WHO CARES? BUILDING THE CARE WORKFORCE OF THE FUTURE - PWC
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Who cares? Building the care workforce of the future
Contents Foreword 01 The challenge in statistics 02 Summary of our findings 04 The state of play 05 The burning platform 08 Carers love caring 13 Squaring the circle 16 What does ‘good’ look like? 24 How we can help 26 Methodology 27
Foreword
Every day, across the country, hundreds of thousands of
hardworking and committed health and social care professionals
go to work to care for people at their most vulnerable. They are
strongly motivated by their desire to work in a sector that directly
helps so many people. Many find their work hugely rewarding
but working in the care sector is becoming more challenging.
Funding pressures, red tape and low wages contribute to high Rt Hon Alan Milburn
levels of staff turnover. How do you successfully attract, develop Health Industries
Oversight Board Chair
and inspire a care workforce in this environment?
Society needs a well functioning, high We have carried out research amongst
quality social care sector. A growing elderly people working in care to better understand
population makes it a necessity. Demand what can be done to help. This report
is rising and is set to do so for decades to contains a diagnostic of the workforce
come. Yet the challenge of delivering safety issue and it proposes positive and practical
and quality to those people needing care steps that organisations can take to
is exacerbated by the impact of financial navigate workforce challenges. The health
pressures. Social care is on the frontline and social care landscape is changing
of under-funding across the whole of the quickly, not least due to the introduction
health and care system. For example, the of new and innovative technologies that
Health Foundation estimates the funding are transforming how care is delivered.
gap for adult social care will be over £4bn by The key to sustainability and success
2020/21. for organisations in the care sector is a
workforce that is motivated, equipped and
Behind the gloom, it’s worth noting that the galvanised to embrace the challenge of
vast majority of care homes, overwhelmingly change. We very much hope this report will
provided by the private sector, are now help you put that into action.
rated ‘Good’ or ‘Outstanding’ by the Care
Quality Commission. This is testament to
those providers who have persevered in this
challenging setting, but above all else to
the commitment of their workers. Their job
is getting more difficult not easier. Brexit
uncertainty is not helping. It has become
harder and harder to carry out effective
workforce planning as shortages severely
impact the ability of organisations to recruit
and retain staff.
Authors
Andrew McKechnie Reena Virdee Ollie Cohen
Partner Senior Manager Manager
M: +44 (0)7799 602 349 M: +44 (0)7712 596 068 M: +44 (0)7816 588 757
E: andrew.mckechnie@pwc.com E: reena.virdee@pwc.com E: oliver.j.cohen@pwc.com
Who cares? 1
The challenge in statistics
Over 1 million adults 1.6m people
are employed
in social care
(more than
the NHS)
Representing
used formal social care last year 5% of the UK workforce
This vacancy rate has risen
consistently for the
last 5 years The
vacancy
rate amongst
…partly due to rising
staff turnover, 8% care workers
is high
now at 31%
37% for care
workers under 30
Carers want
to care An majority of
87% carers have an overall
positive
61% experience
of social care
said the primary reason for
joining the sector was for the
opportunity to
help people
2 PwC
A further
The elderly
8% of the UK
population
population is
growing at
are informal
carers c.3%
per year
By comparison,
we have only managed
to recruit a net
20,000 carers If demand continues
to grow at this rate,
per year we will need an
since additional
2013
440,000
carers by 2030
And over 90% of Operators need to capture
carers plan to stay this positivity to recruit and
within the sector beyond the next year retain enough carers to
2019
Meet demand Deliver high Drive positive
quality care outcomes
Who cares? 3
Summary of our findings
Social care is a critical part of our health economy, but it is
facing a number of challenges. Of these obstacles, staffing is
becoming ever more critical.
Developing and maintaining a sustainable We have spoken to over 2,000 carers and
workforce is key in delivering high quality care home managers to better understand
care with positive outcomes, but recruitment what is driving this staffing crisis and
and retention of staff is becoming more importantly, how a good operator
increasingly difficult. Vacancy rates are can distinguish itself in the eyes of the
high and agency spend is rising, impacting workforce. Through our research, we have
the viability and growth of health and care identified 5 key actions for operators to put
operators across the market. in place.
