Recommendation		Page
1	The Adult Social Care department and the Employability and Skills team to explore the options for broadening engagement in the work of the Health and Social Care Sector Task Group, to include consideration of: · enhancing links between the ASC department and the work of the Employability and Skills Team; · the pathways for independent sector views to feed into the Task Group and for the work of the Task Group to be promoted in ongoing engagement with the sector; and · the potential to expand the membership of the Health and Social Care Sector Task Group to include representatives of the independent sector.
2	With a view to increasing the numbers of Industry Champions and Open Doors opportunities drawn from the independent sector, the Adult Social Care department and Employability and Skills Team to work together to identify ways to further develop the Careers Hub’s approach to generating interest in these roles. The aim being to create a pool of participants which is more proportionate to the size of the care sector in East Sussex. All contracts of £100,000 or more issued to the Independent Care Sector by the Adult Social Care department to include social value skills targets that are facilitated by the Employability and Skills Team.
3	The Adult Social Care department to work with the Apprenticeship Team to assess the impact of levy funding in relation to care sector employers. This could include evaluating: · the level of interest from the care sector and whether further promotion is needed; · the effectiveness of the process for identifying which providers are allocated the levy funding; · whether the funding successfully targeted those areas where the recruitment pressures are the most challenging; and · whether vulnerable groups, such as Looked After Children, have been identified by the Apprenticeship team as requiring any additional support to access apprenticeships funded through the levy.
4	All councillors, via their connections with local groups and organisations, to help raise awareness of the role of the Personal Assistant and the related advice and support available from the Support with Confidence team.
5	The Adult Social Care department to explore the feasibility and potential benefits of developing a bespoke website to provide information on jobs and careers in the East Sussex care sector.
6	The Adult Social Care department to: continue to reinforce the national recruitment campaign locally via support from the East Sussex County Council’s Communications Team; and · work with the Employability and Skills Team to ensure that this is integrated into the cross sectoral careers campaign run by Skills East Sussex.

Objectives and Scope of the Review

1. Members of the People Scrutiny Committee are aware of a range of challenges facing the local care market. Some of these were highlighted in the 2018 Care Quality Commission Local Area Review of East Sussex; others are well known locally and nationally and are linked to increased demand for services and resources which are declining in relative terms. The Committee established a Scoping Board to explore these challenges, with the aim of identifying specific areas which would benefit from additional scrutiny. The Scoping Board found that the Adult Social Care (ASC) and Health department has a range of initiatives in place to manage the immediate and short-term issues, particularly in terms of engagement with providers and the NHS to support the market and deliver appropriate and more integrated care. Work is also underway to address longer term challenges and this was the focus for scrutiny.

2. It was apparent to the Scoping Board that the care market will need to change significantly in the coming years to adapt to increasing demand, changing public expectations and the reduced resources available for statutory services. These challenges are particularly acute in East Sussex given the county’s demographics. The Scoping Board identified four key areas for scrutiny:

· Public understanding and expectations of social care (subject of a completed scrutiny review)

· Social care workforce challenges

· Developing care markets

· Increasing community resilience, in particular addressing loneliness.

3. This review seeks to address aspects of the developing workforce challenges facing social care providers (the second bullet point above). The review is timely as the recruitment and retention challenges in this sector are stark. For example, Skills for Care (SfC) estimate that if the workforce continues to grow proportionally to the projected number of people aged 65 and over, then the number of adult social care jobs in the south east region will increase by 48% by 2035. Given the demographic profile of the county, the required increase in the size of the workforce in East Sussex is potentially even higher.

4. The Committee agreed three areas of focus for the review:

· Older people’s services: It was agreed to focus on social care for older people as this is the biggest and the fastest growing area of demand for Adult Social Care.

· Independent Care Sector: It was agreed to focus on workforce issues within the independent sector (as opposed to the social care workforce directly employed by the ASC and Health department). This is because the independent sector is by far the largest employer of adult social care staff in the county.

· Commissioned services: It was agreed that the review should focus particularly on independent sector services commissioned by the ASC department.

5. The Committee also agreed that the review should consider the following two lines of enquiry which specifically relate to the Council’s role:

· Is the Council working effectively in partnership with others (e.g. schools and colleges) with regard to future workforce needs?

· Could the Council do more to support recruitment and retention in the independent sector?

6. This report presents a summary of the Board’s findings in relation to these questions and its recommendations. The Board focused on developing recommendations which are realistically achievable and within the Council’s sphere of influence and available resources.

