the state of the social care workforce 2004-workforce... · the state of the social care workforce...

Part of the Sector Skills Council Skills for Care and Development

The State of the Social Care Workforce 2004

The second Skills Research & Intelligence annual report

Researched and compiled by Christine Eborall Workforce Intelligence Officer, Skills for Care

April 2005

CONTENTS

1. INTRODUCTION ............................................................................................................................................. 5

2. EXECUTIVE SUMMARY ............................................................................................................................... 6

3. STATISTICS ON CARE PROVIDING ORGANISATIONS...................................................................... 11

3.1 LOCAL AUTHORITIES ................................................................................................................................. 11

3.2 ADULT CARE.............................................................................................................................................. 12

3.2.1 Care homes........................................................................................................................................... 12

3.2.1.1 Adult placement: homes and schemes.......................................................................................................... 14

3.2.2 Supported housing / assisted living ...................................................................................................... 14

3.2.3 Day care ............................................................................................................................................... 15

3.2.4 Domiciliary care................................................................................................................................... 16

3.2.4.1 Direct payments ........................................................................................................................................... 17

3.3 CARE OF CHILDREN AND YOUNG PEOPLE ................................................................................................... 17

3.3.1 Children’s homes.................................................................................................................................. 17

3.3.2 Family centres ...................................................................................................................................... 17

3.3.3 Fostering and adoption agencies.......................................................................................................... 17

3.3.4 Direct payments.................................................................................................................................... 18

3.3.5 Day care of children aged under eight ................................................................................................. 18

3.3.5.1 Length of time in operation.......................................................................................................................... 20

3.3.6 Schools.................................................................................................................................................. 20

3.3.6.1 Residential special schools and boarding schools ........................................................................................ 21

3.3.7 Connexions service ............................................................................................................................... 21

3.3.8 The Children and Families Court Advisory and Support Service (CAFCASS) .................................... 21

3.3.9 Other services for children and young people...................................................................................... 21

3.4 PARTNERSHIP WORKING BETWEEN EMPLOYING ORGANISATIONS .............................................................. 22

3.4.1 Partnership arrangements under the 1999 Health Act......................................................................... 22

3.4.1.1 ‘Section 31’ staff transfers ........................................................................................................................... 23

3.4.1.2 Other Health Act partnership arrangements ................................................................................................. 23

3.4.2 Care Trusts ........................................................................................................................................... 25

3.4.3 Children’s Trusts .................................................................................................................................. 25

4. STATISTICS ON THE WORKFORCE ....................................................................................................... 26

4.1 ESTIMATE OF THE TOTAL SOCIAL CARE WORKFORCE ................................................................................. 26

4.1.1 Estimated numbers of qualified social workers in the social care workforce....................................... 27

4.2 STATISTICS ON THE WORKFORCE AS A WHOLE ........................................................................................... 28

4.2.1 The Labour Force Survey ..................................................................................................................... 28

4.2.2 Local authorities’ 2003 data on their statutory and independent sector workforces ........................... 29

4.3 THE INDEPENDENT SECTOR ADULT CARE WORKFORCE .............................................................................. 31

4.4 LOCAL AUTHORITY SOCIAL SERVICES WORKFORCE ................................................................................... 32

4.4.1 Agency staff working for local authority social services departments.................................................. 35

4.4.2 Approved foster carers and adopters.................................................................................................... 35

4.5 THE NHS SOCIAL CARE WORKFORCE......................................................................................................... 36

4.5.1 Social services staff employed in the NHS............................................................................................ 36

4.5.1.1 Social services staff in Care Trusts .............................................................................................................. 37

4.6 THE CHILDCARE, EARLY YEARS AND EDUCATIONAL SETTINGS WORKFORCES ........................................... 37

4.6.1 Childcare and early years .................................................................................................................... 37

4.6.1.1 Use of agency staff....................................................................................................................................... 39

4.6.2 Care workforce in schools .................................................................................................................... 39

4.6.3 Connexions service ............................................................................................................................... 40

4.6.4 The Children and Families Court Advisory and Support Service (CAFCASS) .................................... 40

4.6.5 Other services for children and young people...................................................................................... 40

5. VACANCY AND TURNOVER RATES ....................................................................................................... 41

5.1 ALL EMPLOYERS: VACANCIES.................................................................................................................... 41

5.2 LOCAL AUTHORITY WORKFORCE ............................................................................................................... 42

2004 Annual Report VFamended 17 04 06 - 2 -

5.2.1 Total workforce in local authority social services departments ........................................................... 42

5.2.2 Social workers and other specific types of staff.................................................................................... 43

5.2.2.1 Comparison with previous years .................................................................................................................. 45

5.3 INDEPENDENT SECTOR WORKFORCE .......................................................................................................... 47

5.4 NHS WORKFORCE ..................................................................................................................................... 47

5.5 CHILDCARE AND EARLY YEARS WORKFORCE............................................................................................. 49

5.6 SICKNESS ABSENCE.................................................................................................................................... 53

5.6.1 Local authority staff.............................................................................................................................. 53

6. LENGTH OF TIME IN JOB AND IN SOCIAL CARE .............................................................................. 54

7. PAY................................................................................................................................................................... 56

7.1 SOCIAL WORKERS ...................................................................................................................................... 56

7.1.1 All employers ........................................................................................................................................ 56

7.1.2 Social workers employed by local authorities ...................................................................................... 57

7.1.2.1 Benefits ........................................................................................................................................................ 58

7.2 MANAGERS IN RESIDENTIAL AND DOMICILIARY CARE ............................................................................... 59

7.2.1 Managers employed by local authorities.............................................................................................. 59

7.2.1.1 Benefits ........................................................................................................................................................ 60

7.2.2 Managers in the independent sector..................................................................................................... 60

7.3 CARE WORKERS ......................................................................................................................................... 60

7.3.1 All employers ........................................................................................................................................ 60

7.3.2 Care workers employed by local authorities ........................................................................................ 61

7.3.2.1 Benefits ........................................................................................................................................................ 62

7.3.3 Care workers in the independent sector ............................................................................................... 62

7.3.4 Comparison with retail sector pay........................................................................................................ 62

7.4 CHILDCARE AND EARLY YEARS STAFF ...................................................................................................... 63

7.4.1 Managers and supervisors.................................................................................................................... 63

7.4.2 Childcare workers ................................................................................................................................ 64

8. LEVELS OF TRAINING AND QUALIFICATIONS IN THE WORKFORCE ....................................... 66

8.1 THE WORKFORCE AS A WHOLE................................................................................................................... 66

8.2 SOCIAL WORKER TRAINING AND QUALIFICATIONS ..................................................................................... 67

8.2.1 Pre-qualifying training ......................................................................................................................... 67

8.2.1.1 Applications ................................................................................................................................................. 67

8.2.1.2 Registrations and awards.............................................................................................................................. 67

8.2.1.3 Routes to study............................................................................................................................................. 68

8.2.1.4 Student demographics .................................................................................................................................. 69

8.2.1.5 Practice placements...................................................................................................................................... 69

8.2.1.6 Social Work qualifications obtained overseas.............................................................................................. 70

8.2.2 Local authority support for social work training ................................................................................. 70

8.2.2.1 Secondments, sponsorship and bursaries...................................................................................................... 70

8.2.2.2 Support for practice learning........................................................................................................................ 73

8.2.3 Post Qualifying Awards in Social Work ............................................................................................... 74

8.2.3.1 Student demographics .................................................................................................................................. 75

8.3 SOCIAL CARE TRAINING AND QUALIFICATIONS .......................................................................................... 75

8.3.1 Management training and qualifications.............................................................................................. 75

8.3.1.1 Staff in local authority social services departments...................................................................................... 75

8.3.1.2 Managers in local authority care homes ....................................................................................................... 77

8.3.1.3 Managers of local authority domiciliary care services ................................................................................. 79

8.3.1.4 Managers in independent sector domiciliary care services........................................................................... 79

8.3.1.5 Managers of adult placement schemes ......................................................................................................... 80

8.3.2 Care worker training and qualifications .............................................................................................. 80

8.3.2.1 Staff in care homes for older people............................................................................................................. 80

8.3.2.2 Staff in independent sector care homes for older people.............................................................................. 81

