Debbie Sorkin shows how good social care employers and staff can put development at the heart of their practice
Training and development, the theme of this month’s Care Talk, has long been a contentious issue in social care. On the one hand, everyone knows it’s absolutely necessary. On the other, there is no central ‘pot’ of money to fund it 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[1]. 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 c £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, development opportunities are 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 training and development?
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[2]. High vacancy rates 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[3]. And they also mean providers incur regular recruitment and induction costs, because most new workers in an organisation will already come from social care. In 2016-17, 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[4], you don’t need to not recruit many replacement front-line workers to save significant sums. 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?
Once you have people working with you, being a good leader – exhibiting the behaviours in the Leadership Qualities Framework for Adult Social Care[5] (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 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 training and 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[6] 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 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.[7] For example, The King’s Fund, in their recent report on Enhanced Health in Care Homes, noted many creative approaches to training[8]:
“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 many social care employers must be doing something right. In its last Annual Report[9], CQC reported that the proportion of adult social care services rated ‘Good’ had increased from the previous year, with 78% achieving the rating vs 71% in 2016. Moreover, strong leadership played a pivotal role, with good leaders characterised by individuals with innovative approaches who were open to feedback and actively sought out best practice to steer improvements. The Report also explicitly noted that good managers also truly valued their staff, supporting them to maintain their knowledge of best practice and person-centred care through training and establishing ‘champions in different areas of care. And leadership was not restricted to registered manager level: everyone could play a leadership role through exhibiting good everyday behaviours. So despite everything, training and development is happening. Let’s make more of this. In the words of Dame Denise Platt, we can show that social care, when delivered well – by people who are committed to the sector and who are motivated to stay with their employer – has the power to transform people’s lives[10].
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] 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
[2] 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
[3] 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
[4] 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
[5] See https://www.nsasocialcare.co.uk/about-us/leadership-qualities-framework
[6] See: https://www.publications.parliament.uk/pa/cm201617/cmselect/cmcomloc/1103/1103.pdf
[7] See, for example, http://stickypeople.co.uk/#home and http://www.skillsforcare.org.uk
[8] 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
[9] CQC: The state of health care and adult social care in England 2016/17: See: http://www.cqc.org.uk/sites/default/files/20171123_stateofcare1617_report.pdf
[10] The Status of Adult Social Care: Dame Denise Platt, 2007: http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074218.pdf
