Social Care Roundtable

27 January 2023 by Emma Selinger

In 2021-22, more than one-in-ten frontline care jobs in England were vacant, up from fewer than one-in-twenty in 2012-13, with 68 per cent of current care workers saying they work under a high degree of tension.

The Resolution Foundation has been exploring different aspects of the problems in the care sector, to identify what can be done to address these challenges in this vital workforce. This is a policy challenge, but also one that many people have been tackling through building tools, services and new types of care employer.

Resolution Ventures hosted a roundtable in December 2022 of organisations with direct experience of care work, to discuss where innovation and technology can improve the experience of work for carers, and address the issues highlighted by the research. This blog summarises the discussion highlighting the key issues facing care workers, including areas where tech innovation could potentially play a role.

The current state of care

This week the Resolution Foundation published a report on social care work, exploring the lived experience of care workers in the UK and analysing data to understand the immediate issues faced by the sector and its workers. The report finds that care workers like their jobs and generally feel secure in their role, but are faced with inflexibility, safety issues caused by a recruitment crisis, and low pay, sometimes even falling below national minimum wage when travel time is accounted for.

Care is becoming an increasingly integral part of society as our life expectancies increase, and the pandemic only served to highlight the key role that carers play in the fabric of communities. The Future Care Workforce estimated that the adult social care sector in England alone will need to add approximately 1 million workers by 2025.

The care industry needs radical improvement to meet these growing demands. Primarily, we need more carers; there is currently a national vacancy rate of 9.5 per cent, increasing to 13 per cent in London. But with low wages – the average hourly pay in 2021 was £9.29 – and poor working conditions (such as unpredictable schedules, lack of progression, lack of pay for travelling to and from clients) recruitment and retention is extremely challenging. In 2020, some home care organisations experienced staff turnover of a staggering 50 per cent.

In addition to this, systemic issues add to the difficult experience of care workers and limit innovation. Tight budgets for local government care provision and difficulty joining up with healthcare services heightens unpredictability of demand and limits progression routes.

Matching flexibility offers and expectations to attract and retain care workers

One of the benefits of care work, highlighted through the focus group research, is its flexibility. However, it often also involves unsociable hours, overnight and weekend working. Those working directly in the sector observe that carers and their employers often have mismatched expectations about what a particular job might involve, including hours, pay and flexibility. For example, while the shift to flexible work has been beneficial to some workers, in some cases it is a privilege allotted to long-standing employees, rather than something that a worker has a right to on day one of their job.

This can lead to high attrition rates of newly-recruited workers as their expectations for flexible work are not met, and they seek work elsewhere, even outside of the sector, compounding understaffing and safety issues highlighted by our own research.

There are various ways in which WorkerTech might play a role. Better scheduling tools that maximise paid time (rather than travel) and that factor in workers’ preferences for hours and shift patterns could help accommodate flexibility and attract and retain more carers in the industry. Roundtable attendees highlighted that those with more sophisticated scheduling tools were better able to accommodate a range of preferences over hours. Care City has partnered with schedule optimisers, Satalia, to pilot scheduling district nurse visits to accommodate patient needs and team hours.

Greater transparency to help with realistic expectations might also help here, as well as guidance on types of flexible work and ways for workers to request or negotiate flexible hours. Timewise’s Carers by Design project explored how employers and carers could work together to improve flexibility in the sector.

Integrating training, autonomy and progression

Resolution Foundation’s focus groups with care workers found that workers don’t necessarily want more training, but they do want the quality of their current training to improve to allow them to provide better care.

There was a general view that specific training courses were not as useful as ‘on the job learning’, but with this being hard to do. Regulation for care work demands high levels of supervision, limiting the autonomy of care workers to try out new skills and problem solve for themselves – the default of a supervisor when a challenge arises is often, ‘leave it to me’.

There is a role tech might play in updating and improving edtech for the care sector. Embedding bite-sized training via an app into day-to-day care work could be a way to tie together more formal training and on the job learning. Organisations such as CuppaCare are piloting this already.

Technology can support connection and community

As with any role, the people carers work with play a huge part in shaping working lives. Whether this is other care workers, managers, NHS staff or unpaid carers, strong relationships and clear communication are important.

There is an opportunity for tech to enhance care work by supporting these connections and relationships. Equal Care uses tech to bring together everyone involved in a caring setting, including crucially the person receiving care if they wish, into one digital communication channel where they can share updates on the care recipient, discuss care schedules and seek advice.

A clear finding of our research with care workers is that they are attached to the emotional aspects of the job – building relationships with care recipients, being involved in their lives. That attachment can come at an emotional cost, and ways to support and understand that impact could also be mediated by better networks and connections.

Finding better models of blended care

There are 5m people providing unpaid care in England and Wales (2021 Census), compared to 1.7m in the paid care workforce (UK figure). Many care recipients are balancing a blend of unpaid and paid care support. Ways to make these combinations more effective, with clearer communication, and better connections could make better use of both types of support. There are also opportunities for services that provide better emotional and practical support for unpaid carers, including those juggling unpaid care with work. Mobilise and Companiions are just two examples of companies tackling this.

What next?

While tech and innovation are no replacement for enforcement of the minimum wage and employment rights within the care sector, they clearly can have a role to play in the other more variable parts of care work that can really make a difference to carer job satisfaction, retention , and ultimately the quality of care provided to users.

We’re seeking to back tech-based solutions to these issues to improve the experience of care work, so if you think you have an idea that might help tackle any of the areas highlighted in this blog, please get in touch via ventures@resolutionfoundation.org

Thank you to the organisations that contributed to the roundtable: