Workforce

Key statistics

• Almost two thirds of social workers said their service did not operate with a safe staff-to-service ratio.
• More than 75 per cent of staff who took between 11 and 20 sick days worked in settings without safe staffing levels.

Key messages

• England had the highest proportion of staff working in unsafe staff-to-service ratios, followed by Northern Ireland.
• Staff in unsafe conditions were twice as likely to plan to leave their organisation compared with colleagues in safer environments.
• Workload pressures were increasing, with insufficient staffing to meet care needs and growing concerns about unsafe working conditions.
• Staff reported compromised practice, poorer decision-making and difficulties following procedures due to being overstretched.
• Teams lacked capacity to cover absences or annual leave, leading to frequent overtime and pressure on colleagues.
• Administrative tasks were prioritised over direct work, reducing time with people who draw on care and support.
• Wellbeing was negatively affected; staff described burnout, reduced resilience and unmanageable caseloads.
• Post-COVID pressures persisted, with concerns about unrealistic demands, limited support from senior leaders and feeling unheard by managers.
• High turnover and intentions to leave were driven by cumulative daily pressures and frustration that concerns were not addressed.

Commentary

This study highlights the pressures facing the adult social care workforce and how limited capacity affects staff wellbeing and safe practice. Respondents described burnout from covering understaffed shifts, low pay and being unable to take leave without increasing workloads for colleagues. These pressures reduced opportunities for training and career progression and contributed to high turnover, including among newly qualified social workers.

Staff reported having less time for personalised work with people who draw on care and support, with administrative tasks often taking priority. This has implications for quality, experience and outcomes. The findings reflect a national issue with workforce capacity and sustainability.

The study supports calls for urgent action to increase workforce capacity, strengthen supervision and improve training pathways. Current staffing conditions fall short of recommended guidance, such as the British Association of Social Workers’ expectation that 80 per cent of time should be spent engaging with people and 20 per cent on administration.

Limitations included limited ethnic diversity among respondents and an overrepresentation of participants from Northern Ireland. The authors also note that those who responded to open-ended questions may have held strong views on the issues discussed.

Key statistics

• Twenty-one per cent of the social care workforce are from diverse ethnic backgrounds, compared with only 15 per cent of managers.

Key messages

• Quality of life at work is shaped by organisational and financial resources. Staff need enough time, support and equipment to work safely.
• Low pay and financial insecurity contribute to feeling undervalued and affect overall wellbeing.
• Staff need more choice and control over shifts, and access to training and learning opportunities.
• Positive workplace cultures depend on good models of care, recognition of skills, strong leadership, trust and access to advice and support.
• Diversity and inclusion are essential, as staff from ethnic minority backgrounds face fewer opportunities for progression.
• Supportive strategies include employee assistance programmes, staff surveys, discount schemes, flexible shifts and leave, regular check-ins, virtual catch-ups, mental health first aiders, team activities and communication tools for lone workers.
• Recommendations focus on improving resources, respecting and empowering care workers, strengthening relationships and promoting compassionate, representative leadership.

Commentary

This study highlights how workforce wellbeing is closely linked to the quality of care provided. Many of the pressures described—low pay, limited progression, rising workloads and inconsistent support—contribute to high turnover and recruitment difficulties across the sector.

Improving pay and conditions, strengthening workplace cultures and offering reliable mental health and peer support were identified as important for retention. Staff also emphasised the need for inclusive leadership that reflects the workforce and values their experience.

The findings suggest that quality of life at work is not an optional extra but a requirement for sustainable, high-quality care. Investing in staff support, training and fair workplace cultures can help build a more stable and equitable workforce, with benefits for both staff and people who draw on care and support.

Key statistics

• Care workers accounted for 50 per cent of all Health and Care Worker visas in 2023.
• International recruits rose from 4 per cent (2021) to 11 per cent (2022).
• Over 60 per cent of international care workers were aged 25–39 years.
• Sixty-two per cent had been in the UK for six months or less when interviewed for their roles.

Key messages

• The 2022 visa expansion enabled care workers to apply under the Health and Care Worker visa, helping address severe staffing shortages.
• Care providers reported challenges around sponsorship costs, compliance requirements and ethical recruitment duties.
• International care workers faced risks including financial exploitation, long working hours and uncertainty about rights linked to visa dependency.
• Policy implications include the need for stronger safeguards, clearer guidance and monitoring of wellbeing to support ethical, sustainable recruitment.