8.3.2.3 Staff in care homes for young adults............................................................................................................ 81

8.3.2.4 Staff in children’s homes.............................................................................................................................. 81

8.3.2.5 Care workers in local authority children’s homes and learning disabled services........................................ 82

8.3.2.6 Care workers in independent sector domiciliary care services ..................................................................... 82

8.3.2.7 Other care workers ....................................................................................................................................... 82

8.3.3 Local authority spending of Department of Health workforce development grants ............................. 83

8.3.4 The childcare and early years workforce ............................................................................................. 84

8.3.4.1 Managers: childcare ..................................................................................................................................... 84

8.3.4.2 Supervisory staff and nursery nurses............................................................................................................ 85

8.3.4.3 Other childcare staff ..................................................................................................................................... 86

8.3.5 Numbers of NVQ registrations and awards.......................................................................................... 87


8.3.5.1 Registered Manager’s Award (NVQ Level 4).............................................................................................. 87

8.3.5.2 Care and Early Years NVQs ........................................................................................................................ 88

9. WHAT WE (STILL) DON’T KNOW............................................................................................................ 91

9.1 REASONS FOR LACK OF KNOWLEDGE ......................................................................................................... 91

9.2 THE MAIN AREAS OF UNCERTAINTY ........................................................................................................... 92

9.2.1 The independent sector workforce........................................................................................................ 92

9.2.2 Levels of training and qualification in the workforce........................................................................... 92

9.2.3 Day care ............................................................................................................................................... 92

9.2.4 Social care staff employed in the NHS.................................................................................................. 92

9.2.5 Employees of partnership bodies.......................................................................................................... 92

9.2.6 New types of care providers ................................................................................................................. 93

9.2.7 Separating the adults’ and children’s workforces ................................................................................ 93

9.3 FUTURE DEVELOPMENTS AND POSSIBLE SOLUTIONS .................................................................................. 93

9.3.1 GSCC registration ................................................................................................................................ 93

9.3.2 CSCI Registrations and Inspections Database ..................................................................................... 93

9.3.3 National Minimum Data Set for Social Care (NMDS-SC) ................................................................... 94

9.3.4 Other things that are being or could be done ....................................................................................... 94


1. INTRODUCTION

This is the second Annual Report of the Workforce Intelligence Unit of Topss England. Its main objective is to update the statistical information shown in the first Annual Report, which was published in December 2003, and to draw attention to areas where data about the social care workforce is still lacking.

Because of this statistical focus, the format of the report is different from the 2003 one. Generally, summary and national data is in the commentary section, and more detailed statistical information and regional breakdowns are in the Statistical Appendix at the end of the report. It is hoped that this approach will make the report reasonably easy to read while not losing any information.

The report tries to reflect the recent separation of the sector skills councils into adults’ and children’s workforces, by providing data on the two workforces where possible. However, in some areas it is very difficult to separate the two.

The Occupation Therapy workforce has largely been excluded from this report but will be the subject of an additional section to be produced shortly.

Social care is a fast-changing sector and new words and terms appear regularly. In general, this report uses a similar approach to terminology to that used in the 2003 report. The term ‘domiciliary care’ has been used to describe the ‘home care’ sector, to avoid any confusion or inadvertent word reversal with the care home (former residential homes and nursing homes) sector. The term ‘service user’ is used in preference to ‘client’, although the former may also be becoming outdated. The term ‘carer’ is used to describe people who care on an unpaid basis for family or friends, and paid care staff are referred to as ‘care staff’ or ‘care workers’. The only exception to this is where the term ‘care assistant and home carer’ is used, as this is the official description used in the 2000 Standard Occupational Classification (SOC2000) to describe care workers in care homes and domicillary care.

Acknowledgements

Many people have contributed information and knowledge to this report or have helped to resolve queries and provide additional data, and their help is much appreciated. Particular thanks are due to Lionel Took at the Department of Health and Stephen Triffitt and colleagues in DH Statistics; Adam Cooper, Michael Walton and Andy Hesketh at the Department for Education and Skills; David Mellor, Stephen Richards and Mark Dunn at the Employers’ Organisation survey research unit; John Barker, Imogen Shillitoe, Cindy Whiffen and colleagues at the General Social Care Council; Keith Gardner, Jenny Wells, Graham Booth, David Crosbie and others at the Commission for Social Care Inspection; Owen Davies at Unison; Sheelagh Richards at the College of Occupational Therapists; the Labour Force Survey analysis team at the Office for National Statistics; Lohan Wolf at the Qualifications and Curriculum Authority; Philip Blackburn at Laing & Buisson; the Information Services team at the King’s Fund and the Social Care Workforce Research Unit at King’s College London, for their help in providing information and responding to queries.

Many thanks also to Francis Ward, Workforce Development Officer at Topss England, for continued support and encouragement.

Responsibility for any errors in the report is the author’s alone. Feedback on any aspect of the report will be very welcome and will help to improve future editions. Please contact:

Christine Eborall Workforce Intelligence Officer, Topss England Tel. 020 8998 7307 or email [email protected]

March 2005


2. EXECUTIVE SUMMARY

The main objective of this report is to update the statistics in the first Annual Report of the Topss England Workforce Intelligence Unit with the latest ones available at the time of writing.

Numbers of care providing organisations

There were an estimated 31,000 social care providing organisations in England in 2003-4. This estimate includes local authorities, various parts of the NHS, and independent, i.e. private + voluntary, sector organisations. Adding childcare brings this total to 55,000, and to 127,000 if childminders are included too. In addition, there were 13,000 people buying social care via direct payments.

The majority of social care providers are in the private sector.

There were about 21,000 care homes for adults registered with the CSCI, of which 1,400 were adult placement homes. Of the remaining 19,500, the majority (71%) are privately owned and 17% owned by voluntary sector organisations, taking the independent sector’s share of adult care homes excluding adult placement to 88%. Nearly four-fifths (79%) of the 19,500 adult care homes are registered to provide care only, the rest to provide care with nursing. The latter are even more dominated by the private sector (89% privately owned) and the great majority of these are operated by small independent businesses.

About 3,700 branches of agencies providing domiciliary care staff and nearly 1,000 providing nursing staff were registered with the CSCI towards the end of 2004. An estimated 700 which provide both types of staff are registered separately for each. Of total registrations, 77% were private sector, five percent voluntary/not for profit and the rest local authority and others. The provision of around 35,000 supported housing/assisted living units, mainly local authority funded, are treated as domiciliary care rather than care homes by the CSCI.

The number of providers of day care for adults is largely unknown.

The 13,000 individuals in receipt of direct payments at end September 2003 was a 60% increase on the number 12 months earlier. Most were for adult care.

Just over 2,000 children’s homes were registered with the CSCI, of which 59% were privately and 34% local authority owned. A total of 232 independent and 143 local authority fostering agencies, 62 voluntary and 148 local authority adoption agencies, and 35 residential family centres were also registered.

Around 34,900 childcare-providing organisations – day nurseries, playgroups, out-of-school & holiday clubs and crèches – were registered with Ofsted at September 2004, along with 71,900 individual childminders, providing a total of 1,470, 000 childcare places. Around 85% of the organisations are in the independent sector. Since registration began in March 2003, the total number of providers (including childminders) has increased by seven percent and places by 12%.

Over 800 partnerships established under Health Act 1999 flexibilities involving local authority social services staff were in operation or preparation at end March 2004. By early 2004 eight Care Trusts had been set up.

Workforce numbers

In 2003-4, an estimated 922,000 people were employed in ‘core’ social care as traditionally defined, i.e. including local authority social services staff, residential, day and domiciliary care staff, agency staff and a limited number of NHS staff. Of these, an estimated 61% were working in services for older people, 19% in disabled adults services, 13% in children’s services and seven percent in mental health services.

If a wider range of NHS staff who do some care work, and if childcare, foster carers and early years and school teaching assistants and other support staff are included, the estimated number of people working in social care increases to 1.6 million.

The reduction in these estimates since the first Annual Report is due mainly to using more recent sources of data and to including different workers in the early years and education sector. However, there is some evidence that the social care workforce in traditional sectors – care homes and domiciliary care – is


getting smaller. This is likely to be due to changing patterns of care delivery which are not being picked up in the available workforce statistics.

