Research and analysis

Executive summary: work-related quality of life of the ASC workforce in England in 2025

Published 2 July 2026

Applies to England

This report presents findings from the second wave of the adult social care (ASC) workforce survey undertaken by Ipsos in partnership with Skills for Care, University of Kent and King’s College London, on behalf of the Department of Health and Social Care (DHSC). The research involved an online survey with members of the ASC workforce in England between August and October 2025 to measure their wellbeing and care work- related quality of life (CWRQoL). The first wave of this survey took place in 2023 just after the COVID-19 pandemic.

This executive summary provides an overview of the headline findings from analysis of weighted data for 3,008 survey participants. The analysis is based on:

• overall results for all wave 2 participants (the cross-sectional sample)
• changes in views and experiences since wave 1
• comparisons by important sub-groups such as job role, type of employer or service and demographic characteristics

This provides a descriptive analysis of associations and care should be taken to avoid assuming causation. Longitudinal analysis was also conducted, based on the 926 participants who took part in both waves. It is important to note that wave 1 took place as the sector was recovering from the COVID-19 pandemic and therefore constitutes an unusual benchmark for wave 2 findings.

Overall wellbeing

Participants were asked 4 questions about their overall wellbeing, taken from the UK Measures of National Wellbeing used by the Office for National Statistics (ONS). These questions cover:

• life satisfaction
• happiness
• feelings of worthwhileness
• anxiety

Findings from wave 2 indicate that the overall wellbeing of the ASC workforce in England has increased since wave 1 across 3 of the 4 measures: life satisfaction, feelings of happiness and perceptions of how worthwhile what they do in their life is.

Life satisfaction has increased, with half of the workforce (51%) now rating their life satisfaction as high or very high - a 10 percentage point increase from wave 1 (41%). Feelings of how worthwhile what they do in their life is have also improved with almost two-thirds (63%) now providing high or very high ratings when asked if the things they do in life are worthwhile, compared to 52% at wave 1.

Happiness ratings show similar positive trends, with over half (55%) reporting high or very high happiness the day before completing the survey, compared with 45% at wave 1. However, feelings of anxiety remain prevalent within the workforce with 2 in 5 (40%) rating their anxiety as high, consistent with wave 1 findings (42%).

Care work-related quality of life

Participants were asked to rate their care work-related quality of life using the ASCOT-Workforce measure. The questions included in the measure capture aspects of a person’s quality of life most impacted by working in the adult social care sector and account for the specific challenges they face. The ASCOT-Workforce measure comprises 13 questions about different domains of CWRQoL:

• making a difference
• relationships with people drawing on care and support
• autonomy
• time to care
• worrying about work
• self-care
• feeling safe at work
• professional working relationships
• supported by managers
• skills and knowledge
• career pathway
• financial security
• valued by society

Using the responses to these 13 questions, an ASCOT-Workforce score was combined for each participant, with values ranging from 0 (the worst possible CWRQoL) to 39 (the best possible CWRQoL).

The CWRQoL of the ASC workforce has increased between wave 1 and wave 2. The overall ASCOT-Workforce mean score has increased from 23.30 to 25.04, with improvements observed across all 13 domains of the measure. Improvements are also observed in the longitudinal sample specifically, though these are less marked and occur in some but not all ASCOT-Workforce domains. This is partly related to the longitudinal sample having spent 2 years more in the sector by wave 2, with time in the sector being associated with more negative experiences.

Again, it is important to bear in mind that wave 1 was conducted in the aftermath of the COVID-19 pandemic, which badly affected the sector. Rather than a marked improvement in the CWRQoL of the ASC workforce, the increases observed at wave 2 may just indicate that the ASC sector has regained a sense of normality after the COVID-19 pandemic.

The most notable improvements in the cross-sectional data relate to:

• people having time to do their job within paid hours, which increased by 8 percentage points to 60%
• feeling supported in the role, which rose by 7 percentage points to 71%
• financial security, which increased by 12 percentage points to 44%

Despite the improvement, financial security remains a significant challenge for the workforce, with over half of the ASC workforce reporting that they have no or insufficient financial security (56%). Related to this, over two-thirds of the workforce (69%) find that the cost of living is too high, half (49%) report that their hourly rate of pay is too low and over a third (36%) cite a lack of sick pay.

