Official Statistics

Adult social care workforce survey: April 2025 report

Published 10 April 2025

Applies to England

Summary

The adult social care recruitment and retention workforce survey was a voluntary survey completed by Care Quality Commission (CQC)-registered adult social care residential care and domiciliary care settings via Capacity Tracker. The survey ran for one month from 19 August to 19 September 2024. The survey aimed to gain insight into the scale of adult social care workforce challenges and specific areas of concern in the lead up to winter 2024, following a fall in the number of entry visa grants for care workers and senior care workers at the beginning of 2024. 

Home Office statistics for the number of entry visas granted by occupation showed in quarter 1 (January to March) 2024 the number of entry visa grants for care workers and senior care workers was 84% lower than the previous quarter (quarter 4 2023), and 87% lower than quarter 1 2023, see Sponsored work entry clearance visas by occupation and industry (SOC 2010), year ending March 2024.

The survey received responses from 4,913 adult social care provider locations, with a higher number and proportion of responses from domiciliary care settings. These responses were evenly distributed across regions, with the North East and Yorkshire having the highest combined response rate. The main findings of the survey relate to the following themes:

• retaining staff
• recruiting staff
• maintaining morale
• agency usage
• recruitment and retention barriers and general workforce capacity
• international recruitment

The survey found that 71.0% of provider locations reported that they found the current workforce recruitment situation challenging and 37.0% were concerned about sustaining the current level of service delivery over the next 6 months. However, 58.6% also said that the recruitment challenges they faced had remained unchanged compared with the same time last year (August to September 2023). Respondents said that the primary challenge to both recruitment and retention is better pay outside the adult social care sector (27.8% and 35.2% respectively).

Domiciliary care settings reported greater recruitment and retention challenges than residential care settings. In domiciliary care settings, 74.0% responded that recruitment was challenging, and 58.5% reported the same for retention. In comparison, 66.7% of residential care settings found recruitment challenging, and 53.9% reported retention difficulties. These workforce pressures may be linked to staff morale, with 46.1% of domiciliary care settings reporting low morale, compared with 41.4% in residential care settings. Less than 1% of respondents answered that recruiting social workers, occupational therapists and nursing associates has become more challenging compared with last year.

When asked about their recent experience with accessing agency staff and how it compared with the same period last year, 58.4% of respondents reported a positive experience. Additionally, 65.6% noted no change in access compared with last year, with more respondents reporting an improvement than a deterioration. Meanwhile, 54.5% of residential care locations and 45.1% of domiciliary care settings showed no concerns about recruiting internationally over the next 6 months. Respondents selected complexity and expense as the most important barriers to sponsoring visas for international workers, both within and outside of the UK.

The survey results also showed 53.0% of the provider locations who responded reported positive staff morale, with most indicating no change or improvement since last year. Domiciliary care settings reported more challenges with morale compared with residential care locations.

The main limitation of these results is that they are not weighted to be representative of the entire adult social care sector and hence should be viewed as a limited indication of provider sentiment. Further, as a location-level survey of adult social care providers, the findings might differ from those that would have been elicited from a worker-level survey - for example, on questions about staff morale.

Introduction

These findings are being published as an ad hoc analysis as part of the Department of Health and Social Care (DHSC) Monthly statistics for adult social care (England). This is a collection that provides a monthly overview of statistics and other information on adult social care settings, including care home staffing ratios. Data for both this publication and the regular monthly statistics are taken from Capacity Tracker.

Background

There were concerns that a fall in the number of entry visa grants for care workers and senior care workers would impact workforce capacity over winter 2024. A survey was launched to understand perceptions of recruitment and retention within the sector in the run up to winter 2024 and to check whether existing data sources were failing to capture real impacts. The survey questions and the list of stakeholders was based on a previous Capacity Tracker survey commissioned during the COVID-19 pandemic (Adult social care workforce survey: December 2021).

In February 2022, care workers became eligible for the Health and Care Worker visa and were added to the Skilled Worker visa: immigration salary list. This is part of the Skilled Worker route, which allows employers to recruit people to work in the UK in a specific job in an eligible skilled occupation. Senior care workers were added to the list of eligible occupations for the Health and Care Worker visa in January 2021.

