Attraction and recruitment
Prepared by Urban Foresight and edited by Dr Kat Deerfield
February 2024
In this evidence summary, we highlight relevant and up-to-date research on attraction and recruitment in the social care sector in Wales.
Attracting people into social care roles, as well as selecting and appointing suitable applicants, can be challenging. Understanding these challenges is important because we need a complete and knowledgeable workforce to deliver effective, accessible, and empowering social care services.
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Introduction
We need well-staffed social services and a knowledgeable workforce to deliver effective, accessible services that empower the people who access support. But social care is facing significant difficulties in attraction and recruitment.
In Wales, Social Care Wales’s (2023a) annual workforce data collection for 2022 estimated that 84,134 people were employed in the social care workforce – this is seven per cent lower than in 2021, despite increasing care needs in the population. Getting attraction and recruitment right is vital if we want organisations to have enough staff with the necessary workplace skills, values, knowledge, and experience (Chartered Institute of Personnel and Development [CIPD], 2022a; Edwards et al., 2022).
What do we mean by attraction and recruitment?
Attraction and recruitment are closely linked concepts.
- Attraction: drawing in or enticing people to a job vacancy
- Recruitment: selecting and appointing an applicant to fill the role (Newman Marketing, 2022; CIPD, 2022b).
If someone isn’t attracted to a role it’s very unlikely that they’ll be recruited into it.
Problems with staff retention can have a knock-on effect on attraction and recruitment efforts, because when more employees leave their roles, there’s an increased need for employers to attract and recruit new staff. The things that cause low retention rates, such as high workloads and poor terms and conditions, can also make attraction and recruitment difficult. For more information, check out our evidence summary on well-being and retention (Urban Foresight and Deerfield, 2024).
The current challenges
Social care is facing attraction and recruitment challenges across the world. There was a 59 per cent increase in the number of vacancies in the Welsh care sector reported between 2021 and 2022, from 2676 to 4257 (Social Care Wales 2023a). The actual number of vacancies in Wales is likely to be higher due to incomplete data (Social Care Wales 2023a).
Employers who struggle to fill vacancies sometimes end up relying on agency staff, which can be expensive and isn’t sustainable in the long term (Migration Advisory Committee [MAC] and Revealing Reality, 2022). This can also affect the quality of care if there is inconsistency in who provides care (MAC and Revealing Reality, 2022).
However, jobs offered by agencies can be attractive to some jobseekers because they may offer better pay and less intense workloads. They can also give staff more choice as to when and where they work.
For employers, using agency workers can offer a short-term solution to issues of short staffing, because agency workers are able to work on an as-needed basis. While some jobseekers prefer the flexibility of agency work, however, others would like more stable employment. The need for flexibility in some care provision means that employers don’t always offer longer-term job opportunities. As a result, they may fail to attract jobseekers who do want more stable employment (Urban Foresight, 2023a; for more on this, read our evidence summary on well-being and retention; Urban Foresight and Deerfield, 2024).
Staff shortages already affect our ability to provide care, and this is likely to worsen as the population ages and demand for care rises (Hanney and Karagic, 2019; Teo et al., 2022). This is particularly relevant to Wales, which has a higher percentage of the population over retirement age than England, Scotland and Northern Ireland (The Health Foundation, 2020a). It’s predicted that by 2040, 53 per cent of the Welsh population will be aged over 65, and the number of adults living with severe dementia could double (Senedd Research, 2021; Siôn and Trickey, 2020).
Social care also has a broad role in supporting families, communities and the Welsh economy. Shortages in services often mean that family members or friends provide care to people who need it. The people providing support often leave their own jobs to do so. This has a knock-on effect at a community and national level, both socially and economically.
Staff shortages in the care sector impact on other areas of the economy and public services, such as NHS provision. One well-publicised use of social care services is to support individuals to leave hospital (Gordon and Elder, 2023). Staff shortages in social care settings mean patients remain in hospital beds for longer than needed, resulting in treatment delays and longer waiting lists (Gordon and Elder, 2023). In the UK in 2020, 30 per cent of bed delays for people in hospital were due to patients not having social care arrangements in place for their discharge (The Health Foundation, 2020b). Research shows that adequately staffed social care services act in a preventative way, reducing the likelihood that an individual will need NHS treatment, like being admitted or re-admitted to hospital (SCIE, 2022). For more on social care working in partnership with health, see our evidence summary on place-based care (Deerfield et al., 2024).
