Abstract
Social care systems across the United Kingdom face persistent workforce shortages that threaten service quality and sustainability. This dissertation synthesises contemporary evidence to identify effective local-level strategies for improving recruitment and retention in social care. Through systematic literature review, the study examines four interconnected domains: job quality improvements, career development pathways, values-based recruitment approaches, and place-based community interventions. Findings indicate that no single intervention adequately addresses workforce gaps; rather, successful local systems implement coordinated strategies combining enhanced pay and conditions, structured professional development, targeted local recruitment pipelines, and community integration support. Evidence demonstrates particular promise for values-based recruitment targeting individuals with rural origins, apprenticeship programmes, supportive supervision frameworks, and holistic community-led initiatives addressing broader life circumstances including housing and family needs. The research reveals that sustainable workforce solutions require moving beyond ad-hoc incentives towards comprehensive, locally-tailored approaches that recognise social care work’s intrinsic value whilst addressing structural barriers. These findings hold significant implications for local authorities, integrated care systems, and policymakers seeking evidence-informed strategies to stabilise the social care workforce.
Introduction
The social care sector in the United Kingdom confronts an unprecedented workforce crisis characterised by high vacancy rates, persistent turnover, and growing difficulties in attracting new entrants to the profession. Skills for Care (2023) reports vacancy rates of approximately 9.9% across adult social care in England, representing over 150,000 unfilled positions at any given time. This shortage has profound implications for service delivery, placing strain on existing workers and compromising care quality for vulnerable populations who depend on these essential services.
Understanding why this crisis persists requires acknowledging social care’s complex positioning within the broader labour market. Unlike the National Health Service, social care operates predominantly through local authority commissioning and private or third-sector provision, creating fragmented employment conditions and limited mechanisms for coordinated workforce planning (Bottery et al., 2019). Workers frequently experience low wages, precarious contracts, and limited progression opportunities, factors that collectively undermine the sector’s attractiveness compared to alternative employment options offering comparable or superior remuneration with fewer demands.
The academic significance of this topic extends beyond immediate operational concerns. Workforce sustainability in social care intersects with broader debates about care ethics, labour market segmentation, and the societal value attributed to caring professions. Feminist scholars have long argued that care work’s association with traditionally feminine qualities contributes to its systematic undervaluation, a phenomenon reflected in persistent pay gaps between health and social care despite comparable skill requirements (England, 2005). Understanding effective interventions therefore demands engagement with these deeper structural dynamics alongside practical workforce planning considerations.
From a practical perspective, local authorities and integrated care systems urgently require evidence-informed guidance on which interventions actually work. Resource constraints necessitate careful prioritisation, yet the evidence base remains fragmented across diverse settings, staff groups, and outcome measures. This dissertation addresses this gap by synthesising current knowledge to identify actionable strategies for local-level implementation.
The social implications of workforce shortages extend throughout communities. Inadequate staffing compromises care quality, increases safeguarding risks, and places unsustainable burdens on unpaid family carers who must compensate for service gaps. As demographic ageing increases demand for social care services, resolving workforce challenges becomes essential for maintaining societal wellbeing and enabling dignified ageing in place (House of Commons Health and Social Care Committee, 2022).
Aim and objectives
The primary aim of this dissertation is to identify and evaluate evidence-based interventions that effectively improve social care workforce recruitment and retention at local level.
To achieve this aim, the following objectives guide the research:
1. To examine the principal factors driving turnover and recruitment difficulties in social care settings across the United Kingdom and comparable contexts.
2. To evaluate evidence regarding job quality improvements, including pay, conditions, and organisational culture, as mechanisms for enhancing workforce stability.
3. To assess the effectiveness of career development pathways, training programmes, and professional development opportunities in supporting retention.
4. To analyse innovative recruitment strategies, particularly values-based approaches and local pipeline development, for attracting workers to social care roles.
5. To explore place-based and community-led interventions that address broader determinants of workforce sustainability, especially in rural and remote areas.
6. To synthesise findings into practical recommendations for local authorities and care providers seeking to strengthen their workforce strategies.
Methodology
This dissertation employs a literature synthesis methodology, systematically reviewing and integrating evidence from peer-reviewed research, policy documents, and grey literature to address the stated research objectives. This approach is appropriate given the breadth of interventions under consideration and the need to draw together insights from diverse disciplinary perspectives including health services research, human resource management, and social policy.
