Better Careers for Better Care: what we learnt from leaders in adult social care
In this blog, our Head of Grants Susan O'Sullivan shares the journey the Foundation has been on to learn about the challenges and opportunities facing adult social care, and our future plans for proactive funding into the sector.
Over the past sixty years, the Rayne Foundation has been privileged to fund and learn from countless organisations working to improve the quality of life of older people and their carers. And in my years as the Head of Grants, I have been privileged to visit many inspiring and innovative projects bringing care, creativity and joy into older people’s lives.
Through these relationships, we have learnt that providing better career and professional development opportunities for people working in care results in better care for those who need it most. And the evidence supports this[i].
To better understand the ways in which the Foundation, as an independent grant-maker, can support career opportunities for care workers, we have spent the past few years listening to leaders across adult social care. These leaders, while navigating the complex and volatile pandemic context, generously shared with us the challenges and opportunities they see in the sector in relation to staff development.
What we learnt is detailed below, as are our plans for proactive and collaborative funding which resulted.
In this article:
- The journey so far
- Key learning
- Principles for future funding
- Proactive and collaborative funding: Better Careers for Better Care
The Rayne Foundation has funded organisations supporting care for people in later life since its founding in 1965, and for many years, improved quality of life for older people and their carers has been an area of special interest.
The Foundation has previously been a responsive funder in our areas of special interest. In 2018, the Trustees and Staff felt that we could improve our grant-making if we had a better understanding of the sector.
Trustees commissioned an external report on the current state of residential care for older people which included recommendations for funding. A number of grants were made as a result, in the main to organisations providing activities and creative opportunities in care homes.
The Foundation also collaborated with the Dulverton Trust, the Tudor Trust, the John Ellerman Foundation and Social Finance to develop concepts with the potential to provide scalable and sustainable ways of improving quality of life for older people. You can read more about this work here.
And then the pandemic hit. Those drawing on and working in social care faced the most challenging and distressing time since the welfare state was established. The every-day kindnesses that were part of care workers’ day jobs became acts of heroism.
The pandemic highlighted the significant issues already facing social care and we at the Foundation saw how these issues prevented the everyday activities we funded from making the impact we hoped for. Chief among these issues was, and is, the recruitment and retention of care workers.
With a belief that well supported, trained, and motivated staff are key to improving the quality of life for older people, we changed our direction to focus on the social care workforce. We have spent the past two years listening to social care leaders, umbrella bodies and providers about the challenges and opportunities in relation to staff development. The Foundation has convened a number of events and working groups, exploring four main themes:
- Replication of existing good practice
- Mentoring and Coaching
- Bullying and Harassment
- Community Engagement
The culmination of this process was a plenary session bringing together all those who had contributed so far, and which resulted in our a commitment to co-create a responsive and flexible funding programme in partnership with the local care landscape.
We learned an incredible amount about the experience and needs of the social care workforce. We want to share this learning to ensure all in the sector can benefit.
Training and qualifications
- There is a gap in the market for an inspirational training programme or qualification for those new to care which can demonstrate their developing skillset and identify the aspects of care which interest them most and might help shape their career.
- Local authority and NHS training for the workforce is patchy and based on the commissioners’ view of what is needed rather than the care sector’s view.
- Some career progression routes do exist, for example Nurse Associates, but depend on a stable nursing workforce. There is no specialist qualification for Social Care Nurses.
- Care staff have specific expertise in areas of value to NHS peers such as dementia, complex needs, and end-of-life care.
- Cross-sector placements within health and social care are valued to share expertise, develop trusting relationships, and gain understanding of the other’s roles and the pressures they experience.
- Ancillary staff such as cooks, gardeners, and care takers, are often overlooked but contribute to the culture of a care home and also have the potential to become care workers.
Mentoring and coaching
- There is consensus that mentoring and coaching techniques are a good thing and can support staff when they experience particular challenges or at particular points in their careers.
