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Care sector bosses in England are struggling to recruit staff, with more jobs unfilled than before the pandemic, says a leading industry body.
The number of unfilled jobs fell at the start of the pandemic but rose this year as the economy opened up, suggests analysis by Skills for Care.
Employers are also finding it harder to keep existing staff, the report finds.
The government says extra funding and a regular recruitment drive will help boost the workforce.
The annual State of the Adult Social Care Sector and Workforce in England report is based on data provided by a representative sample of employers of England's 1.54 million care workers.
The researchers calculate that employers were failing to fill 8% of posts before the pandemic.
Figures obtained since suggest this had fallen to below 6% by June last year - but by August this year, the trend had reversed, with 8.2% of care sector roles unfilled.
This amounts to more than 100,000 posts with no-one to fill them, says Skills for Care.
In Buckinghamshire, home care providers Caremark are finding it impossible to find enough staff.
Many staff are exhausted, sickness rates are high and better rates of pay are on offer elsewhere.
'Overstretched'
It means care supervisor Charlotte Backhouse and manager Vicky Hartgill, who are both normally office-based, have to step in and do front-line work.
On top of her regular job, Vicky worked through the weekend and on Monday had an 05:00 start. Although she loves seeing clients, she says she is "shattered".
She added: "We need to be able to recruit, we need to be able to recruit in a safe way and just have a bigger workforce.
"We do have to pick up the phone and change times. We do have to be creative with the care that we provide - and until we can get some more people through the door to support us.
"That's the way things will have to stay."
Dr Kris Owden, who runs Caremark Aylesbury and Wycombe, says they are already overstretched and having to turn down up to eight new people needing care each day because they do not have the capacity to help them.
Dr Owden, who worked in a hospital discharge ward at the height of the pandemic, worries about the knock-on effect of the care worker shortage on the NHS, with patients who are medically fit to go home being unable to do so.
"For us to be in this position before the winter, before the Christmas period is terrifying," he said.
He says a properly resourced care system would take pressure off the NHS and wants to see carers better paid, with a proper career structure and recognition of their skills.
The report finds the carer workforce is:
- 82% female
- 27% aged over 55
- 21% from ethnic minority backgrounds
Employers with "favourable workforce metrics", such as high levels of learning and development had lower staff turnover, the research found.
Covid and Brexit
The impact of Covid and Brexit travel restrictions was mixed, with no evidence of the existing non-British workforce leaving at an increased rate since new immigration rules began in January 2021.
However, since March 2021, there has been a sharp drop in people arriving in the UK to take up adult social care jobs, compared with the same period in 2019, says the report.
"This report is a stark reminder that our recruitment challenges continue and, to help tackle that, we need to properly reward and value care workers for their high skill levels and dedication," said Skills for Care chief executive Oonagh Smyth.
"Social care is fundamental infrastructure in our communities."
A Department of Health and Social Care spokesman said: "We appreciate the dedication and tireless efforts of care workers throughout the Covid-19 pandemic and beyond.
"We are providing at least £500m to support the care workforce as part of the £5.4bn to reform social care.
"We are also working to ensure we have the right number of staff with the skills to deliver high quality care to meet increasing demands.
"This includes running regular national recruitment campaigns and providing councils with over £1bn of additional funding for social care this year."