Background

Adult Social Care responsibilities

7. Section 5 of the Care Act 2014 states that a local authority has a duty to ‘promote the efficient and effective operation of a market in services for meeting care and support needs’. The aim of this duty includes helping to ensure that residents who wish to access care services in the local care market have a range of providers to choose from who (taken together) provide a variety of high quality services. The Act also states that in performing its duty to promote a diverse and high quality care market, the local authority must also have regard to the need to:

· ensure that it is aware of current and likely future demand for such services and to consider how providers might meet that demand; and

· the importance of fostering a workforce whose members are able to ensure the delivery of high quality services.

8. The above (and other associated) duties are often to referred to as ‘market shaping’. In line with national recommendations, the county council has produced a ‘Market Position Statement’, designed to help the social care provider market to contribute and respond to emerging need, required service developments and pathway reconfiguration.

9. The position statement supports the development of the social care workforce by providing information about where demand is likely to increase and therefore where workforce capacity and skills will need to develop. It also sets out how the council supports the independent sector in terms of training and workforce development.

The social care workforce

National context

10. The number of adult social care jobs in England was estimated by Skills for Care at 1.6 million in 2017. Only 22% of the total workforce were employed by local authorities, by the NHS (who have employees who are classified as adult social care workers) or in support of direct payments (clients employing care workers themselves with funding provided by a local authority). This means that independent providers, with 78% of the total workforce, are by far the largest employers in the sector. Services within the independent sector include residential nursing homes, residential care homes, home care, and extra care (which includes sheltered housing). The social care workforce comprises: contracted staff; casual staff; agency staff; self-employed personal assistants; front line staff and managers.

Local context

11. In line with the national picture, the majority of the social care workforce in East Sussex is employed by small independent organisations in the private and voluntary sectors. The county council purchases (commissions) services from some of these independent providers for clients who are entitled to funded social care services from the council under the appropriate legislation. However, many older people in the county (or their relatives) purchase care services direct from these organisations and pay for them without the involvement of the council. These people are often called ‘self-funders’.

12. Skills for Care (the sector skills council for adult social care which takes a strategic lead on workforce development) estimates that in East Sussex in 2017 there were an estimated 21,000 jobs in adult social care. These were split between local authorities (9%), independent sector providers (83%) and jobs for direct payment recipients (9%). The figures indicate that the majority (79%) of the workforce in East Sussex was female and the average age was 43 years old. Those aged 24 and under made up 10% of the workforce and those aged over 55 represented 25%. Given this age profile approximately 5,200 people will be reaching retirement age in the next 10 years.

13. Pay rates for social care occupations in East Sussex are generally lower than average rates in the south east region, although usually higher than average rates in England. For example, the average hourly rate of a care worker (in 2017/18) was £8.27 in the county, £8.37 in the south east, and £8.19 in England. Skills for Care estimates show that 50% of the workforce in East Sussex hold a relevant adult social care qualification (49% in the south east and 53% in England). Of those workers without a relevant adult social care qualification recorded, 56% had three or more years of experience in the adult social care sector, 64% had completed or were in the process of an induction and 31% had engaged with the Care Certificate.

Future trends and challenges

14. Demographic pressures: The population in England aged 65 and above is projected to increase to 14.5 million by 2035 (from a population of 10 million in 2017). This necessitates a huge increase in the capacity of health and social care services, a challenge which will increasingly impact on all local authorities with social care responsibilities. Given the older than average age profile in East Sussex, the situation here is even more challenging. For example, assuming the workforce grows proportionally to the number of people aged 75 and over in the population, it is estimated that by 2030 the adult social care workforce in East Sussex will need to grow by 55% to meet the needs of the ageing population. This would result in an increased workforce total of 32,600 jobs in the social care sector in East Sussex (as opposed to the 2017 figure of 21,000). Whilst this figure includes those directly employed by the local authority and the NHS, the main impact of this potential increase in demand will be felt within the independent sector, given that over three quarters of care jobs are within that sector.

15. New skills required: As well as increased capacity in the social care workforce there is a need to develop the skills within that workforce to meet future needs. Health and social care services are becoming increasingly integrated, leading to new and different roles. The skills required of health and social care staff are undergoing significant changes as the roles increasingly require workers to enable people to manage their own health and care with support from technology. And, as people are supported to live independently at home for as long as possible, those needing residential or nursing home care are likely to have more complex needs requiring additional skills from staff. There is an increasing demand for newer roles such as Personal Assistant which require skills in managing a business as well as care and support.

16. Recruitment and retention: The scale of the recruitment and retention challenge in the sector is demonstrated by estimates from Skills for Care that in England in 2017/18 approximately 390,000 care workers left their job during the year and there were around 110,000 vacancies at any one time. The adult social care workforce within East Sussex has a vacancy rate of 8.6%, which equates to 1,700 vacancies at any one time. This vacancy rate is similar to the region average, at 8.7% and similar to England at 8.0%. The turnover rate in the workforce is high, at 31% overall and 36% for direct care roles. There is significant churn within the system with staff moving from one care role to another. However, whilst the turnover rate is relatively high, many staff are remaining within the care sector. National research suggests that it is difficult to attract workers because of relatively low pay and negative perceptions of the work. Compared to its neighbouring local authorities, East Sussex has the lowest rate of zero-hour contracts at 15%, compared to 26% in Kent, 24% in Brighton and Hove and 23% in West Sussex and Surrey.