Pay is usually low and doesn’t reflect the level of responsibility involved
What can be done to address the challenges?
Social care can be an attractive career option due to flexible hours and the rewarding nature of the work (MAC and Revealing Reality, 2022). And with so many vacancies, it can also be easy to find opportunities in the sector.
But it can be difficult to attract and recruit suitable workers to the sector. External factors – like the effects of Brexit, COVID-19, and the cost of living crisis – add to existing challenges like low pay, working conditions, and lack of public awareness of social care roles (Urban Foresight 2023b).
The recruitment phase – including application and selection processes – is often challenging, and drop-out rates can be high even among people who are attracted to the social care sector (Urban Foresight 2023b). In addition, unemployment in Wales is falling, and while this is generally good for the economy, it means there are fewer jobseekers for care roles (Hemmings et al., 2022).
Research suggests there are some key steps that employers can take to improve attraction and recruitment (Edwards et al., 2022; Pitarella, 2020; Teo et al., 2022; Urban Foresight, 2023a).
- Raising awareness: advertising and getting involved with the local community to show the variety of roles and benefits of joining the sector. It’s also important to raise awareness about how people can enter the sector.
- Improving working conditions and incentivising roles: better conditions and incentives make roles more attractive. Developing career progression pathways that reward individuals for completing training and qualifications can help attract people to the sector.
- Simplifying recruitment processes and providing support:
- shortening application forms and being more flexible with interview slots can open roles up to more applicants
- application and registration can be confusing and off-putting for potential employees; providing support with these process can make them less intimidating for people.
Raising awareness
Although social care is highly valuable to society, public awareness and appreciation of the sector is low, and perceptions are often poor.
Many people don’t know about the types of roles available, what these involve, and the skilled nature of the work (Pitarella, 2020; Urban Foresight, 2023a). Teaching about the sector in schools is often limited, and negative media attention means that care is either not considered as a career pathway or is not perceived to be an attractive one (MAC and Revealing Reality, 2022; Teo et al., 2022; The Health Foundation, 2022a; Urban Foresight, 2023a).
Responding to these difficulties, Social Care Wales launched WeCare Wales in 2019. WeCare Wales (2023) also supports the sector by:
- improving the profile and perceptions of social care through advertising and campaigning
- providing resources and information to explain potential career pathways
- engaging and supporting potential employees through outreach work
- providing training opportunities to those interested in a career in care
- supporting employers and providers, for example, through the free online job portal.
WeCare Ambassadors are employees in social care who volunteer their time to promote the sector. This helps raise the profile of social care jobs by giving members of the public a chance to hear directly from people working in the sector.
Employers can also actively raise the profile of the sector. When employers get involved with their local communities – by attending job fairs, connecting with job centres and local charities, and/or presenting at schools and colleges – research shows that they find it easier to fill their vacancies (Urban Foresight, 2023a).
Many employers are working to attract jobseekers by improving their offer
Improving working conditions and incentivising roles
Social care roles can be physically, mentally and emotionally challenging, and may require long and unsociable hours (Devi et al., 2021; MAC and Revealing Reality, 2022; Teo et al., 2022). Also, the reality that employees can be investigated and held responsible if something goes wrong can be daunting for workers and jobseekers in the sector (MAC and Revealing Reality, 2022).
Pay is usually low and doesn’t reflect the level of responsibility involved (Gordon and Elder, 2023; MAC and Revealing Reality, 2022; Urban Foresight, 2023a). Following Brexit and COVID-19, pay is increasingly less competitive than in other sectors, such as retail or healthcare (Miller Research, 2021). Workers in other sectors may also receive additional incentives like enhanced sick pay, pension plans, holiday allowance, and better career progression opportunities (Gordon and Elder, 2023; MAC and Revealing Reality, 2022; Teo et al., 2022; Urban Foresight, 2023a).