To sponsor a worker under the Skilled Worker route, employers must provide evidence to show that they have a vacancy that meets the requirements of the Health and Care visa. This is to ensure that those coming to the UK have sufficient work available to meet the required salary threshold and can support themselves without recourse to public funds. Since October 2023, providers have found difficulty in justifying the need to sponsor overseas workers to UK Visas and Immigration (UKVI) and it is likely that this led to the reduction in visa grants. There may be additional impacts on visa grants as a result of the range of policy measures introduced in March and April 2024, including:

• restricting dependants
• the requirement for care sponsors in England to be registered with CQC
• the increase to the minimum salary threshold

Methodology

The workforce survey was a voluntary survey completed by CQC-registered residential care locations and domiciliary care settings via the Capacity Tracker.

For more details on the Capacity Tracker data collection and the methodology for the monthly statistics, see Adult social care in England statistics: background quality and methodology.

The draft survey questions were reviewed by sector representatives including the Capacity Tracker Operational Change Advisory Board and members of the DHSC provider Workforce Advisory Group (WAG) (see Social Care Sector COVID-19 Support Taskforce: report on first phase of COVID-19 pandemic). Members of the WAG and Capacity Tracker Operational Change Advisory Board are shown in Annex A below.

The survey was live on Capacity Tracker for a month to allow providers time to complete it. Provider locations were notified via their usual Capacity Tracker homepage and communications when the survey was live and received multiple reminders within the month to complete by the deadline.

CQC-registered providers consist of one or more locations. A total of 4,913 adult social care provider locations responded to the survey out of the 27,548 locations who have access to Capacity Tracker, giving a response rate of 17.8%.

Response rates varied by type of provider: for example, 13.8% (2,002) of all residential care locations (care homes) with access to Capacity Tracker responded to the survey, compared with 22.9% (2,972) of domiciliary care settings (home care), reflecting higher engagement among domiciliary care settings. The totals do not sum to 4,913 because some care providers are dual-registered, meaning they offer both residential (care home) and domiciliary (home care) services from the same provider location. Of the survey respondents, 1.2% of survey respondents fall into this category. These providers are counted in both care categories, but to prevent duplication, they are included only once in the overall total.

When calculating percentages for the analysis, respondents who did not answer or selected ‘not applicable’ (‘N/A’) are excluded, as this suggests the question was not relevant to them. However, responses of ‘unsure’ or ‘don’t know’ are included, as they indicate the question was relevant, but the respondent was uncertain of the answer.  Where respondents could select multiple responses, percentages are based on the total number of respondents who answered that question. This excludes those who did not answer or selected ‘N/A’. Since respondents could choose more than one option, the percentages may add up to over 100%, as they reflect the proportion of respondents who selected each option.

Data tables summarising results from this survey can be found in the ODS files accompanying this publication, with data split by care type (residential care locations and domiciliary care settings).

Current workforce situation

Respondents were asked to describe their current workforce situation across 4 areas:

• retaining staff
• recruiting staff
• maintaining staff morale
• accessing agency staff

The results highlight challenges, particularly in recruiting and retaining staff. Recruitment remains the biggest workforce challenge, with a large majority indicating they were currently struggling to hire staff. Results are summarised in table 1 below. 

Table 1: overview of provider assessment of the current workforce situation

Question	Challenging	Unable to say	Not challenging	Excluding N/A responses (with number)
Retaining staff	56.6%	1.2%	42.2%	100% (4,913)
Recruiting staff	71.0%	2.7%	26.3%	100% (4,913)
Maintaining morale	44.2%	2.8%	53.0%	100% (4,913)
Accessing agency staff	37.5%	4.1%	58.4%	38.4% (1,888)

Of those who responded:

• 56.6% reported finding it ‘extremely challenging’, ‘very challenging’ or ‘somewhat challenging’
• 42.2% reported that staff retention was ‘not very challenging’ or ‘not challenging at all’

Full breakdowns are available in sheets 1.1, 2.1, 3.1 and 4.1 of the accompanying workforce survey data tables (available on the Adult social care workforce survey: April 2025 page).

Workforce challenges compared with last year

Most respondents felt that workforce challenges had either stayed the same or improved. See table 2 for a further breakdown.

