Howard Gospel and Paul Lewis Management Department, King’s College London DH, 17 November 2009

1. ‘Who cares about skills? The impact and limits of statutory regulation on qualifications and training in the social care sector’ Howard Gospel and Paul LewisManagement Department, King’s College London DH, 17 November 2009

2. Context Methods Impact of regulatory framework training OPH, PLDH, CH Continuing impediments to training Significance and discussion Conclusions Outline

3. 1990 Health Services & Community Act quasi-market in social care purchasers and providers The regulatory framework 2000 Care Standards Act and NMSs Inspection regime – NCSC, CSCI, CQC Registration regime – GSCC NMSs Training central – for managers and workers Training targets – 50%/80% 2005 Classic quality assurance model service standards internal quality control procedures external monitor Context: the social care sector

4. 1.6 million, circa 5% of UK labour force 2/3 of whom care workers 85% women, 50% part-time, 65% 35+, High turnover and vacancy rates International recruitment  Labour costs 80% of total costs Training limited Context: the social care workforce

5. Replication study – 2003 DfES; 2008 DH 7 case studies 4 OPHs, 1 PLDH, 2 CHs; spread of types Interviews with key organisations Examination of various statistical databases Research methods

6. 2003, 1 met NMSs; 2008 all met NMSs All registered managers compliant Managers attributed higher qualifications to NMSs See also CO 2008 study: ‘Everyone we spoke to believes that far fewer employees would have been trained in the absence of regulation’ (16) Representativeness? The impact of training targets

7. Table. New registrations (levels 2 and 3)  each year 2000-05; tails off in 2006 Biggest increase in 2003 and 2004 Same story with registered managers The impact of targets – flow measures

8. Staff 2003 20% at level 2 or above SfC NMD 23% CO 30% Some, but limited, progress to 50% SfC NMD registered managers 57% Homes OPH 48% compliant in 2002/3; 78% in 2006/7 HPLD 63%, 80% CH 46%, 70% Significant , but still considerable work to be done The impact of targets – stock measures

9. Induction standards – in place in all case studies Induction training  in length, breadth, formality Better integrated into subsequent NVQ Minimum number of days training – all compliant Used for mandatory training e.g. h&s, POVA etc. Built into routines Conclusion: Significant positive effect, but still considerable scope for improvement The impact of targets – other

10. Costs of training / funding 2003 direct costs covered, but not indirect 2008 more state money Constraint  Assessment 2003 cost and time of assessor 2008 move to external assessment Constraint  Turnover Fear of poaching in both 2003 and 2008 But fears not well grounded – turnover not  Perceived constraint continues Impediments to achieving NMSs:employers

11. Time constraints NVQ study 1 – 2 hours per week Still a constraint The academic demands of NVQ Tho’ practical, on-site, on-the-job Still fear of ‘going back to school’ 2008 constraint : older workers have quit; more of a tradition; smaller portfolio; in-house assessment Deficiencies in basic skills literacy and numeracy immigrant labour Still a constraint Impediments to achieving NMSs:employees

12. 4. Weak financial incentives no or very small increment But HPLD £1 / 15% 5. Limited career prospects Little scope for progression to 3 (or 4 in CH) a. barriers to gaining experience b. paucity of senior positions c. blocked by professional requirements e.g. nurse, DipSW Impediments to achieving NMSs:employees

13. Improvement, caused by regulatory framework but still NMSs still not fully met. But scepticism about NVQ assessment, not training certification of existing competencies formal compliance as opposed to real commitment Some agreement with thisBut most think real advice and training – better underpinning knowledge, more reflective Would like more technical training Discussion 1: NVQs - training or certification of existing skills?

14. Is training being integrated into a broader set of HRM practices – pay, job design / team work, job security, career, better information, voice? None had moved much towards integrated strategies However, genuine training; integrated (induction, NVQ, mandatory) Also, job security – little use of agency work Also, team working But, only a minority had aligned qualification and pay. Discussion3: broader HRM linkages

15. Only limited granting of more discretion Progression a problem Despite fact that most workers desired. Lessons to be learnt from NHS (Cox 2007) May have to change in future a. demand for more multi-skilled workers may  domiciliary care ; older on entry b. pool of labour may shrink higher educational and aspirational levels Discussion: broader HRM linkages

16. 2000 regime was a major development: ‘brave new world of social care’ Some improvements under this regime. But a long way to go. Managers and employees supportive of present framework and would like to see a tightening up. However, re-fashioning of the system / regime - ‘lighter touch’ regulation – ‘risk-based’, ‘output-driven’ - revision of NMSs – targets likely to go - ‘personalisation’ – direct payments, individual budgets Conclusions

17. ‘Who cares about skills? The impact and limits of statutory regulation on qualifications and training in the social care sector’ Howard Gospel and Paul LewisManagement Department, King’s College London DH, 17 November 2009