International research shines light on workforce crisis facing adult social care

Findings from a new European research project, led by Lancaster University, will be submitted as evidence to a Government inquiry exploring recruitment, retention and training issues in health and social care this week.

The Learning for Adult Social Care Practice Innovation and Skills (LAPIS) project, launched in 2021, is an EU-funded project designed to explore the challenges and opportunities faced by the adult social care sector across the UK and Europe. Led by academics from Lancaster University Management School, it hopes to share best practice and innovations within the sector across county and country borders, and provide digital tools and recommendations to drive meaningful change.

The project builds upon findings from earlier research by the group, Helpcare – a project led by Lancaster University and completed in 2018 – which worked with almost 700 care workers to explore issues surrounding recruitment and retention in the sector, identifying a host of training shortfalls.

Now, after securing €370,000 funding from the European Commission, the three-year LAPIS project will see partners in the UK, Greece, Poland, Italy and Bulgaria work together to unearth the challenges facing the workforce on an international level within the sector, provide recommendations to drive improvements across Europe and create open source training tools for care managers and commissioners. A free app is also being developed, which aims to capture and share stories of best practice and innovation across Europe.

After conducting a series of workshops and in-depth interviews with around 60 senior leaders from the sector across the five partner countries, the team of researchers have now launched their first set of recommendations. These have today been published on the LAPIS website, and will be shared with Government later this month.

Dr Carolyn Downs from Lancaster University Management School is the lead investigator. She said: “Our research has uncovered five major areas of concern that need to be addressed urgently if the issues plaguing the adult social care sector are to be addressed and overcome. The UK sector is in crisis with over 400,000 clients in the UK waiting for assessment of their care package to commence, as of December 2021. With rates of attrition averaging 28% across the workforce, it is unlikely that this waiting list will shorten without decisive intervention.

“We found that despite different countries having different structures, funding systems and support in place for adult social care workers, what most share is a striking absence of national and common frameworks for professional caregivers. In most cases, the care sector is fragmented and organisations operate on a stand-alone basis, with no sectorial, national or EU training framework in place to help employees move between organisations, and with no direction for professional development.

“During the last year we have spoken to some of the most senior voices across the sector in Europe, and heard time and time again that instead of a portfolio, or plans of carefully selected training programmes, caregivers in most countries tend to do the same basic training on repeat throughout their careers, whenever they enter a new role. This turns people off the sector, can result in rapid burn out, and contributes to the high rates of attrition.”

The Helpcare Project identified more than 400 training needs in total and found specialist training and Continuous Professional Development (CPD) to be extremely limited or, in many cases, non-existent. While the UK has a national Care Certificate for sector workers, it is not externally validated and the quality of training was found to depend very much on the employer, who individually sign off their own employees’ certificate. There is no comparable certification in Poland, Greece and Italy, although some basic training is provided in each country. However, in Bulgaria, quality standards for induction training and the more specialist training that follows are currently being finalised under its recent Social Care Act.

“Care workers and managers identified a range of barriers to accessing CPD and training,” Dr Downs continues. “This included a lack of suitable, externally validated programmes, a lack of staff cover to enable participation in training, the cost of training programmes, a lack of confidence in developing ‘in-house’ training and a lack of awareness about the possibility of creating bespoke programmes with training providers. However, Bulgaria have introduced a new Social Care Act and are now embedding a training framework. Fellow countries need to follow suit.

“There is also great pressure on organisations to innovate in a bid to address the extreme challenges the sector faces – but we found the silos and fragmented nature of the sector across all countries means that where novel approaches were being taken, they were almost never shared. There was no mechanism for sharing knowledge or best practice, so there is very limited opportunity for growth.”

Researchers found that in all five countries, training for the sector workforce was reduced to the “essentials”, and the most common training given was limited ‘on the job’ training, experienced when first joining an organisation. Training relating to the development of specialist professional skills and knowledge, or linked to the wellbeing of staff were most rarely embedded in organisations’ agendas, but researchers found care managers were very keen to provide training in these areas as a way of better demonstrating the standing of the individual care giver, to enhance staff wellbeing, and raise the perceived value of the profession as a whole.

A host of recommendations for government, sector bodies and care organisations have been outlined by the project team and will be submitted to the UK’s Health and Social Care Committee’s inquiry, ‘Workforce: recruitment, training and retention in health and social care.’

The research team are working to release a digital guide for care managers in Spring 2022, providing the tools to develop and teach their own work-based learning courses. Later in the year a digital guide and map for both care organisations and vocational education providers will be developed, outlining how these courses could be jointly developed into portable, recognised qualifications.

In addition to Lancaster University Management School, partners in the LAPIS project include the University of Lodz – Poland, Associazione Submeet – Incontrarsi per Crescere – Italy, Druzhestvo Znanie – Bulgaria, Applied Industrial Technologies (APINTECH) Ltd – Cyprus , 50+ Hellas Astiki Me Kerdoskopiketairia – Greece and

Lancaster and Morecambe College in the UK.

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