Not-for-profit quality care for over 25 years

The Stark Reality of the Care Workforce

The National Care Forum (NCF) – the leading association for not for profit care providers – together with The Outstanding Managers Network surveyed registered managers of care services to ascertain the full extent of the challenges faced by care providers and registered managers on the ground in the wake of the significant staff shortages experienced in the sector.

340 registered managers running services that employed 21,314 staff and supported 15,450 people across a broad range of care services completed the survey. Of those who responded 76% ran services for older people – the majority being care homes without nursing, and 24% ran domiciliary care services.

Managers responding to the survey report an average staff vacancy rate of 17%.  This is leading to a significant reduction in the amount of care available because there are not enough staff to run services at the level that people, hospitals and communities desperately need.

Some 67% report that they have either limited or stopped admissions of any new people into care homes or they have had to refuse to take on new requests for domiciliary care for people living in their own homes in the community. Some have had to hand back packages of care to the local authority because they do not have enough staff to provide them. This includes 33% who said they had limited or stopped admissions from hospitals.

The 340 survey respondents estimated this amounted to approximately 5,000 people being turned away from their care services since 1st September.


‘Previously, we took on average 4 hospital discharges a week plus another 3/4 reablement requests for care per week from discharge to assess. In the last 12 weeks we have only been able to take 2 hospital discharges due to having to reduce capacity because of staff shortages.’

‘Heartbreaking turning down 10 plus requests for care that are needed a day.’

‘Turned down complex care requests sadly, have not got enough staff to look after new people with complex needs safely.’

‘Stopped admissions for service users who require additional one-to-one support.’

‘Extremely concerned at the financial viability of any service. Having to increase wages to compete with others but no increase in funding. Also still got substantial increased costs related to Covid.’

‘Seriously considering having to close if something isn’t urgently done.’


Vic Rayner OBE, CEO of the NCF said:

“These findings make uncomfortable reading and offer evidence of the stark reality being experienced by care providers and registered managers on the ground, and of the pressure they are under every day to provide care and support to the people who rely on them. The significance of this data means that people are not being discharged from hospital when they need to, to continue care and treatment at home or in residential care settings. And providers are having to make very difficult decisions about who they can support – sometimes resulting in people with high or complex needs not getting access to the care and support they desperately need. This cannot continue – it has to stop now.

It is imperative that the government acts now to do the following:

  • Pay a retention bonus to recognise those staff who have worked tirelessly, 24/7 for the last 19 months of the pandemic to provide care for those who need it most
  • Fund a pay increase now for all care staff to improve recruitment and reduce the numbers leaving
  • Add care workers to the Shortage Occupation List for a time limited period to help the care sector NOW
  • Create a new fully funded, flexible dedicated workforce fund ​to support the wellbeing of existing staff, highlight how valuable they are and supporting recruitment and retention
  • Delay the implementation of mandatory vaccinations in care homes


Jane Brightman, co-founder of the Outstanding Managers Network said:

“These responses are stark reading and highlight the difficulties faced by the sector and consequently the people who use care. This has been getting worse over time and very concerning for the winter ahead. Care Managers are exhausted, as are their teams. They have been working tirelessly with no let-up in sight. We’ve been calling on the government to work with the sector to provide more support and opportunity to improve this dire situation. Our thanks to NCF for working with us on this survey.”


Note to Editors

  • The National Care Forum brings together over 150 of the UK’s leading social care organisations, representing large numbers of care providers, offering thousands of services across the country, which are not for profit and always at the heart of community provision. Collectively, these organisations deliver more than £2 billion of social care support to more than 167,000 people in 9,200 settings. The NCF membership body collectively employs more than 95,500 colleagues.
  • A copy of the survey results can be found here.
  • More information is available on the National Care Forum at @NCFCareForum @vicrayner @NCF_Liz
  • For enquiries, please contact Edna Petzen, [email protected]
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