Call for evidence outcome

Care workforce pathway for adult social care: call for evidence summary of responses

Updated 10 January 2024

Introduction

This is the summary of responses to the call for evidence for the care workforce pathway for adult social care (referred to as the pathway). This document is a high-level summary of responses to the call for evidence and forms part of the ongoing development of the pathway. The government, in partnership with Skills for Care, has used the information supplied, alongside wider evidence and research, to shape the policy proposals for the adult social care workforce to ensure that the pathway:

• reflects the realities of receiving or providing adult social care
• builds on existing good practice
• can grow and develop as our expectations of adult social care change

We are approaching the development of the pathway in phases. The next phase of development will focus on registered managers, deputy managers, personal assistants and enhanced care worker roles, which we intend to publish in summer 2024.

Background to the call for evidence

Our white paper, People at the Heart of Care, published in December 2021, set out our 10-year vision for the adult social care workforce. We want the adult social care workforce to be recognised as the professional workforce it is, and to improve people’s perception and experience of a career in care. This means supporting people to feel empowered to deliver high-quality care, to develop in their roles and progress in their careers, if that is right for them. We committed to working with the sector and people who draw on care and support, to co-develop a universal pathway setting out the knowledge, skills, values and behaviours needed to work in adult social care, as well as a clear career structure for the workforce.

In April 2023, the government published the plan Next steps to put People at the Heart of Care, which sets out how the government will build on the progress so far to implement the vision for adult social care. Alongside this we published a call for evidence to inform the development of a new care workforce pathway for adult social care.

What we asked

The example pathway set out in the call for evidence was a proposal for how the adult social care workforce might be structured and how we can articulate the knowledge, skills and behaviours needed to perform different roles. It provided an opportunity for the sector to tell us their views and to test our approach. The call for evidence was also published in an easy read format.

We asked people for their views on:

• what the pathway should include
• how it should be set out
• how we can support people working in care - and adult social care employers - to use it, so that the workforce can develop the knowledge, skills and behaviours to become specialists in their field, progress into new roles or to develop within their current role

To make sure that the pathway meets the needs of the workforce and those who employ them, now and in the future, we asked for examples of:

• what is working well in the sector
• what needs to change
• where there are barriers and challenges and how we can address these

The questions in our call for evidence focused on 4 main themes where we asked for insight and evidence:

1. The structure of the pathway, including whether it represents the adult social care sector and the range of different roles and careers within it.
2. The type of information the pathway should include.
3. How the pathway will benefit the adult social care workforce and the sector as a whole.
4. What would encourage people to use the pathway or stop people from using it.

To raise awareness of the call for evidence and enable more detailed conversations we held virtual events, in partnership with Skills for Care, with a range of stakeholders. Feedback from these events is also reflected in this document. The government will continue to engage with stakeholders as we develop our policy thinking. We are committed to co-developing and testing policy with the sector throughout the development of the pathway.

Summary of responses

In total we received 586 responses to the call for evidence, with respondents representing:

• members of the adult social care workforce
• people who use adult social care
• other adult social care organisations, including local government and training and learning providers
• adult social care employers

The responses were broken into:

• 524 responses to the online survey in the call for evidence
• 54 responses sent by email
• 8 responses to the easy read publication

Where we refer to responses to the call for evidence, we mean all of the above categories. Where we refer to survey responses this is only in relation to the 524 responses received to the online survey. Where we refer to respondents to engagement sessions, we are referring only to the engagement that happened alongside the call for evidence.

The majority of people who responded to the call for evidence or participated in our engagement were supportive of the pathway’s development, including its aims and benefits, with most agreeing that there is a clear need for it within the sector. Respondents to both the call for evidence and engagement sessions agreed that it could help change the perception of a career in care and provide opportunities for care and support workers to develop and progress, while also supporting recruitment and retention. Many felt they could see the pathway working in their organisation.