The job roles with the highest and lowest CWRQoL remain similar to wave 1. Personal assistants (26.7) and registered managers (25.9) have the highest ASCOT-Workforce mean scores, while social workers (23.5) and nurses, nursing associates and allied health professionals (AHPs) (24.3) have the lowest mean scores, closely followed by senior care workers at 24.4. However, substantial improvements have been observed across many job roles since wave 1, with particularly notable increases among nurses and nursing associates (from 20.8 to 24.3) and social workers (from 20.7 to 23.5).

Differences are observed across most ASCOT-Workforce domains by demographic characteristics. People from Asian ethnic backgrounds, those aged under 35 and those working in home care services are more positive than average across many domains. By contrast, disabled participants and those who have unpaid caring responsibilities are more likely to report challenging experiences across many domains.

Looking at the individual domains, 9 in 10 members of the workforce (90%) report having good relationships with the people they support and a similar proportion (92%) feel they have the skills and knowledge needed to do their job well. Around three-quarters (75%) say they are able to make a difference in people’s lives, 7 in 10 (71%) have freedom and independence in their role and 87% report good professional relationships with colleagues. Most of the workforce (85%) feel safe at work, representing a 5 percentage point increase from wave 1.

However, challenges remain in several areas. Just under half of the workforce (46%) say they often or constantly worry about work outside of working hours and 48% report that they are sometimes or rarely able to look after themselves at work. Over a third (35%) say they do not have adequate opportunities to develop and progress in social care, and just under half (47%) feel their role is not valued by others.

Experiences of physical violence, harassment, abuse and bullying

Physical violence, harassment, abuse and bullying are prevalent in the ASC sector. Experiencing physical violence from people cared for or supported is common, with 2 in 5 members of the workforce (41%) reporting that they have experienced this at least once in the past year, which is more than NHS staff (14% have experienced physical violence from patients or service users, their relatives and other members of the public at least once). It is important to note that aggression and violence can be symptomatic of certain health conditions that are linked to care needs, including certain neurological conditions such as dementia.

Over half of those who have experienced physical violence in ASC have experienced it 3 times or more (22%). Physical violence also affects professional relationships - 1 in 15 members of the workforce say they have experienced physical violence from colleagues (7%) or managers (6%) at least once in the last 12 months.

Registered nurses, nursing associates and AHPs (54%), senior care workers (53%) and care workers or assistant care workers (47%) are most likely to report experiencing physical violence from the people they care for or support, with around half of them having experienced this at least once in the last 12 months, compared with 41% of the workforce overall.

Harassment, abuse and bullying from people cared for or supported is also commonly experienced, with 2 in 5 members of the ASC workforce (39%) saying they experienced this at least once in the past year, including 9% who have experienced it more than 10 times. Again, this appears to be higher than in the NHS, where a quarter of staff (25%) said they experienced harassment, bullying or abuse at work from patients or service users, their relatives or other members of the public in the last 12 months. Harassment, bullying and abuse from colleagues (23%), managers (22%), family members of the people cared for (22%) or the public (12%) are also prevalent, and more so than in the NHS.

Overall, participants who have experienced physical violence, harassment, abuse and bullying in the workplace at least once over the last 12 months report a lower CWRQoL than those who have not experienced this, and this is the case for each source of violence, harassment, abuse and bullying covered in the survey.

When physical violence, harassment, abuse and bullying are experienced, they usually get reported. Over three-quarters (77%) of those who experienced physical violence say they reported the last incident and a further 1 in 10 (12%) say a colleague reported it. In addition, those who have experienced harassment, bullying or abuse say that the last incident was reported, either by themselves (66%) or by a colleague (7%).

Longitudinal analysis shows that experiences of physical violence, harassment, abuse and bullying are somewhat persistent over time, with those reporting frequent experiences at wave 1 very likely to also do so at wave 2, which may also reflect that many are in the same role as at wave 1.

Learning and development

Overall, 7 in 10 participants (69%) say they had an appraisal, annual review or development review over the last 12 months, an 8 percentage point increase since wave 1 (61%). However, this remains lower than reported in the 2024 NHS Staff Survey (85%).

The impact of appraisals has improved since wave 1. Over 3 in 5 members of the workforce who had an appraisal or review agree that it helped them agree clear objectives for their work (61%) and left them feeling valued (62%), compared with around half at wave 1 (51% for each statement). In addition, half agree that their appraisal helped them improve how they do their job (52%, compared with 42% at wave 1).

