Guidance

Care workforce pathway for adult social care: overview

Published 10 January 2024

Applies to England

Background

In December 2021, the government published People at the Heart of Care, which set out our 10-year vision for the adult social care workforce. We want the adult social care workforce to be recognised as the professional workforce it is, and to improve people’s perception and experience of a career in care. This means supporting people to feel empowered to deliver high-quality care, and to develop in their roles and progress in their careers, if that is right for them.

In April 2023, we published the plan Next steps to put People at the Heart of Care, which set out how we will build on the progress so far to implement the vision for adult social care. Alongside this, we published a call for evidence to inform the development of a new care workforce pathway for adult social care (the pathway) including a proposal for how the adult social care workforce might be structured and how we can articulate the knowledge, skills, and behaviours needed to perform different roles.

In the call for evidence, we asked:

• what the pathway should include
• how it should be set out and how we can support people working in care and adult social care employers to use it

We asked for examples of:

• what is working well in the sector
• what needs to change
• where there are barriers and challenges, and how we can address these

Together with the pathway, we have published a response to the call for evidence. This outlines what we heard through the call for evidence and associated engagement sessions, and shows how that has shaped the development of this pathway. The majority of responses to the call for evidence were supportive of the pathway, the proposed structure and its aims and benefits. Full details of the feedback received is available in the response.

Care workforce pathway for adult social care: call for evidence and response

The care workforce pathway

This publication, the first phase of the care workforce pathway, meets our commitment to work with the sector and people who draw on care and support, to co-develop a universal pathway setting out the knowledge, skills, values and behaviours needed to work in adult social care, as well as a clear career structure for the workforce.

The government, in partnership with Skills for Care, has used the information supplied through the call for evidence, alongside wider evidence and research, to ensure that the pathway:

• reflects the realities of receiving or providing adult social care
• builds on existing good practice
• can grow and develop as our expectations of adult social care change

Understanding the care workforce pathway

The role categories

This first phase of the pathway focuses on direct care and support roles at 4 levels with each level relating to a role category. Roles within each category may have different job titles but the roles will have a high degree of similarity across the sector. The role categories are:

• role category A: new to care
• role category B: care or support worker
• role category C: supervisor or leader
• role category D: practice leader

Future phases of the pathway will include further role categories as outlined in the ‘Next steps’ section of this publication below.

Included within the pathway are a number of suggested learning opportunities to help members of the workforce develop knowledge and skills within a role or within a specific area of practice. At present, these learning opportunities align with the knowledge and skills breakdown for each role category. As further development and parts of the pathway are launched, additional suggested learning opportunities will be added within each role category along with the inclusion of new specific areas of practice.

The pathway provides, for the first time, a shared ambition and vision for care and support workers across adult social care. The pathway is designed to be a foundation which, along with wider workforce reforms, will enable individuals to develop a portable portfolio of skills attained both through learning programmes and practical experience within a range of care services, such as learning disabilities, autism or dementia. These skills can include developing the clinical expertise to equip people to move into enhanced and complex care roles. The pathway will provide an evidenced and recognised platform for career progression and individual learning. 

By setting out an incremental route to build their skills and experience, the pathway should enable our adult social care workforce and employers to be ambitious in developing and recognising people’s contribution, providing opportunities to move from novice through to specialist and practice leadership roles, and on to potentially becoming a registered practitioner.

Quality assurance is vital when planning training and development for staff, knowing that the product is of value and will meet your training needs. The Department of Health and Social Care (DHSC) is considering how to best ensure that future suggested learning opportunities included within the pathway meet the needs of the sector, and are of good quality and value.

Values

We commissioned Think Local Act Personal (TLAP) to work with people who draw on care and support to develop a universal set of values for the sector. Values are the beliefs and views that people hold about the importance of something.

The values that have been defined apply across all role categories outlined in this phase of the pathway. The intention is for these values to apply across the whole of the adult social care workforce. The values reflect what people who draw on care and support said they want to see in all members of the adult social care workforce. The values also explain to those considering a career in adult social care the values they must have. The values were shared with representatives from the adult social care workforce to make sure that the values identified by people who draw on care and support aligned with what members of the adult social care workforce think.

Some employers and sector organisations will already have values that meet the needs of their organisation, workforce and people who draw on care, which may already align or partially align with the values set out within the pathway. We do not expect the pathway values to replace existing organisational values where these are working well. However, we would suggest that all organisations consider how the pathway values might be useful to them. The values may be useful where an organisation is looking to create or refresh their values or they could help in attracting new recruits into the sector. The benefit of using the pathway values is that they are in line with the lived experience of people who draw on care and support.

