Story updated, 2 December 2021
The government has pledged to invest in new training routes into social work as part of its white paper on adult social care reform, published today.
The Department of Health and Social Care (DHSC) said these would be funded from £500m allocated for developing the adult social care workforce from 2022-25.
It also vowed to “improve the pre and post-qualification landscape” for social workers, and ensure “a sufficient supply of social workers with the right skills, knowledge and values”.
The £500m was announced in September, when the government unveiled its plans for reforming the funding of adult social care, including the cap on care costs.
Subsequently, chief social worker for adults Lyn Romeo said part of this would be used to support the training, recruitment and retention of social workers because of the need for more practitioners arising from the funding reforms.
New training routes
The white paper does not provide any details about the new training routes and how these would differ from the current suite of entry points for social work, which are:
- Undergraduate degrees, which take three years full-time and generally involve two practice placements;
- Postgraduate degrees (two years full-time, also with two placements);
- Social work apprenticeships, which are work-based and take three years;
- Step Up to Social Work programme, which takes 14 months, is also work-based and focuses on entry into children’s social work;
- The Frontline fast-track programme, also work-based and targeted at children’s social work, with qualification taking one year, followed by a further year’s study for newly qualified practitioners;
- Think Ahead, equivalent to Frontline and focused on entry to mental health social work.
The DHSC said it would also work with the Department for Education, Social Work England and the two chief social workers – Romeo and DfE counterpart Isabelle Trowler – “to improve the overall pre- and post-qualification landscape for social workers”.
‘A sufficient supply of social workers’
Unlike Romeo’s comments last month, the white paper does not address the specific implications of the funding reforms for the demand for social workers. They will substantially increase the number of assessments, care plans and reviews councils have to carry out each year through an influx of self-funders into the system due to:
- The need to assess and determine eligibility for anyone wanting to benefit from the £86,000 cap on personal care costs, in order to quantify the cost of meeting their unmet eligible needs. This would need to be set out in an “independent personal budget”, which would have to be reviewed each year.
- The increase in the upper capital limit for the social care means-test, making more people eligible for council-funded care.
- The full implementation of section 18(3) of the Care Act 2014, meaning self-funders can request their local authority meets their needs, necessitating assessment, planning and review for them.
However, the DHSC pledged to maintain “a sufficient supply of social workers” as part of improvements to training.
“We are committed to improving the quality of social work education and training, and maintaining a sufficient supply of social workers with the right skills, knowledge and values. We will invest in new training routes for people who want to become social workers.”
It said it had commissioned Health Education England to develop a long-term framework for health and social care staff, including social workers. When published next spring, this would “inform long-term workforce planning, and ensure we have the right numbers, skills, values and behaviours to deliver world-leading clinical services and continued high standards of care”.
Adult care white paper: key points
- Sets out 10-year vision for social care based on three principles: choice, control and support to lead independent lives; access to outstanding and tailored care and support; and fair and accessible care.
- Allocates £1.7bn to improve social care in England from 2022-25, in addition to £3.6bn to reform funding system announced in September.
- As previously mentioned, this includes £500m to improve the training, qualifications and recognition of the social care workforce.
- £300m will be spent to improve housing for people with care needs, focused on boosting the supply of specialist housing.
- £150m will go on digital technology to support independent living and quality of care.
- At least £70m will go on helping councils improve services, including by boosting their capability to shape the social care market.
- £30m will be spent on promoting innovation and new models of care, evaluated to identify what works.
- The government will provide up to £25m to improve services to carers, including for breaks and wellbeing and peer support.
- Funds will be provided for a new service to make minor repairs and changes to people’s homes to help them live independently.
- Alongside this, the government will increase the limit that the disabled facilities grant (DFG) can allocate to any adaptation. However, DFG funding will remain at the same level as now (£570m a year, from 2022-25).
Social work shortage concerns
The white paper comes amid concerns about shortages of social workers and occupational therapists in local authorities.
Speaking at the National Children and Adult Services Conference last week, Association of Directors of Adult Social Services (ADASS) vice-president Sarah McClinton said: “We are also seeing a real shortage of OTs, other therapists and social workers and they are really crucial in terms of supporting people to stay out of care homes and remain independent.”
OT vacancy rates fell from 9% to 6.7% from 2019-2020 to 2020-21, while rates remained stable for social workers, at 8.1%, found Skills for Care’s annual report on the adult care workforce. However, there are no figures for the period since April 2021 when vacancies across other social care roles have been increasing.
Jenefer Rees, chair of the Adult Principal Social Worker Network, said that OT shortages were a longstanding problem that militated against councils working with people in a reabling way, while social work gaps differed from area to area.