1. E
nsure care is always at 2. B
uild the right 3. F
acilitate a smooth
the core organisational structure day-to-day
• Create a care-centric culture • Invest in managers • Streamline paperwork
• Get the right KPIs • Redefine management roles • Ensure sufficient resources
• Champion carers • Consult on rostering
• Embrace technology
4. Commit to 5. D
rive career
personal development development
• Understand needs • Develop career plans
• Build resilience • Codify ‘good, better, best’
• Promote collaboration • Track progress
• Celebrate success • Endorse role models
• Focus on training
Focus, commitment and investment in But unpicking the issue isn’t simple. At a
addressing these issues is an immediate headline level, carers love their job and find
priority as staffing supply is increasingly the work hugely rewarding. However, there
unable to meet growing demand. This is are specific areas of dissatisfaction that
likely to get worse over the coming years. span the breadth of their role, ultimately
driving them to leave. Our research assesses
these areas in detail and helps navigate this
increasingly complex issue.
4 PwCThe state of play
Social care is fundamental to our health, care and wellness system “Government must act
and is becoming increasingly important. A functioning, high- to halt crisis in social
quality social care system is key to the wellbeing of the individuals care recruitment…
who require care, and the wider health and social care ecosystem. Undervalued and poorly
rewarded care workers
The move towards therapy, based in The rapid development in the size, quality are leaving the sector
and around the community rather than and efficiency of the social care system is and they are not being
institutions, requires a well-developed challenging on multiple fronts. Demand is replaced quickly enough
and sustainable social care system. This rising and becoming more complex, whilst
in turn can release pressure on the NHS. funding has been under pressure for a
to meet demand”
Between 2007 and 2018, two million NHS number of years. As a result, the thresholds
Guardian, Feb 2018
bed days were lost due to delayed transfers at which you’re eligible for care have been
(‘bed-blocking’), caused by a lack of social tightened, placing further pressure on the
care support. social care system but also the NHS.
Key challenges facing social care:
Integrating health and social care
Balancing public and private provision
Managing rising volume and complexity of demand
Regulating and delivering quality care
Maintaining a sustainable workforce
Of all these challenges, creating and The adult social care sector employs 1.6m
maintaining a sustainable workforce sits people, spread across elderly, nursing and
across the entire health and social care specialist care. This workforce is made up
system and is integral to its functioning. of frontline workers (carers in care homes,
Care is one of three sectors with the highest personal assistants and nurses) as well
concentration of low-paid workers, alongside as managers and senior managers who
retail and hospitality. It is a challenge coordinate care delivery, and are integral to
that faces government, public and private the working of the social care system.
providers. Government and the Department
of Health realise the importance and
extent of this challenge, and spend £23m
per year on the monitoring of the state
and development of the adult social care
workforce through its associated charity and
thinktank, Skills for Care. Who cares? 5Adult social care jobs by type of employer
6%
Independent
9% (private sector)
7%
Local authority
78% Direct pay
NHS
Adult social care jobs by setting
2%
Residential
13%
42% Domiciliary
Community
42%
Day
Adult social care jobs by type of role
11% Direct care
5%
7% Managerial
Regulated professional
76%
Other
Source: Skills for Care (2018)
6 PwCThe social care workforce is diverse, with The formal care sector now faces the “Brexit and Social Care
83% of staff being UK nationals, 8% EU additional challenge of the decline in crisis threaten NHS,
and 9% from the rest of the world. And informal carers, driven by an increasing
hospital boss says on
there are geographical nuances – London retirement age, decrease in co-residence
is particularly reliant on non-UK workers with parents, the increase in single person 70th Anniversary…
as 39% of the current workforce are from households, and a decline in community We are going to need
outside of the UK. With Brexit looming and networks. The increasing demand placed on more and more people,
immigration rules coming into question, this the formal care system, and the associated not fewer”
is a further potential challenge to the sector. increase in required carers further highlights
the importance of the workforce to the Huff Post, July 2018
Alongside these formally employed workers, whole system.
there is a parallel economy of informal,
unregulated care workers who have But what is the scale of the issue? What’s
historically relieved much of the pressure its impact? What’s causing it? And more
on the system. This informal sector is made importantly, what can be done about it?
up of relatives, friends, and simply those We’ve done extensive primary research,
employed directly as carers or personal involving over 2,000 UK carers and home
assistants without official records, employed managers to better understand how they feel
via word of mouth or local advertising. about their roles, what they like, whether
they’ve considered leaving, what drives staff
turnover and what can be done to make
them stay.
From this we have distilled a set of
meaningful and practical steps that the
sector can take to create a more content,
cohesive and loyal workforce.