Table 2: provider assessment of current workforce challenges compared with last year

Question	More challenging	About the same	Less challenging	Unable to say	Total responses (with number)
Retaining staff	11.2%	57.0%	27.7%	4.2%	100% (4,913)
Recruiting staff	14.4%	58.6%	21.9%	5.1%	100% (4,913)
Maintaining morale	10.1%	57.2%	27.3%	5.3%	100% (4,913)
Accessing agency staff	7.4%	60.4%	24.2%	8.0%	44.9% (2,207)

Full breakdowns are available in sheets 1.2, 2.2, 3.2 and 4.2 of the accompanying workforce survey data tables (available on the ‘Adult social care workforce survey: April 2025’ page).

Barriers to recruitment and retention

Respondents were asked:

What do you think are the most important barriers to recruitment and retention that need to be addressed? 

Of those who responded, 60.7% selected ‘level of pay compared with other sectors’ as one of the main barriers to recruitment and retention that need to be addressed (see figure 1). This was followed by ‘access to childcare support’ (34.6%), ‘access to funding to pay for childcare support’ (30.9%) and ‘Disclosure and Barring Service (DBS) checks being too long (30.8%) as other barriers.

Figure 1: main barriers to recruitment and retention

Response	% of respondents
Level of pay compared to other sectors	60.68
Access to childcare support	34.64
Access to funding to pay for childcare support	30.93
DBS checks too long	30.83
Access to transport	23.54
Immigration rule changes which have reduced volume of applications	23.54
Length of recruitment process	21.60
Access to funding to pay for transport	21.01
Sick pay offer	20.13
Workforce recognition	17.95
Immigration rule changes which have impacted retention	15.40
Non transferability of DBS check	14.24

The response rate was 87.1% (4,278). Multiple responses could be selected. The percentages above are the percentages of respondents who reported the corresponding issue as one of their responses. The selected data is from sheet 5.1 of the data tables. Responses selected by less than 10% of respondents individually have been omitted to enable clearer presentation.

Retaining staff

When asked about staff retention:

• 56.6% of respondents reported that retaining staff was challenging, selecting either ‘extremely challenging’, ‘very challenging’ or ‘somewhat challenging’
• 42.2% reported that retaining staff was ‘not very challenging’ or ‘not challenging at all’
• 1.2% of respondents were unable to say (as shown in table 1).

There were no statistically significant differences between regions, as shown in table 3.

Table 3: perception of level of challenge in staff retention, by region

Region	Percentage of respondents reporting retaining as staff as more challenging
East of England	54.0%
London	53.5%
Midlands	57.3%
North East and Yorkshire	59.4%
North West	55.2%
South West	59.4%
South East	56.7%

Domiciliary care settings were more likely to report a challenging retainment situation than residential care settings. In domiciliary care locations, 58.5% of respondents found retainment challenging and 40.2% not challenging. In comparison, 53.9% of residential care locations reported retainment as challenging, while 45.1% did not (see table 4).

Table 4: perception of level of challenge in staff retention, by provider type

Response	Residential care location	Domiciliary care settings
Challenging	53.9%	58.5%
Unable to say	1.0%	1.3%
Not challenging	45.1%	40.2%

Reasons for increased challenges with staff retention

Respondents were asked about the reasons for increased challenges with staff retention. For this question, respondents could select one reason as a response. There was a 76.2% (3,743) response rate to this question.

The reason that attracted the highest number of responses was ‘better pay outside the adult social care sector’, which 35.2% of respondents cited as the main reason for staff leaving the sector.

Among residential care locations, the top 3 reasons cited were:

• better pay outside of the care sector (35.0%)
• better pay elsewhere within the care sector (17.1%)
• role with lower responsibility outside of the care sector (11.8%)

Among domiciliary care settings, the top 3 reasons cited were:

• better pay outside of the care sector (35.3%)
• better pay elsewhere within the care sector (14.7%)
• better hours elsewhere within the care sector (8.3%)

