Adult Social Care: Long-term Workforce Plan

Question

15:07:00

Asked by

To ask His Majesty’s Government what steps they are taking to develop a long-term workforce plan for adult social care, similar to the NHS workforce plan.

My Lords, as the social care system in this country is failing, we are therefore launching an independent commission into social care to gain cross-party consensus and lay the foundations for a national care service. The commission will look at how we recruit, retain and recognise the workforce, building on work that is already under way to provide a career structure, to give care professionals greater skills and to legislate for the first ever fair pay agreements.

I thank my noble friend the Minister for that response and remind her that, when it comes to social care, time really is of the essence. Does she agree that one of the real problems we face is the great difference in status between those who are employed in the NHS and those who are employed in social care? Could next steps, therefore, including the work of the commission, include looking towards developing a workforce that is much more flexible, so that it can actually work across both disciplines—for example, working with a patient in hospital and following them when they are discharged into social care—for the benefit of patients, users and their families?

My noble friend is right that it is important that we have a workforce built around the needs of patients, rather than patients having to be worked around the needs of the workforce. I certainly hope and intend that, as we go forward, we will see much more of this flexibility. I share her view that time is of the essence and I also know that my noble friend and your Lordships’ House also understand that it is very important that we get this right.

My Lords, the turnaround rate for social care staff was about 30% last year, so retention is clearly an important issue. However, the Government have not helped the situation since July by cutting £115 million from the adult social care training budget. What will the Government do to mitigate this cut and try to help retention within such a vital service?

Retention is absolutely crucial. I was looking—as I know the noble Lord also does—at the vacancy rates and they are currently running at some 131,000. However, I was interested to note that they are not actually the best measure of capacity, or lack of it, because those vacancies can reflect new roles and short-term vacancies because of anticipated staff turnover. So I have had to rein myself in when looking at the relevance of vacancy rates. On retention, there is a whole range of factors. In the immediate, I say to the noble Lord that we are professionalising the workforce by expanding the national career structure and have developed and launched a level 2 adult social care certificate qualification.

My Lords, as the Government and the NHS introduce new workforce patterns to take account of changes, surely they should also take account of advances in technology. Recent years have seen the successful testing of virtual wards in the NHS to treat and monitor patients who can be discharged from hospital but who require further care. They can be monitored in their home, freeing up capacity in hospitals. Given this, what are the Government and NHS doing to extend virtual social care to monitor care for social care patients? It would allow them to remain in their home for longer, where they are more comfortable, and it could be one of the many ways to alleviate workforce shortages in the social care sector.

I myself have seen some tremendous examples of the use of technology in allowing people to be in the right environment for themselves and their situation. I assure the noble Lord that we are continuing to work to develop medical technology, not just getting it rolled out and applicable but developing new medtech where necessary. Perhaps I could use this opportunity to make an allied point. We have also published new guidance on safe delegation to care staff, which I hope will also help professionalise the workforce. We are working to support that across the country. That includes, for example, having care staff taking blood pressure. These are simple but obvious measures that I think work for everybody.

My Lords, the Minister will realise that the workforce in social care is not as varied as in the National Health Service. However, that is not to underestimate the fact that there are staff working in clients’ homes, day centres, residential units and office-based organisations. Will she ensure that, when the workforce is being considered in social care, it will be considered in the round and not just in a narrow way?

I can give that assurance to the noble Lord, and I am glad he has identified to your Lordships’ House the wide range of circumstances in which the workforce might be. For the benefit of your Lordships’ House, I should add that, in their manifesto, the Government made a commitment to “ensure the publication of regular, independent workforce planning, across health and social care”. We are currently developing advice on the options about how to fulfil this commitment for adult social care, which will take account of the point the noble Lord made.

My Lords, one of the major problems is that most care workers are employed by privately owned care homes, both large and small. Many of these employees are on zero-hour contracts—it is a mess. How does one ensure that we have a national workforce plan if we have all these workers in various organisations? We must bring them all together and have a centrally regulated qualification that is nationally recognised. I hope I am not boring my noble friend by asking the same question: when are we going to get a nationally recognised qualification and registration?

My noble friend is never boring and certainly does not bore this Minister. I very much take the point about the difference between the social care workforce and the NHS workforce, because the majority of the jobs in social care, as my noble friend says, are in the independent sector and the Department of Health and Social Care does not have the levers to ensure a development pipeline. However, this is a challenge for us to meet, not something to turn away from: it is a matter of working across the whole of the workforce, no matter where they are from. On professionalisation, I agree that we need to enhance skills, because care needs to be of the right quality. I mentioned earlier the development of the care workforce pathway, which is a new career structure, and also that the level 2 adult social care certificate qualification has been confirmed.

My Lords, will the long-term workforce plan include the voluntary sector and the army of unpaid carers, such as family, friends and neighbours—in other words, care in the community rather than in care homes?

The workforce plan will be about employed members of staff. On unpaid carers, I am glad to remind your Lordships’ House that, from April, we will be increasing the carer’s allowance weekly earnings limit from £151 to £196, which is the largest increase in the earnings limit since the carer’s allowance was introduced in 1976. I hope that gives some indication of the mode of direction of this Government in respect of unpaid carers.

My Lords, was the Minister listening to the answers to the previous question on the problems with the charity sector? Does she believe that the restrictions on revenue in the charity sector will have an effect on her department as well?

I was indeed listening very closely to the questions put to my noble friend, and have been asked them myself on a number of occasions in this House. On national insurance contributions, the Chancellor did take that into account when deciding the funding for the Department of Health and Social Care, and made available up to £3.7 billion of additional funding for social care authorities in 2025-26. In addition to other further uplifts, I want to identify the £86 million uplift in disabled facility grants that will promote independence and allow some 7,800 adaptations to be made to homes in the very near future.