There are extra costs associated with social care work like training, registration, and car maintenance. Time spent training and or travelling might also be unpaid. These costs and expenses can be an additional barrier to people entering the sector (MAC and Revealing Reality, 2022; Urban Foresight, 2023a).
The effects of low pay for care workers are far reaching. Before 2020, one in five residential care workers lived in poverty in the UK, compared to one in eight of all workers (The Health Foundation, 2022c). A Bevan Foundation report in 2021 found that many social care workers needed either the additional support of a partner’s income or to receive Universal Credit to cover the cost of basic needs (Miller Research, 2021). The cost of living crisis has increased pressure on individuals and made a career in care financially impossible for many people (Urban Foresight, 2023a).
The Welsh Government plans to address the financial pressures faced by some care workers by increasing health and social care funding and paying care workers the real living wage (Welsh Government, 2023b).
The Social Care Fair Work Forum, set up in 2020, is also trying to address low pay and working conditions for social care workers. The forum is working to define what good terms of employment look like and is pushing for increased pay across the sector (Welsh Government, 2023a).
The Welsh Government is also exploring the potential of a National Care and Support Service for children, families and adults. An expert group has been formed to produce practical recommendations on how this could be done to ensure that care is accessible, localised, and properly resourced and valued (Welsh Government, 2022b). But a lot of financial investment is needed to make sure social care staff have the same pay, career progression, training and working conditions as their colleagues in the NHS (Palmer, 2022; The Health Foundation, 2022b).
Many employers are working to attract jobseekers by improving their offer, increasing pay, and providing incentives, such as vouchers for car maintenance or introducing refer-a-friend schemes (Urban Foresight, 2023a).
Simplifying recruitment processes
When recruitment processes are too complex, applicants may turn to other, more immediate job opportunities like those found in retail or hospitality (MAC and Revealing Reality, 2022; The Health Foundation, 2022a; Urban Foresight, 2023a). Barriers to recruitment include the need for background checks or requirements for pre-employment training or qualifications (Urban Foresight, 2023a).
Simplifying recruitment processes isn’t an easy task and requires additional time and money. But it’s important that employers consider where complex processes can stop people from entering the sector (Urban Foresight, 2023a). Job adverts should be easy to understand, highlight available benefits, and show career progression opportunities to prospective candidates (Urban Foresight 2023b). Confusion about qualification and visa requirements and inflexible interview processes can also mean that applicants regularly start but don’t complete application forms, don’t turn up for interviews, or don’t accept job offers (Urban Foresight, 2023a).
Some employers have tried innovative ways of supporting their recruitment processes. Changes that have had good results include (Urban Foresight, 2023a):
- shortening application forms
- spending more time with applicants to support them through the application process
- introducing more flexible interview options, such as evening or weekend interviews
- paying for training and registration.
Having a more diverse workforce can improve outcomes
Recruiting the right workers
Even if employers attract applicants, they may struggle to recruit people with the right qualifications for the role. The mandatory professional registration of employees was introduced to improve the status and quality of social care. But it's also possible that its introduction has made the sector less attractive and more difficult to enter. (Urban Foresight, 2023a).
In other cases, particularly in rural areas where demand for services can vary, employers find it difficult to attract applicants that are willing or able to work the required shift patterns. In response to this, employers sometimes offer zero-hours contracts or use agency workers. But the lack of reliable hours can negatively impact interested candidates and push them to take up more stable roles in other sectors (Urban Foresight, 2023a). This can cause additional problems for services because agency workers are expensive for employers (MAC and Revealing Reality, 2022).
Some employers are considering more innovative solutions. One local authority is working toward establishing a local not-for-profit recruitment agency. Other employers are offering flexible and targeted shift patterns aimed at groups such as parents or students (Urban Foresight, 2023a).
