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The Employment Model of Adult Social Care

Duncan Brown, Senior Economist, Emsi UK
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Jobs in Adult Social Care

What counts as social care is critical for policy making. We count social care from 5 industry classes of the 2007 ONS Standard Industry Classification: residential nursing care activities (SIC class 8710); residential care activities for learning disabilities, mental health and substance abuse (8720); residential care activities for the elderly and disabled (8730); other residential care activities (8790); and social work activities without accommodation for the elderly and disabled (8810).

Using these categories, social care provides around 1.05m jobs across Britain, having grown by 9% in the past decade and by 45% since 2003. Social care employment now accounts for a significant number of jobs in all parts of the country – somewhat more concentrated in the North East and Wales, but only half the national average share in London.

Qualification Levels

In terms of qualifications, care workers are typically qualified to Level 2. Senior care workers are typically qualified at Level 3.

Recruitment and Retention

There is widespread reporting of the problems of recruiting and retaining staff in the social care sector sufficient to meet growing demand. The DfE’s 2019 Employer Skills Survey found more than 27% of vacancies for care workers are hard to fill because of skills shortages, compared with 24% across the wider labour market. Senior care workers are slightly harder to recruit, with a 29% skills shortage rate.

Migrant Workers

Immigration has in the past been an important recruitment channel for the social care sector. Around 17% of care workers are born abroad, although the share of migrants within the workforce has fallen over the past decade (Health Foundation, 2016) (Franklin & Urzi Brancati, 2016), (Independent Age/ILC-UK, 2015). As society ages and demand increases, there may be increased pressure to recruit from overseas – already senior care workers have been added to the Shortage Occupation List used to regulate Skilled Worker visas.

Enterprises in the Adult Social Care Sector

The same underlying trend has driven the growth of a significant social care industry with 17,800 enterprises, up 10% on a decade ago. Of these, 7,500 (42%) have fewer than 10

employees; 6,800 (38%) have 10-49 employees; 2,900 (17%) have 50-249 employees and 600 (3%) have 250 or more employees.

Roles

These enterprises employ workers across a wide range of roles but with obvious concentrations. Care workers, senior care workers, nursing auxiliaries, nurses and care workers account for around 64%, nearly two thirds of sector jobs. The remaining third are spread across residential, catering, cleaning and administrative roles.

Gender

Across all roles, the sector is overwhelmingly female, with 81% of jobs held by women, rising to 84% for care worker roles.

Age

The overall sector workforce is older than average, with a quarter of jobs held by workers aged 55 and over, compared to 18% across the wider labour market.

UK Apprenticeship Levy

Earnings per job across the care sector are typically around £20,000 per year. Only care enterprises with 150 workers or more are likely to have wage bills of £3m per year and be liable for the Apprenticeship Levy. We estimate a little over 1,000 care enterprises are likely to be in this position and pay the levy.

Employment Model

Reports on recruitment challenges within the adult care sector often cite its employment model, which is a stand out feature.

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A Part-Time Employee Sector

45% of all care sector jobs in 2019 were part-time compared to 32% across the wider labour market.

Above Average Temporary Employees

Most part-time work in Britain reflects employee preferences, but 7% of care employees are on temporary contracts compared to 5% across the wider labour market.

Potentially Many Care Workers on Zero Hour Contracts

There are no specific data on the prevalence of zero-hour contracts for care workers. The ONS estimates that across the entire health and social work sector, over 190,000 workers are on zero-hour contracts, around a fifth of all zero-hours employees across the labour market. Anecdotally at least, it seems likely that many of these are in social care rather than in direct NHS employment.

A Relatively Low Wage Occupation

In 2021, care worker median pay was £10.19, in the bottom quartile of the labour market. Senior care workers – typically qualified to Level 3 – see only slightly higher median hourly pay at £10.93.