Figure 2: main cause of staff leaving

Response	% of responses - residential care	% of responses - domiciliary care
Better pay elsewhere - outside of care sector	34.98	35.32
Better pay elsewhere - within care sector	17.06	14.72
Better hours elsewhere - within care sector	1.07	8.27
Better hours elsewhere - outside of care sector	5.35	7.56
Outside work commitments	6.56	7.16
Working pattern or lack of flexibility in hours worked	2.14	4.63
Migration issues or leaving UK	3.61	4.18
Cost or distance of travel to work too high	2.47	3.74
Roles with lower responsibility - outside of the care sector	11.77	3.60
Feeling burnt out or stressed	4.62	3.20
Don’t know	5.62	3.02

The selected data shown in figure 2 is from sheet 1.4 of the accompanying data tables. Responses selected by fewer than 2% of respondents individually have been omitted to enable clearer presentation. These account for less than 10% combined across this question.

The order of popularity of responses remained broadly similar when respondents could select all responses they felt were applicable. Among both domiciliary care and residential care provider locations, the top 3 reasons believed to be the main cause of staff leaving were:

• better pay elsewhere - outside of care sector (52.3%)
• better pay elsewhere - within care sector (29.8%)
• better hours elsewhere - outside of care sector (28.8%)

At a regional level, the percentage of respondents who identified better pay outside the care sector as the main reason for staff leaving varied slightly, ranging from 39.6% in the North East and Yorkshire to 31.2% in the East of England. This indicates consistent challenge across regions, with some variance likely reflecting the competitiveness of demand in labour in these regions versus supply (table 5).

Table 5: percentage of respondents that identified better pay outside the care sector as the main cause of staff leaving, by region

Region	Percentage of responses that selected better pay outside the care sector as the main cause of staff leaving, by region
East of England	31.2%
London	32.2%
Midlands	36.2%
North East and Yorkshire	39.6%
North West	37.3%
South West	36.2%
South East	32.9%

Responses were also analysed by brand. CQC data sets out whether or not a provider is part of a larger brand. A third (33.5%) of non-brand provider locations who faced retention challenges cited better pay as a reason for the challenges, compared with 25.5% of brand provider locations. This could be for many reasons, and would need further research, but could include:

• branded provider locations may have more resources to allocate to recruitment
• they may be able to use their network or sites to signpost workers to locations that require staff
• workers may be attracted to other locations within the brand due to familiarity

Roles that are difficult to retain

Respondents were asked:

Are there specific roles that are harder to retain than at this time last year? If so, which roles?

For this question, respondents could select all applicable roles. The response rate was 82.3% (4,042 respondents).

The most commonly reported role that was harder to retain compared with last year was ‘home (domiciliary) care worker’, chosen by 38.5% of respondents as one of their responses. This was followed by ‘senior care worker’, selected by 29.2% of respondents.

Recruiting staff

Current situation recruiting staff

When asked to describe their current situation with recruiting staff, 71.0% of respondents described recruiting staff as challenging, while 26.3% reported it was not challenging. A small percentage (2.7%) were unable to say.

Domiciliary care settings reported greater recruitment challenges than residential care locations. In domiciliary care locations, 74.0% of respondents found recruitment challenging and 23.3% not challenging. In comparison, 66.7% of residential care locations reported recruitment as challenging, while 30.7% did not. The remaining respondents were unable to say.

The South West had the highest percentage of respondents reporting recruitment challenges (74.7%), while London had the lowest (64.5%) (data is shown in table 6).

Table 6: current workforce situation with recruiting staff

Region	Percentage of respondents reporting recruiting staff as more challenging
East of England	69.3%
London	64.5%
Midlands	68.0%
North East and Yorkshire	73.1%
North West	74.0%
South West	74.7%
South East	74.2%

Current situation recruiting staff compared with last year

Responses showed:

• 15.2% reported recruitment challenges had worsened over the last year
• 23.1% reported recruitment challenges had improved compared with this time last year
• 61.8% reported no change in recruitment

Main difficulties finding new staff

Respondents were asked about the reasons for increased staff recruitment challenges. For this question, respondents could select one reason as a response. This question received 78.9% (3,876) responses.

The reasons most cited by respondents for difficulty in finding new staff were:

• better pay outside of the care sector (27.8%)
• application did not meet job requirements (16.2%)
• better pay elsewhere within the care sector (11.1%)
• does not hold a valid UK driving licence (8.2%)

Comparison of number of applications

Respondents were asked:

If you have recruited recently, compared with this time last year, how do the number of applications compare?

