Guidance

Executive summary: adult social care workforce and work-related quality of life

Published 26 February 2025

Applies to England

© Crown copyright 2025

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/adult-social-care-asc-workforce-and-work-related-quality-of-life/executive-summary-adult-social-care-workforce-and-work-related-quality-of-life

This report presents findings from a research project undertaken by Ipsos in partnership with the University of Kent and Skills for Care, on behalf of the Department of Health and Social Care (DHSC). The research involved an online survey with members of the adult social care (ASC) workforce in England between August and October 2023 to measure their wellbeing and work-related quality of life.

This summary provides an overview of the key findings from analysis of weighted data for 7,233 survey participants. The analysis is based on overall results for all participants as well as a comparison of findings by individual characteristics such as job role, working hours and ethnicity. This provides a descriptive analysis of association, and care should be taken to avoid assuming causation.

Overall wellbeing

Participants were asked 4 questions about their overall wellbeing, taken from the UK Measures of National Wellbeing, provided by the Office for National Statistics (ONS). These questions cover life satisfaction, happiness, feelings of worthwhileness and anxiety (see chapter 3 of the main report for an overview of findings for each measure).

Looking across these questions, the wellbeing of the ASC workforce is mixed. While 2 in 5 (41%) rate their life satisfaction as high or very high, a quarter (26%) rate their life satisfaction as low. Ratings of happiness are equally split, with just under half (45%) rating their happiness as high or very high and just over 1 in 4 (28%) rating their happiness as low. Similarly, when asked if they feel the things they do in life are worthwhile, half (52%) provide a high or very high rating, whereas 1 in 5 (18%) provide a low rating. Anxiety is very common within the ASC workforce, with 2 in 5 people (42%) rating their anxiety as high when asked how anxious they felt the day before the survey.

Some groups within the ASC workforce are more likely to report better overall wellbeing across the 4 ONS measures than the workforce as a whole. This includes:

  • registered managers
  • personal assistants
  • occupational therapists
  • people employed by local authorities and those working in home care services

Ratings of wellbeing are also related to age, number of hours contracted to work and household income. People aged 55 or over, those contracted to work 1 to 20 hours per week and those who live in households with an annual income over £52,000 or more, consistently report higher mean scores across the ONS wellbeing measures than the workforce as a whole.

The survey included 2 measures of work-related quality of life:

There is some overlap between the 2 measures, which was intentional, to help decide which measure is best suited for future waves of the survey.

The Van Laar measure was developed by the University of Portsmouth and is designed to understand the work-related quality of life across any given workforce. The measure has previously been used in research with NHS trusts, trade unions and other large UK organisations such as the BBC and the Royal National Lifeboat Institution (RNLI).

ASCOT-workforce was developed by the University of Kent to measure care work-related quality of life and accounts for the particular context and challenges of working in ASC. As outlined below, both measures provide similar results in relation to work-related quality of life among the ASC workforce in England.

Van Laar measure

The Van Laar measure includes 6 factors which are combined into an overall score. The average scores for each are provided on a scale of 1 to 5, with a high average score indicating good work-related quality of life for the factor it relates to.

The 6 factors are:

  • general wellbeing (GWB), with an average score of 3.15 for the ASC workforce, which indicates low to moderate levels of wellbeing
  • control at work (CAW), with an average score of 3.16, which indicates low to moderate levels of control at work - this is in line with the ASCOT-workforce measure on autonomy
  • stress at work (SAW), which has the lowest mean score (2.36) across the 6 factors, which indicates fairly high levels of stress among the ASC workforce
  • home-work interface (HWI) - this factor addresses issues relating to work-life balance and the extent to which an employer is perceived to support someone’s home life, and has a mean score of 3.41
  • working conditions (WCS), with a mean score of 3.53
  • job and career satisfaction (JCS), with a mean score of 3.55

The mean scores for HWI, WCS and JCS indicate moderate levels of wellbeing across the ASC workforce.

The overall score for the ASC workforce is 3.27, which indicates a low to moderate level of wellbeing.

Personal assistants, registered managers and occupational therapists have consistently higher scores across the 6 Van Laar factors, indicating a higher level of overall work-related quality of life than the workforce as a whole.

