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England is now the only UK country not to register care workers

Registration and professional regulation can reduce risk to the public, improve outcomes for people drawing on social care services, improve confidence in the workforce, and can drive up workforce standards.

However, regulation can also introduce unnecessary barriers to recruitment and retention, and it is costly.

A new report from the Nuffield Trust, New horizons: What can England learn from the professionalisation of care workers in other countries? points out that England is the only country in the UK to not introduce registration and professional regulation of care workers.  

It also details other challenges for residential care management associated with the recruitment and retention of care workers, including low pay, poor terms and conditions, variable access to training, and limited opportunities for career development.   

Among the other key points raised by the report:

High-quality training supports retention and better care: Programmes tend to be most effective when training is relevant to the role, equitable in terms of access, and sits alongside alternative routes for workers to demonstrate their skills.

Increased pay reduces staff turnover, particularly for staff paid at lower wage levels. Countries around the world have used a number of different routes to improve pay: Scotland and Wales are taking steps to standardise pay and increase it beyond the National Living Wage, and pay bonuses have been awarded in all three devolved countries. Germany has introduced a sector minimum wage and policymakers are seeking to implement collective wage agreements to increase and standardise wages across the country. The national pay and progression framework introduced in New Zealand has helped improve retention, and this more attractive pay scale has also attracted new starters who are male, younger, or with graduate degrees.

Day-to-day working terms and conditions of care workers in England need urgent attention. New Zealand funds home care workers’ travel time and travel costs, while Germany has introduced childcare grants and additional days of annual leave. Scotland is distinct in the UK for requiring providers to take staff wellbeing into account in their staffing decisions. Other countries such as Norway and Germany offer much more generous sick pay provision.

Measures must be designed and implemented together rather than introduced in isolation. Unintended consequences of, for example, mandatory training may introduce unnecessary rigidity; pay increases may further minimise the difference in pay for more senior staff; guaranteed hours at a national level may not benefit all staff consistently.

Address inequalities in progression and earnings to attract underrepresented groups into the workforce: one in four are from Black, Asian or minority ethnic backgrounds and these groups are less well represented in senior positions. 

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