The evidence synthesis draws primarily upon systematic reviews, scoping reviews, and primary empirical studies published between 2009 and 2025. This timeframe captures both foundational research establishing key drivers of turnover and recent innovations in workforce strategy developed in response to intensifying shortages. Sources were identified through structured database searches and supplemented by reference list scanning to ensure comprehensive coverage.
Inclusion criteria prioritised studies examining social care and social work settings within the United Kingdom and comparable high-income countries with similar care system structures. Studies addressing health workforce retention in rural and remote areas were included where findings held clear relevance to social care contexts. Quality assessment considered methodological rigour, sample characteristics, and applicability to local-level implementation.
The analytical framework organised findings according to four thematic domains identified through preliminary review: job quality improvements, career and skills development, recruitment strategies, and place-based interventions. Within each domain, evidence was evaluated for consistency across studies, strength of association with retention outcomes, and practical feasibility for local implementation.
Limitations of this methodology include reliance on published literature, which may underrepresent unsuccessful interventions due to publication bias, and the inherent challenges of synthesising evidence across heterogeneous settings and outcome measures. The relative scarcity of randomised controlled trials in this field necessitates drawing conclusions from observational and qualitative research, requiring appropriate caution in attributing causality.
Literature review
Understanding workforce turnover in social care
Workforce instability in social care reflects the interaction of individual, organisational, and structural factors that collectively determine workers’ decisions to remain in or leave their positions. Research consistently identifies low pay as a fundamental driver, with social care wages typically falling below comparable roles in retail and hospitality despite the sector’s demanding nature and skill requirements (Edwards et al., 2022). This pay disadvantage creates ongoing recruitment challenges whilst simultaneously incentivising experienced workers to seek better-remunerated employment elsewhere.
Beyond remuneration, working conditions profoundly influence retention. High caseloads, administrative burdens, and emotional demands generate occupational stress that precipitates burnout and intention to leave (Evans and Huxley, 2009). Studies of care home staff highlight how inadequate staffing ratios create pressured environments where workers cannot deliver the quality of care they aspire to provide, generating moral distress alongside physical exhaustion (Devi et al., 2020). Similarly, research with social workers emphasises how excessive caseloads compromise professional practice and personal wellbeing, with workload emerging as a stronger predictor of turnover than pay in some studies (Pitarella, 2020).
Insecure employment arrangements compound these difficulties. Zero-hours contracts and fragmented scheduling characterise much of the domiciliary care sector, creating income unpredictability that particularly affects workers with caring responsibilities or financial commitments. Teo, Vadean and Saloniki (2022) demonstrate strong associations between contract stability and retention intentions, suggesting that employment security represents a modifiable factor amenable to organisational intervention.
Organisational culture mediates how structural conditions translate into individual experiences. Workplaces characterised by supportive supervision, team cohesion, and effective management demonstrate superior retention outcomes even when facing similar external constraints (Edwards et al., 2022). Conversely, experiences of discrimination, inadequate support, or poor leadership accelerate departure decisions. Morris et al. (2023) identify discrimination-free cultures and psychological safety as core organisational factors supporting workforce sustainability across professional care settings.
Job quality interventions
Improving job quality represents the most direct mechanism for addressing workforce shortages, targeting the fundamental conditions that render social care employment less attractive than alternatives. Pay enhancement constitutes the most visible intervention, with evidence consistently supporting positive associations between remuneration and retention (Edwards et al., 2022). However, the relationship is not straightforward; modest pay increases may prove insufficient to alter relative attractiveness compared to other sectors, whilst substantial increases face financial constraints within existing commissioning frameworks.
Evidence suggests that pay interventions achieve greatest impact when combined with complementary improvements. Teo, Vadean and Saloniki (2022) demonstrate that stable contracts, predictable hours, and enhanced terms significantly improve retention alongside pay improvements. This finding implies that pay increases function most effectively as part of comprehensive employment packages rather than isolated initiatives.
Workload management emerges as a critical organisational lever. Structured approaches to caseload allocation, clear boundaries around working time, and adequate staffing ratios protect workers from unsustainable demands (Edwards et al., 2022). Implementation requires both additional resource investment and management commitment to prioritising workforce wellbeing alongside service delivery pressures. Houck et al. (2025) emphasise safe staffing as foundational to retention strategies, noting that chronic understaffing perpetuates a destructive cycle wherein departing workers increase demands on those remaining.
