The care home workforce: A breakdown of the issues surrounding staffing
Brexit has been a clear headache for many care home operators who rely significantly on a migrant workforce to provide services to the elderly and dependent adult population.
3 minutes to read
This uncertainty looks more inconvenient when we consider that staffing costs, recruitment and retention were an issue for operators even before the free-movement of EU migrants was put into question.
Rising costs
Data from the Knight Frank Care Home Trading Performance Review 2018 shows that staff costs for care home providers, have increased some 44% in the last decade from 2008 to 2018 to reach £23,575 on a per resident basis.
The increase owes much to rises in the National Living Wage (NLW) which has increased exponentially in recent years to support many low-income workers such as those in the care industry.
As a percentage of income, staff costs also now represent on average 57.6% of income compared to 55.5% in 2008. Broadly speaking, operators have passed on extra costs in their wage bill to residents through fee increases in order to protect their businesses.
This is certainly the case in the private-pay market but less so in the case of publically funded (local authority) homes where staff costs are close to 70% of income in severe cases.
With further rises in the NLW approaching in 2019 and targeted for 2020, many operators will continue to face an increasing wage bill. This is a clear challenge but better pay is also a necessary step if the UK is to attract more workers into the care sector.
Recruitment and retention
A recent report by the Kings Fund stated that 1 in 11 care worker roles are unfilled and nearly 1 in 3 staff in the adult social care sector left their role in 2017/18 alone.
Such stats support claims that more needs to be done to attract and keep staff in their roles. Increasing pay is one obvious way to do this, as is the employment of flexible agency staff, but neither are solutions to the broader problem.
The current shortfall of skilled nurses is a challenge for home operators focused on the higher dependency end of the acuity scale. The removal of the NHS student bursary in 2016 is one reason for the decline of new entrants into the nursing profession, but the impact of Brexit is also now adding to the shortage.
The latest figures from the Nursing and Midwifery Council (NMC) show that the number of new nurses coming from the EU has fallen some 87% from 6,382 in 2016/17 to 805 in 2017/18. While non-EU nurses may help to fill this void, this issue needs to be addressed.
Politics delaying action
It is widely agreed that decisions need to be made to secure the future of the care home workforce, but the current political climate is only delaying the process.
The long-awaited Green Paper on adult and elderly care will hopefully give operators some sort of outline for the future, but this paper has seen numerous delays in its release.
Operators are also awaiting a resolution to Brexit and some clarity on how this might affect the migrant workforce that many homes depend on. As it currently stands the 3.5 million EU nationals living in the UK will need to apply for ‘settled status’ if they wish to remain in the UK after June 2021.
Even if the majority of migrant workers currently living in the UK are granted the right to remain in the UK, longer-term changes to immigration law are still unknown.
Recent think tank predictions state that the removal of free movement could result in more than 30% of positions in the residential care sector left unfilled by 2028.
Such claims would suggest that careful decisions need to be made to ensure the care home sector has a workforce fit for the future.
Knight Frank’s Care Home Trading Performance Review is an annual survey of trading performance across the UK, providing industry-leading benchmarks on occupancy rates, mix of funding type, average weekly fees (AWF), costs such as staff and agency outlays, and profitability.
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