TLAP has produced a method statement (Annex A) that explains the process that was followed to reach this point where a set of values statements have been incorporated within the pathway.

Role category descriptions

Each of the 4 role categories will outline the following.

What people do in their work

This section will outline the kind of responsibilities someone within the role category is likely to undertake as part of their role.

The behaviours people must show (must do)

Behaviours are the way that values are demonstrated in practice. This section will outline the behaviours required to work within the role category. These are the things people must be doing in their job. While there is no legal requirement to demonstrate these behaviours, we want to develop universal acceptance of these behaviours as what is expected in adult social care roles.

Knowledge and skills people need to have (should do)

Knowledge means the things that someone needs to understand to undertake the responsibilities of the role. Skills are the ability to apply that knowledge in practice. This section includes the things people should know and the things they should be able to do in their job within the role category.

Specific areas of practice (can do) and current suggested learning opportunities

This section will outline 2 things:

1. The opportunities within the role category to specialise in one or more areas and the opportunities to develop within their role or to progress into another role. These are the things people could be doing in their job or in their development. Where people are working in a setting where there is a particular specialism focus, the knowledge and skills will be a requirement of working in their role. For example, someone working in a dementia setting will need to have dementia care skills and knowledge.

2. Suggested learning and development opportunities represent an opportunity to develop and specialise within the role category, either to develop a practice specialism or to progress into another role. Suggested continued professional development to develop these knowledge and skills is outlined in this section, both for learning in specialisms as well as additional suggested learning opportunities that may be applicable to all roles.

A role category persona

The persona is a case study of what someone within the role category may be doing in their job.

Links to wider adult social care workforce reform

The care workforce pathway outlines the knowledge, skills, values and behaviours needed to work in adult social care as well as the learning and development options the workforce has at each role category. 

To support the implementation of the pathway and to help people develop expertise and progress, we are providing funding for hundreds of thousands of training places. Our training offer will include funding for:

• a new Care Certificate Level 2 qualification - over time we want this new qualification to become the baseline standard for all new care and support workers to work towards when they join the profession
• learning and development, including training courses on:
  • healthcare interventions to support delegation
  • learning disabilities and/or autism
  • dementia care
  • leadership
• digital skills training and development of a new digital leadership qualification based on the recently updated Adult Social Care Digital Skills Framework from Digital Social Care

The pathway will make it easier for people to understand the knowledge and skills members of the workforce need and identify the learning and development that will help them develop. We’re working with partners to make it easier to access funding for the costs of training that employers and people working in adult social care identify through the pathway to support their learning and development. This will provide flexibility for employers and members of the workforce to access training specific to their individual roles and the people they support. Likewise, individual employers will be able to access funding for training to support the development of personal assistants.

In addition, we will introduce a digital skills passport by spring 2025 to improve portability of training and we’re developing a website for the adult social care workforce that will provide them with access to support, information and advice on careers in adult social care, linked to the pathway. This will include an explanation of the newly developed care workforce pathway, and other useful information about careers and career structures.

Recognising the importance of adult social care apprenticeships within the sector, we are working closely with the Institute for Apprenticeships and Technical Education (IfATE) and apprenticeship trailblazers during the review of the existing apprenticeship standards to ensure there is alignment between adult social care apprenticeships and the pathway.

Next steps

The pathway will empower anyone working in adult social care to develop themselves and their career by setting out how they can:

• gain skills
• access learning and development
• progress in their careers in a way that meets their aspirations

Employers, leaders and managers will be able to use it to identify what learning and development opportunities may be most appropriate for the workforce.

The first phase of the pathway provides an overview of direct care roles, including care or support workers. The pathway will eventually cover the whole adult social care workforce, creating a universally understood overview of the structure and roles within it. The pathway will be developed in phases and will continue to evolve as the sector and workforce adapt to meet the changing needs of people who draw on care and support services. The next phase of development will expand on the links between health and adult social care outlined here, ensuring that the pathway appropriately captures enhanced care worker responsibilities, and will focus on new role categories to cover deputy managers, registered managers, personal assistants and enhanced care worker roles. This will be published in summer 2024.

In order to see the full benefits of the pathway, it will need to be widely adopted across the sector. We want to understand more about how the sector will use the pathway and what conditions are important for it to be widely adopted and seen as helpful. DHSC will be launching a programme of early adopters - a small number of adult social care providers who will test the fundamental elements of the pathway.