Who cares? 7The burning platform
Addressing the issue now is critical. There is no doubt that
our current cohort of care workers is already under strain,
and our need for more carers, with more specialised skills,
is only increasing.
Drivers of increased carer requirements
Growing elderly Increase in Increase in Increase in
population single person acuity of needs complexity of
households amongst needs of people
the elderly with physical
population and learning
disabilities
8 PwC290,000 –
estimated deficit in
the number of carers
required to meet
demand in 2030 vs.
the forecast number
of carers employed
in 2030
Source: PwC analysis
According to estimates from Skills for Care, The need could be greater. If the workforce
the adult social care workforce will need demand grows at the same rate as the 75+
to grow to over 2.0m employees by 2030 to year old population, without any workforce
maintain the same level of service we have efficiency savings, we’re going to need closer
currently, up from 1.6m today. And that’s to 2.5m employees by 2030.
just a conservative estimate.
Projected demand for adult social care workers (England) 2013-2030
2.5
Projected
2.0
Number of workers (m)
1.5
1.0
0.5
1.61 1.65
0
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Baseline case Medium case High case
Note: High case: assumes the workforce demand grows at the 75+ population growth rate. Medium
case: assumes the workforce demand grows at the 65+ population growth rate. Baseline case: assumes
the workforce demand grows at the current workforce growth rate.
Source: Skills for Care (2018) and PwC analysis
Who cares? 9This analysis only takes growing demand
into account. In other words, how many
The pool is emptying faster than it can be
filled. As operators scale, their recruitment 2,800 –
carers do we need if demand continues to functions don’t typically grow at the same the average number
grow? But we know that recruiting and pace. And so the deficit continues to grow. of unfilled care home
retaining carers is becoming increasingly manager jobs at any
challenging and there is already a gap one time
emerging between the number of carers
Staff vacancy rate by Local Authority
we need and the number we have. We can (England) 2018
see this in the number of vacancies across
Source: Skills for
the sector. Care (2018)
Vacancies can’t be filled and agency spend
is rising, impacting operating margins.
Staff turnover across the sector, already
high, is increasing and this is seen across
all care settings, whether provided by
Local Authorities or private operators.
Recruitment and retention of care staff is
fast becoming the greatest challenge for
operators across the UK. Operators are
spending time, money and resources on
innovative recruitment techniques to target
and attract carers.
They are using cutting edge digital
marketing initiatives to identify potential
carers, grow the addressable pool of
potential care staff and target them in the
most impactful way. But this can’t keep up.
Source: Skills for Care (2018)
Staff turnover rate for adult social care workers by type of employer (England) 2013-2018 Staff turnover rates
(2018):
35
28.9%
32.1% Independent
(private sector) 30.7%
30 28.7% all job roles
27.2% 30.7% All
25
24.6%
25.7%
27.4% 27.7% 34.8%
25.8% direct carers
24.1%
23.1%
26.1%
Turnover rate (%)
20
regulated professionals
15 13.7% 14.1% 14.1% Local authority (e.g. nurses and
12.5% occupational
11.7% 11.3%
therapists)
10
14.9%
5 managerial staff
20.6%
0 other staff
2013 2014 2015 2016 2017 2018
Source: Skills for Care (2018) Source: Skills for
Care (2018)
10 PwCThese market-wide staffing challenges Estimated number of adult social care workers required vs. forecast
are having a significant impact on all (England) 2013-2030
stakeholders: service users, families,
carers, managers, social services and 2.2
Projected
operators. Ensuring it doesn’t negatively 2.0
impact front-line service delivery and
1.8
quality is a priority.
Number of workers (m)
1.6
So operators are having to tackle a 1.4
growing demand for carers whilst the 1.2
staffing environment is becoming even
1.0
tougher. Today, it is estimated that the
number of staff employed falls 120,000 0.8
short of the number required within the 0.6
adult social care system. Conservative
0.4
estimates suggest that this could rise to 1.61 1.65
140,000 by 2030, assuming the vacancy 0.2
rate doesn’t increase further. If the 0
vacancy rate increases as it has been
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
over the past three years, the gap in
the industry’s workforce could be over Number of workers Forecast number
required to meet demand of workers
290,000 by 2030.
Note: Number of workers required uses the baseline case, where we estimated
demand to increase at the current workforce growth rate. The forecast number
of workers is estimated by assuming the vacancy rate continues to grow at its
current rate.
