Work in the health and care sector is increasingly seen as a key skill area as the country deals with the consequences of the pandemic and as a major career opportunity for young people and those seeking a valued change of direction mid-career. Although a great deal of effort has been devoted to developing curriculum content relevant to work in the sector, including apprenticeship standards and new T Levels, less attention has been paid to supporting learners themselves. In particular, developing in them the personal qualities of strength and resilience to cope with the demands of long, often unsocial hours and the demanding and frequently stressful situations in which they will work.
The problems of exhaustion, stress and “burnout” in the sector were recognised long before the pandemic. The Select Committee for Health and Social Care noted in its report “Workplace burnout and resilience in the NHS and Social Care” (June 2021) that in 2019, 40.3% of NHS staff respondents reported suffering from signs of stress at work. Although data for the adult social care sector is not available, there is no reason to believe the result would be radically different.
A recent report prepared by Care England indicated that 41.4% of staff turnover arose from workers leaving their posts soon after joining, with the figure for those under 20 years of age rising to 46.9% (“The state of the adult social care sector and workforce in England” October 2020). This is against a background of a sector where 27% of those employed are over 55 years of age and where up to 520,000 new jobs will be needed by 2035. Despite that, it was also noted that workers with qualifications in social care were less likely to leave.
Preparing Young People and Adults to enter Adult Social Care
Of course, there may be many reasons why individuals choose to leave the sector, including low levels of pay and unsocial hours. However, the way in which those individuals are prepared for roles which can be physically and emotionally demanding must play a part.
Analysis of qualifications acting as pathways for entrants to careers in adult and social care reveals a common pattern. Understandably, the focus is on skills and knowledge directly related to the recipients of care and not the carers themselves.
For example, the Care Certificate, intended as an induction to work in the sector, covers topics such as ‘Understand your role’, ‘Equality and Diversity’ and ‘Infection prevention and control’. The apprenticeship standard for Level 2 Adult Care Workers rightly identifies, amongst other attributes and behaviours, qualities such as care, compassion and courage, but aimed at applying those qualities to the recipient of care. Even the Level 3 standard in Lead Adult Care Worker makes little if any reference to the need to apply those caring skills to co-workers or themselves. The recently introduced T Levels, intended to provide the key workers of the future, follow the same path.
Personal Demands of Working in Social Care
Almost without exception there is no overt recognition of the personal demands these roles can bring, nor any identification of ways in which those early in their care careers can be supported to become resilient, looking after their own physical, social and emotional needs and those of co-workers. The development of these skills became even more important during the pandemic. As Care England identified, adult social care staff had to take the place of residents’ relatives and loved ones, increasing the already heavy burden.
One way to address this is to adopt a concept more often found in higher and professional education, that of “threshold crossing”. As set out by, amongst others, Jan Meyer and Ray Land (e.g. “Threshold Concepts in Practice” 2016), a range of concepts which characterise the changes required of individuals who choose to embark upon challenging careers has been identified. These changes are permanent, “irreversible” in the language of threshold crossing, and apply to the care sector. For example, many of the experiences of care workers are demanding in ways not found in other professions.
Much of the knowledge and experience acquired could be described as “troublesome”, requiring individuals to address challenging knowledge (and in the case of the care sector, emotional and physical challenges). Although the analogy is not perfect, there is much to consider in an approach which ensures those who give care to others are cared for themselves.
The Institute for Apprenticeships and Technical Education must ensure that standards and qualifications at all levels contain effective means to recognise, develop and accredit skills of resilience, self-awareness and mutual support.
Employers providing work placements for apprentices and full-time students, and those inducting new employees into the sector, must actively recognise the need for emotional support, training leaders at all levels to recognise this as a vital part of their role.
Careers advisers must be clear with potential care workers about the challenges they will face, the personal qualities required and the rewards of undertaking roles which have the potential to change them forever.
John Widdowson, Former FE College Principal
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
- Camille Oung, The Nuffield Trust: The Funding and Delivery of Adult Social Care in England
- Duncan Brown, Emsi: The Employment Model of Adult Social Care
- Louise Murphy, Policy in Practice: Wages, Universal Credit and Adult Social Care Workers
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