There were an estimated 76,100 qualified social workers employed in England in 2003-4, of whom 75% were employed by local authorities (including agency staff), seven percent in independent sector care homes and domiciliary care, 17% by other public and voluntary sector employers and, apparently, less than one percent in the NHS. There is reason to believe that not all social services staff employed in the NHS are being recorded as such.

The importance of the independent sector as the main provider of social care services continues not to be reflected in reliable statistics about the numbers of workers it employs. Using the very limited data available, it is estimated that a total of 390,000 staff, of which 288,000 are care workers, are employed in independent sector adult care and with-nursing homes. The independent sector domiciliary care workforce is estimated at 106,500, of which 97,500 are care workers. No centrally-collected information about independent sector day care has been found.

At September 2003 local authority social services departments in England were employing 277,000 staff, and an estimated further 11,000 agency staff, taking the total to 288,000, of which agency staff accounted for four percent.

Since 1994 total numbers of local authority social services department (measured in full-time equivalents) have been declining steadily, but in 2003 this trend was reversed and numbers increased. This was due to the substantial increases in numbers of area and field social work staff of recent years outweighing the continuing reduction in domiciliary, residential and day care staff as service provision is switched to the independent sector.

Depending on the definitional approach used, the NHS was employing between 62,000 and 261,000 care staff at September 2002, including qualified social work and occupational therapy staff. Numbers of agency staff are not recorded.

An estimated 305,000 staff were being employed in early years childcare, including 72,000 in childminding, and a further 45,000 in early years (nursery school/nursery class) settings. Depending on the definitions used, there could perhaps be 100,000 staff working in care-type roles in post-early years state sector education.

Workforce demographics and employment patterns

The social care workforce is predominantly female: 80%+, increasing to 95%+ in sectors such as residential and domiciliary care and some early years childcare. Mainly as a consequence of this, part-time working is common — around 50% of the total workforce work part-time.

The workforce includes people of all ages, but especially 35-49 year olds who account for 40% of the total, compared with 35% under 35s and 25% 50+s. However, settings for older people tend to employ older workers, while childcare workers tend to be younger. Occupational therapists and qualified nursery nurses are among the youngest in the workforce.

Workforce vacancy and turnover rates

Vacancy rates in social care are about twice as high as those for the totality of all private and public sector business activity in England.

Little is known about current vacancy and turnover rates in the independent sector. The average vacancy rate for all directly-employed staff in local authority social services departments in England at end September 2003 was 11.0% (one in nine posts vacant); the average turnover rate for 2003-4 was 12.7% (one in every 7–8 staff leaving). Both of these measures have been improving slowly but steadily since 2001-2.

However, there is wide variation, both geographically and between individual authorities. Regional vacancy rates continued to be highest in London (17.2%) and were above 12% in the South East and Eastern region. Turnover rates varied less, but were particularly high (16.7%) in the South East. But within each region there are local authorities with vacancy rates at five percent or below, and turnover rates in single digits. Some authorities are much better than others at retaining their staff.


Vacancy and turnover rates were particularly high for local authority occupational therapists (vacancy 19%, turnover 17%), children’s social workers (vacancy 12%, turnover 12%), care workers in children’s homes (vacancy 13%, turnover 14%) and domiciliary care workers (vacancy 11%, turnover 15% including retirement, 13% excluding retirement). While vacancy rates for these categories remain high, turnover rates are showing signs of falling.

Recruiting occupational therapists is as difficult in the NHS, which records numbers of posts vacant for three months or more. Three-month vacancy rates for occupational therapists have been increasing since 1999 and by end March 2004 had reached five percent, higher than the average for all allied health professionals (4.3%). Over half these vacancies were in London and the South East.

In the childcare sector, estimated 2003 staff turnover rates were 18% in day nurseries, 14% in playgroups and 20%+ in after-school and holiday clubs. In early years settings they were lower (11% or less). These rates were, however, lower than comparable ones in 2001. Around 20% of childcare and 10% of early years staff leave the sector each year.

Pay

Social workers’ pay levels are among the lowest of the professional occupations.

According to ONS’s Annual Survey of Hours and Earnings, at April 2004 the median gross weekly pay of male social workers in the UK was £475.30, which is below the corresponding rates for probation officers and nurses and well below that of teachers of all types.

Median gross weekly pay for full-time female social workers was £448.30, above that for probation officers and nurses though again well below all types of teacher. Corresponding pay for part-time female social workers was £249.90, below that for probation officers, nurses and teachers.

Pay levels for social workers in London are substantially higher than in other regions. Between 2002 and 2003 social workers’ pay is estimated to have increased by about seven percent overall, and more local authorities are offering flexible working hours to social workers.

At September 2003, median annual salaries for registered managers of local authority care home and local authority domiciliary care services were around £28,000, and around £30,500 for registered managers of children’s homes. These are estimated to have increased by 4-5% since 12 months earlier.

At April 2004 the median gross pay of female care workers in the UK was £6.40 per hour. This ranged from £4.80 per hour or less in the bottom 10% of workers, to over £8.30 for the top 10%. Care workers in the public and voluntary sector earn on average 22% more than those in the private sector, and pay is highest in London.

Lowest-paid care workers earn similar amounts to retail sector cashiers and check-out operators. However, the pay range of care workers is much wider, reflecting the diversity of seniority, experience, qualifications, settings and employer types among care workers. Nationally, 50% of care workers earn more than the highest paid check-out operators. There is a little evidence to suggest that NVQ-qualified care workers are paid more than unqualified ones.

In the childcare and early years sectors, staff qualified to supervisory level, including nursery nurses, are paid at least 10%-15% more than unqualified childcare and support staff.

Social work training and qualifications

In England, a total of 5,382 students starting courses leading to a social worker qualification registered with the GSCC during the 12 months to 31 March 2004. This is a 13% increase on the 4,771 of the previous 12-month period. Just over half were starting the last wave of Diploma in Social Work (DipSW) courses and the rest were starting the new social work degree.

During the same period, nearly 3,550 students qualified from DipSW course in England. This is a four percent increase on the previous period and reflects to some extent of the increased number of students enrolling for social work training in 2001-2 when the Department of Health recruitment campaign began.


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In England, just over 4,300 students applying for September 2004 entry through UCAS (Universities and Colleges Admissions Service) were accepted onto full-time social work degree courses. Corresponding figures for part-time and post-graduate students are not yet available.

Over 3,000 local authority staff were being funded by their employer on social work training at March 2004, a marked increase on the 2,300 twelve months earlier. Local authorities have increased their support for social work training, both for their own employees and by offering sponsorships to external students. They also provided an average per authority of 3.4 assessed practice learning days for their own employees and 5.6 for external students during 2003-4.

In the last 13½ months of its operation, the GSCC’s International Recognition Service (now superseded by social worker registration) issued over 2,500 Letters of Verification to social workers qualified overseas to allow them to work in the UK. Australia, South Africa and the USA headed the list of countries from which applicants had qualified.

In 2003-4 a total of 3,606 Post-Qualifying Awards in Social Work (PQSW) were made, continuing the increase of previous years, but the number of registrations fell back to 3,888 from over 4,000 twelve months previously.

The number of Post Qualifying Awards in Child Care (PQCC) in 2003-4 increased by 11% to 633. Since its introduction in 2000, a total of 1,610 awards had been made by end March 2004. Overall, only a third of the local authority social workers and home managers working with children who need to obtain this award had done so by this date, although some regions and individual authorities have made better progress than others.

Also in 2003-4 the number of Mental Health Social Work Awards picked up to 319 after a drop the year before, and 31 people obtained the new Regulation of Care Services Award. The number of Practice Teacher awards continued to decline, to 535, mirroring the continuing decline in registrations for this award.

Social care training and qualifications

At the time of writing up-to-date analyses of numbers of staff in CSCI-regulated care providers holding or working towards the NVQs and other qualifications specified in the National Minimum Standards were not available, so it has not been possible reliably to assess progress towards the NMS targets.

At September 2003 an estimated 10% of registered managers in local authority care homes (including children’s) held the NVQ Level 4 Registered Manager’s Award and a further 26% were studying for it. A third held another management qualification and 37% a professional social work qualification. The proportion of qualified managers appears to be steadily increasing. No information about managers in independent sector care homes was available at time of writing.