Source: Skills for Care (2018) and PwC analysis
Who cares? 11Whilst trying to fulfil this growth, the
system will have to battle with an ageing
are unavoidable. Many younger workers
choose carer roles as temporary jobs before 27%
workforce. The average age of care workers settling on longer-term careers outside of of carers under 35
has increased consistently over the last care. The problem being that these transient chose the sector to
five years, a trend seen across the country. workers continue to perform a vital role in gain recognised
There’s a real need to reduce staff turnover the workforce, but care is not seen as an qualifications,
in younger cohorts to be able to sustain attractive long-term career.
carer tenures. There are some reasons that
versus only
5%
Average adult social care worker age 2013 – 2018 of carers over 55
Source: PwC research
(2018)
2018
43.3
2013
40.6
Source: Skills for Care (2018)
Staff turnover rate for adult social care workers by age (England) 2018
42%
37%
30%
25% 22% 22%
< 20 20 – 29 30 – 39 40 – 49 50 – 59 60+
Care worker turnover rate by age bands (%)
Source: Skills for Care (2018)
12 PwCCarers love caring
Carers are driven by a desire to help people and support “One problem with
individuals in need. They don’t do the job for the money or with care work specifically
an agenda, it’s to make individuals feel happy and ‘normal’. is its reputation as a
Seeing positive development, progression and outcomes, and ‘last resort’ career...
the impact this has on families, is hugely rewarding. people say, ‘If I can’t find
anything else, there’s
always care work’.
What most attracted you to working in the care sector?
Although the people
who work in care say
it’s very rewarding, the
external view is that
4% 2% The opportunity to it’s not rewarding, but
help people
demanding.”
15% The chance to gain
recognised qualifications Carolyn Downs, the
61% 17% It suited my skills
Helpcare Project in The
Guardian, 2017
The pay
Other
Source: PwC research (2018)
A key underlying driver of satisfaction the development of individuals and often
amongst carers is the ability to create and moderates challenging or disruptive
maintain meaningful relationships with behaviour. The carer becomes trusted,
the people they care for. This develops a and the importance of this extends to service
reciprocal appreciation that extends beyond users across the sector but particularly those
the daily tasks and duties that carers will with dementia, learning disabilities, mental
fulfil. These strong personal relationships health issues and special educational needs.
are critical in delivering care that supports
Who cares? 13The role is clearly challenging, both What are the key reasons why your experience is positive?
physically and emotionally. It is (Top 3 reasons shown)
also varied with no two days the
same. This creates a vast learning
opportunity for carers who are exposed
to a multitude of situations and the key
decisions are usually in their hands.
They make the judgements that often
shape the operation of a home and 63%
I like the nature of the work
the delivery of care to an individual.
They see the impact first-hand, and can
see improvements in their knowledge
and ability to make these decisions,
creating an intellectually fulfilling
experience.
Further to ‘on the job’ learning,
carers also have the opportunity to
gain qualifications, and are often
encouraged and funded to do so.
Having a formalised and recognised
qualification can create a platform for
them to develop and build a career
within social care. 53%
I have had opportunities for
Taking these factors together, training and learning
sentiment towards the sector is
positive. As a result, the majority
of carers are not planning on
changing careers.
50%
My shifts are regular / predictable
Source: PwC research (2018)
14 PwCHow would you describe your experience of working in the social care sector, with your “There is a real value
current employer? to making a resident
smile. Such small things
2% we do can make a real
11% difference and make
them happy. Many of
Very positive
them don’t often feel
Somewhat positive
39% Somewhat negative
happy, so making that
Very negative
difference is a great part
48% of the job”
Carer, elderly
residential care home,
Source: PwC research (2018)
PwC research (2018)
How would you say your experience has changed over the past year or so?
12%
Got better
Stayed the same
30% Got worse
59%
Source: PwC research (2018)
What are your expectations for how long you will be working for your current employer?
10%
Leave current employer inSquaring the circle
So if carers love caring, why are they leaving?
The issue isn’t as simple as the pay, or the role, Loyalty is limited and resignations can be
or the job, or the individuals. It often lies with triggered easily, so a carer can leave and
employers not always creating and nurturing have little trouble finding another job at
the most effective working environment. short notice.
And, as we’ve seen, vacancy rates are high
so alternative jobs are available.