17. Future national policy: There are significant uncertainties nationally regarding the direction of travel for adult social care policy. An anticipated Green Paper is still awaited and it is unclear if or how future government funding of adult social care will respond to demographic changes and the significant pressures on local authority budgets. In addition, there may be some impact on the social care workforce from Brexit as some staff working in the care sector in the UK are from EU countries. These factors contribute to a challenging backdrop for adult social care workforce planning and development.

Findings and Recommendations

Workforce planning and development

18. The Board heard that the Council works with Skills for Care to ensure a good understanding of future workforce needs both for the local authority itself and the independent sector. This includes projections of total future workforce needs and by type of role and service.

19. The Council’s Market Position Statement provides an overview for the independent sector of where future demand is expected to fall, both geographically and by type of service, to inform the sector’s plans for service development and the associated workforce requirements. The statement concludes that, if the current volumes of service provision and purchasing patterns are applied to the demographic data for East Sussex, there is an expectation that demand will continue to rise in the following areas:

· Personal Assistants: Given the trend for people to increasingly want to stay in their own homes, it is anticipated that the demand for Personal Assistants that can support more complex health and social care needs will continue to grow.

· Home care: Whilst in some areas of the county there is currently sufficient home care provision, there are locations in the county which have a shortfall of care options for clients.

· Dementia residential care: additional dementia residential care is needed in the west of the county.

· Nursing care: nursing and dementia nursing provision across the county which is able to cope with a clientele that has increasingly complex levels of need.

20. The Board was therefore satisfied that there is a good picture of future care and workforce needs available to both the ASC department and independent providers, and that this forms the basis of efforts to address workforce challenges. The Board went on to consider the work being undertaken by the council and its partners to develop the social care workforce and the effectiveness of these initiatives.

Skills development

21. The Board was informed about the work of Skills East Sussex (SES), the county’s recognised strategic body for employment and skills and the East Sussex sub-board of the South East Local Enterprise Partnership Skills Advisory Group. SES is made up of representatives from colleges, universities, secondary schools, business representatives, employment agencies (DWP, careers service) and other key stake holders.

22. The overarching goal of SES is to agree and set priorities and provide direction for the county’s approach to employment and skills. The main responsibilities of SES include providing forums and spaces that enable businesses and providers to develop a common understanding of employment and skills needs and deliver joint actions to address these. The responsibilities also include developing a sustained dialogue with East Sussex employers to:

· Identify generic and sector-specific skills needs and develop effective strategies to address these;

· Promote employer investment in workforce skills; and

· Encourage employer involvement in activities to promote and develop skills amongst young people and vulnerable adults.

23. The work of SES is supported by the council’s Employability and Skills Team. The team is uniquely positioned between the Communities, Economy and Transport department and the Children’s Services department. The Employability and Skills Team aims to embed activities relating to employment and skills across all relevant areas of the council’s activities. The team’s activities include:

· Updating and publishing a Sector Skills Evidence Base which is used to inform strategies for developing the county’s skills landscape and addressing skills gaps. (The details of the evidence bases for each sector, including Health and Social Care, are available via the Council’s East Sussex in Figures service.)

· Overseeing and coordinating the work programme of six Sector Task Groups, including a Health and Social Care Sector Task Group.

24. The Review Board focused on the role of the above mentioned Health and Social Care Sector Task Group and its potential for improving links with the independent sector. The Board were informed that the membership of the group includes a wide variety of representatives from the health and social care sector (including Skills for Care, Health Education England and the NHS and the Adult Social Care and Health Department). The scope of the Group is to:

· Identify ways of promoting careers in the Health and Social care sector to those in education, returning to work, considering a change in career

· Explore ways of upskilling those in employment in the sector to ensure that East Sussex has a highly skilled Health and Social Care workforce

· Explore and develop new ways and models for supporting and delivering Health and Social care teaching and training (e.g. virtual and remote learning)

· Promote Apprenticeships within the sector and encourage young people to explore working in the sector

· Examine opportunities for encouraging more men to take up work in the health and social care sector.

25. The Board heard that the Group have developed a range of initiatives. These include, for example:

· HEE and ESCC ASC staff providing training for secondary school Careers Leaders/ Coordinators on pathways in to Health and Social Care in December 2018.

