Boosting pay, conditions and training must ‘underpin’ social care reform

Improving pay, conditions and training of social care staff must ‘underpin’ wider reform of the sector, a leading think thank has warned.

In a new report published today, The King’s Fund unless these issues were addressed there would ‘simply not be enough care workers’ to deliver the quality of care needed.

The document sets out ‘key problems’ within social care and has put forward suggestions around fixing them.

It is intended for consideration by the government’s Casey Commission, which is overseeing reform of social care.

The first phase of the commission, set up earlier this year, is due to end in mid-2026, with the second phase not expected to end until 2028.

Among its key concerns, the think tank pointed to workforce pay and conditions and highlighted that staff were ‘underpaid’ and ‘overworked’.

‘Increasing basic pay is essential, and pay differentials between junior and senior staff need to widen,’ the report said.

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While it welcomed the government’s proposed £500m Fair Pay Agreement for social care as a ‘first step’ towards improving recruitment and retention in the care sector, but warned this was not enough to ‘solve’ long-term hiring challenges.

‘There are also continued concerns among providers about whether it will be fully funded,’ the report said.

‘What constitutes “fair pay” differs among organisations: some want to see a minimum set at around the level of the real Living Wage, while others argue for full pay parity with comparable NHS roles.’

In addition, the think tank said a government-led recruitment strategy for social care had still not been implemented.

It added that training opportunities were ‘patchy’ for the care workforce, and that ‘comprehensive training’ must be made available across the sector.

Another key ask from The King’s Fund is for the establishment of a national system for assessing social care needs, a leading think tank has suggested.

It said that replacing local authority assessments with a nationally run system, like those used in Australia, Germany and Japan, could help support fairer and more consistent care access across England.

‘This has the potential to provide greater consistency of needs assessment, would limit the risk of individual authorities “rationing” care because of budget constraints, and might provide some efficiency saving,’ the report said.

Currently, each of England’s 152 local authorities assesses individuals using a national criteria, but wide variation in delivery means people in different regions experience a ‘postcode lottery’ in care access, eligibility, and quality, The King’s Fund suggested.

Simon Bottery, senior fellow at The King’s Fund and author of the report, said: ‘It would be a major change to shift away from the principle that people’s social care needs and finances should be assessed by local authorities.

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‘However, it works well in other countries and now is the time to explore whether it would be an improvement here as well.’

He added: ‘The Casey Commission should consider this and other ideas in this report. However, there is also much that the government could do in the meantime ahead of the commission reporting, including ensuring that local authorities have the finances they need to run the current system fairly and effectively.’

Calls for funding reform

The report also said that more people should be entitled to publicly funded social care.

Although welcoming the government’s commitment to put a cap on care costs, the King’s Fund said this was only the ‘very minimum’ of what is needed.

It suggested the free personal care model, as used in Scotland, as a potential solution to the underfunding of the social care sector in England.

The cost of care should be shared more equitably by individuals and the state, the report states, calling for the state to pay the majority of care costs, especially for those who are unable to pay.

The report also called for a review of NHS Continuing Healthcare, which it says plays a ‘crucial but overlooked’ role in the social care system.

A Department of Health and Social Care spokesperson said the Casey Commission will look at how to ‘best need’ the future needs of the population.

‘This includes speaking with experts, charities, the sector and people drawing on care to inform her recommendations.

‘But we know the sector needs urgent support, which is why we are providing a funding boost of more than £4bn, delivered the biggest uplift to the Carer’s Allowance threshold since the 1970s, investing an additional £172m in the Disabled Facilities Grant, and have launched the first ever Fair Pay Agreement for care workers,’ they said.