Written evidence submitted by SeeAbility (RTR0076)

Introduction

1. Our short submission from SeeAbility is as a provider of support for people with learning disabilities, autism and sight loss, and concentrates on the urgent issues we face in terms of recruiting and retaining staff to provide that support. We are a registered charity and employ over 700 people mostly in face to face supporting roles.
2. The issues facing social care are well rehearsed, and the Committee’s reports in 2020 and 2021 have been welcome on both social care funding issues and workforce reform. This includes the Committee’s estimate that social care needs at least £7 billion additional funding a year as a ‘starting point’, and more than this for proper transformational funding.
3. While recent months have seen some policy announcements in relation to social care, and short term funds released by central government to local authorities for sectoral support during the pandemic, neither resolves the urgent need to safely staff social care, now described as ‘an emergency’ by the Association of Directors of Adult Social Services.[1] Recent reports by CQC and Skills for Care have amplified those calls.
4. Without proper staffing, it is the case that nationally more people that need to draw on care and support will suffer, directly impacting on the continuity of care that people need and deserve. This is rarely heard in the debate over the ‘sector’ and ‘workforce’ but should be the core concern.
5. Presently it is clear from these national reports that the crisis in social care staffing is not just causing huge anxiety for people who need social care to live their lives. This reporting could actually be harming recruitment as would be recruits are potentially put off.

Context

6. Like other providers of care, we cannot compete with the pay from other sectors of the economy. This is because pay is directly linked to the fees which commissioners pay for support. This pay suppression has been the case for many years. Skills for Care has recently published that sales and retail assistants earned 13 pence per hour less than care workers in 2012/13 but in 2020/21, on average, they earned 21 pence per hour more than care workers.[2]
7. This year, all indications from our commissioners are that we will not receive an uplift to reflect even the 6.6% rise in the National Living Wage, let alone reflect other inflationary costs. There is a disconnect and lack of clarity as to what government policy is and how that is applied by local authorities.
8. The Treasury responds to fairer funding campaigns by citing the National Living Wage rise from April 2022, but ignores how this can be paid if there are no uplifts given by authorities.
9. It is also questionable to ‘celebrate’ that social care pay is benchmarked at the very minimum pay rate possible. Research has already shown that in other areas of public service with equivalent skill sets a care and support worker could expect to be paid £7000 more.[3]
10. The DHSC’s workforce recruitment and retention fund, distributed to councils in October and another due for distribution from January, is welcome, but funding ends in March 2022. There is no plan in the long term to provide funding to recruit staff at a pay scale that does justice to the job.
11. The temporary funding is of course helpful and some recognition of the pressures but working across numerous authorities we see the different approaches that are taken. Some councils are more flexible and open to working with their providers than others. Again directives are not clear enough nationally and there are only a few areas where we have had responses about bonuses for staff.
12. At the time of writing we will be waiting to see if January ‘round 2’ funding of £300m will be transferred by councils directly to providers as the guidance is more explicit on the ability to offer some form of bonus to frontline staff (although tens of pounds that this may be). And the guidance still allows for a variation in approaches.
13. It is notable that there has been no nationally led government bonus given to frontline care staff during the pandemic in England, unlike in Wales, Scotland and Northern Ireland.
14. We are trying everything to retain staff, investing in initiatives around wellbeing, training, employee assistance and reward schemes, as well as running a hardship fund during the pandemic, and for Christmas 2021 we were able to afford to give our staff a small bonus.
15. However in a number of areas there is little council co-ordinated support for recruitment and retention for their independent provider sector, and the sense is we are all competing for a shrinking workforce rather than working together.
16. Social care providers are seeing fewer and fewer applicants interested in working in social care, in some areas this has dropped drastically. This is in part due to the economy opening back up during the lifting of lockdowns, as people see that hourly pay rates are more attractive in areas such as retail and hospitality.
17. We are part of the BetterPay4SocialCare campaign calling for the Real Living Wage for social care staff, however in the current economic circumstances we are now doubtful that even this starting wage would be enough to encourage recruits to social care.
18. As a provider of support across the South East and South West of England we do see different geographical challenges, in more rural or market town locations we find it difficult to recruit often because of travel considerations and a lack of public transport, in other areas such as surburban Surrey and London it is almost impossible for the starting salary for a care and support worker to rent or buy a property in that area and there is more competitive pay and job availability in other sectors.
19. Staff may be considering how they can stay in their roles given we and other providers cannot adequately renumerate against the cost of living pressures they are facing, we and other providers are losing staff due to the mandatory vaccination in social care policy rollout and our recruitment pool has shrunk further due to the limits on EU migration.
20. The National Insurance Levy to be introduced in April 2022 and the inevitable additional rise in council tax will also hit our colleagues pay packets, as well as bearing the Levy ourselves as an employer. The irony being both Levy and council tax rises are in part to fill the funding gap for social care.
21. While the social care white paper, released in November 2021, states that part of the Levy will be used towards a £500m investment in the social care workforce, this is directed at a knowledge and skills framework, professionalisation and wellbeing initiatives. It is not tied into any strategy for pay reform in social care.
22. It is already well documented that little of the Levy monies will reach social care in the first three years, and most of it will be directed at the NHS. Of what funding there is, most relates to means testing/cap on care cost changes and reforming the market accordingly.
23. The reforms announced have a tendency to focus on support for older people despite half of adult social care budgets being directed at those of working age. We have seen this through the pandemic where residential care and support for older people became the focus of government guidance and vaccination policy. Both people with learning disabilities and autism and their support workforce continually feel they are a secondary consideration.
24. It continues to be very apparent during the pandemic that the DHSC and policymakers have little specific grasp of the very many roles and different types of support (regulated and unregulated) that there is for people with learning disabilities and autism. The majority of people with learning disabilities live in their own homes or make use of Supported Living, but pandemic guidance for the latter was always many weeks later than guidance for residential care.
25. Meanwhile the NHS is funding at great cost hospitals that to all intents and purposes have become homes for people with learning disabilities and/or autism, rather than places for short term treatment and intervention. This has left many people and their families traumatised.
26. The government’s piecemeal, disjointed approach to social care, also compares badly to its approach towards the NHS and other crucial areas of the economy. With a 1.54 million strong workforce, and contributing an estimated £50 billion to the economy it has little profile or attention by other government departments eg. BEIS.

