Health, Wellbeing and Local Government Committee
Inquiry into Health and Social Care Workforce Planning
Introduction
Care Forum Wales is an all-Wales umbrella organisation, co-ordinating representation on behalf of care providers and local associations in Wales. Our membership includes the private, voluntary and public sectors. Our aim is:
To provide high-quality representation to Government, statutory organisations and other relevant agencies on behalf of members and affiliated Associations in order to influence health and social policy in Wales.
To assist members to maintain and enhance their effectiveness by promoting good practice and high quality community care.
To provide information to enable members to be aware of national, regional and local plans and strategies, to raise awareness of new statutory requirements, to share good practice and to promote debate about the present and future needs of citizens in Wales.
To promote high quality training and education for staff in the care sector, and to provide support for members to make the best use of training opportunities.
There are currently 1,191 registered care homes in Wales providing 26,450 beds and 344 registered domiciliary care agencies.
General
Care Forum Wales welcomes the inquiry into Health and Social Care Workforce Planning. We believe current arrangements do not provide the information required for the development of coherent cross sector workforce strategies. It is important for information to be presented in an accessible format which can be used for effective planning by all sectors.
CFW does not have the capacity to gather the required information to inform planning and we believe workforce development information should reflect the one-sector one workforce ethos of Welsh Assembly Government and present information that assists in planning and developing a future workforce that has the skills and flexibility to meet the needs of the citizens of Wales. To be effective this needs to be representative of the whole health and social care workforce in Wales.
Care Forum Wales participated in the Welsh Assembly Government Task and Finish Group on Workforce issues in Social Care which published its report in September 2001. We subsequently participated in working groups co-ordinated by the Social Services Inspectorate examining workforce issues. The review of workforce issues lead ultimately to the publication of "Human Resources Guidance - Planning for Caring” in March 2003.
Care Forum Wales considers that this guidance provided an excellent basis for the development of comprehensive workforce planning across the whole Health and Social Care Sector which could be used to deliver the objective of "one sector - one workforce.”
Whilst significant progress has been made in some of the areas identified in the Guidance there are other areas where little progress has been made. Service commissioners need to address key areas of the guidance to enable the sector to recruit a sufficient and adequately skilled workforce to meet the current demand and the projected growth in demand for services arising from demographic pressures.
The 10 year strategy for social services 'Fulfilled Lives - Supportive Communities’ has significant implications for the workforce. The objectives of continuous service improvement, the development of new and innovative approaches to meeting care needs and the development of intermediate care services will require the delivery of appropriate training to up-skill the workforce.
Question 1
The division of responsibility amongst organisations charged with workforce planning and the mechanisms they use.
Local authorities have established Social Care Workforce Development Partnerships (SCWDPs). These partnerships are supported by Welsh Assembly Government funding and are intended to promote workforce development across all social care sectors.
The Care Council for Wales have established four Regional Social Care Partnerships, these analyse workforce issues, develop local and regional plans, and bid for resources. There is a good basis for future workforce planning but the effectiveness depends on engagement by all partners in the health and social care sector.
Care Forum Wales is concerned that issues identified in workforce planning groups are not being incorporated in commissioning strategies. Sector representatives are identifying the workforce training needs, the difficulties of recruiting an adequately skilled and motivated workforce and the causes of unacceptable high levels of staff turnover.
Providers are addressing these issues as far as they are able to, by adopting good human resource practices. Their ability to address these issues is however constrained by the funding available to them. Independent sector service providers have on average 75% of their clients funded by local authorities and local health boards who set the price they are prepared to pay for the service. For most organisations employment costs represent between 60% and 80% of their total income and therefore the price paid for the service by public bodies has a significant impact on the resources which service providers can allocate to workforce training and terms and conditions of employment. In general, service commissioners claim that the constraints on the resources available to them, do not allow them to address the concerns the sector has in relation to the terms and conditions of employment which it is able to offer to its workforce.