The early adopters will map their current organisational structures and job roles to the pathway, and will test the structure, language and content across different care settings. In doing so, the early adopters will generate key evidence and learning, feeding into the:

• refinement of the next iteration of the pathway
• development of the digital product
• development of case studies and supporting resources for the wider sector

Action for employers

The pathway is designed to set the direction of learning and development across the adult social care sector going forward. In advance of launching of the digital product, we recommend that any employer in the sector should consider the pathway and think about how they can apply it. This could involve:

• adopting the values in the pathway
• looking at how existing organisational structures and job roles map onto the pathway
• using the pathway to guide conversations about careers, development and progression

The government will continue to build on the pathway, developing resources to enable people across the sector to use it effectively, including a digital product that will link through to training opportunities.

The government will continue to engage with stakeholders as we develop our policy thinking. We are committed to co-developing and testing policy with the sector throughout the development of the pathway.

Universal sector values

Values are the beliefs and views that people hold about the importance of something.

The values below apply across all role categories outlined in this phase of the pathway and to role categories that will be added in further phases of the pathway.

These values have been developed in co-production with people with lived experience of drawing on care and support.

They outline what people want from the workers who support them.

Kind, compassionate and empathetic

Be kind, compassionate and empathetic so you can see things from my point of view, with concern for what matters to me, my wellbeing and health.

Honest, trustworthy and reliable

Be honest, trustworthy and reliable so you turn up when you say you will, and provide the care and support we have agreed. Be discreet and confidential to build up a trusting relationship between us.

Respect

Treat me, the people around me and where I live with respect. Respect my values and my choices about the life I want to lead and respect your role to value and uphold my goals.

Courageous and principled

Show strength, courage and commitment to speak out if something is not right or could be better, and to step back when I am exercising my choice and control. Act according to principles of human rights, equity and inclusion and in line with my personalised care and support plan.

See the whole person

Be curious and listen carefully to understand the unique person I am with strengths, abilities and aspirations. Make plans and decisions about me, with me.

Flexible, open and learning

Be reflective, open and non-judgemental so we can learn and adapt how we work together in the longer term.

Proud and positive

Take pride in your work and have a friendly, positive and proactive attitude so we can enjoy spending time together.

All the behaviours set out in the pathway must be set within the context of these values. The need to prioritise each person’s own needs and preferences, while actively working in co-production with the person drawing on the care and support provided is paramount. These are the bedrock of our approach, ensuring that our adult social care workforce consistently delivers compassionate and person-centred care and support.

Values persona: Ann

Ann has a disability caused by a neurological condition, uses a wheelchair and draws on daily support from a home care agency. She works as a manager of a deaf and disabled people’s organisation alongside an active family life and a number of voluntary roles. Care workers assist her 7 days a week with getting up and ready for the day and going to bed, which involves the use of specialist equipment to help her move. Without this support, Ann would be prevented from leading an active and contributing life.

Ann has had good and bad experiences of care. Things do not work well when people turn up at the door acting as if their job is to carry out a series of tasks. Things work best when care workers show respect and see her as a whole person. For example, by taking the time to get to know Ann and her family situation. What appear as little things can count for a lot, like asking her how she wishes to be addressed.

It is vital to Ann that she feels able to put her trust in those that are supporting her with intimate aspects of daily living and that she can direct how she is supported. The equipment Ann has in her home is specific to her needs, and her care workers must be confident and competent in using it. It has therefore been agreed that all new workers undertake some shadow visits alongside an existing care worker. Ann then lets the agency know when she thinks the worker is ready to manage on their own.

It is also important that her workers are reliable. It is not always possible to turn up at the same exact time but, when running late, Ann likes being informed. While she appreciates consistency in how she is supported, no day is exactly the same, which means that it is important that her workers are flexible in their approach so Ann is ready and set up for the day. On occasions, if there are problems that they cannot resolve together, with Ann’s agreement, the care worker will take the initiative to feed this back to the agency. Important to Ann is feeling confident that the worker will be listened to seriously and an agreed approach worked out together.

Ann knows that being a care or support worker in any role requires a great amount of skill, and wants all the people that support her to feel recognised and rewarded for the work they do with opportunities to develop.

Annex A: Think Local Act Personal method statement

In May 2023, DHSC requested that TLAP, as part of its grant-funded work programme, undertake activity to support the development of the care workforce pathway. The purpose and focus of the work was to convene people who draw on care and support to establish their views on the sorts of values people working in social care should have in order to provide personalised care and support in line with:

• the Care Act 2014
• People at the Heart of Care and subsequent Next steps to put People at the Heart of Care

The intention was that the outputs would underpin the pathway.