Commentary

This study examines the impact of extending the Health and Care Worker visa to care workers in 2022. While international recruitment increased and helped ease staffing shortages, the findings show that the current system exposes workers and providers to significant pressures.

Care providers faced the financial and administrative burdens of sponsorship and compliance. Internationally recruited care workers reported experiences that reflected wider systemic issues, including exploitation, excessive hours and vulnerability created by restrictive visa conditions.

The paper raises questions about the long-term sustainability of relying on international recruitment without parallel investment in workforce planning, pay and support. Strengthening protections and providing clearer guidance are recommended to ensure a fair and resilient approach to international recruitment in adult social care.

Key statistics

• Health and social care workers with two years’ experience earned an average of £1.80 less per hour than equivalent NHS workers.
• On average, health and social care workers spent seven hours per week working unpaid.

Key messages

• Pay inequality was a consistent theme: health and social care workers earned significantly less than NHS colleagues with similar experience.
• In 2023, much of the sector relied on minimum-wage work, contributing to insecurity and low morale.
• During COVID-19, workers could not work from home and reported concerns about basic needs such as food availability during lockdowns.
• Low-paid workers felt the UK government reacted slowly, with constantly changing guidance increasing workplace stress.
• Participants felt the public narrative and policy response were “all about the NHS,” reinforcing feelings of being undervalued and seen as inferior to NHS staff.
• Limited PPE access and unclear communication increased insecurity, moral distress and concerns about safe practice.

Commentary

This study shows how care workers were marginal in the UK’s pandemic planning and response. Burnout was already common before COVID-19, but rising demand, low pay and insecure contracts intensified pressure and left staff with little protection when isolated or unwell.

The findings point to systemic inequities. Poor pay, limited support and weak recognition undermined wellbeing and increased vulnerability, especially for workers expected to deliver frontline care without adequate equipment or clear guidance.

The study calls for urgent action to address economic disparities, improve working conditions and ensure that adult social care is treated as an equal partner to the NHS in future crisis planning. A more consistent, inclusive approach could help strengthen workforce resilience and reduce burnout across care settings.

Key statistics

• Thirteen per cent of staff said they could not solve a problem with a device or digital service using online help.
• Nine per cent said they could not check whether information found online was accurate.
• Seven per cent said they would not be able to buy and install apps on a device.
• Average confidence scores (out of 4): social care workers 3.84, social workers 3.35, social work students 3.70; overall score 3.70.
• Fourteen per cent of respondents aged over 65 were not confident at all in using some technologies at work.

Key messages

• Digital skills declined with age, and confidence levels aligned closely with self-reported digital skills.
• E-learning was widely valued for flexibility and time efficiency, but many staff completed it at home due to limited time or support at work.
• Face-to-face learning remained preferred, though many staff were already using websites and mobile apps for informal digital learning.
• A small proportion (around 10 per cent) were resistant to e-learning, often due to low skills or confidence and a need for more tailored support.

Commentary

This study shows that while most staff reported strong confidence in using technology, a small but notable group across all job roles had low confidence or limited skills. These staff may be at risk of being excluded from digital learning opportunities.

The findings highlight a need for targeted training and support to help build confidence and skills, particularly for older workers and those who are unsure about using digital tools. Without this support, there is a risk of creating a digital divide within the workforce.

The authors suggest that raising awareness of the benefits of digital learning and offering accessible, tailored training could improve engagement and ensure that the entire workforce can benefit from digital learning and development.

Key messages

• Video consultations saved staff time by reducing travel and allowing more contact with people, supporting earlier intervention and prevention.
• Data protection and confidentiality requirements meant many staff avoided recording appointments, often relying instead on manual note-taking.
• Broadband and connectivity issues created delays and wasted staff time, affecting continuity and communication.
• Strong relationships between GPs and care homes were central to successful use of video consultations, more so than formal guidance.
• NHS-provided devices were valued, but unclear processes for replacing or repairing equipment highlighted a fragile support infrastructure.

Commentary

This study shows that video consultations can support more flexible and responsive care, but only when staff have the training, time and support needed to use technology confidently. Having a dedicated staff member to assist with devices and facilitate the conversation was identified as a key enabler.

Access to reliable equipment, funding and technical support is essential for sustainable use. Without this, video consultations risk increasing workload rather than reducing it. The findings also point to the need for clearer processes for device management and for understanding any unintended consequences, such as additional administrative tasks or digital barriers for residents.

Overall, the study highlights that successful implementation depends on workforce capacity, stable digital infrastructure and strong relationships between care homes and health professionals.