Contracting arrangements ought to encourage and promote quality in the delivery of services. Recognition should be given to employers who ensure their workforce can deliver high standards of care by promoting continued professional development of their staff attaining Investors in People accreditation, and adopt other methods to promote continuous improvement in the quality of their services. This would require the addition of additional resources to support the attainment of standards above those prescribed as National Minimum Standards.
In the independent sector we do not have effective intelligence to inform planning - issues such as training are driven by agencies that have agendas that often do not match those of employers. Employers recognise their immediate, and in many instances, long term needs but are often unable to access effective mechanisms to support delivery. We are striving to achieve Welsh Assembly Government policy drivers by up-skilling the workforce to reflect changes in service delivery and support the new ways of working. Service planning and commissioning should be linked to support training capacity.
Managers are asked to duplicate information which is not shared, where relevant, to enable the information to be used to full effect.
Question 2
The availability and quality of intelligence to inform workforce planning.
Social Care Workforce Development Partnerships are collecting workforce information to support bids for resources. Such information relates to the number of staff employed, grades and qualifications. Care Forum Wales believes much more information needs to be collected for effective workforce planning including staff turnover rates, exit survey summaries, conditions of service and their competitiveness in the local economy. All too often partner agencies are competing for the employment of staff from the same pool of potential employees. The disparity between the terms and conditions offered by partners usually puts the independent sector at a disadvantage when recruiting staff.
Question 3
The involvement of all relevant stakeholders in the process.
There is insufficient intelligence about the independent sector workforce to carry out useful workforce planning. This huge section of the workforce is 'bolted on’ almost as an afterthought. It must be at the forefront if we are to achieve the objectives contained in 'Fulfilled Lives - Supportive Communities’.
Until there is parity of access to training and development for all care workers there will not be equality of service provisions for our citizens
In addition to using the mechanism of the Regional Social Care Development Partnership and local Social Care Workforce Development Partnerships further input to the workforce agenda could be obtained through the development of Local Independent Sector Forums which were identified as fulfilling an important role in 'Fulfilled Lives - Supportive Communities’.
Question 4
Changing patterns of demand (including an aging population) and service provision in the health and social care sectors, (including reconfiguration of services, use of new technology, new public service arrangements)
Any involvement of the independent sector is embryonic - the involvement would be much more successful if the sector felt an equal part of the process.
The increasing ageing population generates the need to significantly increase the size of the current workforce particularly if more people are to be supported in their own homes. Employers are finding it difficult to recruit an adequate workforce to meet current needs and much more needs to be done to enhance the attractiveness of working in social care as a profession. Care Forum Wales has attempted to raise the profile of social care work through the establishment of the annual Wales Care Awards and supporting the creation of an Academy of Care Practitioners. Whilst these initiatives can raise the profile of social care as a profession, consideration also needs to be given to the value of social care work and the appropriate remuneration to those persons who choose it as a career.
Question 6
Changing professional roles and training programs.
There will be significant changes in the roles of social care workers arising from the 10 year strategy and National Service Frameworks. One example is the ability of care workers to support the work of therapists to enable the maximum impact of therapeutic interventions to be attained. This will require access to appropriate training to embed the skills required.
Questions 7 and 8
The workforce needs of the public, voluntary and private sectors.
The recruitment of a workforce that reflects the diversity of the Welsh communities, including Welsh speaking staff and those from BME group, and general equality with reference to the retention of staff.
Care Forum Wales believes that the workforce needs of the private and voluntary sector are not being adequately addressed by current planning mechanisms. There is insufficient examination of the causes of high turnover of staff and recruitment problems in the independent sector. Whilst commissioners stress the importance of delivering services in a culturally sensitive manner in their service specifications, little consideration is given to the impact of the sectors’ increasing reliance on workers from overseas on this objective.
