Summary of the impact

Adult Social Care (ASC) is a growing sector which currently employs 1.6 million care workers and benefits 1.8 million care recipients. Research carried out by Manchester Metropolitan University (MMU) into the recruitment, development and retention of ASC workers has had a direct impact on ASC policy, management practice and human resource (HR) practice.

In the area of health, welfare and public policy, the primary research impact was on the Adult Social Care Recruitment and Retention Strategy 2011. Among ASC managers and HR practitioners, the research findings informed and stimulated debate over the conduct of ASC work and the benefits of good HR practice.

Underpinning research

Adult Social Care remains under-researched and poorly understood. Yet in recent years, the demographic imperatives of an aging population have driven it up the policy agenda of successive governments. By 2041, the number of older people requiring care will increase by 2.2 million to around 4 million. By 2026, care jobs could rise by over 1 million to 2.6 million. Robust ASC policy that ensures an adequate labour supply to support high quality care is thus vital.

It was this increasing need that research at MMU Business School's Centre for People and Performance sought to address. The research was led by Professors Rosemary Lucas (joined MMU in 1984, Chair of Employment Relations since 1999) and Carol Atkinson (appointed Senior Lecturer 01/01/2000; SL University of Bradford 01/09/2008-31/08/2012; Professor of HR Management 01/09/2012) and funded by Skills for Care (SfC), which oversees workforce development in ASC in England. Carried out between July 2007 and April 2009, it began with a literature review which identified knowledge gaps with regard to recruitment, development, pay and retention of ASC workers in England [1-4].

In 2007/8, the team undertook a secondary statistical analysis of the National Minimum Dataset-Social Care (NMDS-SC), an SfC-established dataset providing information on employment practice and outcomes in ASC. This analysis explored relationships between HR practice and quality of care delivery, as measured by Care Quality Commission (CQC) inspection data. Findings revealed a mixed picture: engagement with induction training among ASC workers was shown to be strong, but completion of NVQs (on which government policy relies for quality) was low; this may limit the effectiveness of current workforce development policy in improving care quality. There were high levels of secure employment, yet pay was shown to be low and flexible working arrangements scant. In all, the research found no compelling evidence of widespread sophisticated HR practice in the sector [4].

This was followed in 2008/9 by a qualitative study of Registered Manager and ASC worker views on employment practice in 18 case study residential/care homes and domiciliary care agencies. Key findings highlighted the impact of cost-driven Local Authority commissioning on low pay rates [5, 6]; the contrast between care workers' own perceptions of the high value and status of ASC work and wider perceptions of its low status; and the way pay suppression was compounded by positioning care worker roles as low-skilled `women's work' [1, 2]. The researchers concluded that in a period of rising demand for care, a policy reliant on a supply of poorly educated, low-skilled women with increasing choices was risky [2]. Findings also showed the rudimentary nature of many recruitment and selection processes in the ASC sector, and the need for context-appropriate HR practice and the enhancement of particular employment and management practices to support recruitment and retention [3, 4].

A qualitative study of employment practice for Personal (care) Assistants (PAs) in seven case study Direct Payment Support Organisations (DPSOs, which support people receiving direct payments to commission their own care/support) was carried out in 2009. The research focused on issues relating to the recruitment and retention of PAs and how in their care recipients handle the employer role. The findings showed that generally recruitment and retention of PAs was not a significant issue, but that PAs were receiving insufficient support in terms of training and development [A].

With regard to employee attitudes and gender, the research (carried out through employee interviews and a focus group) found that employees perceive flexible working as making them "happy" and that this is linked with performance outcomes [5]. However, the findings showed that take-up of flexible working is very largely confined to women, with the `male breadwinner' role seen as precluding it. The research highlighted the need for informal flexibility for those working full time [6] and ways in which the image of social care roles and careers can be changed to make them more attractive to potential applicants and existing care workers [A].

References to the research

Grants to indicate research quality:

Professor Carol Atkinson and Professor Rosemary Lucas, Rewards and Incentives Research in Adult Social Care in England. Sponsor: Skills for Care. July 2007-April 2009. £99,000. The findings from this project were written up in 3,4,5 and 6 (above) as well as A, B and C (Section 5).

Details of the impact

Impact can be demonstrated in relation to ASC policy, management practice and HR practice.

Adult Social Care Policy:

In February 2009, Atkinson and Lucas presented three research reports to the Skills for Care (SfC) Research and Policy team. These are all now available for download directly from the Skills for Care website [A] along with Key Messages for Employers, a leaflet informed directly by the research [B]. The team used these reports (alongside other inputs) to inform the `Recruitment and Retention Strategy for Adult Social Care 2011' [C]. The research's impact on the strategy is shown in an SfC testimonial [D]:

`In the past there had been a tendency for adult social care policy to be unduly influenced by pressure groups, anecdote and old wives' tales. This [MMU-led] research helped to change attitudes and to provide a sounder base for policy development.' Head of Research and Policy, Skills for Care

Clear links between the strategy and research reports are also apparent to the reader. For example, Section 3.1 of the strategy sets out a plan for `selling' a career in care which is aligned to the research findings and recommendations for a marketing campaign; and Section 3.3 promotes more sophisticated recruitment and selection practices, again aligned to the MMU team's findings on their rudimentary nature. This national recruitment and retention strategy was disseminated to all Local Authorities' commissioners of ASC, over 300 in total, and most have used it to inform their local workforce strategy [E]. Local Authorities were advised how to disseminate the key messages to local care providers [F].

