Category Archives: Care work

Why are people leaving social care jobs, and what could help them stay?

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Wenjing Zhang (Research Fellow, KCL), Ann-Marie Towers (Professor of Social Care Research, KCL), Bo Hu (Associate Professorial Research Fellow, LSE) and Annette Boaz (Professor of Health and Social Care, KCL) discuss findings from the Leavers Study, which involved interviews with 30 people who had left adult social care roles within the previous two years. First published on the Care Work website. (747 words)

Adult social care depends on skilled, compassionate people. Yet across England, many workers are leaving the sector because the pressures of the job are becoming too difficult to sustain. This matters not only for staff wellbeing, but also for the quality and continuity of care that people receive.

To better understand why people leave adult social care and what might have encouraged them to stay, we carried out a study with former adult social care workers in England. The research builds on a 2023 national survey of more than 7,000 people working in adult social care in England. Around one in three said they intended to leave their job as soon as they found another one, with low pay, stress and burnout identified as the main reasons. By 2025, 12% of those who took part in a follow-up survey (1,073 people) had left adult social care altogether, including a small number who did not intend to quit two years earlier.

To better understand these decisions, we interviewed 30 people who had left adult social care roles within the previous two years. Participants included care workers, social workers, occupational therapists, personal assistants and managers. Some had moved into jobs in other sectors, while others had retired early or left work altogether because of health or caring responsibilities. Although every story was different, common themes emerged.

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Building research capacity in social care research to improve care for older people in care homes

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Filipa MaiaThe NIHR-funded SHARE programme aims to build social practitioners’ skills and knowledge, to use research to inform and improve services in the workplace. The SHARE programme is a collaboration between Kingston University and King’s College London working closely with NIHR ARC South London and the NIHR Policy Research Unit in Health and Social Care Workforce. Filipa Maia, one of the people who have been awarded funding to take part in the programme, writes here about her experience of the SHARE programme and how her research could improve care for older people in care homes. Filipa is an education, research and engagement officer at Nightingale Hammerson, a care home provider. (1,249 words)

Please tell us a bit about your background and why you applied for the funding?

I moved to London in July 2021, shortly after completing a Master’s degree in Sociology at Nova University of Lisbon. I majored in English and Spanish studies, before my Master’s in Women’s Studies. By mixing my passions for literature and theatre, I wrote my thesis, “Women’s views of their own bodies: a study on representations of the female body in feminist theatre.” During that process, I discovered how much I like writing about people, their stories, their work and their motivations. Sociology felt like a good choice, a way to understand people more deeply in society and create space for their experiences to be explored and shared.

When I arrived in London, I stepped into the world of care by chance and found an entirely new way to connect with people. My first role was as a therapy assistant at Nightingale Hammerson, where I spent hours alongside residents and observed healthcare professionals of all kinds (physiotherapists, occupational therapists, healthcare assistants, registered nurses) all working with one shared goal of giving residents the best possible quality of life. Continue reading →

New research shows how better pay and training could rescue social care in England

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Republished from the LSE Business Review Blog (12 October 2025).

Low pay, job insecurity and post-Brexit recruitment challenges are plaguing the adult social care sector in England. With rising demand and chronic underfunding, work conditions are only getting worse. Andreas Georgiadis and Andreas Kornelakis suggest ways to improve the situation, including better pay and training.

Adult social care suffers from a long-standing “workforce crisis” in England. Recent reports from industry bodies highlight the challenges to the sector’s workers and their ability to offer high quality care. Staff in social and health care are overworked, exhausted and stressed, sometimes to the point of becoming ill, leading to absenteeism or quitting altogether.

Increased workloads and time pressures arise partly due to increased demand for services by a rapidly ageing population. At the same time, over half of adult care providers said they faced challenges recruiting new staff; 31 per cent struggled to retain employees. Difficulties in recruitment and retention intensified after Brexit, as the sector relied heavily on migrant workers.

It is widely known that adult care is one of the lowest paying jobs in the UK. Forty-three per cent of all adult social care workers in England are paid below the real living wage. It will continue to be challenging for care providers to retain pay differentials between those on the wage floor and those with more experience and qualifications. But pay levels are not the only challenge for care workers, as they also face problems of job insecurity and unpaid overtime.

For example, most of those who do home visits are not compensated for the time they spend travelling to homes, which can make up to a fifth of their working day. The use of contingent contracts in social care may deliver some cost savings for providers, but has the drawbacks of job insecurity for workers, and concerns about service quality. Continue reading →

What are the experiences, motivations and plans of Health and Care Visa holders and their dependants?

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Kalpa KharichaDr Kalpa Kharicha is Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s College London. She leads the Unit’s work on the Health and Care Visa, the report from Phase of 1 of which was published in October 2023. (679 words)

Internationally recruited care workers made the biggest contribution to reducing vacancies in frontline adult social care in England during 2022-3; 70,000 people came to the UK to work in a direct social care role. During this time the number of domestic recruits to care work fell. Vacancies in social care are currently at 152,000.

The increase in international care workers follows changes to government immigration policy in recent years. In particular, the addition of ‘Senior care workers’ and ‘Care workers’ to the shortage occupation list (on 27 January 2021 and 15 February 2022, respectively) allows people from other countries to apply for these jobs, with a licensed UK employer and if eligible for a Health and Care Visa.

Recent announcements on immigration policy mean that from early 2024 (exact date to be confirmed at time of writing), Health and Care Visa holders arriving in the UK after that time will no longer be able to bring their dependants with them Health and Care Visa holders who are already in the UK can bring dependants whilst on their current visa.