- Coaching techniques give structure to staff responsible for supervising and managing other staff, and support opportunities for reflective practice, action learning sets and development of shared best practice.
- There is no prescribed approach to mentoring & coaching for social care and the evidence base is mixed.
Bullying and Harassment
- Anecdotally, bullying & harassment is widespread. The scale of the problem is not known and complicated further by the lack of a clear definition and reluctance to complain.
- Lots of examples were shared of bullying happening at all levels and between all agencies, among individuals and at the institutional level, some of it overt but much of it subtle and insidious.
- In some cases, it can be difficult to separate bullying from holding staff to account for poor decisions in managing someone’s care.
- Open working cultures, space for reflective practice, values-based recruitment, staff learning and development, and non-siloed working with other professionals were identified as ways of helping to address concerns.
- It is important to connect the wider community to social care so that people can see its value, the many different roles within it, and that it is an exciting place to work. Social care settings also have an important contribution to make to the communities in or near which they are sited.
- Many opportunities have been overlooked in relation to partnerships with local schools, colleges, universities and others, particularly in smaller homes without a large support infrastructure. There is a need to help to broker and maintain these relationships.
- Sharing the stories of the many and varied roles in social care and different career progression routes is very important, particularly from the perspective of those working in the profession and the perspective of those receiving care.
- Good community engagement starts with homes led by strong, confident leaders who feel able to connect their home to the wider world; the pandemic has negatively affected engagement but also increased public awareness of care homes.
Through this listening process, we have developed the following principles to guide our future funding.
Share the learning.
- Funding will be directed towards areas of practice that can be replicated.
- Where possible, funding should support opportunities for staff across different sectors within and across health and social care.
- Share learning through communications and events.
Acknowledge the diversity of jobs in the care sector and provide career development opportunities for areas of workforce which have been historically less well supported.
- Provide opportunities to staff who may not habitually have development opportunities.
- Increase public understanding of diversity of careers in social care.
- Consider the value that specific groups bring to the care sector such as neurodiverse individuals, people returning to work after a career break, and recently retired.
Support career progression in different contexts
- Increase equality of access to career development by supporting career progression for staff in small care homes which may not have the infrastructure of large corporate chains, large charities or Local Authorities.
- Consider the difference between rural and urban contexts.
- Reach out to homes with relatively few self-funding residents.
- Recognise the diverse needs of people receiving care.
Acknowledge the multiple impacts of the pandemic
- The negative impacts such as burnout and the impact of deaths on both staff and residents.
- The positive impacts such as the increased understanding and appreciation of the role of care workers.
Armed with the rich learning and increased understanding of the challenges and opportunities for the social care workforce, the Foundation is now embarking on a proactive funding programme: Better Careers for Better Care. The Foundation has earmarked £2 million for the work and a Programme Development Lead has joined our team to work alongside sector leaders and innovators to deliver the programme.
In June this year, we made our first grant, to the North Central London (NCL) Councils in support of their Social Care Workforce Programme. It will fund the development of an NCL-wide Apprenticeship Programme and a Leadership and Integration Programme. North London will serve as our pilot site and provide the opportunity to learn alongside commissioners and providers as the grant-making programme develops.
This Autumn, we will launch an open call for Expressions of Interest, seeking partners to work with on ambitious proposals for funding that have the potential to transform career and development opportunities in adult social care. We hope to support innovation, creativity and collaboration in the sector, and be part of the wider ecosystem of organisations, funders and commissioners seeking to address the many challenges faced by older people and their carers. More information on the call for Expressions of Interest will be shared in the coming month.
I would like to extend many thanks to those who have given their time so generously and taught us so much. We look forward to continuing this journey together.
For more information on Better Careers for Better Care, click here.
Towers A, Smith N, Allan S, Vadean F, Collins G, Rand S, et al. Care home residents' quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study. Health Serv Deliv Res 2021;9(19)