Information about the proportion of care workers in care homes who are qualified to the appropriate NVQ level is sketchy, but generally points to non-achievement of the 2005 targets at a national level (though many individual homes have achieved them). Some 22% of independent sector care homes for older people were estimated to have achieved the 50% NVQ 2 target in early 2004, but in around half fewer than 20% of staff were qualified. Two-thirds (63%) of all types of homes for younger adults, and 52% of children’s homes had sufficient staff with the necessary qualifications in 2003. At end March 2004 39% of local authority children’s home workers and 35% of local authority care workers in adult learning disability services had the relevant NVQs.

The proportion of managers in local authority and independent sector domiciliary care services with and studying for management qualifications is uncertain but appears to be considerably lower than among their counterparts in care homes. There is similar uncertainty about numbers of qualified domiciliary care workers, but estimates of 10% qualified and 18% studying for NVQ Level 2 or higher in 2004 have been made.

By June 2004 over 3,000 Registered Manager (Adults) and 78,500 Level 2 NVQ in Care certificates had been awarded. Over half of NVQ Care awards are assessed via private training providers.


Missing information about the social care workforce

There is a great deal that is not known about the social care workforce. The key areas where information is lacking are: the independent sector workforce, levels of training and qualification in the workforce as a whole, day care, employees of partnership bodies, social care staff in the NHS, information about new types of care providers, and separating the adults’ services from the children’s services workforce.

Work is being done in several areas to address some of these problems.

• During 2005 the GSCC should be able to produce analyses of its Social Care Register to show numbers of Registered Social Workers employed, together with other information about them (demographics, qualifications, how long qualified etc.) and the type of employing organisation they work for.

• It should in future be possible to analyse the CSCI Registrations and Inspections Database to obtain aggregated and detailed data about social care providers registered with the CSCI, both about the range of care services offered by any provider, and about the workforce employed. Data on the extent to which the individual National Minimum Standards are being met should be available.

• Topss England has developed a National Minimum Data Set for Social Care (NMDS-SC), a standard set of data items about social care providers and their employees. This will be used to collect standardised employment data from employers throughout England, probably annually, and compiled into a national database of standard information about the social care industry and its workforce. At the time of writing, the NMDS-SC was in the process of testing with social care employers in three areas of England.

Other ways in which information could be improved include:

• Clarification and development of the codes used to collect the NHS annual employee census, to better describe social care activities. Guidance on the use of these codes may also be necessary as social care may be unfamiliar territory to some NHS HR staff.

• A regular sample survey of social care providers (along the lines of the regular surveys of childcare and early years providers commissioned by the DfES) would enable the size and structure of the social care workforce to be monitored, and key information on recruitment, retention and turnover, training and qualifications, pay and other variables to be measured and tracked.

• Regular quantitative research on the care and other services that recipients of direct payments are buying.

• An end user survey to assess the scale of cash paid social care.

The Department of Health’s three-year programme of social care workforce research will cover many aspects of the workforce, including some of the above.


3. STATISTICS ON CARE PROVIDING ORGANISATIONS

Estimating the number of organisations in England providing care and employing social care staff is problematic for a number of reasons. Social care overlaps with health, childcare, education, housing and other people-focused services. Increasing partnership working is creating new operations whose organisational boundaries are sometimes unclear, and whose partner organisations may be double-counted. There is a lack of data, both for established services like day care, and for new ways of delivering care such as assisted living. The position of people receiving direct payments to employ care workers is evolving. And there is the traditional difficulty of which organisational level to count: individual establishments where staff work or are based, or the parent organisation which employs them, which itself may have a regional structure.

In practice, limitations on the available data mean that there is little choice of approach. So the estimate below is somewhat rough and ready, but is intended to give an idea of the scale of the industry.

ESTIMATED NUMBER OF SOCIAL CARE PROVIDING ORGANISATIONS / ORGANISATIONS EMPLOYING

SOCIAL CARE STAFF, ENGLAND, 2003-4 (FROM VARIOUS SOURCES)

Industry segment Estimated number of care providing / employing

organisations

Cumulative total

Core social care: local authority social services, local authority and independent care homes and domiciliary care, children’s homes, fostering and adoption, NHS.

31,000 31,000

Direct purchase of care services via direct payments 13,000 44,000 Childcare (excluding childminders) 24,000 68,000 Childminders 72,000 140,000

This estimate excludes: supported living/extra care services, independent sector day care, non-departmental public bodies such as CSCI, schools, some or all of the grey economy (employers paying cash), unregistered childminders. It double-counts to some extent: local authority employing

organisations and partnerships organisations which in local authorities and/or NHS are partners.

3.1 Local authorities

The Department of Health’s annual record of staff employed in local authority social services departments shows that at 30 September 2003 (1) nearly all the 150 local councils with social services responsibilities (CSSRs) in England were employing staff to provide residential, day and domiciliary care services to adults, but fewer were providing corresponding services for children. While it is not possible to establish from the data whether these local authorities are actually providing these services themselves or merely employing staff to organise and manage outsourced service(s), the types of staff employed suggest that most are providing at least some services themselves. For further details see the Statistical Appendix.

NUMBERS OF LOCAL COUNCILS WITH SOCIAL SERVICES RESPONSIBILITIES (CSSRs) EMPLOYING

STAFF TO PROVIDE ADULT AND CHILDREN’S SERVICES, ENGLAND, 30 SEPTEMBER 2003 (SOURCE:

DEPARTMENT OF HEALTH (1)

Type of service user

Type of service No. of CSSRs employing staff to provide this service:

% of total CSSRs

Adults Residential care 146 97 Day care 148 99 Domiciliary care 146 97

Children Residential care 130 87 Day care 126 84

All Any residential services for adults or children 148 99 Any day care services for adults or children 149 99 Domiciliary care services 146 97


3.2 Adult care

3.2.1 Care homes

A total of 20,965 care homes for adults were registered with the Commission for Social Care Inspection (CSCI) at November 2004. This total falls to just under 19,500 if the 1,400 adult placement homes1 registered are excluded. Of this total, the great majority (71%) are privately owned and a further 17% owned by voluntary sector organisations, taking the independent sector’s share of care homes (excluding adult placement) to 88%.

The majority of homes were registered as care-only homes (73%). The 20% providing care with nursing are even more dominated by the private sector (89%). See table below; for regional breakdown see Statistical Appendix.

NUMBER OF CARE HOMES FOR ADULTS REGISTERED WITH CSCI AT 12 NOVEMBER 2004, BY TYPE AND OWNERSHIP (SOURCE: CSCI REGISTRATIONS AND INSPECTIONS DATABASE)

Ownership:

Type of home (CSCI register categories)

Private % Voluntary % Subtotal:

Indepen dent

Sector

% Local author

ity

% NHS % Other* % Total %

Care only 10,103 66 2,922 88 13,025 70 1,367 99 163 99 767 92 15,322 73 With nursing 3,718 24 376 11 4,094 22 5 0 2 1 57 7 4,158 20 Non-medical 10 0 3 0 13 0 2 0 0 0 1 0 16 0 Sub-total: care homes excluding adult placement

13,831 91 3,301 99 17,132 92 1,374 99 165 100 825 99 19,496 93

% distribution by type of ownership

71% 17% 88% 7% 1% 4% 100%

Adult placement 1,434 9 18 1 1,452 8 11 1 0 0 6 1 1,469 7 Total all adult care homes

15,265 100 3,319 100 18,584 100 1,385 100 165 100 831 100 20,965 100

% distribution by type of ownership

73% 16% 87% 7% 1% 4% 100%

* At the time of writing it in unclear what this category includes. There may have been a lack of standardisation about the types of organisations included (which could account for the regional variation - see Statistical Appendix).

Homes are registered with the CSCI to provide care for one or more service user groups. At the time of writing it was possible to analyse by total registrations, but not to analyse the number of registered homes by type(s) of service user provided for or by available places/beds.