Reasons for leaving social care employment 2018
15% 15%
4% 4%
Personal
Personal reasons
reasons / resignation
/ resignation
Competition / transfer
Competition to
/ transfer to
36% 36% another provider
another provider
11% 11%
Development
Development
/ nature
/ nature
of employer
of employer
Fired /Fired / contract
contract terminated
terminated
17% 17% Conditions
Conditions
/ pay / pay
17% 17% Other Other
Potentially preventable
Source: Skills for Care (2018)
Destinations of leavers from adult social care employment 2018
Adult care
Adult care
36% 36% HealthHealth
Unemployment
Unemployment
Same Same
organisation
organisation
23% 23% Retail Retail
36% 36% 2% 2% AbroadAbroad
3% 3%
Children's care care
Children's
5% 5%
Other Other
14% 14% 14% 14%
Potentially preventable
Source: Skills for Care (2018)
16 PwCWho cares? 17
But the issue can only be addressed if the underlying drivers “Strong leadership
behind staff turnover, and dissatisfaction more broadly, are has a pivotal role in
understood in more detail. Our research has highlighted a number both high-performing
of these key drivers. services and bringing
about improvement
Home managers in adult social care. At
The quality, experience and capabilities of home managers is critical in retaining direct care registered manager level
staff. Our research and analysis shows a correlation between home manager experience and … strong managers were
carer turnover.
visible in the service,
and known to staff,
Average care home manager tenure (to nearest year) vs. direct carer turnover
people using the service,
carers and families, for
35 example by sharing an
office with all levels of
30 staff and working closely
with them.”
25
Direct carer turnover (%)
Care Quality Commission
20
15
10
5
0
2 4 6 8 10 12 14 16 18 20
Average care home manager tenure in the sector (to nearest year)
Source: Skills for Care (2018) and PwC analysis
18 PwCRecruiting home managers from within the sector is important. Often home managers
are from outside the sector or haven’t previously been carers, this presents an immediate
tension between them and the front-line carers. This can lead to poor relationships
between managers and carers that can create a negative and sometimes detrimental
environment in the home.
“
”
They don’t get it.
They have no idea what or how much we do.
They don’t understand our needs or those of the
individuals we care for.
They ask me to do things without understanding what
it entails or how long it’s going to take. And then I get
in trouble because it obviously takes longer.
Source: PwC research (2018)
Understanding and appreciating the demands of front-line carers, and demonstrating
a willingness to muck-in and help out where needed, is critical. Further to that, internal
promotions to manager are important in creating role models for junior carers and helping
them develop career aspirations.
Profit-only culture
Costs across the sector are rising, often faster than fees. Operators are having to drive
efficiencies to maintain margins. Whilst carers understand this and appreciate that
this needs to be done, it shouldn’t become an overwhelming aspect to the culture of the
places they work. Care should be at the core and carers shouldn’t be faced with messages
about maximising revenue and minimising cost as opposed to delivering great care with
positive outcomes.
“
”
I don’t want to hear how much money you’re making,
I want to know how the clients are developing.
Every team meeting starts with a telling off about the
empty beds. It’s not my fault.
Communications are all about targets and metrics, not
about how I or my service users might be getting on.
We’re not motivated by these kind of targets. That’s how
you incentivise people in suits, not us.
Source: PwC research (2018)
Clearly, maintaining and driving financial and operational performance is critical for
all businesses. And this is ever more important in the sector as margins are often under
pressure. But the KPIs that front-line carers see and hear about should focus on great
teamwork, quality and outcomes to motivate them in the most effective way.
Who cares? 19Resources
Clearly local authority funding has been under pressure, and as a result operators have
had to drive cost efficiencies across their businesses. Whilst the impact of cost efficiency
initiatives is widespread, it shouldn’t affect the availability of resources and the investment
in equipment and refurbishments. In many cases, cut-backs are inevitable but it is vitally
important that this doesn’t impact the quality of care that is being delivered or have a knock-
on effect on the development of service users.
“
”
Our clients don’t have activities anymore. There’s no
money for it. They suffer as a result.
We used to do day trips to the seaside, which was great for
the older people. It used to make such a difference.
We really need a Hydropool. We’ve asked so many times
but the answer is always no. There’s no money.
The washing machine has been broken for days. I’m
having to take the washing home and do it myself.
We’re always running out of gloves, paper towels, wipes,
pads, etc. How can I do my job without these basics?
