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Social care England: report slams ‘Cinderella service’ and says DH not doing enough to support workforce

The National Audit Office report into the adult social care workforce in England says workers feel insufficiently appreciated and there are limited opportunities for career progression. 
Social care

The National Audit Office report into the adult social care workforce in England says workers feel insufficiently appreciated and there are limited opportunities for career progression

Social care in England is running as a Cinderella service, with the sector undervalued and its workers poorly rewarded, the National Audit Office (NAO) has said.

A new report into the adult social care workforce in England concludes that the Department of Health and Social Care (DH) is not doing enough to support the development of a sustainable workforce.

Unmet need increasing

The number of people working in care is not meeting growing demand for care and the number of people with unmet need is increasing, the report adds.

The authors

The National Audit Office report into the adult social care workforce in England says workers feel insufficiently appreciated and there are limited opportunities for career progression


There are one-and-a-half million people working in adult social care in England who
provide essential support to adults with care needs. Picture: iStock

Social care in England is running as a ‘Cinderella service’, with the sector undervalued and its workers poorly rewarded, the National Audit Office (NAO) has said.

A new report into the adult social care workforce in England concludes that the Department of Health and Social Care (DH) is not doing enough to support the development of a sustainable workforce.

Unmet need increasing

The number of people working in care is not meeting growing demand for care and the number of people with unmet need is increasing, the report adds.

The authors said that there is increasingly difficulty in recruiting and retaining staff, yet the DH does not have a workforce strategy.

The Adult Social Care Workforce in England report draws on Age UK analysis which estimated that 1.2 million people over the age of 65 had some level of unmet care needs in 2016-17.

It highlights higher than national average vacancy rates in care and an increasing staff turnover rate.

1.34 million adult social care jobs

The NAO said that workers feel undervalued and there are limited opportunities for career progression.

There are around 1.34 million adult social care jobs in England, and around half of care workers were paid £7.50 last year.

The last time a national social care workforce strategy was published by the DH was in 2009 –  but this document is only accessible on the National Archive website and mentions organisations that no longer exist, the NAO said.

The authors conclude: ‘The one-and-a-half million people working in adult social care in England provide essential support to adults with care needs, yet the care sector is undervalued and its workers poorly rewarded.’

Inadequate pay

The NAO has recommended that the DH produces a national workforce strategy and invests more to enable commissioners to set appropriate fees for providers, so they can pay staff adequately and afford to offer career development and training opportunities.

NAO head Amyas Morse said: ‘Social care cannot continue as a Cinderella service.

‘Without a valued and rewarded workforce, adult social care cannot fulfil its crucial role of supporting elderly and vulnerable people in society.

‘Pressures and demands on the health and social care systems are increasing, so the DH needs to respond quickly to this challenge by giving the sector the attention it deserves and needs instead of falling short and not delivering value for money.’

‘Damning indictment’

Commenting on the report, Age UK charity director Caroline Abrahams said: ‘This report is a damning indictment of the failure of successive governments to carry out workforce planning and the end result is the dangerously fragile situation we see today. One that means that in some parts of the country there are not enough care staff to give older people the support they need, even if they are willing and able to pay top rates for it.'

A government green paper on reforming adult social care is expected in the summer.

A DH spokesperson said: ‘Everyone is entitled to good quality care and we recognise there are challenges. That’s why we will shortly publish a health and care workforce strategy to address these issues.

‘We've provided an extra £2 billion funding to the sector and this week announced a further £150 million for next year. In the summer we will outline plans to reform social care to ensure it is sustainable for the future.’

Further information


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