Investigating variation in pay in adult social care
What did we do?
This study explored variations in pay for adult social care workers, who deliver care to vulnerable people in their own homes, residential/nursing care homes or supported accommodation in England. We explored how local conditions, such as deprivation, and local authority processes for buying care, affect pay variations. Finally, we investigated how pay variations affect workers, for example, leaving their jobs or developing skills.
Why was this important?
This research was important because care worker pay is low, and this has a negative impact on recruiting workers and keeping them in their jobs. There are often staffing shortages and this negatively affects the care of those in need and the families/friends who support them. For example, care visits may be short or missed, and there might be many different people delivering care to the same person, which is undesirable. Improving pay, the experiences of care workers, and making sure that care delivered is of high quality is very important.
How did we do it?
This research had three parts:
- The first part, led by Dr Akbar Ullah, Research Fellow at the University of Manchester and a member of the Organising Care Theme within ARC-GM, utilised statistics provided by Skills for Care to investigate the factors affecting pay variations, including local authorities' fee levels and contracting practices, as well as the effect of pay on workers' outcomes such as skills and retention.
- The second part, led by Professor Carol Woodhams from the University of Surrey, was a survey of organisations that provide adult social care which explored their pay practices and identified good practice.
- The final part, led by Dr Gail Hebson from Manchester Metropolitan University, involved interviews with managers of care organisations and with care workers themselves to explore their views on pay variations and the consequences for care workers, care recipients and their families.
Public and Community Involvement and Engagement (PCIE) for this project was led by Dr Will Whittaker, Senior Lecturer at The University of Manchester and Deputy Lead of the Organising Care Theme in ARC-GM. We worked closely with a local authority commissioner, managers of care organisations and the lead and a representative of the ARC-GM Public and Community Involvement and Engagement (PCIE) Panel to develop the questions and design the project.
Findings:
Pay for adult social care workers is low, with limited variation within and across roles. Most care workers receive a similar hourly rate, often at or only slightly above the National Living Wage. Senior care workers typically receive an hourly rate that is only marginally higher than that of care workers. Many care providers offer just one pay rate for each group. To maximise rates, few pay enhancements are available, such as unsocial hours payments.
Additionally, very few providers offer pay scales that reward qualifications and/or experience, limiting opportunities for care workers to increase their earnings and reducing incentives to gain qualifications. Low pay is also linked to lower retention, and working conditions and job stability are equally important for retention. Other terms and conditions of employment tend to be basic. Care providers argue that local authority fees are too low to enable higher wages.
Policy implications include:
- Increasing government investment in adult social care to raise local authority fees and care worker pay.
- Changing the way care is commissioned and/or introducing regulation to ensure fee increases translate into higher pay and stability.
- Establishing pay structures that reward qualifications and experience.
- Improving other terms and conditions of employment.
Stable and flexible working patterns are also essential. Leadership development is needed to support the implementation of pay systems and to foster strong working environments.
Who did we work with?
This study was led by Professor Carol Atkinson at Manchester Metropolitan University, with support from University of Manchester and University of Surrey.
Throughout the study, we worked with:
- A PCIE group that represented the views of carers, care workers and care recipients/their friends/families.
- A Project Steering Group involving the Department of Health and Social Care, local authorities, care managers and PCIE representatives to ensure that our results have wide uptake by both policy makers and those working in the sector.
Funding information
This research study was funded by the National Institute for Health and Care Research (NIHR), Policy Research Programme The views expressed are those of the authors and not necessarily those of the NIHR or the Policy Research Programme.
More information:
Programme Manager
Alison Littlewood
alison.j.littlewood@manchester.ac.uk