Main themes

Overall, the majority of respondents were supportive of the proposals, including the example pathway structure.

Feedback focused on how to make the pathway as effective as possible for a diverse sector, as well as including many examples of best practice which have been taken into account as we developed the first phase of the pathway. Most respondents to the call for evidence acknowledged the value that the role categories could add to recruitment, retention and career development, while many respondents took the opportunity to respond on wider themes that were not explicitly outlined in the call for evidence - for example, links to wider workforce reform.

The following sections outline the main themes that were raised in the responses to the call for evidence, through the online survey, by email and through the easy read publication, as well as in feedback to the engagement sessions that were held alongside the call for evidence.

The care workforce pathway structure

The call for evidence proposed a new workforce structure which included 4 broad categories of direct care roles as well as a managerial route to be developed in a future phase of development. For direct care roles, it suggested ‘care and support practitioner’ as an entry level role, progressing to ‘advanced care and support practitioner’, ‘senior care and support practitioner’ and then into a ‘practice leader’ or ‘specialist practitioner’ role.

Of the 524 who responded to the survey, 58% agreed or strongly agreed that the proposed structure matched how they would like the workforce to be structured in future. Moreover, in relation to role categories and their descriptions, 57% strongly agreed or agreed, while 23% disagreed or strongly disagreed with them.

Throughout the engagement sessions the majority of feedback about having a structure and role categories was positive, and respondents felt that the pathway would help facilitate improved career opportunities. Managers agreed that the pathway would be helpful for staff to think about their career in care by signposting to the types of roles that are available and showing staff options to specialise and develop without moving into management.

Respondents to both the call for evidence and engagement who disagreed or strongly disagreed were often supportive of having a structured workforce but did not necessarily agree entirely with the outlined structure or role categories, often with a focus on how categories were titled or described in the example pathway. There was a wide range of suggestions for what the most appropriate titles and role categories should be, with some commenting that there should be clearer differentiation between categories. The pathway published alongside this response includes the detail on the knowledge, skills and behaviours expected at each level, providing the differentiation that call for evidence respondents referenced. We have also signposted to training and other learning and development opportunities within different role categories.

Sixty-nine per cent of respondents to the call for evidence said the pathway provides all the important information they want it to have. Of the remaining respondents, most did not feel able to conclude whether information was missing as they wanted to see more detail before being able to confirm whether anything was missing.

The majority of respondents to the call for evidence from the adult social care workforce and employers agreed that the inclusion of values within the pathway will enable them to recognise the values those working in adult social care should have and what they can expect to see in their colleagues and those they manage. Of the 28 respondents who draw on care, just over two-thirds agreed or strongly agreed that the pathway will improve the quality of care they receive, by enabling employers to recruit people with the right values and behaviours. Those respondents who disagreed either felt that values were an integral part of adult social care already or wanted to see more detail about the values and behaviours before being able to confirm whether anything was missing.

We have worked with Think Local Act Personal (TLAP) to co-develop a universal set of values for the whole adult social care workforce. TLAP is a national partnership aimed at promoting personalisation in adult social care and health and brings together the adult social care sector with people who draw on care and support. The values will underpin the pathway and, while we do not expect the pathway values to replace existing organisational values where these are working well, we have suggested that all organisations consider how the pathway values might be useful to them.

There were differing views on titles for role categories in call for evidence responses, with a variety of views about the use of the word ‘practitioner’. Some thought that it may increase recognition of the role of adult social care, with others commenting that it would not accurately reflect what jobs in adult social care may offer to new recruits or those looking to progress. Some respondents also suggested that people may confuse practitioners with clinical roles in healthcare settings. As a result of the feedback we received, we have removed specific titles to the roles in the pathway, instead using role categories titles. This will allow the pathway to remain flexible and ensure that employers are able to adopt the pathway into multiple settings and can choose the job titles they feel most appropriately fits the role.