ASCOT-workforce measure

As previously mentioned, the ASCOT-workforce measure differs from the Van Laar measure as it is designed specifically to be sensitive to the impact of social care work. This means capturing the aspects of a person’s quality of life most impacted by working in ASC and taking into account the specific challenges of working in the sector. The resulting measure can be described as a care work-related quality of life. The measure consists of 13 domains:

  • making a difference
  • relationships with the people cared for
  • autonomy
  • time to care
  • worrying about work
  • self-care
  • safety
  • professional relationships
  • support in the role
  • competency
  • career path
  • financial security
  • feeling valued

Around 7 in 10 (69%) of the ASC workforce say they are able to make a difference in people’s lives, with 1 in 4 (25%) able to make as much difference as they would like and around 2 in 5 (44%) able to make some difference. Personal assistants (84%) are more likely to agree with this statement compared to any other job role in the ASC workforce.

Most participants (86%) also say they have a good relationship with the people they care for.

Around two-thirds (65%) say they have freedom and independence to make decisions and carry out tasks as part of their day-to-day work. Personal assistants (82%), registered managers (75%), occupational therapists (74%) and those working in home care services (76%) all report higher levels of autonomy than the overall workforce. Just over half also say they have the time they need, or adequate time, to do their job well (52%), and a slightly lower proportion (48%) say they do not have time to do their job well. People working in home care (69%) and community services (57%) are more likely to say they have enough time to do their job well.

Over half (52%) of the workforce say they worry about work outside of working hours, including 1 in 6 (16%) who constantly worry about it. Registered managers (77%), social workers (62%) and those working in deputy or other managerial roles (67%) are more likely to say they worry about work. A similar proportion of the workforce (54%) also say they are rarely able to look after themselves at work or not able to look after themselves well enough.

The majority (80%) of the ASC workforce feel safe at work, while 1 in 5 (20%) say they do not feel adequately safe (16%) or do not feel safe at all (5%). This is despite half of the workforce experiencing or witnessing physical violence, harassment, abuse and bullying from the people they care for or support over the last 12 months. Feeling unsafe is more common than average among people in direct care roles, in particular care workers or assistant care workers (25%).

Most (83%) participants say their relationships with their colleagues and the people they work with are as good as they want them to be or good enough. Around two-thirds (64%) of the ASC workforce feel highly or adequately supported in their role, while one-third (36%) say they do not feel supported in their role, and 1 in 10 (10%) say they do not feel supported at all. As with feelings of safety at work, care workers and assistant care workers are the job role least likely to say they feel supported.

Nine in 10 (89%) of the ASC workforce feel they have the skills and knowledge, or adequate skills and knowledge, to do their job well. Three in 5 (59%) say they have adequate opportunities to develop and progress in ASC, or as many as they would like. Around 2 in 5 (41%) say they have some opportunities but not enough, or no opportunities, to develop and progress.

In the Van Laar measure participants were also asked to what extent they agree or disagree with the statement: ‘I am satisfied with the opportunities available for me here’. Around 2 in 5 (42%) agree with this statement while under a third (29%) disagree and the same proportion say they neither agree nor disagree. This indicates that having opportunities to develop and progress does not necessarily equate with being satisfied with these opportunities.

Seven in 10 (68%) of the ASC workforce say they do not have enough, or they do not have any, financial security. Only around one-third (32%) say they are financially secure. As to be expected, participants living in a household with an annual income of up to £25,999 (which is the case of 34% of the ASC workforce) are more likely to say they do not have enough or do not have any financial security (78%) compared with the overall workforce. In contrast, those with an annual household income of £52,000 to £99,999 (48%) and £100,000 and above (49%) are more likely to say they have financial security compared with the workforce average (32%). However, only 1 in 10 members of the ASC workforce (11%) live in a household with an annual income of £52,000 or more before tax.

Over three-quarters (76%) of the ASC workforce say the cost of living is too high, and two-thirds (64%) state their hourly rate of pay is too low. Low income or pay is the most frequently cited motivation for leaving their job (67%). This indicates that pay and financial pressures are a key concern for the workforce.

Participants were evenly split on whether their role is valued by other people. Just over half (54%) say their role is not at all valued or not as valued as they would like, while under half (46%) say their role is highly or adequately valued. The job role where people are least likely to feel valued is social workers, with around three-quarters (72%) stating they do not feel valued by other people. Less than 3 in 10 social workers (28%) feel their role in social care is highly or adequately valued by other people.

Across the ASCOT-workforce domains there is also a clear pattern of personal assistants, registered managers and occupational therapists reporting higher than average levels of care work-related quality of life. In contrast, social workers, nurses and nursing associates, care workers and assistant care workers tend to provide more negative responses to many of the ASCOT-workforce domains. These differences are also reflected in the overall scores by job role. Across the domains those working in home care services report higher levels of care work-related quality of life than those working in residential care homes.