Latest Data

At the sharp end of the labour market, recruitment demand for care workers has reached record highs since the end of the pandemic – having barely been affected during it. As of October 2021, Emsi Burning Glass recorded 28,500 online job advertisements for care workers, up from 17,500 in October 2019, before the pandemic. That pattern seems likely to reflect the wider tightening we have seen in the labour market in the second half of 2021 – what was already a high turnover labour market for care services is seeing even greater competition than before. Those same demand pressures are also translating into rising pay offers – in the most recent three months, median advertised salaries were £20,800, 9% up on the same period in 2019.

Future Demand

Population ageing means that the demand for social care services is not going away. Combined with a higher level of temporary and likely zero-hours employment, it is perhaps no surprise that the labour market sees higher turnover – and that will make it particularly vulnerable to the pressures of what is now an extremely tight labour market, where other employers may offer better opportunities.

Recommendation 1

DfE and DHSC should investigate what skills are driving the most acute demand pressures. This is especially important if we want to move to a higher-skill higher-wage model.

Recommendation 2

DfE, DHSC and DBIES should monitor the changing pattern of employment practices in the care sector. Given that the market is so tight, we should expect to see employers improve terms and conditions of employment as well as pay levels. Understanding whether pay or conditions is the key factor and whether different types of role are more affected is important in terms of meeting employment demand.

Recommendation 3

DfE and DHSC should set out more clearly what career paths exist and how they can be improved. Looking at the paths of those reaching senior care worker and care home manager role to identify what skills and experience make this possible, will help to improve employee engagement.

Duncan Brown, Emsi


Reforming Adult Social Care – Integrating Funding, Pay, Employment and Skills Policies in England

The Campaign for Learning’s report, Reforming Adult Social Care: Integrating Funding, Pay, Employment and Skills Policies in England, is based on seventeen contributions from experts in both the adult social care sector and the post-16 education, skills and employability sectors. 

Three themes are common to most of the authors’ contributions – the scale of the adult social care sector in England, the complexity of policy making for the sector, and the need for greater integration of funding, pay, employment and skills. 

Part One: The Adult Social Care Sector

Part Two: Strategic Reforms to Adult Social Care

  • Paul Nowak, TUC: A National Care Forum to Fix Social Care
  • Stephen Evans, Learning and Work Institute: A Long-Term Pay, Employment and Skills Plan for Adult Social Care

Part Three: Recruitment in the Context of a Skills-Based Immigration Policy

  • Becci Newton, Institute for Employment Studies: Improving Pay and Job Quality in Adult Social Care
  • Karolina Gerlich, The Care Workers’ Charity: Encouraging Young People and Adults to become Adult Care Workers
  • Chris Goulden, Youth Futures Foundation: A Career in Adult Social Care: The Views of Young People
  • Andrew Morton, ERSA: Targeting Active Labour Market Policies to Fill Adult Social Care Vacancies

Part Four: The Delivery and Design of Social Care Qualifications

  • John Widdowson, Former FE College Principal: Embedding Emotional Support for Learners on Health and Social Care Courses
  • Naomi Dixon, Education and Training Foundation: Supporting Post-16 FE Practitioners to Teach Social Care

Part Five: The Role of Post-16 Education and Skills Policies

  • Elena Wilson, The Edge Foundation: Valuing Level 3 BTECs for 16-18 Year Olds Studying Health and Social Care
  • Julian Gravatt, AoC: What Post-16 FE Can and Cannot do to tackle the Adult Social Care crisis
  • Jane Hickie, AELP: Reforming Apprenticeship Funding and Delivery for Adult Social Care
  • Gemma Gathercole, CWLEP: Adults Skills, Adult Social Care and Devo-Deals

Part Six: Adult Learning and Adult Social Care

  • Susan Pember, HOLEX: The Wider Benefits of Adult Learning for Adult Social Care
  • Simon Parkinson, WEA: Adult Learning for Adults in Social Care
  • Campaign for Learning: Proposals for reform in England 
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