Our engagement with human resource leads told us that having consistent definition of job roles and structure across the sector could aid with recruiting the right people and, if linked to the wider workforce reforms laid out in Next steps to put People at the Heart of Care, there is an opportunity to reduce repeat training that is expensive and time consuming for staff and providers.

Some respondents to the call for evidence question felt there was scope in the first phase of the pathway to reflect other roles more effectively within the structure, such as ‘champion’ or ‘expert’ roles, and wider roles in adult social care. They highlighted specialist knowledge in different roles to better support career progression and development in non-management routes. We have reflected this in the pathway by including specific areas of knowledge and practice within role categories and we are developing other role categories in future phases of the pathway’s development.

Some feedback to the call for evidence and our engagement suggested the pathway could help to bring uniformity to the sector in what is expected at each level of the workforce, locally, regionally and nationally, which in turn might bring greater consistency and standardisation to the quality of care being delivered in the sector. The feedback included references to how the Care Quality Commission (CQC) could be involved in the implementation of the pathway. While the pathway will not be mandated in legislation, we are engaging with CQC on what this will look like, including how the pathway links to CQC’s single assessment framework.

Reflecting training and development

Respondents to the call for evidence were broadly consistent in telling us that training, learning and development should be reflected within the pathway. They viewed the pathway as an opportunity to support members of the workforce in their career progression, as well as progression within roles, in addition to supporting the sector in delivering high quality care for people who access care and support.

There were varying views on how the pathway should link to training and development in the sector in the call for evidence responses. Some suggested the pathway should align with different types of training, with others suggesting the focus should be on linking to the formal qualification framework that already exists in the sector. Both suggestions were made on the basis that this would highlight and address skills gaps and improve quality of care. Many responses also highlighted the existence of apprenticeship standards within adult social care and the importance of aligning these with the pathway. A small minority of respondents to the call for evidence expressed concerns that the pathway should not reinvent what already exists in the sector and we should use things that are already working successfully in the sector. Some respondents in our engagement sessions welcomed the recognition of practice leadership as a role category. They considered it important not just from a perspective of being able to meet specific care needs themselves, but also training others to do the same.

Respondents involved in engagement also highlighted the importance of the pathway in bringing clarity and consistency into the sector when linking role categories to training and qualifications. A few suggested that foundation training for each level should be mandated and workers should be completing qualifications before moving into other roles.

Some responses to the call for evidence also suggested that the pathway should take into consideration a mix of experience, competency, qualifications and supervision to enable career progression. Respondents, as well as many engagement participants, highlighted that workers may not always want to progress to more senior roles and highlighted the need for continuous development to maintain up-to-date knowledge. Those involved in our engagement also agreed that the pathway would support progression into specialist roles, which would be of benefit as there is a general perception in the sector that the only progression pathway is into management.

We have used this feedback when considering how to link to specialisms and learning and development in the pathway and will continue to review our approach to signposting to learning and development through future phases of development, both in new role categories and in the review of role categories published in the first phase of the pathway.

An integrated health and social care system

There were repeated references to the links between the adult social care and health sectors, with some respondents to the call for evidence commenting that the pathway is an opportunity to join up with healthcare.

Some respondents to the call for evidence, and in the engagement sessions, felt the pathway should give more consideration to an integrated health and care approach to the role categories, so that individuals can attain common knowledge, shared skills and improved communication, and can select from a greater and easily transitioned choice of career routes, being supported by a modular skills and knowledge framework. They felt that this approach would support the work of integrated care systems and that parity between adult social care and the National Health Service roles would align to support the workforce to develop and move up or across health and care. They highlighted that if there was more alignment of roles within the first 3 role categories - for example, specialisms and enhanced healthcare - people would have the right skills and the flexibility to progress into joint roles or between sectors. It was suggested this would help improve retention rates in both the health and social care sectors due to more opportunities to develop knowledge and progress careers.