Experiences of physical violence, harassment, abuse and bullying

Physical violence, harassment, abuse and bullying from people cared for or supported are common: around half (49%) of the ASC workforce has experienced or witnessed physical violence and (46%) have experienced or witnessed harassment, bullying or abuse in the last 12 months. Nurses and nursing associates, senior care workers and registered managers are more likely than average to say they have experienced or witnessed physical violence from the people they care for or support.

Physical violence from colleagues, managers, family members of the people cared for, or members of the public is much less common (7% to 13% have experienced or witnessed physical violence from these sources in the last 12 months). Experiences of physical violence from managers or team leaders or colleagues are more common among nurses and nursing associates, care workers and assistant care workers, and senior care workers. Harassment, bullying or abuse from colleagues, managers, family members of the people cared for or the public are slightly more prevalent (between 13% and 33%).

Encouragingly, when there are incidents of physical violence, harassment, bullying or abuse, they usually get reported. Over 9 in 10 (95%) said incidents of physical violence were reported and over three-quarters (78%) say incidents of harassment, bullying or abuse were reported. Bullying and harassment is a significant contributor to staff turnover with around 1 in 5 (17%) of people who are considering leaving their current role citing this as a reason for wanting to leave.

Learning and development

Three in 5 participants (61%) say they had an appraisal, annual review or development review over the last 12 months. This is around 20 percentage points lower than in the 2022 NHS staff survey.

Among those who had an appraisal or review over the last 12 months, only half agree it has helped them agree clear objectives for their work (51%) or left them feeling that their work was valued by their organisation or employer (51%). Again, this is lower than in the 2022 NHS staff survey with 82% of NHS staff agreeing with this statement.

Over half of the ASC workforce agree they have opportunities to improve their knowledge and skills (56%) and they are offered challenging work (55%). However, only 2 in 5 (39%) agree there are opportunities for them to develop their career in their organisation or with their individual employer. Agreement on all of these statements is lower than those reported in the 2022 NHS staff survey. This has clear implications for retention: over a third of people who are considering leaving their current job cite lack of career opportunities or progression (37%), and just under a quarter cite lack of learning and development offer (23%).

Registered managers, social workers and occupational therapists are more likely to agree they have opportunities for professional development compared with the workforce as a whole.

Intentions to leave

In light of the above findings, it is perhaps unsurprising to see that intention to leave is high across the ASC workforce: a third (34%) agree that as soon as they can find another job they will leave their organisation or employer. This is twice the proportion of NHS staff who agreed with this statement in 2022. Intention to leave their current job is higher than average among care workers and assistant care workers, social workers, people working in residential care and those with a low household income.

For those who are considering leaving, the most common destination is a job outside of health and social care (29%), followed by a job in the NHS or healthcare (18%). Only 1 in 8 would want to move to a job with a different social care organisation or employer (13%), suggesting that there is a challenge of retaining staff in the sector, not just within roles.

Participants in the survey provide many reasons for wanting to leave their current role, which reflects the findings throughout the report. This includes income or salary being too low (67%), impact on health and wellbeing, for example stress, burnout (67%), lack of recognition for the adult social care sector (48%), lack of career opportunities or progression (37%), and employment terms and conditions such as zero-hour contracts, lack of paid overtime, lack of sick pay and maternity pay (31%).

Sub-group analysis

Some groups of the workforce consistently report lower than average ratings on many of the topics covered in the survey.

People working in residential care

In comparison with the workforce overall or with people working in other types of services such as home care, people working in residential care score lower on all but one of the ASCOT-workforce statements (competency). They are also more likely to experience or witness physical violence at work and are less likely to agree they benefited from appraisals and reviews, when they have had one.

The proportion of this group who agree that they have opportunities to improve their knowledge and skills, or that they are able to access learning and development opportunities, is also lower than the workforce overall and than other types of services. Their intention to leave their current role is higher than average.

Nurses and nursing associates

In comparison with the average or with other job roles, nurses and nursing associates report lower scores on 9 of the ASCOT-workforce statements:

  • making a difference
  • relationships with people cared for or supported
  • autonomy
  • time to care
  • worry about work outside of their working hours
  • self-care
  • safety
  • professional relationships
  • career pathway

They are also more likely than average to experience physical violence from the people they care for or support. Only half of them had an appraisal or review in the last 12 months, and they are more likely than average to disagree that they have opportunities to develop their career in their organisation, opportunities to develop their skills and knowledge, and that they are able to access the right learning and development opportunities when they need to.