· In December 2018, East Sussex Healthcare Trust, with the support of ESCC, won a bid through the Pears#iwill Fund to develop a Youth Volunteer Manager post to develop opportunities for young people to volunteer within health and social care settings.

26. Whilst the Board welcomed the creation of the Task Group and the range of activities it is undertaking, Members heard that there is scope to improve awareness of its work within the ASC department, including the impact of its initiatives and whether more needs to be done to ensure that it is addressing the needs of the independent sector. For example, the Board discussed the provision of work experience and were informed that it can be difficult to find placements for under 18’s in the care sector. This is because some providers are stricter about the type of experience they are able to offer. Despite some of these challenges, the Board were informed that significant numbers of placements are being made by the work experience team which is based within the Children’s Services Department. For example, in the academic year 2018-2019 there were 158 placements within the care sector as a whole. Whilst welcoming the number of placements, the Board heard that there is scope for ASC to be more engaged with this programme of work experience.

27. The Board were also informed that there may be a lack of awareness amongst independent sector providers too. For example, the Registered Care Association for East Sussex were not aware of the work of the Task Group within the independent care sector itself. Given that one of the key goals of SES is to provide forums for employers to discuss the skills gaps in their sectors, the Board concluded there is potential to broaden engagement.

28. Evidence considered by the Board indicated that there is scope to develop a clearer pathway for independent provider views to feed into the Task Group, informed by the engagement work which is already undertaken by the ASC department. A clearer pathway of this kind could help the council’s employment and skills strategy be informed by a more developed picture of the needs of the sector. Given the size and importance of the independent sector, the Board concluded that there is a need to more closely align the activities of the Employability and Skills Team with the work being undertaken within the ASC department and with the independent sector itself. This should include considering whether the membership of the Task Group could be expanded to incorporate independent sector representation. The Board also considered that given the scale of challenges facing the sector, that the Task Group should be reconvened as soon as practicable and that further steps should be taken to promote the work of the Task Group within the independent sector.

Recommendation 1

The Adult Social Care department and the Employability and Skills team to explore the options for broadening engagement in the work of the Health and Social Care Sector Task Group, to include consideration of:

· enhancing links between the Adult Social Care department and the work of the Employability and Skills Team;

· the pathways for independent sector views to feed into the Task Group and for the work of the Task Group to be promoted in ongoing engagement with the sector; and

· the potential to expand the membership of the Health and Social Care Sector Task Group to include representatives of the independent sector.

Engagement with schools and colleges

29. Given the need to attract additional workers into social care, and the older age profile of the current workforce, the Board investigated whether effective partnerships are in place with schools and colleges to promote care as a career to school and college students. Another key area of activity for the Employability and Skills Team relates to the Careers Hub East Sussex. Launched in September 2018, the Careers Hub works strategically with the senior leadership of all 40 secondary schools, special schools and colleges in the county to improve the quality of careers, employability and enterprise by meeting the eight Gatsby Benchmarks of Good Careers Guidance, as set out in the Department for Education’s Careers Strategy (December 2017).

30. The Board were informed that the Careers Hub engages with educational institutions and businesses in initiatives such as:

· Industry Champions: These are individuals who are directly involved with delivering activities for young people in schools. The expectation is that the volunteers who perform this role will have an ability to present their role, experience and knowledge with a positive energy and strong understanding of their industry. They are expected to commit some time to careers and enterprise activities in schools such as giving talks at school/college events, mentoring young people, attending careers fairs, giving premises tours or offering work experience opportunities. Candidates can come from any level of work (CEOs, sole traders, freelancers, or apprentices), the key quality being that individuals must have an interest in sharing their experience of work and promoting their industry.

· Open Doors: This is a workplace-based project which offers school pupils across East Sussex an opportunity to visit workplaces and hear from employers about the range of jobs they offer and the career paths into their sector. This initiative aims to help pupils by providing essential knowledge and experience which can help inform decisions about their career path. It also benefits employers as it offers the opportunity to engage with young people who might be attracted to pursue careers in their industry.

31. The Board were informed that the goal is to expand the network of Industry Champions, particularly with regard to a priority sector like health and social care. The Board also heard that the Employability and Skills Team are looking to further develop initiatives that help stimulate workforce growth in the independent sector and its work in this area could be accelerated if contacts with organisations in the sector were expanded.

32. The Board welcomed the steps being taken by the Careers Hub, including the Industry Champions and Open Doors initiatives. However, they were also informed that in the context of a care market of hundreds of employers, only a small number of Champions are drawn from the independent sector. The Board concluded that this figure highlights the need to improve the sector’s engagement as the current low number of champions will not provide enough opportunities to make a significant difference to the numbers of young people interested in pursuing a career in the sector which employs the majority of care staff. The Board agreed that it was especially important that this area should be developed ahead of the introduction in 2021 of the new T Level courses in social care. (T-levels are new technical qualifications aimed at putting vocational qualifications on an equal footing with academic ones and making access to the job market easier.)

