Staff recruitment and retention in adult social care remains a big challenge, says council leader as £11.5m pressure detailed

The leader of Wrexham Council says recruitment and retention of staff to work in adult social care and children’s services is one of the authority’s biggest challenges.

At next week’s executive board meeting, Esclusham Cllr Mark Pritchard (Ind), also the lead member for finance, will give an update on the council’s revenue outturn.

In a media briefing ahead of that meeting, Cllr Pritchard explained one of the biggest budget pressures the authority has is the staffing of children’s services.

He said supply and demand, the ability of authorities over the border to offer more lucrative pay as well as agencies being able to provide a better work-life balance, has made it an expensive service area and difficult for the council to budget for.

This is coupled with the difficulty to predict the numbers of people who will need adult social care and children’s services across the year.

“You just don’t know what the future holds”, Cllr Pritchard said.

“We don’t know how many cases will come through our door.

“When a judge makes a decision that we have to keep children safe, we keep them safe. Then we have to find placements, sometimes these are out of county but we’ve given a commitment to keep children as close as we can or in Wrexham – so there’s an extra cost on that.”

Cllr Pritchard added that the council wants to reduce reliance on agencies and bring staff back ‘in house’, developing their own.

“There’s a cost to it. There’s a personal choice and that’s the difficulty”, he said.

“All the authorities across Wales are struggling to recruit and sometimes retain in social care.

“There’s the pressure of the job and the payments across the border.

“We’re 12 miles from Chester, the M53 and M56, Liverpool and Manchester are only down the road, Cheshire – they pay a lot more in salary than we do.

“There are some authorities paying £6,000 more than what some authorities are paying in North Wales and we can’t compete with that, so we ‘grow our own’, invest in the process and bring our own staff through.”

Cllr Pritchard added: “It’s a very difficult area to recruit to now.

“People’s life choices have changed. People don’t want to work five days a week now, they only want to work two-and-a-half days or three days a week.

“When they’re in an agency it’s their choice and we just have to live with that. Things have changed and I think that’s to the detriment of local authorities.”

The council’s chief executive Ian Bancroft is more optimistic about the future staffing of a service the council is duty bound to provide.

“Agency pay rates are increasing”, he said.

“There’s been work done nationally to try to get an agreement that we try and keep agency rates which mean that difference (in pay) isn’t too great.

“We’ve done lots of work in social care around increasing pay rates, growing our own and making sure we retain staff.

“We are beginning to see now in the first three months of this financial year a number of people moving across from agency work into permanent posts.

“We’re starting to see that shift. Maybe people are deciding they would prefer the security, and also the difference between agency and permanent isn’t as great as it was.”

Mr Bancroft pointed to the newly-refurbished Crown Buildings as an attractive environment to work in, adding that authorities across the UK struggling to recruit to the sector.

But Cllr Pritchard spelled out the importance of staffing the service despite the cost.

“It’s market led”, he said.

“Where there’s a shortfall in resources those staff become a premium and then you have to pay the going rate and that’s what we have to do.

“We have a statutory duty to deliver this service. If we don’t, we’re in trouble.

“It’s the same with the bin collections. If there’s people on the sick, they don’t come into work, we have to bring in agency staff that day to complement the numbers to collect all the bins.

“It’s not ideal, the same with teachers and teaching assistants but that’s the world we live in now unfortunately.

“A lot of people I know in the professional world only work three or four days a week now, they don’t want to work five days so they go to the agency because they can have that luxury.”

Recently the council has been able to bring more environment staff brought back in-house, meaning less reliance on agency staff.

Increases in fuel and energy prices, school transport, and price increases caused by the cost-of-living are all having a financial impact.

Cllr Pritchard said: “It’s been a very difficult year for all the authorities across Wales, but I’m really pleased with where we are in Wrexham on the budget.

“There is pressure in the statutory services, tremendous pressures; adult social care, children’s services, transport, environment department – they’re all frontline services.

“Budgets are getting more difficult every year.

“We’re hoping Welsh Government will be sympathetic this year and give us a bigger slice of the cake when they allocate the budgets and that process has already started.”

The executive board meets on Tuesday (June 13).