The responses showed that compared with last year, 33.1% reported a decline in the number of applications, while 23.5% reported an improvement.

Comparison of the quality of applications

Respondents were asked:

If you have recruited recently, compared with this time last year, how does the quality or suitability of applications compare?

Although half of respondents (51.3%) reported no change in quality or suitability, the proportion who reported a decline in quality was 3 times as high as the proportion who reported an improvement (36.2% and 10.5% respectively).

Difficulty recruiting different roles

Respondents were asked to select which roles were harder to recruit compared with the same time last year (August to September 2023).

There was a 71.0% (3,484) response rate to this question and respondents could select all roles they felt were applicable. Selected data is taken from sheet 2.7 of the data tables.

Among residential care locations, the 4 roles which were most frequently reported as particularly hard to recruit to, compared with last year, were:

• senior care workers (39.8%)
• chef or catering (23.4%)
• registered nurse (22.2%)
• general or nursing care worker (13.2%)

In comparison, less than 1% of residential settings selected social worker, nursing associate, occupational therapist or admin as one of their responses.

Among domiciliary care settings, the 4 roles which respondents most commonly reported as particularly hard to recruit to, compared with last year, were:

• home care (domiciliary) workers (58.0%)
• senior care workers (27.2%)
• support and outreach (13.0%)
• registered manager (7.6%)

In comparison, less than 1% of domiciliary care settings selected occupational therapist, maintenance, nursing associate, social worker, chef or catering and cleaner as one of their responses. This suggests that, compared with other roles, recruitment for these positions has remained relatively stable. This could be because providers have not had to recruit, or that recruitment for these roles has not been significantly challenging.

Concerns on recruitment

Respondents were asked:

In the next 6 months are you concerned about being able to recruit enough staff to deliver your current service?

The responses showed:

• 63.0% of respondents reported they do not feel concerned about being able to recruit enough staff to deliver their current service
• 37.0% of respondents were concerned

This data shows that although most respondents (71.0%) are currently experiencing recruitment issues, the majority are still managing to deliver their current service.

Maintaining morale

As this is a provider-level survey, the responses could differ significantly from responses that workers would give, particularly on questions on morale.

Situation regarding staff morale

Responses across all settings to the question “Thinking about your recent experience, how would you describe the current situation regarding your staff’s morale?” were as follows:

• 53.0% of respondents reported that their staff morale situation was not challenging
• 44.2% reported it as challenging
• 2.8% were unable to say

Domiciliary care settings were more likely to report a challenging morale situation. This may be why domiciliary care settings have reported greater difficulties with recruiting and retaining staff (see table 7).

Table 7: situation regarding staff’s morale, by provider type

Response	Residential care location	Domiciliary care settings
Challenging	41.4%	46.1%
Unable to say	1.6%	3.6%
Not challenging	56.9%	50.3%

Adult social care provider locations that are part of a larger brand, as identified in CQC data, were less likely to report morale challenges than non-branded providers:

• 39.5% of branded providers reported morale as challenging
• 45.9% of non-branded providers reported morale as challenging

Staff morale compared with last year

When asked “How does the current workforce situation regarding staff morale compare to this time last year?”, the majority of respondents (60.4%) reported that their staff morale situation had not changed since the same time last year. Although 10.7% of respondents reported that morale had deteriorated, a much higher proportion, 28.9%, reported an improvement in morale.

This aligns with current perceptions, where most respondents do not view staff morale as a significant challenge. A substantial proportion of respondents have seen improvements, and the majority have reported no change with staff morale, suggesting a level of stability.

Impact of staff morale

Respondents were asked:

Thinking about your staff, what is the main impact you are experiencing (if any) due to staff morale?

The reported consequences (see figure 3) were:

• 28.6% reported staff not being able to or not willing to take on additional hours
• 15.8% reported staff wellbeing worries
• 15.6% reported increased sickness levels

Figure 3: main impact due to staff morale

Response	% of respondents
Staff not able or willing to take on additional hours	28.64
Staff wellbeing worries	15.85
Increased sickness levels	15.62
Staff not able or willing to take on additional responsibilities	11.96
Staff less energised or are not able to do more	11.32
Staff indicating thinking of leaving	10.30
Don’t know	6.30

Respondents could select one response and there was a 54.0% (2,650) response rate. These results were tested for statistical significance using confidence intervals, ensuring that the findings are unlikely to be due to random chance.