“Where the shortages are most acute, this adds to the length of time that people have to wait for assessments and support, and also often means that requirements such as the annual review of support are not met in a timely way,” she said.
Earlier this week, an ADASS survey found that waiting lists were mounting for assessments, arranging personal budgets or reviews, with an estimated 40,000 people having waited more than six months for an assessment.
‘Significant waiting lists’
British Association of Social Workers professional officer Denise Monks said “most areas had very significant waiting lists” and, as a consequence, there were people in residential or nursing care who, but for the involvement of a social worker earlier, could have been supported in the community following referral.
“People in care homes are not going to be seen as a priority for allocation of a social worker, it’s going to be those in the community who are seen at more risk…There will be people in residential care now who, had there been a social worker involved who may have had a different view of risk, they probably could be at home.”
She said the causes of social worker shortages were multiple but that the pandemic had played a significant part, causing staff to re-evaluate their careers, for example, by bringing forward their retirement or moving into roles outside the statutory sector.
This was echoed by Rees, who said: “Social workers like many other professionals may be re-evaluating their life and career aspirations following the pandemic leading to some retiring or leaving the profession; they may be moving and re-locating to more rural/coastal areas; demand for social workers is also currently high as a result of having to carry out a high volume of so-called ‘Covid reviews’.”
She said the number of people choosing to become social workers needed to increase. Alongside, the expansion of routes into social work, she said that “we need to continually raise awareness of the value and importance of social work”.
‘People are running on empty’
Monks said it was a “problem” that the government’s social care recruitment campaign, launched last month, did not mention social work in its publicity materials.
“There needs to be a targeted recruitment drive and promotion of the profession. But it’s no quick fix. It takes three years to train a social worker.”
She said there needed to be a focus on retention too, saying that “people are running on empty” in the wake of Covid.
“I know of people who have left who have only been qualified two years. We need to look at why this has happened.”
In relation to OTs, Paul Cooper, lead professional adviser at the Royal College of Occupational Therapists, said: “What we’re hearing back is that there are quite big gaps in a lot of local authorities because there are challenges recruiting people with the right skills, leading to high agency costs. The lack of OTs does have an impact on waiting lists and an inability to fill certain requirements for social care.”
The white paper has also come against the backdrop of a deep-seated workforce crisis across social care, with mounting vacancies, a fall in roles filled, more competition from other sectors, fewer overseas workers coming into the country because of Covid and tighter migration policies and mandatory vaccination likely to cost several thousand jobs.
Investment in skills
The DHSC said it wanted to use the £500m fund to ensure care staff were “recognised, rewarded and equipped with the right skills and knowledge” and that employers prioritied staff wellbeing.
It said that, over the next year, it would work with the sector to develop a “universal knowledge and skills framework (KSF) and career structure” for social care. This would be backed by funding for “hundreds of thousands of training places and qualifications at all levels”, to tackle skills gaps and support progression.
Staff qualifications would become more portable between employers through a “skills passport”, while this would also be the case for the entry-level care certificate. The DHSC said it wanted to improvement the quality and consistency of training for the certificate and that, ver the longer-term, it should become a requirement for staff.
It also pledged investment in registered managers, including a support programme for those in their first year, and a new fund to support continuous professional development for OTs, registered nurses, nursing associates and other allied health professionals working in the sector.
On pay, the DHSC cited the government’s 6.6% increase in the national living wage due in April 2022, which would see it reach £9.50 an hour. It also said it wanted to ensure care workers were paid for all the hours they worked and to improve terms and conditions, including in relation to zero-hours contracts.
However, there was no action in relation to widespread calls for a winter bonus for staff and for a dramatic improvement in pay that would see care staff gain parity with those carrying out similar roles in the NHS, prompting significant warnings.
‘Little to tackle poor pay or high vacancies’
“Although there are some welcome commitments on training and skills for staff, there is little to tackle poor workforce pay and conditions and high vacancy levels in the sector,” said Sally Warren, director of policy at the King’s Fund.
While generally positive about the white paper, ADASS president Stephen Chandler raised warnings about the scale of immediate pressures.
“The white paper paints a promising picture of a more professionalised care workforce in the future. What we urgently need now is a bridge to that brighter future, to address the immediate crisis and ensure that everyone gets the care and support they need this winter.”
Vic Rayner, chief executive of not-for-profit provider body the National Care Forum, similarly backed the white paper’s vision but said it urgently needed to go further in bridging the gap to the future.
“Staff who have worked in care for years are leaving in their droves through exhaustion, stress and the ability to be paid better in other sectors that can flex and change their wages. Organisations who have delivered care as a vital part of communities are closing their doors, unable to continue in the face of unsustainable pressures. If the government does not take urgent action– then this admirable vision will remain a distant dream.”