Debbie Sorkin shows how good social care employers and staff can put career development at the heart of their practice
In August, Beth Sturgis, a 24 year-old care worker from Plymouth, wrote an open letter on Facebook. The letter was to anyone who thought they could look down on those who work in social care.
She laid out, in absolutely clear terms, how her job involved much more than people assume, noting:
“Today I helped a man that has lived through the war, wash and dress because old age has now hit him and…his body is ageing faster than his mind…Today I helped a lady who this time last year was living her life normally [but] she is now living her life with a cruel disease and is unable to do these things for herself…Today I administered medication to a lady living life with Alzheimer’s. Medication that she doesn’t even how why she’s taking it; medication that I know, and she knows, will not prevent the inevitable.”
Beth showed the high skill and degree of empathy that are at the heart of good social care, and put forward a powerful case for recognising care as a worthwhile career path in its own right[1].
Similarly, Karolina Gerlich, working with older people, wrote in The Guardian in September[2] that “I have grown tired over the past few years of being called ‘just a carer’” and called for entry requirements to join the sector, such as registration, and completion of standard and accredited training that reflected the level of responsibility and skills that a social care role required.
In other words, both Beth and Karolina are calling for social care to be given the status it deserves.
And this means career development. It’s frustrating that this is still such a contentious issue.
On the one hand, everyone knows it’s absolutely necessary. On the other, there is no central ‘pot’ of money to fund career progression adequately, and it doesn’t appear to be anyone’s responsibility to bridge the gap.
The reality of the situation was brought into stark relief in February this year by the National Audit Office, in their Review of the Adult Social Care Workforce in England[3]. The Review noted “the widespread public perception that care work offers limited opportunities for career progression, particularly compared with health.” This in turn acted as a barrier to recruitment. Initiatives to develop staff from bodies such as Skills for Care amounted to investment of £14 per care worker per year: unsurprisingly, they were described by the Review as small-scale and limited in their impact.
Nor does the legislation help. Although the 2012 Care Act states that local authorities should ‘encourage’ training and development of care staff, and there is an expectation that local authorities and care providers will ‘identify appropriate resources to support training and development as part of the commissioning process’, providers are not formally required to offer development opportunities to staff, and local authorities can lack the strategic ability to require providers to support training programmes. And simple lack of money is a major issue: both providers and commissioners told the National Audit Office that funding constraints meant them prioritising provision of care in the short term over training and development in the longer term, although both said better training would be a priority if more funding were available.
So in practice, if you’re working in social care, career development, even as a concept, is likely to depend on your employer. How, then, in the face of severe financial cutbacks, especially for providers reliant on local authority funding, can you make the case for care as a career?
One starting point is to see this not as training and development, but as how you keep your workforce. Staff retention is a key issue in the sector, with annual turnover of all care staff amounting to 27.8% in 2016-17, and turnover being especially high in home care, across the south of the country, and amongst care workers and registered nurses. Overall turnover has been increasing since 2012-13[4].
At the same time, high vacancy rates – thought to be running at 6% for the sector, equivalent to c 90,000 posts, and turnover can disrupt the continuity and quality of care for service users: CQC has found a link between high vacancy and turnover rates, and poorer levels of care being provided[5]. And they also mean providers incur regular recruitment and induction costs, because most new workers in an organisation will already come from social care. Over the last year, data from Skills for Care indicated that 67% of workers were recruited from within the care sector. It’s estimated that the cost of recruiting one new member of staff, taking into account time of senior staff in interviewing, selection and induction, amounts to £2-£3k per individual. If money is tight, and if net migration continues to fall so that the pool of potential workers is smaller[6], you don’t need to not recruit many replacement front-line workers to save significant sums.
Andrew Cozens, the Chair of NDTI, has noted that ending freedom of movement for current or future EU workers will hit the sector hard[7]. So there is an opportunity cost here: why not use the money you would have used on recruiting new people to go towards retaining the good people you’ve got? Why not future-proof your service when competition for good staff is about to get even harder?
Once you have people working with you, being a good leader – exhibiting the behaviours in the Leadership Qualities Framework for Adult Social Care[8] (LQF), which sets out what good leadership looks like at all levels of a team or organisation – is intrinsic to being a good employer. If you’re an employee, at whatever level you’re at, you should expect your employer to provide the kinds of leadership that would make you want to stay with them. This means providing guidance and direction, using people’s skills effectively, reviewing performance of team members to ensure that outcomes are met, and providing motivation and career development opportunities so that people keep improving. You should look to your employer to support you to provide good care and better services, encouraging you to speak up and to innovate around improving people’s lives.
So a second way of looking at career development is not to see it as something ancillary to people’s day-to-day jobs, but as part and parcel of their values and their everyday leadership behaviours, because care work, by definition, is actually highly skilled work. A report by the House of Commons Communities and Local Government Committee[9] in March 2017 quoted one care worker as saying: “I am often frustrated to hear people conflate low pay with low skill and low value. Most people working in adult social care are undertaking very skilled roles and they need high skills and personal attributes and high levels of resilience to be able to do what they do.”