Data from the analysts Laing & Buisson provide a breakdown of care home places by type of ownership and provision for three categories of adult service users: elderly, chronically ill & physically disabled , mentally impaired (MI) and learning disabled (LD). This is shown in the table overleaf, and similarly shows the private sector’s overall dominance of provision, although this is considerably greater in the much larger elderly, chronic and physically disabled care category than in the smaller MI and LD categories. Note, however, that the figures for the former category are inflated by being for the UK as a whole.

1 Adult Placement is defined as short or long term accommodation and support provided to 1-3 adults placed through an Adult Placement Scheme, in the family home of an Adult Placement Carer approved by the scheme. (9)


-

' ' '

SUPPLY OF LONG TERM NURSING AND RESIDENTIAL CARE FOR ELDERLY AND PHYSICALLY DISABLED,

MENTALLY IMPAIRED AND LEARNING DISABLED PEOPLE, APRIL 2004 (SOURCE: LAING & BUISSON) (29)

(35)

Nursing and residential care

of elderly, chronically ill and

physically disabled people:

TOTAL UK

% share

Homes for mentally

impaired adults: ENGLAND

% share

Long term nursing and

residential care for people with

learning disabilities: ENGLAND

% share

unit: places beds beds NHS long stay mental hospitals (excluding EMI) 5,521 18 6,010 11

NHS long stay geriatric 19,500 4 NHS elderly mentally ill (EMI) 9,700 2

NHS younger physically disabled 1,200 0 Private care homes with nursing 164,300 34 5,937 20 1,727 3

Voluntary care homes with nursing 15,000 3 1,452 5 1,285 2 Subtotal: with nursing 209,700 43 12,910 42 9,022 17

Local authority-staffed premises 44,200 9 707 2 4,872 9 Private 'care home only' 182,400* 38 11,289 37 22,977 43

Voluntary 'care home only' 49,700* 10 5,520 18 16,385 31 Subtotal: care only 276,300 57 17,516 58 44,234 83 Total with nursing and care only 486,000 100 30,426 100 53,256 100 Sector shares:

Statutory 74,600 15 6,228 20 10,882 20 Private 346,700 71 17,226 57 24,704 46

Voluntary 64,700 13 6,972 23 17,670 33 Independent (private + voluntary) 411,400 85 24,198 80 42,374 80

* = includes small (adult placement) homes with less than 4 beds, estimated to account for 1,300 places in private and 1,000 places in voluntary care only homes.

Because the great majority of care provision is in the private sector, it is worth looking at this sector in more detail, and particularly the extent to which it is dominated by small businesses.

In its 2004 review of the UK care home industry (29) Laing & Buisson commented that while consolidation in the industry continues to progress gradually, around 70% of homes (and 60% of places2) for elderly and physically disabled people were still provided by small, independent businesses, and only 30% by ‘major providers’, i.e. operators with three or more homes. The dominance of small independent businesses is even more marked (90%) among care-only homes (see table below). (Adult placement homes are excluded from this analysis).

‘MAJOR PROVIDERS’ SHARE OF TOTAL INDEPENDENT SECTOR CARE HOMES FOR ELDERLY AND PHYSICALLY DISABLED, MENTALLY IMPAIRED AND LEARNING DISABLED PEOPLE, UK, 2004 (SOURCE:

LAING & BUISSON DATABASE, 2004) (29) (35)

Type of home/provider

Elderly &Total all

providers

physically disabled Major

providers only

1,733 680

Major providersshare of

total 39% 10%

Total all providers

Mentally impaired Major

providers only

Major providersshare of

total

Total all providers

Learning disabMajor

providers only

led Major

providersshare of

total Private, with nursing

Private, care only 4,388 6,744

Sub-total: private 11,132 2,413 22% 1,361 187 14% 3,988 866 22% Voluntary 2,030 1,472 73% 707 537 76% 2,854 2,377 83% Total 13,162 3,885 30% 2,068 724 35% 6,842 3,243 47%

Laing & Buisson defines ‘major providers’ as publicly-quoted or foreign-own companies; provident associations such as BUPA; private companies, individuals or partnerships and voluntary sector organisations, with 3 or more homes.

2 See Statistical Appendix for major providers’ share of places.


Reflecting this, care-only homes tend to be smaller than with-nursing homes: Laing & Buisson data shows that in the UK as a whole, the average size of care-only homes for elderly and physically disabled people in 2004 was 24 beds, while that of with-nursing homes was 44 beds. See distribution below (for further details see Statistical Appendix):

DISTRIBUTION OF SIZE OF CARE HOMES FOR ELDERLY AND PHYSICALLY DISABLED PEOPLE, UK, 2004 (SOURCE: LAING & BUISSON DATABASE, APRIL 2004) (29)

No of beds Care-only homes % Care homes with nursing

% Total all care homes

%

Less than 10 1,058 13 18 0 1,076 8 10-19 2,429 29 183 4 2,612 20 20-29 2,439 29 898 19 3,337 25 Subtotal: less than 30

5,926 71 1,099 23 7,025 53

30-39 1,272 15 1,169 24 2,441 19 40-49 758 9 1,068 22 1,826 14 50-74 320 4 1,148 24 1,468 11 75 or more 33 0 369 8 402 3 Total 8,309 100 4,853 100 13,162 100 Average no. beds 24 44 n/a

Market trends in care homes for elderly and physically disabled people identified by Laing & Buisson (29) include increasing numbers of homes offering both nursing and personal care; a move towards larger homes, encouraged by economies of scale in delivery of nursing care and the specialist facilities required by dementia patients, and smaller homes responding to financial and regulatory pressures by switching away from elderly care to serve other types of service user, such as learning disabled people and drug and alcohol rehabilitation.

3.2.1.1 Adult placement: homes and schemes

Not all adult placement homes are registered with the CSCI, and transition to registration of adult placement schemes3 rather than individual homes is in place. A survey of adult placement schemes in England conducted in 2004 by Topss England and the National Association of Adult Placement Services(9) identified a total of 130 schemes, of which 112 were local authority-operated and 18 independent, with an average of 33 placement households each, suggesting a total of around 4,300 adult placement homes in England as a whole (c.f. the 1,469 registered with the CSCI at November 2004, Section 3.2.1).

3.2.2 Supported housing / assisted living

The provision of accommodation with centrally-provided care, variously known as ‘extra care’, ‘assisted living’, ‘housing with care’, ‘supported housing’, ‘very sheltered housing’ and ‘Category 2 ½ housing’, is treated for registration purposes as domiciliary care provision rather than as a care home by the CSCI. Typically, this type of accommodation features clusters of independent living units aimed primarily at elderly people, each self-contained with own kitchen, bathroom and front door, together with communal facilities, all designed to mobility standards. Central management provides domestic help, personal care and nursing care to residents as required.

In the 2004 edition of its annual survey of the UK market for care of elderly people (29), Laing & Buisson noted that no market data exist but estimated about 35,000 units of such accommodation for elderly and physically disabled people in the UK as a whole (accommodation for learning disabled people not included in this estimate). Developments may be publicly or privately funded, and units offered for sale or rent. Of the UK total, an estimated 30,000 are local authority-paid and 5,000 privately paid – purchased or rented. The main providers are housing associations, other voluntary sector organisations and local authorities.

3 Defined as schemes (managed by local authorities or independent (profit or non-profit making) bodies) responsible for recruiting, assessing, training and supporting Adult Placement Carers; for taking referrals, matching and placing service users with Adult Placement Carers, and for supporting and monitoring the placement. (9)


This approach to care has several advantages over care homes and domiciliary care in users’ original homes, including efficient delivery of care leading to cost savings and the ability to accommodate people for longer than would be possible in their own homes. Laing & Buisson suggest that the number of new developments may grow rapidly, possibly replacing significant numbers of care homes as the generation of elderly currently in long term care, who were brought up with low expectations in the pre-war years, are replaced by a different generation. “An indication of whether elderly people’s expectations really are changing will be their willingness to buy into the private ‘assisted living’ schemes that are becoming increasingly available.” (29) (35)

Research among people4 aged 16 and over conducted in early 2004 by MORI for the CSCI (34) found that 27% included ‘moving to sheltered housing with a warden’ and 25% ‘moving to sheltered housing with a warden and other social care services like hairdressing and organised social outings’ in the list of things they would prefer to happen to them as they got older, compared with 11% or fewer preferring to move to a residential home. Staying in their own home with support from family and friends and/or trained care workers were the most preferred options (56%+).