Source: PwC research (2018)
There’s a feeling that cost cutting is going too far and there is a perception that
front-line services are being reduced whilst head office costs are remaining high.
This must be addressed.
20 PwCTraining
Classroom training with face-to-face engagement is important in creating a forum in which
carers can learn skills from those more senior and with more experience, but can also ask
questions, seek help or get advice. Whilst e-learning has a place, it’s often becoming the
dominant (and sometimes only) type of training that carers are receiving. Carers learn
and thrive in a collaborative culture where they can draw on other people’s experiences to
help them tackle the challenges of their role. Having an open discussion amongst peers and
superiors is critical in the development of practical skills as well as physical, mental and
emotional resilience.
“
”
We used to get face-to-face training but they
cut that and put in e-learning. It’s no-where near
as useful.
E-learning is just a box ticking exercise so the
managers can say that everyone’s passed it.
Someone completes it and then does it for
everyone else. How is that useful?
You can’t learn in that way. How can I ask
questions if I don’t understand something?
They should get older, more experienced carers
to do proper practical training. You can learn so
much more that way and make sure you’re doing
the right thing.
Source: PwC research (2018)
Carers are driven to develop and progress and the training they receive is
important in helping them shape a viable career. What’s more, it drives retention
and loyalty. If they feel like they’re being invested in, they’ll stay, and they’ll
aspire to be a senior carer or a manager. They want to feel like they’re being
supported and that management wants them to be there.
Who cares? 21Career development
Carers often feel that their job is simply a means to an end. Carers coming into the sector
are typically young, school or college leavers and often don’t have a clearly defined career
plan. They’re not sure what they want to do or where they want to be in two / five /10 years
time. And that’s before they’ve worked out how to get there, the hoops to jump through or
the skills they need. And so caring becomes a stop-gap before they move onto other things.
In order for care to be considered as a career, they need to see examples of it or speak to
someone that’s done it.
”
I don’t see any opportunities to progress where I’m
working so I may as well go and do something else. “
There are no examples of a great career story. There’s no
one to aspire to.
I’ve never had a conversation about where I want to get to.
I don’t really know what I’m expected to do or if I’m any
good or what I need to do to be promoted. Or if that’s even
an option.
I’m just a carer. I’m not really proud of it. I’m a bit
embarrassed actually.
Source: PwC research (2018)
Despite their level and the role they fulfil in an organisation, focus and attention on
developing a career should be seen as priority. There are a numerous examples in
organisations across the sector of people that have worked their way up from carer to senior
management. There are CEOs who were carers. But if these stories aren’t told then it’s very
difficult for carers to see a long-term future within their business. And more immediately,
they need clarity on what skills they need to become a senior carer and then a manager and
then a senior manager, etc. for progression to feel tangible.
22 PwCPaperwork
There’s a feeling that the admin and paperwork burden is increasing and the time carers can
spend caring is diminishing. There’s a growing culture of ‘if it isn’t written down, it didn’t
happen’ and this is creating a fear amongst carers that they’re exposed to disciplinary or
legal action. Carers love their work and so the time they spend with service users should be
maximised. It is critical that their job doesn’t lose its essence.
“
”
I spend more time doing paperwork than I do
caring for my service users.
I didn’t take this job to fill in forms, if that’s what
I wanted to do I’d go and work in an office and get
paid double.
I look around the home and everyone is writing
notes but should be caring and doing their jobs.
I can’t spend enough time with clients. It makes
me feel so bad. It wears me down. I’m constantly
disappointing people.
Source: PwC research (2018)
New ways of working need to be developed. There are a range of cost-effective
digital solutions that can be used to help alleviate the admin pressure and there are
simple apps that can be used to better log notes, file reports and manage care plans.
These are now the norm in many other sectors and social care must keep up.
Who cares? 23What does ‘good’
look like?
1. Ensure care is always at
What can operators actually do to the core
• Create a care-centric culture:
mitigate and improve the staffing Mandate that care and outcomes are
issue? How can you attract the central to the business’ vision and values
right people and retain your best and this is articulated at the forefront
of communications
staff? Through our research, we • Get the right KPIs: Ensure home KPIs are
have distilled a number of actions, a mix of quality, financial, operational,
spanning multiple parts of the engagement, happiness, outcomes, etc.
business, that can help build a • Champion carers: Recognise and
advocate carers as the powerhouse of
more united, productive and the business
fulfilled workforce.