Supervision quality demonstrates consistent association with retention across diverse settings. Effective supervision provides emotional support, facilitates professional development, and enables early identification of workers experiencing difficulties (Evans and Huxley, 2009). However, supervision frequency alone proves insufficient; relationship quality, supervisor competence, and protected time for reflective discussion determine whether supervision achieves its potential benefits. Morris et al. (2023) identify supportive supervision frameworks as essential components of retention-focused workforce strategies.
Wellbeing support initiatives have gained prominence following recognition of occupational stress as a major turnover driver. Employee assistance programmes, mental health first aid training, and trauma-informed management approaches aim to mitigate harm from inherently demanding work. Devi et al. (2020) note that care home providers increasingly recognise workforce wellbeing as requiring proactive organisational investment rather than individual coping alone.
Career development and professional pathways
Opportunities for learning, advancement, and professional identity development significantly influence retention, particularly for workers seeking long-term careers rather than transitional employment. Context-relevant education that builds directly applicable skills demonstrates stronger retention effects than generic training disconnected from daily practice (Morris et al., 2023). This finding emphasises the importance of aligning development opportunities with workers’ actual roles and career aspirations.
Structured career pathways address a persistent criticism of social care employment: the perception of limited progression opportunities. Clear routes from entry-level positions through senior practitioner, supervisory, and management roles communicate that social care offers genuine careers rather than dead-end jobs (Pitarella, 2020). Implementation requires creating meaningful role differentiation, associated pay progression, and transparent criteria for advancement.
Apprenticeship programmes offer particular promise for building local workforce pipelines whilst providing development opportunities. By combining employment with qualification attainment, apprenticeships create pathways into social care for individuals who might not pursue traditional educational routes (Edwards et al., 2022). Early evidence suggests positive retention among apprenticeship completers, though longer-term follow-up remains limited.
Fast-track graduate schemes and practice learning placements support attraction and early-career retention for qualified social workers. Edwards et al. (2022) identify structured induction programmes as protective against the high attrition rates commonly observed in newly qualified practitioners’ first years. These programmes ease transition from education to practice whilst building connections to employing organisations.
Rural and remote settings present particular challenges for career development, with geographical isolation limiting access to training and peer networks. Research consistently identifies upskilling opportunities and role development as retention-enhancing factors in these contexts (Russell et al., 2021; Humphreys et al., 2017). Creative approaches including technology-enabled learning, regional training collaboratives, and expanded scope of practice address some barriers, though structural constraints remain significant.
Rattray, Milanese and Shelby-James (2025) highlight how community mental health support workers value professional development that enhances their competence and sense of occupational identity. This finding reinforces that career development serves psychological as well as instrumental functions, addressing workers’ needs for meaning and mastery alongside practical skill enhancement.
Recruitment strategies and local pipelines
Effective recruitment requires moving beyond vacancy advertising towards strategic approaches that build sustainable local pipelines and attract candidates aligned with care values. National recruitment campaigns raise general awareness but require local adaptation to achieve impact, with evidence supporting regionally-tailored messaging that reflects community characteristics and employment realities (Edwards et al., 2022).
Values-based recruitment represents an increasingly prominent approach, prioritising candidates’ attitudes, motivations, and interpersonal qualities alongside or above formal qualifications. The underlying premise holds that technical skills can be developed through training whilst caring values and relational capabilities prove harder to instil. Edwards et al. (2022) report promising outcomes from values-based approaches, though implementation requires clear articulation of desired values and assessment methods capable of reliably identifying them.
Care ambassador programmes deploy current workers as recruitment advocates, leveraging authentic testimony to communicate social care’s rewards and realities. Edwards et al. (2022) identify ambassador initiatives and refer-a-friend schemes as effective attraction mechanisms, particularly when they emphasise positive relational aspects rather than solely addressing practical employment information. These approaches capitalise on existing workers’ networks and credibility whilst reinforcing organisational culture among participants.
Refreshed employer value propositions acknowledge that social care competes within broader labour markets and must articulate compelling reasons for candidates to choose caring roles. Gibb (2023) emphasises targeting young people through platforms and messaging aligned with their preferences, recognising that traditional recruitment approaches may fail to reach potential applicants. This requires investment in understanding target audiences and adapting communication strategies accordingly.
Local pipeline development focuses on building relationships with schools, colleges, and community organisations to create sustained routes into social care employment. Edwards et al. (2022) support school and college engagement as foundation for longer-term recruitment, enabling early exposure to caring roles and qualification pathways. This approach shifts from reactive vacancy filling towards proactive talent cultivation.