As part of our recent research to understand the impact of the Health and Care visa system on the adult social care workforce in England, we spoke to 29 internationally recruited care workers and dependants, as well as 22 social care providers, 8 brokerage agencies and 15 sector skills experts, who shared their views and experiences with us. Continue reading →

How can we scale-up innovations? Lessons from the development of four local Shared Lives schemes

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Carl PurcellDr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. This is the second of two blogs on Shared Lives. (1,315 words)

In a previous blog we considered the successful spread of Shared Lives (SLs) schemes as an alternative model of care that seeks to replicate ‘ordinary’ family life for adults with care needs. This model has long enticed national and local policymakers’ attention and SLs schemes are now established in most English local authority (LA) areas. However, it remains a very small model accounting for just 1 per cent of those drawing on local authority funded adult social care and less than 0.5 per cent of the workforce. Furthermore, SLs continues to be used predominantly for the care and support of people with learning disabilities (LD) despite efforts to promote its wider use for a more diverse range of people. This prompted us to investigate the challenges faced by local schemes trying to ‘scale-up’. Continue reading →

How do innovations spread? What we can learn from Shared Lives schemes and the role of Shared Lives Plus?

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Carl PurcellDr Carl Purcell is a Research Fellow based in the NIHR Policy Research Unit in Health and Social Care Workforce, part of the Policy Institute at King’s College London. He is also part of the team working on the SASCI project led by Dr Juliette Malley based at the Care Policy Evaluation Centre at the LSE. See also the second blog in this series by Dr Purcell. (1,129 words)

Innovation, or doing things differently, is commonly promoted by policymakers as a response to social challenges in the context of increased pressure on public services and stretched resources. Policy announcements on adult social care are testament to this, but we know surprisingly little about how innovations emerge and are developed, sustained, and spread. The Supporting Adult Social Care Innovation (SASCI) project – an ESRC funded study investigating innovation in adult social care in England – was set up to address this. The spread of Shared Lives (SLs) schemes across England has provided an intriguing case study. Continue reading →

Fair Care Work: A Post COVID-19 Agenda for Employment Relations in Health and Social Care

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Ian Kessler, Stephen Bach, Richard Griffin and Damian Grimshaw introduce their new paper, Fair care work. A post Covid-19 agenda for integrated employment relations in health and social care, published yesterday by King’s Business School. Lead author, Professor Kessler, is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. (908 words)

The courage and sacrifice of the health and social care workforce have emblazoned themselves on the national consciousness as the challenge of COVID-19 continues. While classified as ‘key workers’, along with other occupations essential to the community in times of crisis, the distinctive contribution of frontline care workers, reflected in their direct and relentless engagement with the virus, has until recently been reflected in the Thursday night applause reserved for them. This public applause sits uneasily, however, with the treatment of over two million health and social care employees, mostly women, often from black and minority ethnic backgrounds, typically in undervalued, relatively low paid and insecure employment. In a new paper, we seek to kick start a policy debate on the development of fair care work, to stimulate discussion on a refreshed employment relations (ER) agenda which acknowledges and reflects the worth of care workers to our individual and communal well-being. Continue reading →

From desk to doorstep

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Living well with dementia is important, though there may come a time when initiating social contact becomes a challenge. For some people living with dementia there may be increased isolation. For those living with a partner or family and friends, as dementia progresses their daily care needs may be hard to manage or support.

Attending a day service which offers stimulating activities, whilst at the same time providing respite for family carers, benefits not only the person with dementia, but also helps families continue their support.

The COVID-19 lockdown brought an end to this overnight.

Foreseeing the psychological or emotional consequences of the loss of day centre support, one day centre has switched to offering daily support via phone calls to its former attenders and their carers. Additionally, as day centre staff have great experience in providing ‘customer care’ to relatives, they quickly became part of the COVID-19 Emergency Shielding Residents Response. Continue reading →

Cameos of Care Homes: stories from social care Vanguards

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Jess Harris is Research Fellow at the Social Care Workforce Research Unit, King’s College London. She led the Cameos of Care Homes project. (616 words)

Six ‘Vanguard’ areas across England have been developing approaches to enable care homes to better support the increasingly complex health needs of their residents. These six, focusing on ‘Enhanced Health in Care Homes’, were among 50 Vanguard pilot areas (2015 to 2018) tasked with developing models of care that can be sustained and replicated across England, helping the health and social care system tackle financial pressures and rising demands.

A recent National Audit Office (NAO) report has examined the Vanguards’ impact so far, in terms of value for money, and concluded: ‘there are early signs of a positive impact on emergency admissions’. However, at this early stage it cautions that ‘the longterm impact and sustainability of Vanguards is still not proven’. (page 47)

Staff members taking part in ‘Cameos of Care Homes’

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Providing Support and Care from a Distance

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Caroline White of the University of Hull is seeking participants in a new study. (462 words)

Family members and friends often provide support, help and care to others, instead or in addition to paid sources of care and support. These people (often referred to as carers, although this term is not embraced by all) are collectively estimated to save the UK economy £132 billion per year (according to figures from Carers UK in 2015) and have been the subject of much research and policy development. The majority of existing research about carers concerns those who support someone who lives with or near to them. However, as we become an increasingly geographically mobile population many parents, adult children, siblings, other relatives and friends find themselves living at a distance from those they care for and about. A new research project at the University of Hull is working to find out more about the experiences of those who provide help, care and support to a relative or friend who lives at a distance from them (we are meaning that they have to travel for one hour or more to visit them). Continue reading →