The workforce is also more positive regarding opportunities for development. Two-thirds agree that they have opportunities to improve their knowledge and skills (66% compared with 56% at wave 1), half agree that they feel supported to develop their potential (49% compared with 39% at wave 1) and a slightly lower proportion agree there are opportunities to develop their career in their organisation (47% compared with 39% at wave 1).

Registered managers, social workers and those in care-related managerial or supervisory roles are consistently the job roles most positive about learning and development opportunities, compared with the overall workforce.

Having an appraisal or development review, and having access to learning and development opportunities, is associated with a higher CWRQoL.

Intentions to leave

Intention to leave their current role has decreased since wave 1, with a quarter of the ASC workforce who are not self-employed (25%) agreeing that they will leave their organisation as soon as they can find another job, compared with a third at wave 1 (34%). The same trend is observed across other measures, with 3 in 10 agreeing they will probably look for a new job in the next 12 months (30% compared with 38% at wave 1). The economic context, marked by rising unemployment, may have contributed to this change. Despite these improvements, intention to leave remains higher in the ASC sector than reported in the 2024 NHS Staff Survey, where 16% of NHS staff agree that they will leave their organisation as soon as they can find another job.

Intention to leave is higher among senior care workers, those employed by a care provider, those with a disability and those with an annual household income under £26,000. Participants with lower ASCOT-Workforce scores are also substantially more likely to agree that they often think about leaving.

For those considering leaving, the most common destination is a job outside of health and social care (32%), followed by a job in the NHS or healthcare (21%). Only 1 in 10 would want to move to a different social care organisation (11%), suggesting that retaining staff in the sector, not just within roles, remains a challenge.

Reasons for wanting to leave include:

• impact on health and wellbeing from stress and burnout (60%)
• income or salary being too low (54%)
• lack of recognition for the sector (44%)
• not feeling valued or supported (43%)
• lack of career opportunities (35%)

The top reasons remain similar to wave 1, but their prevalence has reduced.

Delegated activities

Questions on delegated activities were added to the survey at wave 2. In the questionnaire, delegated activities were defined as activities which may be delegated by regulated professionals (such as a nurse, occupational therapist, social worker or other clinical staff) to care and support workers. Examples of delegated activities were provided, which were:

• pressure ulcer care
• blood sugar monitoring
• physio stretches
• post operation physio recovery
• helping someone follow a mental health plan

Three in 5 members of the workforce in direct care roles (59%) say they carry out delegated activities as part of their day-to-day role, sometimes or often. Senior care workers are more likely to do so (73%), as are those who have worked in the same role for more than 10 years (68%).

Of those who deliver delegated activities sometimes or often, two-thirds (66%) say they have been shown, taught or trained in how to do so. Training is provided by a range of professionals including nurses (39%), other healthcare professionals such as GPs, physiotherapists and podiatrists (29%), supervisors or team leaders (35%) and registered managers (23%).

Confidence in carrying out delegated activities is high, with 86% of those who carry them out agreeing they are confident in doing so and only 4% disagreeing. However, the vast majority (85%) do not receive any additional pay for delivering these activities, with only 2% reporting that their hourly rate increased when they took on delegated activities.

Employment terms and conditions

For the first time in wave 2, participants were asked which 5 job-related benefits are most important to them in their current role, from a list of 13. The benefits considered most important are:

• paid annual leave (42%)
• flexible working hours that fit into personal and family life (34%)
• paid for training time and courses (32%)
• a guaranteed number of hours every week or month (29%)
• additional pay for anti-social hours (29%)

In total, 3 in 10 participants (29%) say all the listed benefits are equally important to them.

The employment conditions and benefits that participants most frequently reported are available to them are paid annual leave (73%), employer pension contributions (61%) and pay for training time and courses (56%). There is a difference in entitlement to statutory sick pay and availability of occupational sick pay, with around half (54%) saying they are entitled to statutory sick pay in case of illness but only 1 in 5 saying they are entitled to occupational sick pay (19%) when ill.

The figure for statutory sick pay appears surprisingly low given that this is a legal entitlement for most employees. This may reflect issues related to the question wording and/or participants’ awareness of their employment terms and conditions. It may also be because statutory sick pay applies to absences of more than 3 consecutive days, meaning it may be comparatively rarely claimed and therefore less well understood by the workforce.