The sector also faces significant barriers in recruiting a diverse workforce. In particular, employers in Wales struggle to recruit Welsh speakers, men, and those from minoritised ethnic backgrounds (Urban Foresight, 2023a). Research from healthcare shows that having a more diverse workforce can improve outcomes for those who access support (Gomez and Bernet, 2019). Recruiting a more diverse workforce is difficult, but employers find targeted approaches can be useful. For example, WeCare Wales runs targeted information sessions aimed at specific groups, including men and people who’ve immigrated to the UK. Some employers also use Facebook to advertise vacancies to reach people who are not actively looking for work online (Urban Foresight 2023a). The need for more Welsh language support provision is at the heart of the Welsh Government More Than Just Words action plan. It aims to increase the use of Welsh and the number of Welsh speakers in the health and care sectors (Welsh Government, 2022a).
Conclusion
There are many challenges around attraction and recruitment. But information from research points to several ways that things can be improved. This includes changes that can be made at multiple levels, from simplifying applications and guidance documents to working towards a National Care and Support Service for Wales.
Ensuring there are enough suitable and qualified workers to provide social care services in Wales is vital for those who access care and support. Putting these things into practice has the potential to improve attraction and recruitment, and to ease workforce pressures throughout the sector and beyond.
Additional reading
Here is a list of the five most relevant resources to attraction and recruitment that are either open access or freely available on the NHS Wales e-Library.
- Edwards, D., Trigg, L., Carrier, J., Cooper, A., Csontos, J., Gillen, E., Lewis, R., and Edwards, A. (2022) ‘A rapid review of innovations for attraction, recruitment and retention of social care workers, and exploration of factors influencing turnover within the UK context’, Journal of Long-Term Care, pp. 205-222, doi:10.31389/jltc.130, available at https://doi.org/10.31389/jltc.130.
- Teo, H., Vadean, F., Saloniki, E. C. (2022) ‘Recruitment, retention and employment growth in the long-term care sector in England’, Front Public Health 10, p. 969098, doi:10.3389/fpubh.2022.969098, available at https://doi.org/10.3389/fpubh.2022.969098.
- Read, R. and Fenge, L. A. (2019) ‘What does Brexit mean for the UK social care workforce? Perspectives from the recruitment and retention frontline’, Health and Social Care in the Community, 27 (3), pp. 676-682, doi:10.1111/hsc.12684, available at https://doi.org/10.1111/hsc.12684.
- Migration Advisory Committee and Revealing Reality (2022) ‘Recruitment and retention in adult social care: a qualitative study’, Migration Advisory Committee, available at https://www.gov.uk/government/publications/recruitment-and-retention-in-adult-social-care-a-qualitative-study/recruitment-and-retention-in-adult-social-care-a-qualitative-study-accessible (accessed: 27 November 2023).
- Gordon, A. L. and Elder, A. (2023) ‘Cutting investment in the social care workforce will undermine the NHS recovery plan’, BMJ (Online), 381, p.861, doi:10.1136/bmj.p861, available at https://doi.org/10.1136/bmj.p861.
Reference list -
CIPD (2022a) ‘Wellbeing at work’, CIPD, available at https://www.cipd.org/uk/knowledge/factsheets/well-being-factsheet/ (accessed: 27 November 2023).
CIPD (2022b) ‘Recruitment: an introduction’, CIPD, available at https://www.cipd.org/uk/knowledge/factsheets/recruitment-factsheet/ (accessed: 27 November 2023).
Devi, R., Goodman, C., Dalkin, S., Bate, A., Wright, J., Jones, L. and Spilsbury, K. (2021) ‘Attracting, recruiting and retaining nurses and care workers working in care homes: the need for a nuanced understanding informed by evidence and theory’, Age and Ageing, 50 (1), pp. 65-67, doi:10.1093/ageing/afaa109.
Edwards, D., Trigg, L., Carrier, J., Cooper, A., Csontos, J., Gillen, E., Lewis, R., and Edwards, A. (2022) ‘A rapid review of innovations for attraction, recruitment and retention of social care workers, and exploration of factors influencing turnover within the UK context’, Journal of Long-Term Care, pp. 205-222, doi:10.31389/jltc.130.
Gomez, L.E. and Bernet, P. (2019) ‘Diversity improves performance and outcomes’, Journal of the National Medical Association, 111 (4), pp. 383-392, doi:10.1016/j.jnma.2019.01.006.
