A winter of discontent for social work and social care

Published by Professional Social Work magazine, 20 October, 2022

Social workers and social care staff would be forgiven for approaching this winter with a sense of weariness.

High vacancy rates, increasing demand, the rising cost of living and funding uncertainty in the wake of years of austerity cutbacks and the pandemic have left the sector feeling beleaguered.

Even before Covid, the run-up to winter always came with a series of warnings about the “cliff edge” social care was in danger of falling off, as successive governments kicked the issue into the long grass.

Five years ago, the Red Cross went as far as to call winter bed-blocking, largely caused by a failure to fix the social care system, a “humanitarian crisis”.

This perilous state has only increased in recent years.

A white paper spelling out a vision to transform adult social care published in December 2021 aimed to address the problem once and for all. Funding of £36 billion a year over three years would reform health and social care, the money raised by increasing National Insurance by 1.25 per cent and introducing a subsequent new levy.

But in September, the Health and Social Care Levy was scrapped by former Chancellor Kwasi Kwarteng who was sacked by former Prime Minister Liz Truss (for implementing her policies).

During the Tory leadership campaign Truss said she would shift £13 billion from health to the sector. But market turmoil following September’s unfunded ‘mini-budget’ and a series of policy U-turns culminating in Truss's resignation has called the credibility of such pledges into question.

The government has also failed to install a minister for adult social care. The ongoing delay will affect a wide range of reforms and consultations, against the backdrop of worsening recruitment and retention issues. Not to mention the winter crisis.

Jeremy Hunt, the new Chancellor recruited to restore confidence in the financial markets, has expressed regret about his failure to sort out the social care crisis during his time as health secretary, but his warning of having to make "decisions of eye-watering difficulty" with regard to spending doesn't bode well.

With hospital waiting list in England at a record seven million high and the health sector in crisis, social care could see itself relegated to Cinderella status yet again. Even if funding is found for the white paper reforms, the government originally only intended to spend a seventh of the £36 billion on social care. Most of the rest was earmarked for shoring up the NHS, including the Covid-related hospital backlog.

None has been designated to increase pay in the sector.

A survey of the social care landscape currently shows the extend of the crisis. Skills for Care, in its latest annual report on the state of the adult social care sector and workforce in England, highlights vacancy rates have risen from 3.8 per cent in 2012/13 to 10.7 per cent currently. The employer-led workforce development body warns an extra 480,000 social care workers could be needed by 2035.

A similar number – 430,000 – could be lost in the next ten years if those aged over 55 decide to retire.

Low pay is one of the key drivers for people leaving social care. Skills for Care highlights how salaries in the sector are less than 80 per cent of jobs within the wider economy, contributing, no doubt, to 400,000 people leaving their jobs last year.

A recent survey of 1,000 social care and health workers by tech company Florence found almost one in five is planning to leave due to job pressures, compounded by the cost of living crisis.

The government plans to invest £500 million in the training and development of the social care workforce. But unless this is matched with increased pay, it is unlikely to solve the recruitment crisis.

Look elsewhere in social care and government figures show the vacancy rate for children’s social workers is almost 17 per cent in England, the highest in five years.

And vacancy problems are also reported across the other three nations of the UK.

A range of issues, including diminished resources amid rising demand, excessive paperwork, managerialist cultures and increased caseloads have heaped pressure on workers, and, in turn, fuelled the recruitment crisis as burnt out staff quit.

Newcastle City Council head of children’s services recently highlighted a shortage of children’s social workers, with the cost of living crisis a contributing factor.

Its vacancy rate is at a five-year high, average caseloads have leapt from 5.0 in 2019 to 23.3 in 2022 and the number of children coming into care is increasing.

The authority says staff are leaving for better paid agency work.

Councils across the UK are struggling to balance their books. A decade of austerity cuts imposed under David Cameron’s government in response to the financial crisis of 2008 continue to impact on their budgets.

An analysis this month by Grant Thornton found one in six councils in England is at risk of running out of money next year without extra funding.

Two thirds say they face a “threat” to or “extreme pressure” on key services over the next year, according to a poll by the Special Interest Group of Municipal Authorities.

Gloucestershire County Council – a Conservative-run authority – has overspent on children’s services by an average of £7 million a year for the last eight years.

The service, which was judged inadequate by Ofsted in 2017 and still requires improvement, could be seen as a target for being turned into a trust.

This franchising out of children’s services has been the government’s response to what it perceives as failing departments. Critics, however, claim the ‘failing’ is more down to underfunding and fuelled by an ideological drive to outsource and eventually privatise services, putting local accountability at risk.

In Doncaster, the first children’s trust to be created was recently returned to local authority control because of a failure to improve.

Staff transferred back are now being balloted for industrial action due to reduced terms and conditions compared to other workers.

Issues within children’s social work have been long-running with dramatic increases in referrals and children coming into the care system over the last decade.

The Independent Review of Children’s Social Care in England published earlier this year advocates system change, with a shift to focusing on helping families and early intervention.

But it also recommends ploughing £2.6 billion into the system over the next five years. In a climate of squeezed public finances, how likely is it that the government will stump up this kind of funding? Meaning the same old problem of social workers having to do crisis intervention work with families rather than supportive early help will continue, impacting on staff morale.

In the meantime, social workers themselves warn of economic hardship not only increasing their workloads as pressure on households increases, but also impacting upon their own lives.

The cost of petrol has risen but mileage rates for social workers travelling to visit service users haven't. Pay rise offers have failed to keep up with increasing inflation. Amid this, a fifth of social workers in a survey by PSW fear they may have to use a food bank themselves soon.

Even before the pandemic, a survey by the Social Workers Union highlighted poor working conditions in the profession with 40 per cent of workers planning to leave. BASW's annual survey also highlights the intense pressure social workers are under.

Strike action is already anticipated by teachers, nurses, postal workers and others this autumn. Could social workers and social care staff be next to show their discontent?