Care staff crisis leaves half a million waiting for help in England

By Alison Holt, James Melley and Judith Burns
BBC News Social Affairs Team

Published
Image caption,
'He's our son - we will do what he needs,' says Tania Tillyer

The number of adults waiting for social care in England has risen sharply to more than 500,000, according to estimates by social work bosses.

Similar research last year put the figure at about 294,000, says the Association of Directors of Adult Social Services (Adass).

"We're seeing a devastating impact on people's lives," said Adass president Sarah McClinton.

The government says reforming social care is a priority.

Adass blames a growing shortage of care workers, made worse by low pay rates and the cost-of-living crisis.

As the population ages, more and more people need social care, defined as help with day-to-day living in their own homes or in supported accommodation.

Their needs are increasingly complex but capacity is not keeping pace, says Adass.

The care staffing crisis means "even more pressure on even more families who are propping up a chronic shortage of services", according to Helen Walker, chief executive of Carers UK.

Tania Tillyer, from Northamptonshire, knows only too well how families are having to pick up the strain.

Her 37-year-old son Lee, is quadriplegic and has complex special needs which mean he needs 24-hour care for help with most basic tasks, from changing his incontinence pads and feeding him, to managing his medication and hoisting him when he needs to change his position in bed.

"The majority of it is provided by me and his dad, Brian," says Tania.

Tania says her own health issues mean the additional care work increases the pain she is in.

"When you're looking after someone 24 hours a day, your priority's them, not yourself...

"Over the years, it's impacted on me greatly, particularly on my back because of back pain that I have... but at the end of the day he's our son. So, you know, we will do what he needs."

'Cleaners earn more'

Lee has funding from the NHS for three professional carers. One works four nights a week. Two others used to split the weekdays between them.

But since one of the day carers got a better paid job five months ago, the family has been unable to find a replacement.

The problem is money, says Tania - because the role is only funded up to £10 an hour, and no-one with the necessary skills has applied.

"Cleaners and shop workers and other people are actually getting a lot more money per hour, when actually this type of work requires a lot of sensitivity and a lot of skill," says Tania.

"If you're not paying the right wage, then people aren't going to want to apply."

'We can't help'

In Cleveland, care worker Karen Taggart loves "being able to change somebody's day and provide them with that little bit of independence that they still want to hold on to, and allow them to be with their families".

But she says poor pay, particularly as the cost of living spirals, puts off many potential recruits.

"People with families, trying to get on the housing ladder, just can't afford to be in a job like this and, as well, I think people have been told that it's really hard. It can be hard, but the rewards outweigh that."

Image caption,
Carer Karen Taggart (R) says the pay puts off some potential care workers

Karen's boss, Michelle Jackson, managing director of Caremark Redcar and Cleveland, employs about 280 carers, supporting 570 people.

Demand is "very, very high" at the moment, says Michelle.

"We constantly get emails from the council and requests for extra care packages.

"Past days we used to be able to take all of that work on and currently we can't," she says, estimating that they turn down 80% of new requests, whereas in the past they accepted almost all of them.

"We just can't get enough care workers in the industry."

The problem is low pay, but Caremark cannot put up wages and stay in business, says Michelle "because we don't get enough money from the council", and council budgets are in turn limited by what they receive from central government.

The only solution is for the government "to invest properly in homecare so we can build capacity and reduce unmet need", argues Dr Jane Townson, chief executive of The Homecare Association.

Unmet need

Adass's survey went to directors of adult social services in all of England's 152 councils, and 94 responded.

The researchers extrapolated the numbers whose needs were not being met in those 94 councils, concluding that 506,131 people, across England, are waiting for:

  • a social care assessment
  • care to begin
  • a review of their care

Although 16% more hours of home care are being delivered across England, this is dwarfed by an almost sevenfold increase in hours that cannot be delivered, because of a shortage of care workers.

In the first three months of this year, 170,000 hours of home care each week could not be delivered, the survey suggests.

Ms McClinton said that although the government's health and social care reforms help a bit, they fall short in addressing the most pressing issues, "how we respond to rapidly increasing unmet need for essential care and support, and resolve the workforce crisis by properly valuing care professionals".

"We have not seen the bounceback in services after the pandemic in the way we had hoped.

"In fact the situation is getting worse rather than better."

Image caption,
Social care is 'far from fixed', says Adass president, Sarah McClinton

In a statement, the Department of Health and Social Care said reforming adult social care was a priority for the government which was investing £5.4bn over three years from April, funded by the Health and Social Care Levy.

"This includes £3.6bn to reform the social care charging system and enable all local authorities to move towards paying providers a fair cost of care and a further £1.7bn to begin major improvements across adult social care in England," said an official.

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