously.

Solving the crisis: Government promises not kept?

The current government had pledged to reform social care, with the Prime Minister promising to make social care a priority in his speech after the election results. Likewise, in November 2020, former health and social care secretary Matt Hancock confirmed the Party’s pledge of £1 billion in funding per annum for the next five years to assist local authorities meet the demands of social care.

The plans also set out an intention to work with other political parties to reach long term solutions, as the former Health Secretary Matt Hancock categorically stated that people should not have to sell their homes to pay for their social care. Whilst a positive sentiment, The Conservative Party faced criticism for the lack of detail in its plans.

There had been an expectation that change would arrive at this year’s Queen’s speech, yet there was a distinct lack of decisive action mentioned within it.

Of course, the pandemic took precedent over most other governing concerns, but as we approach 18 months since the pandemic hit out shores, there has been little real support given to the care sector – even though it has borne the brunt of the pandemic throughout.

There has been little progression on the government’s initial promises and even with the spotlight on the sector during the pandemic, there has been no pledge on funding or on a specific Social Care Bill.

The social care tax previously suggested by No.10 gives some hope but it is in keeping with vague promises that, even if stuck to, will take a long time to deliver. Current residents and care service users are already underfunded, however, and require immediate support, sooner rather than later.

Alleviating recruitment pressures

This lack of investment has meant that social care workers are typically not well paid for the difficult work that they do. The workers may be carrying out very difficult and strenuous work that they are not paid for adequately, and thus the social care profession is not attractive as a potential job.

In the past, a large proportion of the workforce was recruited from overseas, often taking on positions in the care sector that they are technically overqualified for in their home country. However, Brexit and associated immigration laws have meant that coming to work in the UK is now a less attractive option to overseas workers. Understaffing has only deepened as a result of the so-called recent ‘pingdemic’ riding roughshod over rotas.

When it comes to alleviating the pressures of recruitment, there will be no one-size-fits all approach and each care home needs to consider this in the context of its own business stream and model. That said, if you are struggling to attract or retain staff, there are a few strategies you can take.

It may seem obvious, but the first point of call should be offering better pay and conditions if you can, standing out from other organisations will make the recruitment process easier. Just recently, we’ve seen some operators offer significant ‘golden hellos’ with the likes of HC One offering a £10,000 welcome bonus for some of its registered nurse positions.

However, this will not be applicable to all employers in the sector, with some providers often facing tight margins as a result of council-funded care, so will therefore not have the resources to offer higher wages.

In terms of retention, the priority should be ensuring you are clear on what pressures each of your employees are currently facing – a formal audit throughout your organisation with each employee is a good way of doing this, as you will have a clear understanding of what concerns are pressing to each individual.

This will not only help with future planning, but you may be able to help solve many underlying issues there and then. For example, if you have staff that are not UK residents and may be impacted by Brexit, it is worth discussing with them whether you are able to provide support, in the form of advice or sponsoring a Health and Care Worker Visa if they meet the salary requirements. More ‘soft’ issues, such as if a worker feels underappreciated, can also be dealt with appropriately, helping you to keep your very best talent.

However, many of these points are short term fixes that will only go so far to solving the current recruitment crisis. For longer-term change, it’s clear that greater government funding and social care reform, which has been repeatedly promised over the years, is going to be needed.

The government’s proposed NHS reforms do suggest a move towards people receiving more care at home.  It’s likely the domiciliary care sector will become more and more prevalent as time goes on, as an often-cheaper alternative to residential care, and the growing use of tech enabling more vulnerable people to live at home safely with adaptations. 

Domiciliary care often gives workers more flexibility in their day and might therefore be a more attractive job prospect. Some providers could well be revisiting their operational models to offer more at-home care, if that is what the workforce increasingly favours.

Future threats to the sector

There have been new challenges in care over the past two years on a near monthly basis. One we can expect to cause significant issues come November 11 is the introduction of mandatory vaccines for care sector workers.

This will provide a further duty of care on employers to ensure all eligible employees are vaccinated, and is likely to further impact staffing levels if there are cases where workers who are, for their own reasons, unwilling to receive the jabs. The government has estimated up to 40,000 could be at risk of losing their jobs as a result, which would cost the sector approximately £100m to recruit and train replacement staff.

Just recently, the government published operational guidance on vaccinations for care providers setting out the importance of vaccination, to protect those in their care. There are many reasons why a staff member may not have the vaccine and those under threat of losing a portion of their workforce when these new rules are enforced should consider launching an internal education program for their workers. If you are able to pinpoint some of the specific issues and concerns, staff members may be more inclined to receive the vaccine, which is crucial at this moment of mass understaffing.

At a time when there are so many new potential legal issues facing the sector, it is sensible to seek specialist, professional advice to navigate your organisation through these obstacles. Though it seems the sector is some way off solving the many recruitment and recovery challenges, early engagement with advice can go some way to ensuring employers and employees alike are supported at this turbulent time.

Photo Credit – engin akyurt