3.2.3 Day care

Day care is currently not subject to registration by the CSCI. There is a lack of up-to-date information about numbers of day care providers, apart from the 148 local authorities which employ staff to provide day care services (see Section 3.1 above). According to Laing & Buisson (29), day care services for adults, in which service users spend the day involved in activities at a day centre or hospital before returning home in the evening, are provided mainly by local authorities, voluntary organisations and NHS day hospitals, and there is little private sector provision.

Day care overlaps to some extent with other types of care, as providers of other care services may also offer day care. Nearly 20% of the domiciliary care providing outlets responding to the UKHCA’s 2004 survey of independent sector domiciliary care (8) said they were also providing day care. It is not clear how representative this is of all domiciliary care providers. There may be less overlap with care homes. Laing & Buisson’s survey of independent sector care homes for the elderly and physically disabled (29) found that very few offer day care as a stand-alone part of the business.

4 A total of 1,049 face to face interviews were conducted with a representative sample of people aged 16 and over in Great Britain.


3.2.4 Domiciliary care

Registration of domiciliary care agencies5 with the Commission for Social Care Inspection (CSCI) began on 1st April 2003; that of nurses agencies6 on 1st September 2002. By November 2004 a total of 3,684 domiciliary care agencies and 987 nurses agencies were registered on the Commission’s Registrations and Inspections Database. As shown in the table below, the majority of the domiciliary care agencies are private sector operations but 630 local authority agencies and 244 in the voluntary sector were also registered. There is a regional breakdown in the Statistical Appendix.

NUMBER OF DOMICILIARY CARE AND NURSES AGENCIES REGISTERED WITH CSCI AT 12 NOVEMBER 2004*, BY OWNERSHIP (SOURCE: CSCI REGISTRATIONS AND INSPECTIONS DATABASE)

Ownership: Private Voluntary Subtotal: independent

sector

Local authority

NHS Other ** Total

Domiciliary care agencies 2,642 244 2,886 630 26 142 3,684 % of total 72% 7% 78% 17% 1% 4% 100%

Nurses agencies 963 6 969 6 1 11 987 % of total 98% 1% 98% 1% 0% 1% 100%

Total registered agencies (including some double-counting)

3,605 250 3,855 636 27 153 4,671

% of total 77% 5% 83% 14% 1% 3% 100%

* Date is when data was extracted from database. **At the time of writing it was unclear what the ‘other’ category includes. There appears to have been a lack of standardisation about which organisations are included (which could account for there being a higher proportion of ‘others’

in some regions - see Statistical Appendix).

Some agencies provide both domiciliary care and nursing staff, and have to be separately registered for each activity, so are double-counted in the above table. Laing & Buisson (28) estimated that in 2004 there were 2,305 independent sector (commercial and not-for-profit) businesses providing nurses and/or domiciliary care workers in the UK as a whole, with a total of 4,230 branches. Of these branches, an estimated 750 (18%) were providing both domiciliary care and nursing staff, with a further 2,830 (67%) providing only domiciliary care staff and 650 (15%) only nursing staff, suggesting a total of 4,980 ‘registerable’ branches/outlets in the entire UK.

Applying this distribution to the CSCI totals for registered branches in England (in the above table) gives an estimated total number of branches of 3,968, split into 703 providing both domiciliary care and nursing staff, 2,654 domiciliary care only and 610 nursing staff only.

Of 618 independent sector domiciliary care branches providing data to the UKHCA’s 2004 survey of independent domiciliary care provision in England (8), over two-fifths (44%) were ‘large’, i.e. providing more than 1,500 hours of domiciliary care per week. A third (33%) were ‘small’, providing less than 500 hours per week, and 23% in the middle range (500-1,499 hours/week). However, it is not clear how representative these are of the industry as a whole7.

5 The term ‘agency’ is defined in the Department of Health’s February 2003 National Minimum Standards and regulations for domiciliary care as including ‘all providers of personal domiciliary care services in the private, voluntary and public sectors including the local authority’s own services, and NHS Trusts and supported housing or living schemes where applicable. Where an agency operates from more than one branch, each branch will have to register and be inspected, and will also be required to have a responsible and registered ‘fit manager’ in charge of the day to day provision.’ 6 Nurses agencies are defined in the Department of Health’s January 2003 National Minimum Standards and Regulations for nurses agencies as employment agencies, as defined in the Employment Agencies Act 1973, which broadly means providing services for the purposes of finding persons employment with employers, or of supplying employers with persons for employment by them. It also covers employment businesses, again as defined in the 1973 Act, who supply persons in the employment of the person carrying on the business, to act for, and under the control of, other persons. In the Standards, wherever the word “agency” occurs, it means the nurses agency or business, as set out above. Where appropriate it means each branch of the agency. “Nurse” means registered nurse, registered midwife, or registered health visitor. NHS nurse banks, including “NHS Professionals”, are exempt from the requirement to register as nurses agencies. Under the definition in section 4(5) of the Care Standards Act, there is nothing to prevent a nurses agency combining other businesses with the supply of nurses. However, agencies supplying domiciliary care workers have to be separately registered with the CSCI under the Act. 7 157 (25%) of the outlets included in this analysis were part of 4 organisations which operate at a national level.


Some domiciliary care agency businesses also provide other care services. Half of 528 independent sector domiciliary care organisations responding to the UKHCA survey (8) were providing one or more additional service(s). Eighteen percent were providing day care, 13% care home(s), 10% domestic services and nine percent sheltered or very sheltered housing. Again, however, it is not clear how representative this is of the entire domiciliary care industry in England.

3.2.4.1 Direct payments

At 30 September 2003 a total of 12,585 people were in receipt of direct payments from local authorities’ social services departments, thereby effectively becoming employers of care workers. This total is a 60% increase over the 7,882 twelve months’ previously. Since 2001, the range of people receiving direct payments has widened, with the main recipient group, adults with physical disabilities, falling from nearly 80% of the total in 2001 to just over half in 2003, and recipients for children’s care increasing from one to eight percent over the same period (see table; the split into adults’ and children’s care is approximate):

TOTAL NUMBER OF RECIPIENTS OF DIRECT PAYMENTS FROM LOCAL AUTHORITIES BY TYPE OF

RECIPIENT (SOURCE: INDICATOR 3344, PERFORMANCE ASSESSMENT DATA AND INFORMATION,

OCTOBER 2004 DATA SETS, NATIONAL INFORMATION, CSCI (3)

Type of recipient

People with Physical Disabilities (18-64)

Total recipients

at 30 September

2001 4,274

% share of total

Total recipients

% share of total

Total recipients

at 30 September

2003 6,944

% share of total

79

at 30 September

2002 5,459 69 55

Older People (65+) 537 10 1,032 13 1,899 15 Learning Disabled People (18-64) 353 7 736 9 1,337 11 Carers 21 0 95 1 957 8 People with Sensory Impairment (18-64) 100 2 159 2 207 2 Mental Health (18-64) 61 1 132 2 229 2 Young Carers (16-17) 3 0 3 0 12 0 Subtotal (approx): adult care 5,349 99 7,616 97 11,585 92 Carers of Disabled Children 66 1 228 3 875 7 Disabled Children (16-17) 8 0 38 0 125 1 Subtotal (approx): children’s care 74 1 266 3 1,000 8 Total all types of recipient 5,423 100 7,882 100 12,585 100

The extent to which local authorities are implementing direct payments varies; see Statistical Appendix for regional breakdown.

3.3 Care of children and young people

3.3.1 Children’s homes

At November 2004, 2,029 children’s homes were registered on the CSCI Registrations and Inspections Database. Of these, 1,196 (59%) were privately owned, 683 (34%) in local authority ownership, 101 (5%) in the voluntary sector, seven NHS and 42 (2%) in other types of ownership. A regional breakdown is in the Statistical Appendix.

3.3.2 Family centres

A total of 35 residential family centres were registered on the CSCI Registrations and Inspections Database at November 2004. The majority (25, 60%) are privately owned and seven (20%) in local authority ownership. For further details and regional breakdown, see the Statistical Appendix.

