Agenda item

The Director for Adult Social Care and Commissioning submits a report providing a summary of the external adult social care and NHS workforce in Leicester.  

The LLR Integrated Care Board further submits a report providing a summary of the NHS workforce in Leicester, Leicestershire and Rutland.  

The Director of Adult Social Care & Commissioning introduced the item noting that two reports had been submitted and that synergies could be seen across both. The adult social care report was based on data from Skills for Care where Leicester has around a 50% return rate.

It was also highlighted that a professional carer of the year award event was being hosted by Inspired to Care in the city at the same time as the meeting to celebrate the workforce.

The item was presented by the Director of Adult Social Care & Commissioning and Chief People Officer for the Integrated Care Board, and it was noted that:

·       The social care workforce nationally is significant, and the Skills for Care data indicates there are around 15k posts in the city, of which around 14k are filled leaving around 1k vacancies. 6% of the workforce are recruited by the local authority, 81% in the independent sector, 8% in receipt of direct payment and around 6% other.

·       There are 268 CQC regulated providers in the city, including 98 residential settings and 170 non-residential, primarily providing home care.

·       Turnover in the workforce compares favourably in the city with the region and national average. Whilst people may leave specific roles, they are likely to be retained in the adult social care sector.

·       Vacancy rates in the city is lower than the region and national rate at 7.5%. National vacancies have decreased due to an international recruitment campaign and benefits are being seen locally.

·       The local workforce is relatively stable with workers on average having eight years’ experience and 68% working in the sector for at least three years.

·       There are various initiatives in place locally to support providers to recruit and retain workers in the sector and deliver training, including working with Inspired to Care and the Integrated Care System.

·       Providers do employ staff on zero-hour contracts, but the authority is working to improve this and request contracted providers provide evidence of where this may be a personal preference of the workforce.

·       Achievable pay rates for providers are incorporated into contracts using the funding formula.

·       There is an ambition to have one workforce across health and social care in Leicester, Leicestershire and Rutland. A People Board has been in operation since 2018 to ensure collaborative working for recruiting, retaining, and upskilling the local workforce prior to the publication of the national NHS long term plan and next steps to put people at the heart of care.

·       Around 70k individuals are employed by the health sector across LLR and the workforce has continuously been growing since 2019 – 7.7% increase. There are around 2855 health vacancies with the largest group in nursing which is a national trend.

·       Primary care has seen the largest growth in the workforce with an increase of 26%. National funding enabled the ‘additional roles and responsibilities’ scheme to ensure multi-disciplinary teams to enable residents to be seen by a skilled professional at the right time.

·       Sickness rates have reduced overall to 6% across the health sector in LLR, although there are variants amongst teams and services. Availability of staff across the workforce enables services to be delivered whilst managing sickness.

·       Work is underway to retain staff and whilst individuals may leave a role within one health organisation and join another within the local system, staff leaving the LLR heath sector workforce entirely has reduced to 7.2%. 

·       The report includes the initiatives and programmes underway across health and social care to shape the workforce for the future.

In response to questions and comments from Members, it was noted that:

·       The workforce is larger than just those providers who the local authority have formal contractual arrangements in place with to specify obligations. There is also a responsibility under the Care Act to support the whole market and the Adult Social Care division contact all providers in the city through campaigns and sharing information via the council and inspire to care website, as well as offering training and advice to all providers.

·       Over the next ten years it is expected the age profile will change and require an additional 2.5k posts to support the sector. It was agreed further information would be circulated in relation to timeframes.

·       Zero-hour contracts is not as good as the service would like and where contractual arrangements are in place, providers are expected to audit where it is the employee’s choice. It was agreed officers would look at how this will be audited.

·       40% of the workforce hold a relevant adult social care qualification but many of those that do not have years of experience or other qualifications.

·       Pay rates are lower than other areas but are based on the local situation and comparable.

·       The workforce cannot be required to be a member of a trade union, but it was agreed that information will be requested and circulated on any available data.

·       Social worker caseloads are carefully managed to prevent turnover which is lower than the authority average, but pressures do exist, including pace and complexity of cases.

·       Adult Social Care have been successful in recruiting and training officers, particularly through the grow your own scheme and utilising apprenticeships. The difficulty surrounds recruitment to experienced posts, especially when officers move into team leader roles.

·       Data is not readily available for safeguarding alerts, but the service monitor alerts made by setting and type of abuse. Other monitoring includes quality improvement work if a provider is in escalation which is normally undertaken by the contracts and assurance team but will also work with individual providers too.

·       Use of direct payments will vary the training required. If the direct payment is being used to pay for agency registered with the CQC then it would be expected that the workforce receive training as part of CQC registration requirements, but the local authority wouldn’t monitor if the provider is not contracted. If an individual uses a direct payment for a personal assistant, then it is their responsibility to check and ask about training. Guidance is provided to individuals in receipt of direct payments on things to ask and look for when recruiting but the local authority has no control who individuals employ or mandating training.

·       Feedback regarding the Inspire to Care website, particularly around lack of reference to apprenticeships will be reviewed.

·       Apprenticeship growth is recognised in the long-term plan and £3.7bn funding to increase professional groups over the next 15years. The ambition is to change the way nursing and the medical workforce is trained - next year will be the first time of medical apprenticeship to remove barriers.

·       Ideally the whole workforce would be in receipt of the living wage but as an independent sector, budgets do not allow without other consequences.

·       The health service has a statutory requirement to publish data annually in relation to the workforce in terms of race, ethnicity and disability. It was recognised senior management level is not representative, but a working group is in place to look at all action plans to improve. It was agreed that data would be circulated to the commission.

·       Monitoring and reporting of the workforce is undertaken at different levels across organisations but this is the first time a combined report has been compiled and shared with the commission.

·       Reverse mentoring involves a senior officer being mentored by a junior officer of a global majority background to provide learning and make change.

The Chair thanked officers for the report, noting it has been an area of interest for some time given the importance across health and social care. It was requested that a future report incorporate more of the workforce and use the same metrics to enable the commission to analyse data.

AGREED:

·       The Commission noted the report.

·       Additional information requested be circulated.

·       Item to remain on the work programme for further updates, including a report on apprenticeships.