Rural origin and substantial rural placements during training demonstrate particularly strong associations with subsequent rural retention. Maclaren et al. (2025), Russell et al. (2021), Morris et al. (2025), and Cosgrave, Malatzky and Gillespie (2019) all identify preferential recruitment of individuals from rural areas as an effective strategy. People who grew up in rural communities possess existing social connections, familiarity with rural lifestyles, and realistic expectations that support longer-term settlement. Esu et al. (2021) confirm this finding through systematic review, noting that rural origin represents one of the most consistently supported retention predictors.
Place-based and community interventions
Recognition that workforce sustainability depends on factors extending beyond the workplace has stimulated interest in place-based approaches addressing workers’ broader life circumstances. This perspective proves particularly relevant for rural and remote areas where retention challenges reflect not only employment conditions but also access to housing, services, and social networks (Carson et al., 2024).
Community-led marketing initiatives enable local areas to present themselves as attractive places to live and work, complementing employer-focused recruitment. Maclaren et al. (2025) document how remote communities develop innovative approaches including welcome events, orientation programmes, and ongoing social inclusion activities. These initiatives acknowledge that recruitment represents only the first stage; sustained retention requires helping newcomers establish satisfying lives beyond their professional roles.
Housing availability and affordability frequently emerge as critical barriers in areas where tourism or second-home ownership inflates property markets. Morris et al. (2025) and Cosgrave, Malatzky and Gillespie (2019) both identify housing support as an important retention lever, with practical interventions including subsidised accommodation, assistance accessing rental markets, and key worker housing schemes. These measures directly address material barriers that might otherwise prevent workers from remaining despite job satisfaction.
Family considerations profoundly influence retention decisions, particularly for workers with partners and children. Attention to partner employment opportunities, school quality, and childcare availability affects whether families can establish viable long-term settlements (Carson et al., 2024). Coordinated approaches involving multiple employers and service providers can address these needs more effectively than individual organisations acting alone.
Sense of belonging emerges as a powerful social determinant of retention, distinct from but related to workplace satisfaction. Cosgrave, Malatzky and Gillespie (2019) identify community participation, social integration, and meeting broader life aspirations as key factors determining whether workers remain in rural areas. This finding implies that retention strategies must engage with workers’ identities and relationships beyond their professional roles.
Morris et al. (2025) emphasise that retention requires ongoing attention throughout workers’ tenure, not merely during initial recruitment and induction periods. Life circumstances change, and workers’ needs evolve; responsive organisations maintain connection with workforce experiences and adapt support accordingly.
Discussion
The evidence synthesised in this review demonstrates convincingly that workforce gaps in social care cannot be resolved through any single intervention. Local systems achieve best results when they combine improved pay and conditions, career development opportunities, targeted recruitment approaches, and place-based community support. This multi-faceted understanding has significant implications for how local authorities and care providers approach workforce strategy.
The first objective, examining factors driving turnover, reveals a complex interplay of structural, organisational, and individual determinants. Low pay relative to comparable sectors establishes the fundamental context, but working conditions including caseload pressures, employment insecurity, and organisational culture mediate how pay disadvantages translate into departure decisions. This finding suggests that pay increases alone, whilst necessary, prove insufficient without complementary improvements to working conditions. Local authorities must therefore resist pressure to pursue single-issue solutions and instead develop comprehensive approaches addressing multiple drivers simultaneously.
Regarding job quality improvements (objective two), evidence strongly supports associations between enhanced conditions and retention. However, implementation presents substantial challenges within constrained funding environments. The finding that stable contracts and predictable hours significantly improve retention offers a potentially achievable lever for organisations unable to deliver dramatic pay increases. Similarly, investment in supportive supervision and workload management may yield retention benefits without requiring proportionate financial outlay. These findings suggest that creative approaches to improving job quality can achieve meaningful impact even within existing resource constraints.
Career development pathways (objective three) emerge as particularly promising mechanisms for supporting retention whilst building workforce capability. The evidence supporting apprenticeships, structured CPD, and clear progression routes addresses a significant weakness in social care’s employment proposition: the perception that caring roles offer limited advancement. Local authorities can strengthen career development by creating meaningful role differentiation, investing in qualification pathways, and ensuring training relevance to actual practice. The particular importance of development opportunities in rural settings highlights how geographical context should inform strategy design.
