Social care staff pay must be improved, warn sector leaders

The Association of Directors of Adult Social Services (ADASS) has today published the findings of its 2024 spring survey .

“Lack of social care provision, funding and workforce continues to put pressure on NHS services”

Sarah Walter

It recommended the new government takes immediate action on social care, particularly home care, calling on it to prioritise growing, and retaining, the sector’s workforce over improving hospital capacity.

ADASS’s report, which featured responses from social care leaders across the country, found reports of increases in the acuity, number and cost of patients.

Social care directors were, as part of the survey, asked to rank common recommendations for solving the sector’s current challenges.

They ranked pay, working terms and conditions and wellbeing support for care staff as the three most important, above others including continued professional development and apprenticeship reform.

The survey also found that local governments were providing around 750 hours of homecare per person in 2024, a rise from 697 in 2022, leading to an increase in spending.

The survey found that the size of care packages had risen. As well as this, around a third of directors recorded a 10% or greater rise in the number of people presenting to adult social care.

This rise was because the NHS had stopped their continuing healthcare funding, which is used when social care patients are assessed to fall into the remit of health, according to survey respondents.

Meanwhile, social care leaders said budgets have sunk and ADASS said the vacancy rate for registered nurses for the sector was at around 9%.

They told the survey that NHS funded nursing care for local governments did not cover the “true cost” of nurses in homecare in 93% of cases.

ADASS president Melanie Williams said spending more on the NHS, without investment in community and social care, was like “pouring water down a sink with no plug in”.

The report concluded that NHS funded nursing care rates were “insufficient”, current funding methodologies “understate” the cost of nurses and called for boosts to the size and stability of the workforce for the sake of the sector.

“Instead of focusing on investment in hospitals and freeing up beds, the new government must shift to investing in more social care, supporting unpaid carers, and providing healthcare in our local community to prevent people reaching crisis point and ending up in hospital in the first place,” she said.

“The next government must have the courage to commit to a long-term, fully funded solution for social care and shift from short-term crisis management, especially during winter, to more care at home in the long term.

“Care at home is better for all involved, but also makes more financial sense,” added Ms Williams.

ADASS’s report also found that around 90% of social care directors said they were either only “partially confident” or not confident that their budgets will allow their organisations to meet statutory duties.

Fewer of the leaders reported feeling confident their budgets were big enough than in the previous year, noted ADASS.

Responding to the report, Sarah Walter, director of the NHS Confederation’s Integrated Care Systems (ICS) Network, said this year’s ADASS survey reflected what ICS leaders were seeing in their local areas.

“Lack of social care provision, funding and workforce continues to put pressure on NHS services, and more importantly mean many people are not receiving the best possible care in the most appropriate setting,” she said.

She added that the forthcoming Skills for Care Workforce Plan, also due to be published this week, and the government’s response to it, could be key to addressing the sector’s challenges.

Nuffield Trust deputy director of policy Natasha Curry described the current situation in social care as “perilous” and said ADASS’s survey showed the need for multi-year funding settlements and stability.

“[The survey] reinforces the grave financial challenges local councils are grappling with just to stand still in the face of growing and more complex needs for adult social care,” she said.

“The fact that 90% of councils are now not confident they have the funds available to meet what is asked of them should be ringing alarm bells for the new government.”

Ms Curry added: “Cost pressures on councils are growing as the type of care people need is changing suggesting that the model of care provided may not be fit for purpose.”

Similarly, National Care Forum chief executive Vic Rayner described a “gap” in the needs of social care patients and what resources are currently available.

“It is well understood that effective care provided at the right time can prevent people requiring further emergency care and hospital admission,” she said.

“The new government has an opportunity to tackle this urgent crisis head on and change the approach, so people are able to live their lives well.”