November 15, 2023

Workforce findings in CQC’s Annual State of Care Report

Social care u turn

In the latest publication of its state of health care and adult social care in England, the CQC identifies the key challenges facing the sector and how some providers are overcoming them.

Staff retention

The CQC’s report highlights that staff feel overworked, exhausted and stressed, with many leaving the workforce. However, wellbeing initiatives are having a positive impact, with some providers appointing wellbeing champions, embracing hybrid working, offering counselling, and creating stronger workplace relationships through social gatherings and team awaydays.

Providers who focus on developing career progression and training opportunities tend to achieve higher retention rates. Focusing on improved flexible working opportunities, and greater support for staff with childcare responsibilities and menopause symptoms can reduce turnover rates.

Care workers are struggling with financial hardship due to the cost of living crisis at a time when many providers are unable to increase pay in line with inflation. This increases the risk of losing workers to other sectors.

However, some providers have increased pay rates above the living wage, and others are helping to mitigate the cost-of-living crisis by offering staff free meals and assistance with transportation costs. These initiatives help with retention and improve staff satisfaction.


Over 54% of providers are struggling with recruitment, with supported living reporting the most difficulties. It appears that workers are more likely to work in other sectors which is better paid and less stressful. There are also regional factors, with variations in pay, rents and house prices determining where people choose to work.

As a result, 26% of organisations are reducing the amount of capacity they offer due to staff shortages. Some homecare providers are struggling to deliver services due to staff shortages or are focusing on more profitable contracts and reducing less urgent visits.

International recruitment

The CQC says that since the Government added health and social care workers to the Shortage Occupation List in 2022, there has been an estimated 70,000 people who have started in direct care roles. This substantial increase is helping to reduce staff shortages and in turn enhances the diversity and skill set of the workforce.

However, the report also highlights the risk of exploitation and modern slavery concerns due to some rogue agencies and providers abusing the system. CQC made 37 referrals last year due to concerns about exploitation. It is likely there will be a renewed focus on unethical international recruitment practices and increased Home Office audits to root out unethical practices.


The findings in the report confirm what we are seeing in the market. Our experience is that providers are finding it easier to recruit, with increased capacity in the system due to an increase in overseas workers. As a result, there is slightly less pressure on providers, and they are turning their attention to tackling high turnover rates to plug the leaky bucket. Some have been able to dramatically improve turnover rates through a wide range of HR strategies, which is positive news but there is more to be done sector wide.

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