The analysis of recruitment strategies (objective four) reveals the value of shifting from reactive vacancy filling towards proactive pipeline development. Values-based recruitment offers a coherent approach aligned with care’s relational nature, though implementation requires clear specification of desired values and valid assessment methods. The robust evidence supporting rural origin as a retention predictor has direct implications for recruitment targeting, suggesting that local authorities in rural areas should prioritise candidates with existing connections to similar communities. School and college engagement builds longer-term pipelines whilst raising social care’s profile among potential future workers.
Place-based interventions (objective five) represent perhaps the most innovative dimension of contemporary retention thinking. Recognition that workforce sustainability depends on factors including housing, family needs, and community belonging expands the scope of legitimate workforce strategy beyond traditional human resource management. This expansion creates opportunities for coordinated local approaches involving multiple stakeholders beyond employing organisations alone. Integrated care systems and local authorities are well-positioned to convene such collaboration, linking workforce planning with broader place-shaping activities.
The practical synthesis for local authorities (objective six) emphasises the need for intentional strategy development rather than ad-hoc initiative implementation. Effective approaches require understanding local labour market conditions, identifying relevant staff group priorities, and selecting intervention combinations likely to achieve greatest impact within available resources. The evidence does not support universal prescriptions; rather, it provides a menu of options from which local systems must construct context-appropriate responses.
Several limitations qualify these findings. The evidence base, whilst growing, remains patchy across different interventions, settings, and outcome measures. Publication bias likely underrepresents unsuccessful initiatives, potentially overstating intervention effectiveness. Much research employs cross-sectional designs or qualitative methods that cannot establish causality, and outcome measures vary considerably across studies. These limitations counsel appropriate humility in interpreting findings whilst still supporting their use in informing strategy development.
The multi-level nature of workforce challenges creates tensions for local-level intervention. Many fundamental determinants, including sector-wide pay structures, funding levels, and regulatory frameworks, lie beyond individual local authorities’ control. Local strategies can achieve meaningful improvement within these constraints, but structural change ultimately requires national policy attention. Local evidence and advocacy may contribute to building the case for such change whilst delivering achievable local gains.
Conclusions
This dissertation has addressed its stated aim by identifying and evaluating evidence-based interventions for improving social care workforce recruitment and retention at local level. The synthesis demonstrates that effective approaches combine multiple intervention types rather than relying on single solutions.
Objective one was achieved through examination of turnover drivers including low pay, poor conditions, high workloads, insecure contracts, and unsupportive organisational cultures. These factors operate interactively, suggesting that effective strategies must address multiple determinants simultaneously.
Objective two was addressed through evaluation of job quality interventions, finding strong evidence supporting pay enhancement, stable contracts, workload management, and supportive supervision. These improvements target fundamental conditions that render social care employment less attractive than alternatives.
Objective three was achieved through assessment of career development approaches, identifying structured pathways, relevant training, apprenticeships, and rural upskilling opportunities as retention-supporting mechanisms. These interventions address social care’s perceived limitations as a career choice.
Objective four was addressed through analysis of recruitment strategies, supporting values-based approaches, local pipeline development, school engagement, and rural origin targeting. These methods shift recruitment from reactive to proactive, building sustainable workforce supply.
Objective five was achieved through exploration of place-based interventions, demonstrating how community integration, housing support, family considerations, and belonging influence retention beyond workplace factors. This expanded perspective enables more comprehensive local approaches.
Objective six was addressed through synthesis into practical recommendations emphasising intentional strategy combining multiple interventions tailored to local circumstances and staff group needs.
The significance of these findings extends beyond immediate workforce planning. Sustainable social care workforces are essential for meeting the needs of ageing populations and vulnerable individuals who depend on these services. The evidence supports moving beyond ad-hoc incentives towards strategic approaches that value care work appropriately whilst addressing the multiple factors influencing workers’ decisions.
Future research should prioritise longitudinal designs capable of establishing causality, comparative studies examining intervention combinations, and economic evaluation quantifying returns on workforce investments. Greater attention to implementation processes would support translation from evidence to practice. Research specifically examining equity implications, including how interventions affect recruitment and retention across different demographic groups, would strengthen the evidence base.
Local authorities, integrated care systems, and care providers can apply these findings by auditing current workforce strategies against the identified intervention domains, identifying gaps, and developing coordinated approaches. Success requires sustained commitment rather than short-term initiatives, recognising that workforce stabilisation represents a long-term endeavour requiring consistent investment and attention.
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