Evidence submitted by the English Community
Care Association (WP 91)
1. The English Community Care Association
(ECCA) is the leading representative body for independent care
homes in England.
Members provide a wide range of services in
residential and nursing settings for adults. Member care homes
are small individual concerns and large corporate organisations
both charitable and commercial.
ECCA campaigns to ensure the optimum environment
exists for care homes to provide high quality care for those who
wish and need it.
2. Workforce planning needs to involve the
independent sector, because (a) the independent sector is the
main (provider of social care (b) the opportunities and direction
set out in the Health White Paper (Our Health, Our Care, Our Say)
with integration of health and social care and use of the independent
sector.
3. Key areas of concern in workforce planning
include:
3.1 Recruitment and retention:
The Department of Health social care adverts
(small things make a difference) are useful, however in 2006 the
slogan "at home not in a home" was not helpful for attracting
staff into working in care homes. Care roles need to be perceived
in a more positive light in order to recruit dedicated staff.
It is important to have career structures in place that acknowledge,
reward and encourage staff to join and remain in the sector.
There needs to be the provision of more flexible
working processes in line with other jobs in the marketplace.
In addition the workforce will be older and their commitments
and abilities, need to be taken into account, especially for shift
work.
3.2 Increased fees for regulatory bodies
and vetting fees may discourage recruitment because potential
employees will not want to invest the money to cover their checks
or wait for them to be returned. For many, the alternative to
working in social care is to work in a supermarket where the wages
are similar and no checks (nor additional expenditure) are needed.
For example Criminal Record Bureau checks are
compulsory for care staff at a cost of £31 for a standard
disclosure and £36 for an enhanced disclosure, there is an
additional charge of £6 per PoVA First check.
It is anticipated that charges will rise when
the Bichard proposals are in place, in addition employees will
be required to register with the General Social Care Council (approximately
£30). There are also proposals in the Protecting Vulnerable
Groups Bill that would make ID cards a compulsory pre-requisite
for those wishing to obtain) CRB checks. This is another cost
for the employee to consider before applying for a job that pays
little more than the national minimum wage.
Many employers bear the costs of the above checks,
but this is not sustainable especially with the substantial under-funding
of the independent care sector.
3.3 Immigration Control. The sector could
not manage without recruiting from the overseas workforce. The
new points based system will need to address the fact that social
care is classified as low paid and relatively low points awarded.
The current position assumes that European countries can fill
all the care vacancies, however owing to the shortage of workforce
this is unrealistic. It also means that European nationals take
precedence over staff who may be better qualified, potentially
more culturally sensitive and have a better knowledge of the English
language. This is not a helpful approach for the development of
workforce planning.
It is essential that the Home Office consults
the health and social care sectors about the new points system.
Joined up Government together with the necessary political will
is needed.
3.4 Extension of Annual Leave. The Government
has recently published consultation on extending holiday entitlement
to 28 days. This will have a knock on effect on workforce planning
owing to the additional costs involved. ECCA will be responding
to this in due course, but clearly for those homes that are currently
not able to offer the 28 days currently will be adversely affected
in terms of costs.
It will be important to know if it is the intention
to amend the Working Time Directive. At present, if an employee
has an annual leave entitlement that exceeds the minimum 20 days,
it is not unlawful for them to work on the additional days (effectively
for double pay). ECCA believes that many staff in the sector may
also choose to work on some or all of these days if it is not
unlawful to do so.
4. Technological change may facilitate workforce
development, however in the care home setting, technology will
not decrease the need for care staff or nurses. In the caring
sector, there is no substitute for one on one care, 24 hours a
day, 365 days a year.
Even with the advent of technology, one of the
dangers of Government policy of everyone living in their own homes
is that individuals will not be able to receive one on one care
and attention and therefore may become isolated. It can also demean
choice andldignity.
5. With the increased use of the independent
sector in the provision of health and social care it is essential
that the ideology that voluntary equals good and private equals
bad is dispelled. Whoever can deliver the best outcomes should
be utilised.
6. Training. The independent sector has
long been delivering social care on behalf of local authorities.
It may be useful to learn lessons from this relationship in order
that new partnerships in the health sector do not face the same
barriers. The independent sector has major problems accessing
funding and resources; particularly training resources. It is
essential that training contracts are negotiated directly with
the provider rather than funding being passed to the local government
department as often they do not pass on the relevant funding.
6.1 Adequate attention needs to be given
to the continuous professional development of the workforce. They
need to be up to date with the plethora of rules and regulations,
for example trained in the Mental Capacity Act, Bichard Vetting
& Barring Scheme and the revised National Minimum Standards.
6.2 Often the independent sector will invest
resources in new staff and train them to the appropriate levels
only for them to be "poached" by the NHS, because the
pay and conditions are better. A level playing field is necessary
for workforce planning to become a reality.
6.3 Much of the current training for the
social care workforce is no longer fit for purpose. It is focused
on processes rather than enabling people to live with maximum
independence. It is necessary to radically re-think staff training
agendas across health and Social care. The NHS in particular needs
a better understanding of social care and some significant cultural
shifts.
6.4 ECCA maintains that Skills for Care
and Skills for Health should be joined together and review the
appropriateness of the current training including the relevance
of NVQs and whether they are fit for purpose.
7. There needs to be a joined up approach
to workforce planning and recognition that public sector pensions
are not viable. By and large, the independent sector finds arrangement
under TUPE too expensive and cumbersome.
In order to meet the needs of the future workforce
across health and social care it is essential that barriers including
public sector pensions and TUPE are, analysed as they currently
prevent the transfer of workforce across sectors. In order to
stimulate cross Sector workforce development the barriers such
as commissioning costs and joint recruitment plans need to be
put into place.
7.1 Measures need to be explored that attract
staff with the relevant skills. For example ECCA has worked with
the Practice Learning Taskforce on developing strategies in practice
learning (Developing Strategies in Practice Learning, A Guide
for Organisations New to Practice Learning). Members of ECCA
participated in a scheme to host social work students in care
homes and identified the benefits, challenges and practicalities
of practice learning. The students brought an enthusiasm and new
perspective which in turn can aid the delivery of high quality
care. The publication offers practical guidance, based on the
experience of working with organisations, including members of
ECCA, about the various aspects of developing, and delivering
a practice learning strategy. Social workers of the future need
to have a good understanding of the range of services that care
homes offer and how they deliver the services.
7.2 The National Minimum Standards should
be amended to allow 16 year old care workers to have a direct
caring role. It makes no sense to exclude this age group.
8. Financial Constraints. There need to
be incentives in the system for the delivery of outcomes. Currently
there are perverse incentives to make people more dependent rather
than rewarding for increasing their independence and well being.
Staff also need to understand that independence is a state of
being not a geographical location.
The independent sector is under-resourced and
it is essential to have an independent cost of care in every local
authority in order to establish (and pay) the real costs of care.
Please contact me if you would like expansion
on any of the above points.
Martin Green
Chief Executive, English Community Care Association
20 June 2006
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