The Inquiry needs to consider the impact of demographic change in Wales over the period of the 10 year Strategy for Social Services, 'Fulfilled Lives - Supportive Communities’. The Government Actuary Department’s projections comparing 2007 with 2018 are that the population over the age of 85 will increase from 70,000 to 93,000, an increase of 33%. As a result there will be a proportionate increase in the demand for social care support. At the same time the working population, from which the social care workforce is drawn, will increase from 1,728,000 to 1,763,000, an increase of 2%.
During this period it is expected that the economy of Wales will improve significantly offering better employment prospects, reduced unemployment and increased wealth for its citizens.
If patterns of employment remain as they are, the increase in the size of the working population will not in itself be sufficient to meet the demands of an increased older population. It therefore follows that a career in social care must be a more attractive choice for individuals than it is at present if we are to be able to recruit a sufficient number of employees with the aptitudes required to meet the increased demand for services.
To make a career in social care more attractive service providers need to be able to improve conditions and terms of employment and offer better rewards for career progression and the attainment of qualifications and new skills. This is an area which requires urgent attention as the sector is currently heavily dependant on recruiting staff from overseas in order to maintain adequate staffing levels. An increasing reliance on overseas staff will inhibit the ability to deliver services which fully meet the cultural needs of Welsh citizens. In domiciliary care the absence of a guaranteed workload is a particular problem as this means that guaranteed working hours can not be offered to employees.
Service commissioners must recognise this need in their commissioning strategies to enable service providers to develop adequate capacity in their services to meet future needs.
Question 9
Examples of good and innovative practice
Care Forum Wales has promoted the following initiatives to support and develop the social care workforce.
1. The Academy of Care Practitioners - launched as a pilot in November 2007, the organisation aims to give social care workers the professional recognition and support they deserve.
The Academy’s objective is to protect vulnerable people and promote high standards of social care. This will be achieved by:
provide its members with access to information, learning and promote best practice,
inform its members about regulation, registration and training matters,
support local, regional and national networking to share experience and good practice,
provide a social care advisory service.
In due course, it is intended that the Academy database of members will include up to date data on the training, qualifications and employment of Academy members. It is possible that the aggregated data could be used for workforce planning purposes as an alternative, or in addition, to present data collection methods
2. The Wales Care Awards - launched in 2003 with the objective to raise the national profile and status of social care workers in Wales.
The Wales Care Awards will be presented annually to recognise individuals who have committed themselves to achieving excellence in delivering the highest possible standards in their sphere of work. In November 2007 fourteen separate Awards were presented to recognise differing roles and client groups within the sector. All the finalists for each award were invited to the ceremony to ensure that their contributions as well as the award winner were recognised.
3. Local Independent Sector Provider Forums (LISPFs) - objective to engage at a local, regional and national level all those organisations engaged in providing social care services to vulnerable people.
Care Forum Wales is supporting the formation of Local Independent Sector Provider Forums to improve communication and facilitate better planning and commissioning of social care services.
The concept which is contained in 'Fulfilled Lives - Supportive Communities’ that a forum of service providers be established to discuss social care plans, strategies, workforce issues and commissioning arrangements. The forum would be supported by an independent professional advisor who could represent the sector at meetings with statutory bodies as a sector representative who had no personal interest. Such an arrangement will have the added benefit of linking workforce planning and development issues within commissioning and contracting arrangements between public bodies and independent sector providers.
4. Social Care Essential Update Seminars
Care Forum Wales has for the last 6 years arranged Social Care Essential Update Seminars for sector representatives from across Wales. The Updates are usually held at 5 different locations on to or three occasions a year depending on the information to be shared. Workforce issues are an important regular topic for the Seminars.
The Seminars offer service providers the opportunity for updates of the latest information on a wide range of issues including legislation, guidance, good practice, regulation, strategic developments and human resource issues.
Care Forum Wales are pleased to have received the support of the Care Council for Wales, the Care and Social Services Inspectorate and Welsh Assembly Government Officials at our update meetings to inform and advise service providers on the latest or planned developments which affect their services. This structure could easily be expanded and developed in the future.