33. The Board also discussed the ASC department’s role as a major commissioner of independent care services and whether there is potential to use its commissioning position to secure commitments to workforce skills development from independent care contractors. In addition to the Industry Champions and Open Doors activities discussed above, a policy of this kind could also include asking contractors to commit to participation in:

· Offering work experience

· Offering apprenticeships

· Taking part in the Skills East Sussex H&SC task group

Recommendation 2

· With a view to increasing the numbers of Industry Champions and Open Doors opportunities drawn from the independent sector, the Adult Social Care department and Employability and Skills Team to work together to identify ways to further develop the Careers Hub’s approach to generating interest in these roles. The aim being to create a pool of participants which is more proportionate to the size of the care sector in East Sussex.

· All contracts of £100,000 or more issued to the Independent Care Sector by the Adult Social Care department to include social value skills targets that are facilitated by the Employability and Skills Team.

34. A further avenue for the Council and care sector employers to work in partnership with colleges and universities is via apprenticeships. From April 2017, all employers with an overall paybill of £3m or more were required to pay into an apprenticeship levy, calculated at 0.5% of the paybill. For East Sussex County Council, this currently equates to a levy of approximately £1.1m per annum. Levy funds can only be used to fund apprenticeship training and are stored in a digital apprenticeship account. From April 2019 it was agreed that levy paying employers can use up to 25% of their annual levy pot to pass on to other employers to fund external apprenticeship activity.

35. Prior to the 25% optional external allocation coming into effect in April 2019, the council’s Apprenticeship Team made contact with local colleges and universities to make them aware it was ESCC’s intention to use the 25% funding to support primarily small and medium sized non-levy paying businesses in the county. This was in support of promoting apprenticeship opportunities in priority areas, including adult social care.

36. East Sussex County Council is now working closely with the Sussex College Group, Plumpton College and Brighton University to offer the opportunity of apprenticeship funding to the network of employers these organisations work with. In addition, this opportunity has been offered out via Procurement and the ASC department to their supply chain of care organisations. The Board was informed that there had been a very positive response from small and medium sized organisations within the county who wished to participate in the apprenticeship scheme. The scheme is proving popular as it supports a provider by organising staff training through colleges and universities which is paid for via the council. At the time of producing this report for example, and in partnership with local apprenticeship training providers, a commitment has been given to fund 29 x Care based apprenticeships at independent care homes within East Sussex. It is hoped to release more funds to support care-based apprenticeships at the end of September 2019. As this is the first year of funding apprenticeships through the 25% levy drawdown, officers will also have an opportunity to evaluate the scheme across all sectors. This will help inform the approach going forward.

37. Officers indicated that going forward it may be possible to more specifically pinpoint areas the council wants to concentrate on, for example to specify with apprenticeship training providers a desire to focus on promoting apprenticeships to those living in rural areas, or those in minority groups. The Board wished to ensure that vulnerable groups such as Looked After Children are able to benefit from the additional apprenticeship funding. Members were assured that the Employability and Skills Team work with under-represented and vulnerable groups, including Looked After Children, to promote social care as a career. The Board welcomed this approach but agreed that it would be helpful to assess whether any additional support is required for these groups to access apprenticeship funding, for example exploring the feasibility of including a requirement for schools and colleges to prioritise specific groups.

38. The Board welcomed the evidence of steps being taken to engage with small and medium size social care employers in the county with regard to apprenticeships. As the external levy funding scheme is new, and the council is learning how best to deploy the increased funds it can make available to support apprenticeships, the Board agreed that its impact in relation to social care should be assessed in due course.

Recommendation 3

The Adult Social Care department to work with the Apprenticeship Team to assess the impact of levy funding in relation to care sector employers. This could include evaluating:

· the level of interest from the care sector and whether further promotion is needed;

· the effectiveness of the process for identifying which providers are allocated the levy funding;

· whether the funding successfully targeted those areas where the recruitment pressures are the most challenging; and

· whether vulnerable groups, such as Looked After Children, have been identified by the Apprenticeship team as requiring any additional support to access apprenticeships funded through the levy.

Recruitment and retention

Support for the independent care sector

39. Independent sector care providers are independent businesses with individual responsibility for their own recruitment and retention of staff. However, the council’s Care Act duties include a wider role in facilitating a diverse and quality care market and an appropriate workforce to deliver it. In this role the Council provides a range of support to the sector, aspects of which specifically relate to supporting recruitment and retention of the care workforce.

