Low pay, job insecurity and post-Brexit recruitment challenges are plaguing the adult social care sector in England. Andreas Georgiadis and Andreas Kornelakis suggest ways to improve the situation.
This article was first posted on LSE Business Review.
Adult social care suffers from a long-standing ‘workforce crisis’ in England. Recent reports from industry bodies highlight the challenges to the sector’s workers and their ability to offer high quality care. Staff in social and health care are overworked, exhausted and stressed, sometimes to the point of becoming ill, leading to absenteeism or quitting altogether.
Increased workloads and time pressures arise partly due to increased demand for services by a rapidly ageing population. At the same time, over half of adult care providers said they faced challenges recruiting new staff; 31% struggled to retain employees. Difficulties in recruitment and retention intensified after Brexit, as the sector relied heavily on migrant workers.
It is widely known that adult care is one of the lowest paying jobs in the UK. Forty-three per cent of all adult social care workers in England are paid below the real living wage. It will continue to be challenging for care providers to retain pay differentials between those on the wage floor and those with more experience and qualifications. But pay levels are not the only challenge for care workers, as they also face problems of job insecurity and unpaid overtime.
For example, most of those who do home visits are not compensated for the time they spend travelling to homes, which can make up to a fifth of their working day. The use of contingent contracts in social care may deliver some cost savings for providers, but has the drawbacks of job insecurity for workers, and concerns about service quality.
Barking up the wrong tree?
Funding cuts have also contributed to the workforce crisis. The Health Foundation estimates an additional £8.3bn will be required by 2033 just for adult social care to keep up with growing demand. In response, the Labour government charged Baroness Louise Casey with preparing a report to recommend ways to address the sector’s funding and workforce crisis. But the independent commission will make its final report by 2028. Until then, problems are expected to pile up.
Nonetheless, the government’s plans on immigration, and especially the axing of care worker visa, will only exacerbate the recruitment and retention problems. Indeed, as Unison’s general secretary, Christina McAnea, stated ‘…the care sector would have collapsed long ago without the thousands of workers who’ve come to the UK from overseas’. Similarly, Martin Green OBE, chief executive of Care England, characterised the government’s plans as ‘a crushing blow to an already fragile sector’.
Pay and train to sustain
Our recent research offers insights on how to fix the crisis. We propose that ‘high-road’ workforce practices can improve rather than hinder, as it is commonly believed, the operational performance of care providers. We find that relative pay increases and pay progression are strong motivators for employees and this provides support to the longstanding demand by union leaders for a fair-pay agreement in the sector. Investing in skills pays off, especially for those providers who suffer from long-term underinvestment.
The evidence suggests that increased investments in staff training, improved pay, career pathways to promotion and permanent contracts could address the poor performance of care providers. Alternatively, it also explains why strategies based on cutting costs via the adoption of ‘low-road’ practices, characterised by low-pay growth and lack of investment in skills are likely to be counterproductive.
Evidence also tempers unrealistic expectations that investment in training and rewards practices is a panacea for care providers. They are much more likely to be effective in ‘low-road’ organisations, characterised by persistently poor performance and workforce skill gaps.
We suggest that the effectiveness of ‘high-road’ pay and training practices is expected to reduce after a threshold level of collective staff skills, knowledge and experience is reached. At that point other interventions are needed, for instance, improving efficiency using advanced technologies such as artificial intelligence.
Conclusion
To sum it up, care providers trapped in ‘low-road’ workforce practices can especially benefit from investment in workforce pay and training, which can bring about considerable improvements in their operational performance. Government should therefore move away from visa restrictions. It should also aim to address the adult care crisis by supporting care providers’ investment in their staff and funding comprehensive training and upskilling programmes. It may also enable improved pay and working conditions by supporting sectoral collective bargaining.
High-road practices can help tackle longstanding performance and turnover challenges. These insights are also likely to be relevant to other sectors with similar characteristics. For example, sectors such as childcare, hospitality or retail, which are heavily tilted towards personal services and interactions with users/customers, and at the same time, rely on a workforce that is predominantly less skilled and low paid.
About the authors: Andreas Georgiadis is an Associate Professor at the International Business Department of Leeds University Business School and a Fellow of the Global Labor Organization (GLO), and Andrea Kornelakis is an Associate Professor at King’s Business School, King’s College, and a Research Associate at LSE’ Hellenic Observatory.
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