The approach taken was founded on co-production with people who draw on care and support including unpaid carers. This statement explains the process that was followed to reach the point where a set of values statements have been incorporated within the pathway.

What we did

The main stages of the process undertaken were:

• a desktop review
• a series of workshops with people who draw on care and support
• support for 4 organisations to run sessions with the people they support
• discussion around the values at a session with care and support workers
• mapping the values against the behaviours in the pathway
• a dedicated session with some older people drawing on care and support living in a care home

The results of these combined activities were analysed in order to distil a set of co-produced workforce values that reflected the views and priorities of people who draw on care and support. A more detailed description of these activities is given below.

Desktop review (June to July 2023)

TLAP commissioned an independent research and evaluation consultant to undertake a desktop review of existing resources in the public domain that relate to workforce values. The review was co-designed with the input of members of TLAP’s national co-production advisory group and framed around the following questions:

• what evidence exists?
• how was it produced?
• how are ‘values’ defined?
• what are the values?
• who are the values for?

A call-out for resources was issued, including internationally through the International Initiative on Disability Leadership, and 6 interviews undertaken with key contacts, which included the chief executive of Skills for Care. All in all, around 80 resources were looked at. These were analysed and turned into a report that informed planning the workshops (see below).

The review highlighted the importance of valuing care and support workers as a key enabler of good person-centred care and support. Also, the interdependency with a range of structural factors likely to influence achieving a values-based approach, including commissioning and markets, leadership, culture, and regulation.

Workshops with people who draw on care and support (1, 3 and 8 August 2023)

Forty people with lived experience of adult social care were recruited to take part in 3 consecutive online workshops, which took place in early August. Participants received remuneration from TLAP for giving their time.

Given the diversity of people who draw on care and support and broad range of services and support people experience, we worked hard to attract a diverse pool of people. A good mix of people were recruited, both in terms of the type of support people were receiving (for example, home care, day care, supported living and direct payments) and in terms of protected characteristics such as age, gender, disability and ethnicity. There was a more or less even split between people drawing on care and support and unpaid carers.

The content of the workshops was co-designed with people with lived experience. The workshops were facilitated and recorded. The broad focus of each was:

• workshop 1 - initial exploration of workforce values
• workshop 2 - developing a long list of values and prioritising them and identifying the barriers that get in the way
• workshop 3 - exploring the behaviours underpinning values and ways of valuing the workforce

For the first 2 workshops, there was a separate group for unpaid carers. For the final workshop, the groups were combined into a mix of people who draw on care and support and unpaid carers.

Participants were invited to give feedback after the first and second workshops so that adjustments could be made where needed. An evaluation form was sent to participants after the third workshop. There was keenness that what people had said would be taken seriously and reflected in the pathway.

The outputs of the workshop were compiled and analysed by the independent research and evaluation consultant who undertook the desktop review. The highest-rated values were clustered into a number of themes and then distilled into a single set of values statements that reflected what people felt was most important.

Support for external sessions (September 2023)

A number of organisations providing care and support expressed an interest in running their own sessions. To support this, a facilitator’s guide was produced and a feedback form used to ensure a consistent approach was taken. Four organisations ran these sessions. The findings from these sessions were built into the analysis of the workshops to check for consistency across key themes.

Sharing the values at session with representatives of the adult social care workforce (6 September 2023)

A first cut of the values was shared with a group of workers and managers organised by Skills for Care to share progress with the pathway. They were well received with most of the discussion focused on how these could be achieved in practice, given current barriers and pressures. There was a clear expression of the need to recognise the role of government, commissioners and employers in creating the conditions where workers are able to translate the values into practice.

Conclusion

In developing the care workforce pathway, a project methodology was applied to secure the input of a broad mix of people drawing on varying forms of care and support to hear their views and experiences of the values they prize most highly when applied to the care workforce.

People clearly articulated their expectations, placing a premium on values associated with respect, reliability and honesty. In sharing their experience and views, participants strongly advocated that, in order for workers to be “proud and positive”, and achieving progress with implementing the pathway, concerted action will be required across the care and support system to address current barriers and to create the conditions where workers are able to translate the values into practice.

The conversations that we had were rich and have been turned into a single set of values to underpin the pathway, which clearly signal and cement that developing the social care workforce depends at its core on holding and acting upon a set of values that reflect a commitment to person-centred care and support.