My Lords, there is no doubt that we need more people to choose to work in social care. Prior to the pandemic, the vacancy rates for care workers in residential care and domiciliary care were 6.4% and 11.4% respectively. By June 2020, that had declined to an overall rate of 6.6%. We would like to see this number reduced further, which is why we are taking action to support recruitment nationally, and we expect local authorities to support care providers locally.
My Lords, yesterday the Prime Minister promised again to deal with the problem of social care. First, how will the Government fill these vacancies as a matter of urgency? Secondly, what priority will there be for social care in the Government’s digital and healthcare strategy?
My Lords, the immediate focus is on the national recruitment campaign across broadcast, digital and social media. We acknowledge that there needs to be more recruitment in social care. Encouragingly, the vacancy rate is down, from 7.8% to 6.6%, but we recognise that more needs to be done. We have launched the CARE brand to try to create a stronger employment brand around the care profession.
My Lords, I welcome the increase in the number of social care workers but there is more to be done not just in social care but across the wider NHS. Can my noble friend update the House on progress on wider NHS recruitment and, in particular, the manifesto commitment of 50,000 more nurses for the NHS? I hope, too, that there will be a reduction in the proportion of expensive agency-employed staff.
My Lords, the recruitment of nurses is extremely encouraging. We have had an enormous response, with more than 10,000 nurses already recruited and recruitment rates to universities for nursing qualifications also up. We have an enormous marketing campaign supported by broadcast and social media. However, more needs to be done and we are very focused on this area. The use of agencies provides some surge capacity for hospitals—it has a role—but I completely acknowledge my noble friend’s point that agency support needs to be used in a considered, thoughtful and commercially intelligent way.
My Lords, the introduction of living allowances for nursing students has improved recruitment this autumn. Stable funding for social care purchasers and providers in both care homes and domiciliary-based service is necessary to ensure dignity in care for the vulnerable in our society. It is essential that careers in social care are attractive and that staff are supported to deliver high-quality personalised care to clients. What plans do Her Majesty’s Government have to support local authorities, further education colleges and social care providers to train and retrain social care staff? Central funding is necessary. Incentives are needed to demonstrate that those joining the social care workforce are as valued by government and society as those working in the NHS.
The noble Baroness makes her point extremely well. We want social care to be a profession that people seek out, where they seek professional development and where they can find a fulfilling lifetime career. That will not be true for everyone, but we need a backbone of people who are committed to social care. That is why we have massively increased the funding to local authorities so that they can address the challenge of social care, and why we have published the adult social care coronavirus winter plan in order to provide short-term support for local authorities to achieve exactly what the noble Baroness has spelled out.
My Lords, when there is a shortage of care workers, as there clearly is, the need for care does not go away; it simply falls disproportionately on the families and neighbours—the unpaid carers. Some 70% of these say that they have had to give more care than previously during the pandemic, with an average of 10 hours extra a week. How will these extra burdens on unpaid carers be recognised and supported both in the long-term plan and in social care reform, when we eventually get it?
My Lords, I pay tribute to all those who contribute to the care of loved ones, neighbours and people in their community. The noble Baroness is entirely right to acknowledge the enormous contribution, born of civic duty and personal love, that people put into caring for those in need. I acknowledge the 10 extra hours that she mentioned; I have no doubt that many have had to put in extra work during the pandemic. That is why we have put in significant financial support for the charity sector, and these are the considerations that we will put into future social care reform.
My Lords, health and care workers can now be reimbursed for the immigration health surcharge. While this is unlikely to fill the gap identified by the noble Lord, Lord Dubs, it is welcome. How are the Government ensuring that all care workers who do not work in large hospitals are aware of their right to the refund, and how are they monitoring what percentage of those eligible are making the claim and what sort of establishment they work in?
This is a very important piece of communication. We have sought to work through the colleges and through the CQC system in order to make sure that employers make knowledge of these funds available to those in social care. I will look at the department to see what we are monitoring and what the take-up rates have been, and if I have any further information I will be glad to write to the noble Baroness with that data.
My Lords, on agency staff, according to workforce statistics from the Department for Education in February, the number of agency social workers grew by 10% last year. Cheshire East Council, for example, spent more than £1.3 million on agency social workers last year, and these costs also include the fees that the authority has to pay to the agencies. What funding and other support has been provided to local councils specifically to enable them to reduce the reliance on agency staff and to ensure that the money spent on temporary staff in social care departments, care homes and domiciliary care can instead be used to increase the number of permanent, full-time and part-time staff in social care that are so desperately needed?
My Lords, the use of agency staff in itself is not something that we are fighting against. Agency staff, although often denigrated, provide an incredibly valuable contribution to the social care efforts of the country. That said, the main way in which we can address the dependence on sometimes expensive employment practices is to ensure that there is a really large pool of people taking the kinds of jobs offered in social care. That is why we are marketing those roles heavily, improving the employer brand around social care and improving the financial arrangements for those seeking training in social care.
My Lords, the latest annual Care Quality Commission State of Care report shows that quality levels in adult social care have been maintained, with 84% of services rated as either good or outstanding, up from 82% last year. Given the dedicated service of our care workers, will my noble friend the Minister update the House on whether a new deal for care workers will include action on pay, training and development, career progression and professionalism, as well as ensuring that those working in care are recognised in the same way as those working for the NHS?
My Lords, I echo the tribute paid by my noble friend to those working in social care during the pandemic. Naturally we have a huge amount of concern about those in social care during the pandemic. However, it is amazing how much hard and committed work those who work in social care have put into the arrangements and how effective many of those arrangements have been. The numbers that she cites are really impressive. I cannot make the commitments that she asks of me right now, because the deal for social care workers has not been written, but I completely acknowledge the suggestions that she makes; those are very much on the wish list and the agenda for any social care reform when it happens.
My Lords, is the Minister familiar with the work of the Tribe Project? It was set up by a successful digital entrepreneur and is now being used by six local authorities to predict the needs for care, match people with carers, and, very importantly in this context, support professional carers in setting up independently as microenterprises. This reduces overheads and therefore both improves care income and reduces costs. Does he agree that this approach could be very useful in helping with this crisis, and will he explore it further?
My Lords, I am extremely grateful for the noble Lord’s recommendation. The project that he describes is incredibly interesting. I am not aware of it today, but I will definitely seek it out and try to find out more. I emphasise the broader point that the noble Lord is making: fresh thinking, digital innovation and the work of entrepreneurs to try to create new ways of working—to pool, for instance, the efforts of teams of people and to use platforms like the one that he describes—can make a massive difference in the area of social care. We are very supportive of digital entrepreneurs bringing fresh thinking to this important area of work.