There are differences in entitlement to employment conditions and benefits by job role and employer. Those in direct care roles typically report lower availability of some employment conditions and benefits, including employer pension contributions, a guaranteed number of hours and paid annual leave. Participants employed by local authorities are more likely to report greater availability of most benefits compared with the workforce as a whole.

Sub-group analysis

Groups reporting lower than average ratings

Some groups of the workforce consistently report lower than average ratings on many of the topics covered in the survey. Below we have listed some of them.

Senior care workers

Senior care workers have one of the lowest ASCOT-Workforce mean scores among job roles (24.4) and are least likely to say they are able to look after themselves at work (41% compared with 52% overall). They are more likely to strongly agree that they often think about leaving their organisation (27% compared with 19% overall) and that they will leave as soon as they find another job (21% compared with 13% overall). Over half of senior care workers have experienced physical violence from the people they care for or support at least once over the last 12 months (53%).

Social workers

Social workers haves the lowest overall ASCOT-Workforce mean score (23.5) and more negative scores on many domains, including making a difference (42% say they are not able to make enough or any difference compared with 25% overall), time to care (62% do not have enough time compared with 40% overall) and feeling valued (55% do not feel valued compared with 47% overall).

Disabled members of the workforce

Disabled members of the workforce consistently report lower wellbeing than those who are not disabled across all 4 ONS measures (mean life satisfaction of 5.34 compared with 6.54, and mean anxiety of 5.59 compared with 4.13). They also report lower ASCOT-Workforce scores (22.4 compared with 25 overall), are more likely to experience physical violence (50% compared with 37%) and harassment (47% compared with 36%).

People with unpaid caring responsibilities

People with unpaid caring responsibilities consistently report lower wellbeing and care work-related quality of life, with lower life satisfaction (5.89 compared with 6.48) and higher anxiety (4.9 compared with 4.31). They are more likely than average to experience harassment, bullying or abuse from managers (29% compared with 22%), colleagues (29% compared with 23%) and people cared for or supported (43% compared with 37%).

Groups reporting higher levels of wellbeing and work-related quality of life

The following groups stand out as having higher levels of wellbeing and work-related quality of life than other groups on at least some domains:

Registered managers

Registered managers report higher life satisfaction (6.63 compared with 6.22) and the second highest ASCOT-Workforce mean score (25.9). They are more likely to feel supported (81% compared with 71% overall), have good professional relationships (93% compared with 87% overall) and feel safe at work (95% compared with 85%). Compared with the overall workforce, they are more positive about the learning and development opportunities available to them. Intention to leave is also lower than average among registered managers (59% disagree they will leave as soon as they find another job compared with 50% overall).

Personal assistants

Personal assistants have the highest ASCOT-Workforce mean score (26.7) and better scores than average on most domains including making a difference (83% compared with 75%), autonomy (90% compared with 71%), having enough time (77% compared with 60%) and feeling safe (92%). They are less likely than average to have experienced physical violence over the last 12 months (20% compared with 41%) or harassment (19% compared with 39%) and less likely to intend to leave their current job (68% disagree they will leave as soon as they find another job compared with 50% overall). However, they are less likely to have had an appraisal and are less positive about career development opportunities (52% say they do not have opportunities compared with 35% overall).

Occupational therapists

Compared with the workforce average, this group reports higher life satisfaction (6.89 compared with 6.22 on average), higher financial security (72% compared with 44%) and lower intention to leave (60% disagree they will leave as soon as they find another job compared with 50% overall). They are more likely to have had an appraisal (82% compared with 69%). However, they are more likely to report not having enough time to do their job well (52% compared with 40%).

People working in home care services

People working in home care services have a higher ASCOT-Workforce mean score (26.6) than people working in residential care (23.3) and than average (25.0). They are more positive than average across most ASCOT-Workforce domains. They are more likely to say they are able to make a difference (81% compared with 75% overall), have good relationships with people supported (94% compared with 90% overall), have freedom and independence (78% compared with 71% overall), have enough time to do their job well (73% compared with 60% overall) and feel supported in their role (80% compared with 71% overall). They are less likely to experience physical violence (29% compared with 59% in residential care).

People employed by local authorities

People employed by local authorities report higher life satisfaction (6.72 compared with 6.22), lower anxiety (3.87 compared with 4.48) and are more likely to feel safe at work (92% compared with 85%). They have greater availability of employment related benefits than average and lower intention to leave (17% compared with 25% overall). They are more likely to feel they have enough time to do their job well, feel supported and have good professional relationships than average. They also report higher happiness (6.96 compared with 6.32 overall).