Agency usage

For questions on accessing agency staff, 58.7% of responses were ‘N/A’, indicating that the respondent was not utilising agency staff, or that they were not using agency staff this time last year, and therefore have nothing to compare against.

Current situation accessing agency staff

Respondents were asked:

Thinking about your recent experience, how would you describe the current workforce situation with accessing agency staff, if you are using them? Respondents could select one response. Over 1 in 3 (38.4% or 1,888) of provider locations responded, with the majority (58.4%) of respondents reporting a positive experience with accessing agency staff.

Figure 4: current workforce situation accessing agency staff

Key	Not challenging	Challenging	Unable to say	Total
% of responses	58.37	37.50	4.13	100

For this question, 59.1% (1,115) of responses were from residential care locations. Table 8 shows that agency staff challenges were generally reported as higher in domiciliary care settings over residential care locations.

Table 8: current workforce situation accessing agency staff

Response	Residential care location	Domiciliary care setting
Challenging	30.6%	40.2%
Unable to say	2.3%	6.7%
Not challenging	62.1%	53.0%

Challenge to accessing agency staff

Survey respondents were asked:

If you use agency staff, thinking about your recent experience, what is the main challenge accessing agency staff if any?

Respondents were only able to select one answer. The majority of respondents (76.8%) reported finding agency staff more expensive as the main challenge.

Recruitment and retention barriers and general workforce capacity: international recruitment

 Visa sponsors for those already in the UK

Survey respondents were asked:

Since 2024, have you tried to sponsor visas for additional care workers and senior care workers who were already in the UK?

There was a 100% (4,913) response rate to this question. As shown in table 9, only 17.7% of respondents have tried to sponsor visas for additional international care workers and senior care workers who were already in the UK. This suggests the majority of respondents are not actively engaging in in-country international recruitment.

A higher proportion of domiciliary care settings (20.4%) were actively engaged in international recruitment, compared with residential care settings (13.8%).

Table 9: have respondents tried to sponsor visas for additional care workers and senior care workers who were already in the UK

Response	Percentage response rate (with numbers)
No	41.1% (2019)
Yes	17.7% (870)
We do not intend or need to recruit international care workers and/or senior care workers from outside the UK	41.2% (2024)

Barriers to sponsoring visas

Respondents were asked:

If you have not tried to sponsor visas for additional international care workers and senior care workers, who were already in the UK, what were the barriers to you trying this?

The most frequently selected reasons were:

• complexity (29.2%)
• expense (28.0%)
• the process takes too long (18.4%)
• the process requires a lot of resource (16.2%)

Figure 5: barriers to sponsoring visas for additional international care workers and senior care workers already in the UK

Response	% of respondents
The process is complicated	29.16
The process is expensive	27.96
No barrier - you have not had the need to recruit international care workers or senior care workers	27.00
No barrier - you have not wanted to	23.88
The process takes too long	18.36
The process requires a lot of resource	16.19
Local authority fee rates are not high enough to meet full-time salary threshold	13.75
The process requires too much evidence to gain a sponsorship licence	8.72
You are unable to guarantee sufficient hours to meet the sponsorship requirements	8.61
The process requires too much evidence to receive certificates of sponsorship	7.65
International recruits not being able to afford accommodation and associated costs	6.34
International recruits not having access to a vehicle	6.02
International recruits not being able to obtain a UK driving licence	5.46

A 54.4% (2,822) response rate was recorded, with respondents able to select multiple options. Data has been sourced from sheet 6.2 of the data tables. Responses selected by fewer than 5% of respondents individually have been omitted for clarity. These responses account for 7% of the total selections for this question.

Concerns on international recruitment

Respondents were asked:

In the next 6 months, are you concerned about recruiting international care workers and senior care workers who are already in the UK?

Responses showed 54.5% of residential care locations and 45.1% of domiciliary care settings who intend to recruit international care and senior care workers who are already in the UK were not concerned about recruiting internationally in the next 6 months.

