New roles are emerging and new career paths are being developed as social care, health and housing rise to the challenge of integrated services. At the same time, the job specs of existing posts are changing and new core skills are being added as organisations across the sectors, and those working for them, respond to the developing landscape.
In Greenwich, south London, care navigators are being employed to guide service users through the integrated health and care system and, crucially, prevent the need for individuals to repeat their story to other professionals. The new role, which is already being copied elsewhere in the country, is said to have achieved £900,000 savings in domiciliary care costs alone in 2013.
For the first time, health and wellbeing officers are starting to appear on the payroll of extra-care and supported housing providers. It is a clinical job, offering emotional support to people being cared for, and its creation has been described by researchers as a key shift in integrated services and workforce development.
Meanwhile, it is being acknowledged that care and support workers should now count dementia awareness and an understanding of the needs of mental health service users, people with learning disabilities or substance misuse issues, as core skills as they move away from a job which has been largely task-driven to one offering more holistic care.
In the wider children and families workforce, it is predicted that the development of apprenticeship standards will be the catalyst for bringing new career paths across services, especially in early intervention and troubled families work. Rachael Wardell, corporate director (communities) at West Berkshire council and chair of the Association of Directors of Children’s Services (ADCS) says: “The apprenticeships framework for these staff means they ought to be able to move [jobs and careers] both horizontally and vertically.”
In adult social care, it is increasingly common for social workers and district nurses to be co-located – something having a direct impact on services. Joan Beck is joint chair of the workforce development network of the Association of Directors of Adult Social Services. She says: “We are working much more closely with our nursing colleagues, which is something we have wanted for more than 10 years. What it means is that district nurses and social workers are sharing the same office and talking about their clients on a day-to-day basis, so the best person is going out [to visit the client]. Good integration is dependent on trusting each other’s assessments and understandings. One of the biggest problems we have is finding offices which are big enough.”
Sharon Allen, chief executive of Skills for Care, the social care sector skills agency, says the adult care workforce is willing to change, but warns that successful integration goes beyond a new jobs spec. “The issue of pay comes into it when the social care workforce sees their colleagues in health earning £2,000 a year more. There is also the need for mutual respect and understanding – that these people working in domiciliary care, if they come along and say, ‘I think this person is at risk of developing a urinary tract infection’, they should be listened to.”
Amid all this change, recruitment challenges persist. Skills for Care estimates that up to 800,000 more care support workers will be needed in the next 10 years to cope with the impact of the ageing population. While there is a problem attracting qualified adult services social workers in some parts of the country, the service does not suffer from the recruitment and retention crisis that exists in children’s services. Local authorities in England have an average 15% vacancy rate for children’s social workers – up to 22% in some London boroughs – and costly agency staff are filling 75% of those gaps.
Some authorities are now changing their recruitment offer to attract qualified staff in the increasingly competitive market. Barking and Dagenham, in east London, still offers a £2,500 golden hello and an annual £2,500 retention payment, but has also added another carrot – an affordable home at 20% less than the market rent. In Somerset, the county council will pay rental deposits and stand as guarantor in an attempt to attract 100 new social workers in the next two years.
According to the ADCS’s Wardell, however, it is how you hold on to experienced social workers, rather than the issue of attracting them in the first place, which is more pressing. “A lot of the focus has been on the pipeline, but for me retention is the principal issue.”
‘It’s been a fast learning curve’
Megan Burrows is one of six young people already enrolled on a one-year integrated health and social care apprenticeship in the east of England. With another 24 places in the pipeline, the region has become a testing ground for new apprenticeship models across the wider care sector.
Burrows, 19, has just completed six months working with older people in a care home in Norwich and is now spending another six months in an acute medical unit at the Norfolk and Norwich University Hospitals NHS foundation trust.
She was attracted to the scheme because it allows her to experience at first hand the differences in health and social care. “It was challenging at the care home, but I knew everybody and had more time with people,” she says. “In hospital it’s much more fast paced – there is always something to do. It’s been a fast learning curve.”
Once she finishes her apprenticeship, Burrows plans to complete an access course as the next step in her ambition to become a nurse. She is already sure that the integrated apprenticeship will make her a better professional: “Most definitely, because it’s given me a much greater understanding of the care sector and the skills that you need to work there.”