The incorporation of the research findings into ASC policy and the cascading of this policy to ASC commissioners and care providers represent a significant step towards influencing the work of 1.6 million care workers and — ultimately — the quality of life of 1.8 million care recipients.

Management practice in social care

As previously mentioned, MMU research findings were summarized into a `Key Messages for Employers' leaflet which focused on the attraction, recruitment and retention of care workers and the role of employment and management practice within this [B]. This resulted in better understanding of the need for good HR practice:

`Because of the highly fragmented nature of the adult social care industry, it takes time for individual managers to be persuaded of the need to change, but there is now a much better understanding of the benefits of good HR practices in the sector' [D]. Head of Research and Policy, Skills for Care.

In October 2009, the leaflet was disseminated to SfC's network of 48,000+ ASC care providers in two ways. First it was made available on SfC's website. Second its content was briefed by the research team to Registered Managers of care providing establishments at meetings of SfC's six regional committees. These established regional networks were used to cascade information/leaflets across the whole SfC network and accessed stakeholders across a range of sectors including the private and voluntary sectors and small employers. This created substantial impact. Research findings were widely disseminated and enhanced awareness and understanding of appropriate practice in the recruitment, development and retention of care workers. Further, the findings were used to inform SfC's (2010) ASC recruitment and retention toolkit [G] which has been adopted by a number of care providing partnerships to change practice. As above, this impacts on significant numbers of workers and care recipients.

HR practice

In June 2011 and June 2013, Atkinson and Lucas presented award-winning papers to the annual conference of the Chartered Institute of Personnel and Development (CIPD, professional body for HR practitioners in the UK, 3.5 and 3.6). They were presented to 200 conference delegates and are available on CIPD's website which is accessed by 135,000 members across 120 countries. In December the research findings were featured in CIPD's magazine, People Management, which has a hard copy and email circulation to more than 128,000 HR practitioners [H]. The findings were also included in a People Management email newsletter which was circulated to over 100,000 HR practitioners and have generated discussion on the Twitter social network [I] and blogosphere, where HR expert Duncan Brown highlighted Lucas and Atkinson's achievement in demonstrating unequivocally that better managed and higher wage-paying care homes deliver better care quality [J].

The research findings have thus had impact in informing and stimulating practitioner debate, developing awareness and understanding and potentially influencing HR practice across the organisations that 135,000 CIPD members operate within.

Sources to corroborate the impact

[A] Skills for Care (2009) Research Reports
http://www.skillsforcare.org.uk/research/latest_research_reports/RewardsandIncentivesResearch.aspx

[B] Skills for Care (2009) Key Messages for Employers
http://www.skillsforcare.org.uk/research/latest_research_reports/RewardsandIncentivesResearch.aspx

[C] Adult Social Care Recruitment and Retention Strategy 2011
http://www.skillsforcare.org.uk/workforce_strategy/recruitmentandretentionstrategy/recruitment_and_retention_strategy.aspx

[D] Full testimonial from Head of Research and Policy (retired), Skills for Care is available on request

[E] Example of Local Authority adoption of national ASC Recruitment and Retention Strategy 2011
https://www.wrexham.gov.uk/assets/pdfs/social_services/workforce_strategy/workforce_strategy.pdf

[F] Dissemination of ASC Recruitment and Retention Strategy 2011 key messages by Local Authority commissioners to care providers
http://www.logontocare.org.uk/2011/06/adult-social-care-workforce-recruitment-and-retention-strategy/

[G] Finders, keepers: the adult social care sector recruitment and retention toolkit (2010)
http://www.scie-socialcareonline.org.uk/profile.asp?guid=23fc28bc-bc3f-48ab-a15b-dba0a78144b6
used by a number of care partnerships, for example http://www.carelearning.org.uk/finders-keepers-the-adult-social-care-sector-recruitment-and-retention-toolkit and http://www.bcpc-net.co.uk/?ID=1129 corroborating impacts on operational adult social care practice.

[H] People Management coverage (issued to over 100,000 subscribers). In hard copy and online:
http://www.peoplemanagement.co.uk/pm/articles/2011/12/gender-jeopardises-adult-social-care.htm

[I] Twitter circulation corroborating impacts of research circulated through People Management magazine: http://topsy.com/www.peoplemanagement.co.uk/pm/articles/2011/12/gender-jeopardises-adult-social-care.htm).

[J] Link to Chartered Institute of Personnel and Development blog corroborating impacts of research on HR professionals:
http://www.cipd.co.uk/pm/peoplemanagement/b/weblog/archive/2013/07/22/living-wages-will-do-more-than-just-increase-your-payroll-bill.aspx