Meanwhile, 16.7% of residential care locations and 22.6% of domiciliary care settings indicated they were concerned about recruiting internationally (table 10).

These results could point to a number of factors, including rising costs for international recruitment and improved retention reducing the need to recruit internationally.

Table 10: providers’ concerns on recruiting international care workers and senior care workers already in the UK

Response	Residential care locations	Domiciliary care settings
No	54.5%	45.1%
Yes	16.7%	22.6%
We do not intend or need to recruit international care workers and/or senior care workers who are already in the UK	28.7%	32.3%

There was a 100% (4,913) response rate to this question. Of those respondents, 30.8% (1,515) said they did not intend or need to recruit care workers or senior care workers who are already in the UK.

Respondents who selected ‘yes’ were asked to select the cause of their concerns, with the option to select multiple choices. Among respondents, the top 4 most cited reasons were:

• the process is expensive (45.4%)
• the process is complicated (43.3%)
• the process requires a lot of resources (31.6%)
• the process takes too long (31.2%)

Visa sponsors for those outside of the UK

Respondents were asked:

Since 2024, have you tried to sponsor visas for additional international care workers and senior care workers from outside the UK?”

Most respondents (69.8%) had not attempted to sponsor visas for recruits outside the UK, while 30.2% reported that they had. Among those who had not sponsored visas for international care workers outside the UK, 59.2% of respondents cited ‘no barrier’, indicating they either did not need or want to recruit internationally. The most common barriers were expense (24.8%) and complexity (23.9%). Respondents could select multiple responses.

Challenge to retention with internationally recruited roles

Respondents were asked:

If you have experienced challenges with international recruited care workers and senior care workers leaving their role, what do you believe is the main cause of this?

Only one response could be selected and the most common response was ‘Don’t know’ (23.9%). Other reasons included:

• job was not as expected (12.7%)
• inability to guarantee sufficient hours to meet sponsorship requirements (12.3%)
• international recruits had difficulty finding appropriate or affordable accommodation (10.8%)
• international recruits could not afford the cost of living (9.5%)
• international recruits could not get a UK driving licence (8.8%)
• unable to meet genuine vacancy requirements to be able to renew their certificates of sponsorship (6.9%)
• unable to offer additional hours or overtime to staff (6.0%)
• workers not working the hours required as per their visa requirements and so you have terminated sponsorship (4.6%)
• international recruits could not afford a car (4.4%)

These findings suggest that both job expectations and logistical challenges, such as housing and work hours, play a significant role in staff retention. There was a 22.4% response rate to this question.

Limitations and caveats

A total of 4,913 provider locations responded to the survey.

Domiciliary care settings accounted for 60.5% of respondents, making them more prominently represented in the survey. Responses by provider type were evenly distributed by region although a slightly higher response rate was observed in the North East and Yorkshire (table 11).

Although this is a large sample size, it does not reflect the views of all adult social care provider locations.

Table 11: response rate, by region and provider type

Region	Residential care locations	Domiciliary care settings
East of England	13.2%	22.9%
London	13.7%	19.3%
Midlands	13.4%	23.2%
North East and Yorkshire	16.1%	24.2%
North West	13.6%	24.7%
South West	13.3%	24.3%
South East	12.9%	23.0%

Responses have not been weighted to represent the entire sector and therefore should be taken as a limited temperature check of provider sentiment.

Annex A

Workforce Advisory Group (WAG)

The WAG is made up of relevant members of teams across DHSC as well as representatives from the following organisations:

• ADASS (Association of Directors of Adult Social Services)
• Care Association Alliance
• Care England
• Care Workers’ Charity
• Coproduce Care CIC
• CQC
• Health and Safety Executive
• Homecare Association
• Independent Living Steering Group
• Local Government Association (LGA)
• National Care Forum
• National Coproduction Advisory Group
• NHS England
• Shared Lives Plus
• Skills for Care
• Skills for Care Lived Experience Network
• Skills for Care PA Network
• UK Health Security Agency
• Unison

Capacity Tracker Operational Change Advisory Board

The board is made up of the following members:

• CQC
• DHSC
• Homecare Association
• LGA
• National Care Forum
• NHS England