Differences between sub-groups

Differences between sub-groups provide insights into how the actions required to tackle the challenges faced by the workforce will vary by job role, service or employer type and the individual characteristics of workers. Also, the characteristics of those who report higher scores and better experiences (for example, registered managers) might provide insight into how their conditions could be extended to other groups within the same service type (for example senior care workers).

Longitudinal analysis

The longitudinal sample comprises 926 participants (hereafter ‘n=926’) who took part in both wave 1 and wave 2 of the survey, representing 31% of the total wave 2 cross-sectional sample. In addition, a small number of wave 1 participants started the wave 2 survey but were screened out because they were no longer eligible (for example, because they were now working outside the ASC sector or had retired).

The longitudinal sample (n=926) has a different profile to the cross-sectional sample - it includes a larger proportion of people who have been working in their current role for 5 to 10 years (24% compared with 20% for the cross-sectional sample) or more than 10 years (39% compared with 32%). It also has a higher proportion of people who are disabled (28% compared with 24%) and from a White ethnic background (75% compared with 65%). These characteristics may account for some of the differences in the trends observed for the longitudinal sample and the cross-sectional sample. Note that weighting has been applied to account for some, but not all of these differences. More information about the weighting applied to the cross-sectional and longitudinal sample can be found in the technical report.

Analysis of the longitudinal sample provides some insights into how workforce experiences have evolved over time and the factors associated with retention.

Wellbeing

Improvements are observed across life satisfaction, happiness and anxiety levels between wave 1 and wave 2 within the longitudinal sample. Overall wellbeing appears linked to workforce retention with those with high life satisfaction at wave 1 more likely to remain in the same role at wave 2 (71%) than those with medium (59%) or low (60%) life satisfaction. Conversely, those with low or medium life satisfaction at wave 1 are more likely to have left the sector entirely by wave 2 (9% and 6% respectively have left) compared with those reporting high life satisfaction (2%).

Care work-related quality of life

The mean ASCOT-Workforce score for the longitudinal sample has increased slightly between the 2 waves with improvements observed in 4 domains (relationship with people supported, competency, career pathway and financial security). Longitudinal participants with a high or very high ASCOT-Workforce score at wave 1 (30 to 39) are more likely than those with a low score (0 to 19) to have stayed in the same role with the same employer or organisation at wave 2 (74% compared with 56%), highlighting the importance of CWRQol for workforce retention.

Violence, harassment and bullying

Experiences of physical violence, harassment, abuse and bullying appear somewhat persistent over time, with those reporting frequent experiences at wave 1 very likely to also report them at wave 2. Among those who experienced or witnessed physical violence from people they cared for more than 10 times at wave 1, 85% report experiencing it at least once at wave 2 and 29% report experiencing it more than 10 times again.

This also reflects the variation in prevalence of incidents by job role and setting, with most people in the longitudinal sample continuing to work in the same job or type of job role as at wave 1. Furthermore, such experiences at wave 1 are associated with a higher likelihood of leaving the sector entirely by wave 2. Those who had experienced or witnessed physical violence at wave 1 more likely to have left the sector at wave 2 than those who had not experienced or witnessed violence (7% versus 3%).

Learning and development

Views on learning and development have marginally improved among longitudinal participants, with fewer of them disagreeing that they do not have learning and development opportunities. Having opportunities to develop knowledge, skills or career is associated with improved retention. Four in 5 (82%) of those who agreed at wave 1 that they had opportunities to develop their career within their organisation are still working for the same employer at wave 2, compared with 69% of those who disagreed. Those who disagreed at wave 1 that they had opportunities to improve their knowledge and skills are more likely to have moved to a job outside adult social care by wave 2 (9% compared with 3% for those who agreed).

Intention to leave

Views on intention to leave have remained stable since wave 1 for the longitudinal sample. Over half of those who agreed at wave 1 that they would leave their organisation as soon as they could find another job, remain in the same role, service and organisation at wave 2 (56%). Those with career development opportunities or high ASCOT-Workforce scores at wave 1 are more likely to have stayed. Among those scoring 30 to 39 on the ASCOT-Workforce measure at wave 1, 74% remain in the same role for the same employer, compared with just 56% of those scoring 0 to 19. This also shows that even among members of the workforce with high or very high CWRQoL, there is still a fair amount of turnover (26% across 2 years).