3.3.3 Fostering and adoption agencies

At November 2004 there were 232 independent fostering agencies, 143 local authority fostering services, and 62 voluntary and 148 local authority adoption agencies on the CSCI Registrations and Inspections Database. Three quarters (77%) of the independent fostering agencies are privately owned. (see Statistical Appendix for further details and regional breakdown.)


3.3.4 Direct payments

At September 2003 there were an estimated 1,000 recipients of direct payments from local authorities for children’s care (see Section 3.2.4.1 for further details).

3.3.5 Day care of children aged under eight

At the end of September 2004 a total of 106,700 providers of childcare for children under eight were registered with Ofsted in one or more of five categories (defined below). Childcare of less than two hours a day is not regulated by Ofsted, nor is care of children aged eight or over. Registered childminders8 account for the majority of providers, but full day care and out of school settings provide the majority of places.

NUMBERS OF REGISTERED CHILDCARE PROVIDERS AND PLACES IN ENGLAND AT 30 SEPTEMBER 2004 (SOURCE: OFSTED DATABASE)

Type of provider

Childminders

No. of providers9

71,900

% of total

67

No. of places10

320,300

% of total

22

Average places / provider

4.5

Ofsted definition

Registered to look after 1 or more children under the age of 8 to whom they are not related on domestic premises for reward and for a total of more than 2 hours in any day

Full Day Care 11,900 11 500,700 34 42.1 Facilities that provide day care for children under 8 for a continuous period of 4 hours or more in any day in premises which are not domestic premises. Includes day nurseries and children’s centres, and some family centres

Sessional Day Care

10,900 10 263,700 18 24.2 Facilities that provide day care for children under 8 for a session which is less than a continuous period of 4 hours in any day in premises that are not domestic premises. Where 2 sessions are offered in any one day, individual children must not attend more than 5 sessions in a week

Out of School Day Care

9,700 9 343,500 23 35.4 Facilities that provide day care for children under 8 which operate during one or more of the following periods: before school, after school, during the school holidays. The total care provided is for more than 2 hours in any day and for more than 5 days a year. Open Access Schemes are included

Crèche Day Care

2,400 2 41,900 3 17.5 Facilities that provide occasional care for children under 8 and are provided on particular premises on more than 5 days a year. They need to be registered where they run for more than 2 hours a day, even when individual children attend for shorter periods

Subtotal excl Childm’ders

34,900 33 1,149,800 78 32.9

Childminders 71,900 67 320,300 22 4.5 Registered to look after 1 or more children under the age of 8 to whom they are not related on domestic premises for reward and for a total of more than 2 hours in any day

Total: 106,700 100 1,470,200 100 13.8

In response to Government policies, numbers of childcare providers and places have increased steadily in the past few years. Since numbers of registrations were first published by Ofsted in March 2003, the number of providers has increased by 7% and places by 12%, with increases in all types of provision except sessional day care, which mainly comprises playgroups and pre-schools. See the Statistical Appendix for trend data and also regional breakdowns of providers.

8 No estimates of the number of unregistered childminders have been found. 9 Registered Providers = the number of settings offered by providers registered on the database at the time of the report. As not all providers inform Ofsted that they have ceased provision, this number is likely to be higher than the actual number of providers. 10 Registered Places = the number of children that may attend the provision at any one time. Registered places are not the number of places occupied, nor the number of children who may benefit from receiving places through providers offering sessions at different times of the day. The number of registered places is likely to be higher than the actual number of registered places as not all providers will immediately inform Ofsted that they have ceased their provision. For about 10% of providers, the database does not hold the number of registered places. In these cases, the number of places has been estimated and included in the figures shown.


-

-

Ofsted’s end-September 2004 total of 106,700 includes around 1,700 (2%) providers who are counted more than once, being registered to provide more than one type of day care. The findings of the 2003 Childcare and Early Years Workforce Surveys (20-24), conducted in early 2003, suggest that up to 10% of providers offer more than one type of care, with predictable overlap between out of school and holiday clubs in particular:

TYPES OF CHILDCARE OFFERED BY PROVIDERS IN ENGLAND (SOURCE: CHILDCARE AND EARLY YEARS WORKFORCE SURVEYS, 2003) (20-24)

Day Nurseries and other full

day care provision (20)

Playgroups and pre

schools (21)

Out of school clubs (22)

Holiday clubs (24)

Total these types of provider

Base = estimated total (early 2003) 10,000 11,900 4,500 2,800 29,200 Other types of childcare offered: % % % % %

Full day care 100 5 11 14 39 Playgroup/pre-school 6 100 7 14 45

Out of school club 5 2 100 43 22 Holiday club 2 2 27 100 15

Three-quarters or more of most types of childcare is provided by the independent sector, with the private sector dominant in day nurseries but the voluntary sector stronger elsewhere (see table).

OWNERSHIP OF CHILDCARE PROVISION IN ENGLAND (SOURCE: CHILDCARE AND EARLY YEARS

WORKFORCE SURVEYS, 2003) (20-24)

Type of ownership Day Nurseries and other full

day care provision (20)

Playgroups and pre

schools (21)

Out of school clubs (22)

Holiday clubs (24)

Total these types of provider

Base = estimated total (early 2003) 10,000 11,900 4,500 2,800 29,200 % % % %

Private: owner-manager/part of chain 77 26 36 29 45 Voluntary/community/Church group 9 68 40 32 40 Sub-total: Independent sector 86 94 76 61 85 Local authority 6 4 11 29 8 School/college 7 2 13 7 6 Other 4 4 4 3 4

Laing & Buisson’s 2004 Survey of Children’s Nurseries in the UK (30), which covered the UK as a whole but excluded nurseries in schools, also found a high proportion of nurseries owned by private sector operators. Of these, just under half are companies, which tend to operate larger nurseries:

STRUCTURE OF THE UK CHILDREN’S NURSERY MARKET, JANUARY 2004 (SOURCE: LAING & BUISSON) (30)

Estimated total No. nurseries

12,075 % 100

No. places 537,450

% Average places / nursery 45100

Total for profit operations 10,200 84 465,000 87 46 companies 4,290 36 217,550 40 51

sole traders and partnerships 5,910 49 247,450 46 42 Total not-for-profit operations 1,875 16 72,450 13 39

voluntary 1,150 10 43,300 8 38 local authorities 725 6 29,150 5 40


Sure Start statistics produced in 200411 showed that local authorities in England were providing a total of 1,282,190 childcare places via 524 Sure Start local programmes, 1,132 Neighbourhood Nurseries, 107 Early Excellence Centres and 63 Children’s Centres (some of the latter also included in the preceding categories). The Government’s target is for 1,700 Children’s Centres by 2008. These will subsume the Sure Start local programmes, Neighbourhood Nurseries and Early Excellence Centres, and will provide a range of integrated services in five key areas: childcare, early years education, family support and health and employment services. (13)

3.3.5.1 Length of time in operation

The 2003 Childcare and Early Years Workforce Surveys (20-24) found that the majority (73%) of registered day nurseries and other full-day childcare provision have been in operation for five years or more, as have 90% of playgroups and pre-schools, 60% of out of school clubs, 70% of holiday clubs and 58% of childminders.

Analysis of Ofsted’s database of childcare providers indicates that around 14% of full day care providers and up to a fifth of others registered ceased to provide that particular type of childcare in the 15 months between March 2003 and June 2004 – although could have remained in operation providing other types. See table below for details:

CHILDCARE PROVIDER TURNOVER RATES BETWEEN 31 MARCH 2003 AND 30 JUNE 2004 BY TYPE OF

PROVIDER (SOURCE: OFSTED, PERSONAL COMMUNICATION)

Provider type: Childminder Full day care Sessional day care Out of school day care Crèche day care Turnover* 21.3% 13.5% 18.2% 18.4% 21.7%

* Turnover is defined as number of providers leaving in the period ÷ average number of providers during the period x 100. Providers who cease to offer a particular type of day care but remain registered on the Ofsted database are included.

3.3.6 Schools

At January 2004 there were 25,543 schools in England, many of which could be considered to employ social care staff (see Section 4.6.2). The majority of these are primary schools (see table). For regional breakdown see Statistical Appendix.