40. ESCC is also a significant commissioner of services from the local care market. In January 2018 the ASC department purchased approximately 1,660 beds from the independent sector, which equates to 24% of the overall market. ASC also commissions 51 independent sector agencies providing home care in East Sussex, delivering just over 19,500 hours of state funded care per week. The council therefore has a direct need to ensure appropriately staffed services are available to purchase for clients eligible for ASC funded care and has more ability to influence and work with providers of commissioned services.

41. The department’s support to the independent sector includes:

· working in partnership with providers following a Care Quality Commission inspection to advise and support on areas for development.

· providing mandatory, bespoke and developmental training to registered managers, care staff and administrators working within the independent sector. This includes providing training to Personal Assistants. Between July 2017 and July 2018, 2529 staff attended training. The Council also offers free access to a range of e-learning modules relevant to social care staff.

· working with providers to enhance the level of service provided; and

· offering an accreditation for providers through Support with Confidence.

42. In addition to the support provided by the local authority, Skills for Care has developed materials to help employers recruit and retain staff. This includes supporting a national recruitment campaign, conducting research on what works well for employers and providing information on values-based recruitment. This approach to promoting careers in the sector places values and motivation at the heart of the recruitment process and enables candidates to demonstrate suitability through personal life experience, as well as qualifications and training. Research that supports this approach includes data provided by Skills for Care which indicates that for low turnover employers in the care sector “finding staff with the right values and behaviours is more important than finding staff who are already qualified; skills can be taught but personal attributes (kindness, compassion, reliability, honesty, etc.) cannot”.

43. The Board considered the effectiveness of key aspects of the current support offered to providers in relation to recruitment and retention.

Support with Confidence/Personal Assistants

44. The Support with Confidence scheme provides a directory of vetted and approved providers who offer a wide range of care and support services for adults in East Sussex. The range of services covered is diverse and the scheme is designed to support providers across the independent and voluntary sectors by offering accreditation and the resulting increased accessibility and assurance to potential clients. There is a particular focus on Personal Assistants, a role which is relatively new and where demand is likely to increase. Personal Assistants are not currently regulated by the Care Quality Commission, hence the scheme provides an important accreditation function for this section of the market.

45. A Personal Assistant (PA) is employed or engaged on a self-employment basis directly by a person who needs care and support, either with funding provided by the council (if eligible) or by self-funding. They can also be employed or engaged by a family member or representative. A PA works directly with the client in a person-centred way, supporting them to continue to live independently in their own home and community. The Board were informed that of the estimated 800 PAs operating within East Sussex, 180 had been accredited under Support with Confidence.

46. The Board were also informed that in terms of the support it provides to PAs and Business Members, the scheme aims to:

· upskill and improve the services offered by the unregulated care and support market

· accredit care and support providers that have been checked and vetted on the grounds of quality, safety and training

· provide a list of accredited providers to the public and ASC operational teams

· provide clients with choice beyond more ‘traditional’ care options, including by developing the market for Personal Assistants, which increases consumer choice and protection.

· help develop and support local ASC providers

47. With regard to PAs the ASC department informed the Board that, as well as anticipated future increase in demand, there continued to be challenges in the rural areas of the county where there are not enough PAs to support the existing demand.

48. The Board heard evidence that Support with Confidence provides a market shaping and developing effect. It helps to build, through training and accreditation, a workforce of PAs comprised of people who may not otherwise want to work for home care or care home companies. This helps to increase the overall social care workforce and work towards meeting the growing demand for social care, as well as providing greater consumer choice.

49. In terms of developing the numbers of PAs working in the county to meet increasing demand, the Board heard that there is a limited marketing resource available for Support with Confidence. This is targeted at areas where there is an identified gap in the PA market, including in specific areas such as rural communities where domiciliary care agencies find it hard to deliver care packages. The Board were supportive of the approach being taken to target relevant rural communities and encouraged the Department to continue with this focus and develop it further where possible. The Board were also informed of a number of other initiatives which the Department are planning to take forward in support of the PA market. These include:

· Streamlined referral processes for operational staff

· Exploration of PA on-call networks

· Further targeted marketing campaigns

50. The Board discussed how elected members interact with a range of different community groups and how via these connections, they could help raise awareness of the role and help signpost interested individuals to the Support with Confidence team. To assist with this, the Board suggest that Members should be provided with a briefing note which explains the role of the PA and the Support With Confidence scheme and how interested individuals should be signposted to advice and guidance on how to apply.

Recommendation 4

All councillors, via their connections with local groups and organisations, to help raise awareness of the role of the Personal Assistant and the related advice and support available from the Support with Confidence team.

Online support for recruitment and retention

51. Evidence presented to the Board suggested that recruitment and retention are key issues for many providers. For example, the Registered Care Association for East Sussex indicated that the large number of small employers in the county makes it difficult to develop a strategic recruitment initiative across the sector (the RCA is an industry body which represents a range of providers of adult social care services in East Sussex).