Solutions (short, medium and long term)

• An immediate winter bonus for frontline care staff from the government (not to be distributed via local councils) by March 2022. ADASS has called for £1000.[4]
• Redirecting more of the NI Levy into social care from Year 1 in order to urgently fund social care, as recently called by the Local Government Association and so ensure that the rise in the National Living Wage and other inflationary costs is funded through fee increases.[5]
• Removing the need to pay the NI Levy if you work in social care or you are a social care employer, in order to alleviate rising pressures on pay.
• The Migration Advisory Committee has highlighted concerns relating to immigration rules for care and support staff.[6] The government has responded by placing care and support workers on the shortage occupation list for 12 months only[7]: clearly this needs to be a long term addition.
• A thorough reconsideration of the mandatory vaccination for deployment policy in social care given changing circumstances both with the Covid pandemic and the economy. The implications at present are losing existing staff as well as shrinking the pool of people who can be recruited in social care.
• The government’s instruction to councils to run cost of care exercises in 2022 should cover the whole sector including learning disability support.[8] The exercise should be based on understanding what a fair price is for care, that includes at a minimum the Real Living Wage not the assumption that the benchmark is the National Living Wage.
• A pay strategy for the whole of the social care that aligns to a similar structure for the NHS Agenda for Change. While we support the Real Living Wage as a starting point, ADASS has said that it would be more appropriate given the skills and demands in social care to align with NHS entry point of at least Band 3 healthcare assistant of £10.90 an hour.[9]
• A specific strategy for the learning disability and autism workforce across social care and the NHS Transforming Care programme, that is focussed on the specialisms and learning that people require to provide the best possible support. This should be co-produced with people with learning disabilities, autism and their families and take a lifelong approach across children and adult social care. Having a keyworker/care coordinator for that journey could really help in terms of continuity of support and someone to coordinate and navigate across the different systems that people with learning disabilities and/or autism encounter.
• Offering key worker status to anyone working in social care enabling support for housing, transport costs and considering a national reward scheme that eg. would enable social care perks such as reduced cost driving lessons, etc?
• The demand and need for social care support continues to grow and it can offer a wonderful, rewarding and enriching career. A cross government workforce strategy towards social care is needed, so it is not just the remit of DHSC but becomes a focus for jobs and investment within the Department of Business, Energy and Industrial Strategy, the Department of Work and Pensions and Department for Levelling Up, Housing and Communities.