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The recruitment of domiciliary carers – is London being hit particularly hard?

If you have clients or family in London who require domiciliary care staff, it won’t have escaped your notice how hard it has become to recruit staff in the past year. Indeed, in some cases it is has also proved hard to retain staff.

The beleaguered care sector has been struggling for some time, but COVID-19 and Brexit have delivered a double whammy of bad news to the sector, something seemingly being especially hard felt in the capital. Staff shortages in other parts of the economy, such as HGV and fuel tanker drivers, have been much more visible and attracted more media attention – queues at petrol pumps and empty shelves in supermarkets make for much more dramatic viewing. Meanwhile, though care sector shortages are less well publicised, the struggle for many who need care support is all too real.

What are the main reasons behind these staff shortages and to what extent, if at all, is London particularly hard hit?

The first issue is the low wages offered. London is notoriously expensive, both to live in and travel into. With inflation going up but care workers pay remaining low this must mean that for some this choice of vocation is simply no longer financially viable.

Similarly, against a backdrop of low wages, the nature of the work itself might prove to act as a deterrent for some, not least in these pandemic times when the care sector has really been shown to form part of our front-line services. Being a carer can be tremendously rewarding, but it can also be very challenging. Bluntly, part of the shortage problem must be linked to prospective candidates looking to other sectors for what may be perceived as easier roles and often higher wages.

Secondly, we have Brexit. A new Skills for Care report showed that adult social care providers had become increasingly reliant on workers from the EU, with 7.2% of staff holding a EU nationality as of 2020/21, up from 4.7% in 2012/13. However, post Brexit that has meant employers have had to find more staff from the domestic labour market in order to keep up with demand. Current shortages would suggest that option has not been working well.

London has the highest social care vacancy rates and the highest social care migrant worker share in England.

To address the recruitment shortage, on 24 December last year the Department of Health and Social Care announced that immigration rules would be relaxed for overseas care workers by adding care workers to the shortage occupation list. The change came into effect from 15 February.

The change to immigration visas was originally announced as only being in place for a 12-month period. However, the legislation around these changes to the immigration rules do not actually address this limited period. Therefore there is a conflict between what government said and what has actually been drafted. If the government do want to keep this visa relaxation for a fixed 12-month period they will need to make further amendments to the legislation. So, for now, anyone coming to the UK, reliant on this kind of visa, will not be limited to stay only for a 12-month period.

The change means organisations will be able to sponsor care workers from overseas. The organisation will however firstly need to apply for a sponsor licence from the Home Office (unless it already has one). To be eligible for the health and care visa as a care worker, individuals much be paid a minimum salary of £20,480.

The change is positive news for those in the sector who are struggling to recruit. However, if it is only a temporary change, it may not be enough to resolve the difficulties. Also, until the change has time to take effect, care in the capital is at risk of being disproportionately affected by existing shortages in the sector.

As a Deputy responsible for ensuring many of our clients have full domiciliary care teams to support them, we have certainly encountered the difficulties with care sector shortages in the capital.

Ultimately, we have found that where possible we are having to increase pay to make the roles more competitive with other sectors. However, we are aware this will not be possible in all cases and will inevitably have a knock-on effect in other areas of the person’s budget where there will be less funds available.

We are also having to be as flexible as possible to improve chances of retaining good staff – for example agreeing to part time hours in order to accommodate other interests the staff member may wish to pursue – whereas in previous years we might have been resolute in needing a full-time worker. We are also having to broaden our search for candidates, expanding far beyond the normal job advertising sites; looking at universities that run relevant courses and utilising local community boards and WhatsApp group.

It seems the care sector shortage is not unique to London but is felt especially hard here. Even before the pandemic, both vacancy and staff turnover rates in London’s domiciliary adult social care sector were above average in 2018/19. Therefore, from an already weak starting position, the pandemic, inflationary rises, and the effects of Brexit on a significant migrant population mean the pain for Londoners trying to source and retain domiciliary care staff feels very acute and alas, looks far from over. However, the change in immigration rules, should provide welcome relief which cannot come soon enough.