52. The Board therefore considered evidence relating to the approaches adopted by other local authorities in support of their local independent care sector. Of particular interest to the Board was a West Sussex County Council initiative. This has involved the development of a recruitment website for independent care providers, which uses the campaign slogan ‘Proud to Care’ to advertise vacancies and promote careers in the sector. For example, visitors to the website are greeted with the following wording:

“Thank you for visiting Proud to Care West Sussex, a one stop website where you can find and apply for a variety of jobs in care across West Sussex and get information about what it’s really like to work in care. At Proud to Care West Sussex we know that working in care can be a hugely rewarding role where you have the opportunity to help people to get the best out of every day. But don’t just take our word for it; check out the films below from local people in West Sussex who work in care.”

53. In terms of support for providers, the website has an Employers Hub which allows employers to easily submit vacancies which are then advertised for free. The website also has sections on careers in care and apprenticeships. To be able to promote through the website, individual providers must clearly set out their employment terms and conditions. This supports the recruitment and retention process as it means job seekers can see which organisations are more likely to suit their own expectations and requirements. More fundamentally it also means individuals can easily find in one place a list of potential employers and other helpful guidance and advice. This means providers have a better chance of having higher numbers of applicants, as well helping to reinforce a positive message about the benefits of working in the adult care sector.

54. The Board noted that there is not similar provision in East Sussex and explored whether a similar online presence would potentially produce benefits for the independent sector in the county. Members also considered that developing a site of this kind in East Sussex could help demonstrate the council’s commitment to the independent sector and could help provide a focus for the sector.

55. The Board were also informed that a key area of workforce recruitment strategy relates to engaging adults and returners to work. The Board noted an initiative being pursued by Chichester College to develop a web resource to engage this group of potential new recruits. The Board agreed that the potential for promoting this resource and signposting providers to the site should also be explored.

56. Although the Board could see potential benefits to a dedicated online resource such as that in West Sussex, this would require significant resource to implement. ASC officers advised that in East Sussex the independent sector is supported through the offer of a detailed and well-regarded training programme which is freely accessible to providers and individuals without charge. Each local authority has had to make decisions around its own priorities for expenditure on support for the independent sector. Currently it is understood that neighbouring authorities do not offer free training of the kind available locally.

57. The Board were informed that the ASC department recognises that the West Sussex model does produce tangible benefits for the sector and that, by extension, this helps relieve the pressure on the authority. However, given the continuing difficult funding context, the department would have to fully explore the costs associated with the development of a bespoke online facility and may need to seek external funding to create such a resource. The department would not, at this stage, support downgrading its training offer to release funds to create an offer of this kind.

58. That said, a website could include, for example, creating a one-stop hub for people interested in working in the East Sussex care sector by bringing together links to a range of existing information and would be developed in partnership with the Employability and Skills team. The website could information such as:

· Job vacancies across the County;

· The work of Skills East Sussex to promote opportunities that raise awareness of careers on Social Care.

· Support with Confidence;

· Initiatives such as Chichester College’s work on the development of a web resource which seeks to engage adults and returners to work;

· Details of the ASC training offer;

· Information about the activity of the East Sussex Employability and Skills team to include, for example, initiatives such as the Careers Hub and any other relevant information;

· Details of apprenticeship schemes and opportunities;

· Links to relevant materials, for example the Skills for Care Staff Recruitment and Retention toolkit.

59. In addition to posting already available information, the website could also form the basis of information sharing about new initiatives that support recruitment and retention in the independent sector, for example:

· setting up of job fayres, in partnership with independent providers to create economies of scale;

· careers events, in partnership with local education providers.

60. However, such work requires further resource and would need to be fully considered and costed. This would include evaluating the success of other such schemes for example in West Sussex.

Recommendation 5

The Adult Social Care department to explore the feasibility and potential benefits of developing a bespoke website to provide information on jobs and careers in the East Sussex care sector.

Recruitment campaigns

61. The Board researched the Department of Health and Social Care’s approach to the recruitment and retention challenges facing many providers of adult social care nationally. One key line of support provided is a national recruitment campaign which aims to drive applications into the adult social care sector. The first iteration of the campaign was launched in 2018 under the banner heading ‘Every Day is Different’. The campaign used national and regional media engagement, as well as google, online, radio and social media advertising to promote a career in the industry. In support of the campaign, a toolkit and suite of partner materials were also made available for care providers to use to meet their local recruitment needs. The campaign website www.everydayisdifferent.com remains live and includes information on different job roles, case studies, quizzes and a job search.