Gordon, A.L and Elder, A. (2023) ‘Cutting investment in the social care workforce will undermine the NHS recovery plan’, BMJ (Online), 381, p.861, doi:10.1136/bmj.p861.
Hanney, N. and Karagic, H. (2019) ‘Responding to the NHS and social care workforce crisis: The enhancement of opportunities through collaborative partnerships’, Higher education, skills and work-based learning, 9 (2), pp. 175-188, doi:10.1108/HESWBL-10-2018-0107.
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Health Foundation (2022a) Health Foundation response – Workforce recruitment, training and retention in health and social care, Health Foundation, available at https://www.health.org.uk/sites/default/files/2022-07/health_foundation_response_-_workforce_recruitment_training_and_retention_in_health_and_social_care.pdf (accessed: 28 November 2023).
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Health Foundation (2022c) ‘1 in 5 residential care workers in the UK living in poverty before cost-of-living crisis’, Health Foundation, available at https://www.health.org.uk/news-and-comment/news/1-in-5-residential-care-workers-in-the-uk-living-in-poverty-before-cost-of-living-crisis (accessed: 28 November 2023).
Hemmings, N., Oung, C. and Schlepper, L. (2022) ‘New horizons: What can England learn from the professionalization of care workers in other countries?’, Nuffield Trust, available at https://www.nuffieldtrust.org.uk/sites/default/files/2022-09/1662995727-nuffield-trust-new-horizons-web.pdf (accessed: 27 November 2023).
Migration Advisory Committee and Revealing Reality (2022) ‘Recruitment and retention in adult social care: a qualitative study’, Migration Advisory Committee, available at https://www.gov.uk/government/publications/recruitment-and-retention-in-adult-social-care-a-qualitative-study/recruitment-and-retention-in-adult-social-care-a-qualitative-study-accessible (accessed: 27 November 2023).
Miller Research (2021) Fair work in the foundational economy – experiences in social care, Bevan Foundation, available at https://www.bevanfoundation.org/wp-content/uploads/2021/05/Fair-work-in-the-FE-social-care-final.pdf (accessed: 27 November 2023).
Newman Marketing (2022) ‘What is attraction and retention of employees?’, Centric HR, available at https://www.centrichr.co.uk/what-is-attraction-and-retention-of-employees (accessed: 27 November 2023).
Palmer, B. (2022) ‘What should a health and social care workforce strategy look like?’, BMJ (Online) 378, p. 1906, doi:10.1136/bmj.o1906.
Pitarella, E. M. L. (2020) Care worker perceptions of recruitment and retention in adult social care settings, available at https://eprints.glos.ac.uk/9249/1/9249_Elisha_Pitarella_%282020%29_Care_Worker_perceptions_of_recruitment_and_retention_Msc_by_Research.pdf (accessed: 27 November 2023).
Senedd Research (2021) Social care: a system at breaking point?, Welsh Government, available at https://research.senedd.wales/research-articles/social-care-a-system-at-breaking-point/ (accessed: 27 November 2023).
Siôn, C. and Trickey, M. (2020) The future of care in Wales: resourcing social care for older adults, Wales Fiscal Analysis, available at https://www.cardiff.ac.uk/__data/assets/pdf_file/0019/2427400/social_care_final2_aug20.pdf (accessed: 27 November 2023).
Social Care Institute for Excellence (SCIE) (2022) Hospital discharge and preventing unnecessary hospital admissions (COVID-19), SCIE, available at https://www.scie.org.uk/care-providers/coronavirus-covid-19/commissioning/hospital-discharge-admissions (accessed: 27 November 2023).
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Teo, H., Vadean, F., Saloniki, E. C. (2022) ‘Recruitment, retention and employment growth in the long-term care sector in England’, Front Public Health 10, p. 969098, doi:10.3389/fpubh.2022.969098.
Urban Foresight (2023a, forthcoming) Understanding attraction and recruitment in the Welsh social care sector and the role of WeCare Wales.
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Welsh Government (2022b) Towards a National Care and Support Service for Wales – Report of the Expert Group, Welsh Government, available at https://www.gov.wales/sites/default/files/publications/2022-11/towards-a-national-care-and-support-service-for-wales_0.pdf (accessed: 28 November 2023).
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