Social workers

Social workers have more negative scores on many ASCOT-workforce domains compared with the workforce overall, including:

  • making a difference
  • relationships with the people cared for and supported
  • autonomy
  • time to care
  • worrying about work outside of their working hours
  • self-care
  • competency
  • feeling valued

One in 5 has experienced or witnessed physical violence from the family or friends of the people they support over the last 12 months (20%), and 1 in 7 (15%) has experienced physical violence from members of the public. Harassment, bullying or abuse are also more commonly experienced or witnessed, whether from the people cared for or supported (58%) or from the family members or friends (49%).

Despite being positive about financial security and opportunities for professional development, 3 in 5 agree that they often think about leaving their organisation, with three-quarters of those who intend to leave mentioning impact on health and wellbeing, for example stress or burnout, as a reason (74%).

The following groups stood out as having higher levels of wellbeing and work-related quality of life than other groups on at least some domains.

Personal assistants

This group has better wellbeing scores than most other groups in the workforce (for example, 6.42 mean life satisfaction compared with 5.74 for the workforce as a whole).

Personal assistants also score better on most care work-related quality of life measures including:

  • being able to make a difference
  • relationships with people supported
  • autonomy
  • having enough time
  • worrying about work
  • self-care
  • feeling safe
  • good professional relationships and feeling supported, as well as the overall care work-related quality of life score

Personal assistants are also less likely to state an intention to leave the workforce, despite being more likely than other groups to say they don’t have enough opportunities to develop. This group are less likely to have experienced or witnessed physical violence or harassment and bullying than other groups, though they are also less likely to report it when it does occur.

Occupational therapists

This group reports higher levels of life satisfaction and feeling that the things they do in their life are worthwhile. Occupational therapists also report higher scores than overall on autonomy and feeling safe. However, like other registered professionals they are more likely than direct care workers to report:

  • not having enough time
  • not having enough skills or knowledge
  • their role not being valued

This group has a lower intention to leave than other groups, higher financial security and is less likely to experience physical violence and bullying and harassment than other groups.

People who work 1 to 20 hours per week

This group report higher levels of general wellbeing, career satisfaction, control at work and lower levels of stress at work for the Van Laar measures. People who work 1 to 20 hours per week are also more likely to say they have autonomy in their job role.

People who have an average household income of over £52,000 per year before tax

This group reports higher general wellbeing and control at work. They are also more likely to say they have autonomy at work, and they feel challenged by the work they do.

It should also be noted that the types of job roles within this income bracket vary considerably. For example, just over 1 in 10 (13%) of the 8% of the workforce who live in a household with an annual income of £52,000 to £99,000 before tax are care workers or assistant care workers; the same proportion are support or outreach workers (13%), 7% are personal assistants and 36% work in a manager, director or supervisor role.

Ethnicity

For some questions, participants from ethnic minority backgrounds are more likely to report positive experiences. For example, participants from Asian and Black ethnic minority backgrounds report higher general wellbeing than average. They also report higher than average scores for career satisfaction, and those from Asian ethnic backgrounds report a higher level of control at work, while people from Black ethnic backgrounds report lower levels of stress at work compared to the average.

Similarly, people from Asian ethnic backgrounds have a significantly higher care work-related quality of life compared with all other ethnic groups. Participants from Asian and Black ethnic backgrounds are also more likely to say they are making a difference at work, that they have autonomy at work, they feel valued and that appraisals have helped to improve how they do their job.

However, these ethnic groups are also more likely to have negative experiences. For example, participants from Black ethnic backgrounds are less likely to say they have financial security and are more likely to say that:

  • their financial responsibilities are too large
  • there is uncertainty about their job security
  • there is insufficient or no pay for travel between visits
  • the number of hours worked is too low or uncertain

People from Asian ethnic backgrounds are more likely than the workforce overall to witness or experience physical violence than average from managers or team leaders, colleagues and members of the public.

Differences between subgroups in response to the domains of care work-related quality of life, questions about destinations and reasons for intentions to leave, access to learning and development and experience of harassment, bullying and violence provide insights into how the actions required to tackle the challenges faced by the workforce will vary by job role, work setting or service and the individual characteristics of workers.

Back to top