Whilst these are a range of short-term
solutions, they must be considered in
the context of a wider set of longer-term
solutions that the sector will have to
consider in order to drive transformational
change – e.g. reforming funding structures,
driving investment, increasing pay,
improving qualification levels, etc.
Importantly, the sector must be aligned.
Carers may be the lowest paid part of the
workforce, but failure to recruit and retain
can make a business unviable. Carers are
the cogs that keep the business moving.
They care for the service users, fulfilling the
fundamental premise of the business, and
so they need to be engaged and appreciate 4. C
ommit to personal
the value they deliver. Attracting talent development
• Understand needs: Carve out time
and empowering carers has to be top of the for managers to have meaningful
agenda for everyone. conversations with staff around their
needs, constraints, preferences, etc.
• Build resilience: Support carers and
provide guidance and training in mental
and emotional resilience
• Promote collaboration: Create a peer-
to-peer forum where carers can meet and
share best practice, without feeling like
they’re competing or being tested
• Celebrate success: Recognise
and highlight great work and
positive outcomes
24 PwC2. Build the right 3. Facilitate a smooth day-to-day
organisational structure • Streamline paperwork: Rethink internal
• Invest in managers: Recruit and promote processes and explore automated and digital
experienced managers who have done options for simple admin tasks
the job • Ensure sufficient resources: Respond
• Redefine management roles: promptly when resources need replenishing and
Increase the time managers can replacing and keep staff informed of progress
spend with staff and make sure they • Consult on rostering: Plan rotas well in
aren’t overloaded by revising their advance and share these with staff whilst being
responsibilities vs. regional managers and open and flexible to changes
other central functions • Embrace technology: Roll-out digital solutions
to carers and managers to better organise rotas,
manage care plans, measure progress and
outcomes, fulfil admin, etc.
5. Drive career development
• Develop career plans: Ensure managers work
closely with carers to discuss and outline career
aspirations, then create a plan and timeline to
get there
• Codify ‘good, better, best’: Define a set of
objectives and behaviours that carers should adhere
to, clearly outlining skills to be developed
• Track progress: Ensure managers feedback and
appraise performance of carers vs. their objectives
• Endorse role models: Identify examples of carers
who have worked their way up and communicate
their story across the business
• Focus on training: Invest in meaningful face-to-face
training that upskills carers to fulfil their role and
develop skills for progression
Who cares? 25How we can help
Through this report we’ve touched on some We can cut our analysis by local authority, type of provider,
type of carer, etc. There are a multitude of lenses that we
of the key insights from our research. We’ve can use to create a picture that’s most relevant to you. And
seen the critical role that social care plays, we can help you take these insights and synthesise them into
meaningful actions to implement across your business. If
the challenges it faces, how staffing fits into
you’d like to hear more about our research and analysis, or
that puzzle, what can be done to fix it and you would like to discuss how our work can help you or your
why we have to act now. business, get in touch.
Some examples of areas in which we can help:
Understanding your carer workforce,
Developing leadership and
what drives them and how to develop a
governance structures
compelling employee proposition
Sizing the addressable pool of potential
carers and / or care home managers in Building robust and engaging
your locations and developing strategies performance management processes
to target them
Assessing the potential uses of
Reviewing your quality and regulatory technology in managing your
infrastructure and performance workforce and understanding the best
options for you
Authors – who to contact if you want to know more
Andrew McKechnie
Partner
M: +44 (0)7799 602 349
E: andrew.mckechnie@pwc.com
Reena Virdee
Senior Manager
M: +44 (0)7712 596 068
E: reena.virdee@pwc.com
Ollie Cohen
Manager
M: +44 (0)7816 588 757
E: oliver.j.cohen@pwc.com
26 PwCMethodology
Our work has been underpinned by extensive primary
research. We conducted an online survey with a
nationally representative sample of over 2,000 UK carers
to understand how they think, feel and behave and how
they expect this to change in the future. To support these
quantitative insights, we also carried out a number of focus
groups with carers to probe specific areas of interest in
more detail and capture more qualitative insights on their
experiences, needs, demands and drivers of sentiment.
We have also used and analysed data published by
Skills for Care on the profile and state of the adult social
care workforce.
Who cares? 27Notes 28 PwC
Who cares? 29
www.pwc.co.uk/healthcare © 2018 PricewaterhouseCoopers LLP. All rights reserved. In this document, “PwC” refers to the UK member firm, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. Design Services 31525 (08/18).
You can also read