Supporting the future of adult social care

Respondents to the call for evidence and engagement sessions also highlighted other areas they thought the pathway could address outside of the immediate scope of the call for evidence. A significant number of respondents referenced a need for additional funding and a new pay structure to implement the pathway effectively. Respondents felt strongly that more funding is needed to support training and development, cost of care and general funding for the sector, and felt that this would be important for the pathway to meet its full potential impact on recruitment and retention and quality of care. 

Feedback from our engagement also suggested that the pathway will help support the recognition of adult social care as a profession, providing a clear route for care and support workers to develop their careers, and setting clear expectations for the workforce. Furthermore, a number of respondents to the call for evidence felt that the pathway could support the registration of the adult social care workforce, which would help improve the quality of care, make it easier for people to take their training and qualifications into new roles, and improve recognition of adult social care as a profession.

The government is already taking several actions linked to these responses. We are also investing funding to increase uptake of learning and development including training courses on healthcare interventions to support delegation, learning disabilities and autism, dementia care and leadership. We are also delivering a comprehensive digital learning offer to complement the wider support package for the adult social care workforce, so that digital skills are embedded in core training and support ongoing career development. This includes a new qualification in digital leadership based on the recently updated Adult Social Care Digital Skills Framework.

We are introducing a new Care Certificate Level 2 qualification, with funding for 37,000 places for people to enrol on the new qualification between June 2024 and March 2025. Over time we want this new qualification to become the baseline standard for all new care and support workers to work towards when they join the profession.

We are also developing a website for the adult social care workforce which will provide them with access to support, information and advice on careers in adult social care. This will include explanation of the newly developed pathway. We are also developing a verified record of their qualifications and training, which they can take with them throughout their careers. This will establish a foundation for registration of staff in the future and will reduce unnecessary repeat training, giving employers the confidence to invest in their staff.

Most care and support workers are employed by private sector providers who set their pay and terms and conditions independent of central government. Local authorities work with care providers to determine fee rates, which should take account of wage costs, based on local market conditions. However, the government is providing nearly £2 billion of ringfenced funding in 2023 to 2024 and 2024 to 2025 to local authorities to support increased adult social care capacity, improve market sustainability and enable local authorities to make tangible improvements to adult social care services, through the Market Sustainability and Improvement Fund (MSIF) and MSIF – Workforce Fund, the latter of which has a particular focus on workforce pay. 

We strongly encourage local authorities to work closely with providers to use this additional funding to grow workforce capacity by investing in improved pay for people who work in care. This could include investing in pay differentials to recognise qualifications, skills and experience, or raising pay.

Publishing the care workforce pathway and next steps

Alongside this response we have published the first phase of the pathway, focusing on direct care roles at 4 levels with each level relating to a role category.

We will continue to co-develop the pathway, ensuring that it reflects the breadth and diversity of adult social care so that it:

• reflects the realities of drawing on or providing adult social care
• builds on existing good practice
• can grow and develop as our expectations change

As we publish the pathway, we are also beginning the next phase of development, which will focus on registered managers, deputy managers, personal assistants and enhanced care worker roles. We intend to launch the digital pathway, which will allow people in the sector to use the pathway to link through to key resources such as training opportunities, in summer 2024. 

In order to see the full benefits of the pathway, the sector will need to widely adopt it. In adopting the pathway, adult social care providers will need to work through how their existing organisational structures and job roles map onto the pathway. Using the pathway to guide conversations about careers, development and progression may be a significant change for organisations, and we want to understand more about how the sector will use the pathway in practice and what conditions are important for it to be widely adopted and perceived as helpful.

In order to support this, the Department of Health and Social Care will be launching a programme of early adopters - a small number of adult social care providers who will test the fundamental elements of the pathway. The early adopters will map their current organisational structures and job roles to the pathway and will test the structure, language and content across different care settings. In doing so the early adopters will generate evidence and learning, feeding into the refinement of the next iteration of the pathway, development of the digital product, and the development of case studies and supporting resources for the wider sector.