Extract from report:

Social Care – Pressure £11,526k The legacy of the pandemic continues to have a range of challenging impacts within Social Care. These include increasing demand for services coupled with increasing complexity, insufficient funding, and significant workforce pressures. The pressure in both adult services and children’s services includes the challenge of recruitment and retention of staff with this issue also affecting commissioned services from providers.

Children’s Social Care

The financial pressure in Children’s Social Care during the year is as a result of the continued challenges the department is facing due to service demand and increased numbers of the younger people (both generally and specifically increasing numbers with more complex needs) it is having to support, along with the continued need for the use of agency staff due to the difficulties in recruiting suitable permanent staff. Both of these key issues are apparent nationally in varying degrees. There continue to be pressures in the Children’s specialised residential and fostering placements budgets, as well as within the budgets for the associated specialist education costs. The growth in specialist placements the council is dealing with is not a unique position and is a pressure facing a number of councils across the country. The table below identifies the placement numbers along with the average and total weekly cost across fostering, residential and educational placements during the year. Total number of placements have increased from 192 at the start of the financial year to 203 at the end. The absolute number though only gives part of the picture as the duration of the placements and the average cost are key to understanding the financial pressure. The number of residential placements continued to increase during the year however they appear to have stabilised by the end of Q4. The weekly cost to the Council for residential placements has increased by £46,516 (29%) since April 2022. Educational placements also continued to increase during the year rising from 43 to 61 (an increase of 42%) and the total weekly cost significantly increasing by the end of the year to £88k, an increase of 60% since the start of the year. The number of fostering placements has decreased during the year

The forecast at Q3 for specialist placements was based on reasonable end date assumptions on a number of placements and the assessment of costs at that time. The final outturn position for specialist placements was a budget pressure of £6.7m and reflected that some placements did not end as forecast at Q3 and where some placements have ended, there have been new placements with a higher cost. There continues to be the need for the use of agency staff due to the difficulties in recruitment. This is a national issue. Measures to reduce reliance on agency staff have not had the impact that was assumed at Q3 however, we can see evidence of this reducing in the new financial year. The final outturn position for agency was a budget pressure of £4.8m.

Adults Social Care

The final outturn pressure was £5.5m and relates primarily to the following: Pressure on the residential/nursing sector is still apparent and care fee levels are higher than budgeted for during the financial year, in addition to increased demand. Costs are increasing significantly whilst overall contributions towards care is decreasing – both in terms of client contributions where applicable and contributions from Health. There is also a budget pressure directly related to positive steps being taken to reduce waits for home care in Wrexham. Somewhat bucking the national trend, local waiting times for care have fallen drastically with wider use of agency workers and the in-house team benefitting from working with agency workers, has greatly improved capacity. This has resulted in significantly better support to older people and little delays for the public and reflects actual demand locally. The cost increases experienced generally by the Council through pay and price inflation have also had an impact on those providing commissioned care services (domiciliary, residential and nursing). Such providers have also had to rely more on agency staff provision, at greater cost. This resulted in a review of agreed care provider fees being undertaken in October 2022 and increased costs in-year by approximately £500k. Day care services are increasing following the pandemic, along with increased costs for direct payments due to a growing service demand and the lack of conventional support in the domiciliary care market. There has been a general reduction in the contribution from Health towards placement costs. The forecast at Q3 assumed a similar level to previous years however this was not forthcoming at the end of the year. The 2021/22 Adult Social Care budget was reduced by £500k with the intention to develop and modernise services. As a result of the significant challenges during the pandemic it was not possible to carry out these re-assessments and therefore continues to be a budget pressure to the department. It must be recognised that there was no additional grant support during the year, unlike in previous years. Whilst the Council does not budget for additional grant it can help to support overall forecasts, based on previous experience. For example, funding such as Winter Pressures has consistently been made available in February or March in previous years. The average support over the last three years is £606k. The loss of the one-year (2021/22) WG Social Care Recovery Funding and Social Care Pressures Grant has also had a big impact. This funding was used to meet pressures in both the Children’s and Adults service and amounted to £4.7m. The final position reported includes the planned use of reserves as reported at Q3. The gross inyear position was £11.5m childrens and £5.5m adults.

 

 

By Rory Sheehan – BBC Local Democracy Reporter