NUMBER OF SCHOOLS IN ENGLAND, JANUARY 2004 (SOURCE: STATISTICS OF EDUCATION: SCHOOLS IN ENGLAND, 2004 EDITION, DFES, 2004) (6)

Type of school Number Nursery schools: LEA maintained 468

Nursery schools: direct grant 2 Total nursery schools 470 Primary schools 17,762 Secondary Schools 3,409

Special schools: LEA maintained 1,078 Special schools: non-maintained 70

Total special schools 1,148 Pupil Referral Units 426 Independent 2,302 City Technology Colleges 14 Academies 12 Total 25,543

At the time of writing, no details of the 100-odd extended schools12 in England were available. Working in partnership with voluntary, private and public sector bodies, schools participating in the DfES Extended Schools programme establish a range of services and facilities on their premises to provide additional facilities for the local community, including before and after-school activities, childcare, advice etc. (13)

11 Source: Sure Start website 23 June 2004, accompanying announcement of early findings of Sure Start evaluation. 12 Care and Health magazine reported (28 September 2004) that there were 106 extended schools in England.


3.3.6.1 Residential special schools and boarding schools

A total of 247 residential special schools were registered on the CSCI Registrations and Inspections Database at 12 November 2004. Half these special schools are local authority-owned and a further 29% in the private sector. There were also 553 boarding schools on the database. For further details and regional breakdown, see the Statistical Appendix.

3.3.7 Connexions service

There are 47 Connexions partnerships in England, providing personal advisory services to young people aged 13-19. They use the same boundaries as the Learning & Skills Councils. (15)

3.3.8 The Children and Families Court Advisory and Support Service (CAFCASS)

CAFCASS, a non-departmental public body whose remit is to safeguard and promote the welfare of children involved in family court proceedings, employs various staff to work with children and families. It operates in nine regional areas in England, and in Wales.

3.3.9 Other services for children and young people

Other services which could provide care to children and young people as part of a range of other services include learning mentors, behaviour enhancement and support teams, education welfare services, educational psychology services, play work services, sport and leisure services, youth work services and youth offending teams. (15)


3.4 Partnership working between employing organisations

3.4.1 Partnership arrangements under the 1999 Health Act

A total of 811 partnerships involving local authorities (with social services responsibilities) were in operation or preparation at 31 March 2004, via flexible joint working arrangements established under the Health Act 199913. This is an average per authority of 5.6, but while some authorities have established or are establishing many partnerships, others have only one or two, or even none, as shown below:

TOTAL NUMBER OF PARTNERSHIPS IN USE OR IN PREPARATION USING HEALTH ACT FLEXIBILITIES -

NATIONAL PICTURE AT 31 MARCH 2004, ENGLAND (SOURCE: INDICATOR 3301, PERFORMANCE

ASSESSMENT DATA AND INFORMATION, OCTOBER 2004 DATA SETS, NATIONAL INFORMATION, CSCI (3)

London

Total number Maximum per Minimum per Average per of authority

13

authority

1

authority partnerships

186 5.6 Outer London 116 n/a n/a 5.8 Inner London 70 n/a n/a 5.4

South East 112 22 1 6.2 North West 112 11 2 5.1 West Midlands 105 15 2 7.5 Yorkshire & Humberside 85 16 2 5.7 South West 66 7 2 4.4 North East 55 10 1 5.0 East Midlands 48 11 0 5.3 Eastern 42 7 1 4.7 England total 811 22 0 5.6 Metropolitan Districts 189 n/a n/a 5.4 Shire Counties 216 n/a n/a 6.8 Unitary Authorities 220 n/a n/a 4.8

Since 2001 the Social Services Workforce Surveys have sought information about the extent to which local authority social services departments are involved in various types of partnership working. Information from consecutive surveys is summarised overleaf.

13 Section 31 of the Health Act 1999 contains powers allowing NHS and local authority social services budgets to be pooled, for local authorities to provide some NHS services and vice versa, and for each to delegate to the other responsibility for commissioning health and social care services. Partners can include health bodies , e.g. SHAs, NHS Trusts and PCTs, and any other health-related local authority services, such as social services departments, housing, transport, leisure and library services. The Act’s provisions include pooled budgets, lead commissioning, whereby one authority is enable to transfer funding and delegate functions to the other and take responsibility for commissioning health and social care, and integrated provision whereby an NHS Trust or PCT is enabled to provide social care services, such as social care staff working alongside GPs or other members of primary and community health teams, or a social services department in-house provider is enabled to provide community health services such as chiropody, physiotherapy. (35)


3.4.1.1 ‘Section 31’ staff transfers

Local authorities can transfer employees to ‘Section 31 services’ either on secondment or under TUPE (Transfer of Undertakings (Protection of Employment)) Regulations. The table below shows the number of authorities which had transferred employees under such arrangements in the periods leading up to the relevant surveys, out of the total number responding to the surveys (data are not additive because the same authority can have made more than one arrangement).

During both the 2001-2 and 2002-3 survey periods just under half of the responding authorities had transferred employees (see table). See Statistical Appendix for regional breakdown.

NUMBERS OF RESPONDING LOCAL AUTHORITIES HAVING MADE EMPLOYEE TRANSFERS UNDER

SECTION 31 PARTNERSHIP WORKING ARRANGEMENTS (SOURCE: SCHWG SOCIAL SERVICES

WORKFORCE SURVEYS)

At September 2001 Between September 2001 and September 2002

Between September 2002 and September 2003

Base = total local authorities responding:

95 84 82

Number having transferred employees in this time period

24 40 39

% of total responding 25% 48% 48%

Note that the data in this table are NOT grossed up to national totals

The surveys have also found:

• The employees most usually affected have been social workers. • Most transfers have been to NHS Trusts and mental health Trusts. • Most of the service provision has been for mental health, older people and learning disability.

In the 12 months to September 2003 the median number of social services department employees transferred was 58, more than in the previous two survey periods. Data on the number of employees transferred is summarised in the table below – note that not all the authorities which had made transfers provided this information so that table is based on a fairly small number of authorities:

NUMBERS OF EMPLOYEES TRANSFERRED UNDER SECTION 31 PARTNERSHIP WORKING

ARRANGEMENTS (SOURCE: SCHWG SOCIAL SERVICES WORKFORCE SURVEYS)

At September 2001 Between September 2001 and September 2002

Between September 2002 and September 2003

Base = local authorities providing data 17 31 24 Total staff transferred 757 2,323 2,768 No. transferred as % of total staff 2% 3% 6% Smallest number of staff transferred 1 3 1 Largest number of staff transferred 182 600 500 Median number of staff transferred 31 30 58

Note that the data in this table are NOT grossed up to national totals

3.4.1.2 Other Health Act partnership arrangements

The table overleaf summarises the information available from the 2002 and 2003 Social Services Workforce Surveys on the diverse range of other partnership working arrangements in which the responding local authorities were involved. Note that because of multiple mentions and incomplete data, numbers do not sum to total partnership arrangements. See the Statistical Appendix for regional totals.


OTHER PARTNERSHIP WORKING ARRANGEMENTS IN WHICH RESPONDING LOCAL AUTHORITY SOCIAL

SERVICES DEPARTMENTS (SSDS) ARE INVOLVED (SOURCE: SCHWG SOCIAL SERVICES WORKFORCE

SURVEYS 2002 AND 2003)

Between Sept 2001 and Sept 2002

Between Sept 2002 and Sept 2003

Base = local authorities responding to this part of the survey

78 84

Number involved in other partnership arrangements 63 67 % of total responding 81% 80% Total no. of arrangements 128 113 Average arrangements per responding authority 2.0 1.7 Base = total arrangements 128 113 Partners involved:

NHS Primary Care Trust PCT 70 78 NHS mental health Trust 44 45 Local education authority 21 20

Independent sector organisation 26 18 Local authority housing department 11 14

NHS acute Trust 16 10 SSD of another local authority 9 10

Another NHS body 10 5 Other organisations including the police, probation

services, Connexions, youth justice services 18 18

Partnership models: Partnership boards 53 59

Commissioning led by the local authority 25 30 Both commissioning and providing led by the local

authority 18 24

Providing led by the local authority

the state of the social care workforce 2004-workforce... · the state of the social care workforce...

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