This is reflected in The Social Care Manager’s Handbook when it states: “The values that underpin social care have developed through recognising that the very best practice comes from the highest standards of personal and professional integrity, and the commitment to deliver a service that centres on and responds to the people who use it.”
These standards are at the root of how you behave in everyday situations and of what you expect from the behaviours of others. And so they’re at the heart of the behaviours identified in The LQF. Continuing your personal and career development, and that of your staff, is one of the four components of leadership around Demonstrating personal qualities. Good leaders:
o Actively seek opportunities and challenges for personal learning and development
o Acknowledge mistakes and treat them as learning opportunities
o Participate in continuing professional development activities
o Change their behaviour in the light of feedback and reflection.
And this doesn’t necessarily mean external training courses. For example, if you’re a Front-line Worker – a Care Assistant, a Care Worker or an Apprentice – you can be (in the words of the LQF): ‘open to learning from others and willing to share knowledge and experience’. So buddying with co-workers, or using coaching approaches from others, can constitute forms of development. If you’re a Front-line Leader or above, you have a responsibility, as part of your leadership practice, to maintain your own learning and development. Again, this needn’t be expensive: there’s plenty of advice available online on low-cost and innovative ways to develop yourself and your teams.[10] For example, The King’s Fund, in their report on Enhanced Health in Care Homes, noted many creative approaches to training as the foundation of career development[11]:
“We did some training for activity co-ordinators. We developed a Facebook page off the back of that where homes can see live feeds and we share information through there, we also use Twitter. Some homes are agreeable to open their doors up and share with other care homes, so…we might go into a home that’s not doing so well on something just down the road from one that’s got it sorted and we’ll pair them up. Or if we’re doing training with them we’ll help them to contact local homes in the area because the more training places get booked, the cheaper it is per person, the more you can share the cost.”
And despite all the pressures on the system, social care employers are taking this on board. In Dimensions UK, for example, which employs more than 7,000 staff, the Head of Learning and Development, Simon Gosney, has credited their career development scheme as key to solving their turnover problem, which has dropped to just 16% overall – 6% in some parts of the organisation. According to Simon: “We [offer] a structured career development path that gives staff a range of professional options and opportunities, and helps the organisation retain and develop key talent.”[12]
So career development, reflecting the true status of social care, is happening. Let’s have more of this. In a year’s time, I’d like to see a very different letter from Beth Sturgis, celebrating how her employer had faith in her and her career, and supported her accordingly.
If you have examples of great leadership in your service, please send them in to www.caretalk.co.uk or contact Debbie.sorkin@leadershipcentre.org.uk.
Debbie Sorkin is National Director of Systems Leadership at The Leadership Centre. Debbie.sorkin@leadershipcentre.org.uk @DebbieSorkin2
[1] See: report in The Independent, 16th August 2018: https://www.independent.co.uk/life-style/care-worker-open-letter-facebook-viral-beth-sturgis-devon-a8494341.html
[2] See: The Guardian, 4th September 2018: https://www.theguardian.com/society/2018/sep/04/im-tired-of-being-called-just-a-carer-looking-after-people-is-a-proper-job
[3] National Audit Office, The adult social care workforce in England: February 2018: see https://www.nao.org.uk/wp-content/uploads/2018/02/The-adult-social-care-workforce-in-England.pdf
[4] Sources: Skills for Care, National Minimum Data Set for Social Care 2016-17 and The size and structure of the adult social care workforce in England, 2017: http://www.skillsforcare.org.uk/NMDS-SC-intelligence/Workforce-intelligence/documents/Size-of-the-adult-social-care-sector/Size-and-Structure-2017.pdf
[5] CQC, The state of adult social care services 2014 to 2017: findings from CQC’s initial programme of comprehensive inspections in adult social care, August 2017: see www.cqc.org.uk
[6] See, for instance: http://www.standard.co.uk/news/uk/net-migration-to-uk-plunges-to-below-250000-after-exodus-of-european-workers-in-wake-of-brexit-a3548626.html
[7] See: ACAINN, Comment/Blog August 2018: http://www.acainn.co.uk/commentblog/4564737885
[8] See https://www.nsasocialcare.co.uk/about-us/leadership-qualities-framework
[9] See: https://www.publications.parliament.uk/pa/cm201617/cmselect/cmcomloc/1103/1103.pdf
[10] See, for example, http://stickypeople.co.uk/#home and http://www.skillsforcare.org.uk
[11] The King’s Fund, Enhanced health in care home: learning from experiences so far. December 2017: see https://www.kingsfund.org.uk/sites/default/files/2017-11/Enhanced_health_care_homes_Kings_Fund_December_2017.pdf
[12] See: People Management, 25th January 2018: https://www.peoplemanagement.co.uk/voices/case-studies/career-development-scheme-was-key-to-solving-Dimensions-UK-turnover-problem