62. The Board were informed that following an evaluation by the Department of Health and Social Care, it was likely that funding would be approved for a second national wave of the campaign to run in 2019/20. The Board discussed the benefits of the national recruitment campaign and were supportive of the ASC department’s development of materials that are in keeping with nationally delivered promotional material. The Board agreed that there is potential for further development of the local promotional work so that it is also suited to the needs of the independent sector. This could form part of the work undertaken in recommendation 5 and may involve, for example, consultation with key representatives of the sector about what they believe would help deliver an effective campaign and how providers can support it locally.

Recommendation 6

The Adult Social Care department to:

· continue to reinforce the national recruitment campaign locally via support from

the council’s Communications Team; and

· work with the Employability and Skills Team to ensure that this is integrated into the cross sectoral careers campaign run by Skills East Sussex.

Conclusions

63. The Board were presented with a stark picture regarding the scale of the workforce challenges facing the independent adult social care sector. These challenges are not unique to East Sussex. Relevant local authorities and independent providers throughout the UK are concerned about the pressures discussed in this report (and given the demographic make-up of the county, it is clear that East Sussex is facing an especially difficult set of circumstances).

64. The Board agreed that whilst many of the challenges will require a national response, it welcomed the Adult Social Care and Health Department’s well-developed local strategy for supporting the care market in East Sussex. However, and in the context of a complex and evolving situation, the Board identified a number of practical recommendations which it believes will further enhance the Department’s strategy. These enhancements aim to both help more closely align the work of the Council’s employment strategy with the needs of the independent sector, particularly the offer of training, and aid the promotion of careers in the sector.

Appendix 1

Scope and terms of reference of the review

The Review was established to consider and make recommendations on matters relating to the developing workforce challenges facing social care providers. More specifically the Committee agreed three areas of focus for the review:

· Older people’s services: It was agreed to focus on social care for older people as this is the biggest and the fastest growing area of demand for Adult Social Care.

· Commissioned services: It was agreed that the review should focus particularly on independent sector services commissioned by the ASC department.

The Board also agreed it would focus on exploring responses to the following two key questions:

· Is the Council working effectively in partnership with others (e.g. schools and colleges) with regard to future workforce needs?

· Could the Council do more to support recruitment and retention in the independent sector?

Board Membership and project support

Review Board Members: Councillors Charles Clark, Michael Ensor, John Ungar and Trevor Webb (Chair).

The Project Manager was Stuart McKeown, Senior Democratic Services Officer, with project support provided by Hannah Matthews, Democratic Services Officer.

Kay Holden, Assistant Director provided ongoing support to the Board throughout the review.

Review Board meeting dates

First formal meeting – 15 April 2019

Second formal meeting – 7 May 2019

Third formal meeting – 24 May 2019

Fourth formal meeting – 22 July 2019

Witnesses providing evidence

The Board would like to thank all the witnesses who provided evidence in person:

ESCC Officers.

Kay Holden, Assistant Director, Planning, Performance and Engagement.

Phil Crook, Head of ASC&H Workforce Planning & Training.

Caroline Bragg, East Sussex Employability and Skills Strategy Manager.

Martin Kelly, Apprenticeship Levy Strategy Manager.

Bianca Byrne, Head of Policy & Strategic Development

Lyndsey Potts, Scheme Manager: Support with Confidence

Skills for Care

Karen Stevens, Locality Manager (London and South East).

Registered Care Association

Mike Derrick, Chair of RCA

Independent Care Sector

Maria Mapletoft, Care Home Operator

Anita Brett-Everest, Personal Assistant

GR, Client

Evidence papers

Item	Date considered
Skills for Care – National Recruitment campaign	11 04 2019
Skills for Care - Recruitment and Retention in adult social care: secrets of success.	11 04 2019
Adult Social Care – Market overview presentation	15 04 2019
Distribution of Support with Confidence accredited PAs across the county	07 05 2019
Data on clients receiving Direct Payments	07 05 2019
Ratings - Adult Social Care	07 05 2019
Skills for Care - A summary of the adult social care sector and workforce in East Sussex 2017/18.	07 05 2019
Skills for Care - Individual employers and the personal assistant workforce, 2019 – survey research	07 05 2019
Employability and Skills report	07 05 2019
South East LEP Skills Strategy	07 05 2019
Briefing note - 25% Apprentice Levy funding to support apprenticeships within East Sussex	07 05 2019
Support with confidence – presentation	24 05 2019
Support with confidence - Code of Conduct	24 05 2019
Changing Care Market - Adult Social Care Workforce - Zero-hours contracts	24 05 2019
RCA Response to the Scrutiny Review of workforce in Older Peoples services	24 05 2019

Contact officer: Stuart McKeown, Senior Democratic Services Advisor

Telephone: 01273 481583
E-mail: Stuart.mckeown@eastsussex.gov.uk