‘I can’t see myself doing this forever’: younger people’s experiences of working in adult social care

Summary

• Young people tended to fall into care work by accident rather than by design. The abundance of care worker roles coupled with a ‘light-touch’ application and recruitment process and some young people’s priority to find paid work of any kind meant that getting a job in care work initially was not a significant problem.  

• Interview participants found care work an extremely tough yet highly rewarding role. The first couple of weeks in particular was described as a ‘baptism of fire’ during which young people needed practical and emotional support from their managers and colleagues. More often, however, they found that they were left to sink or swim. While some young people found a way to thrive as care workers and find enjoyment in the role over time, we heard that many others leave the sector within a matter of weeks.  

• Almost across the board, we heard about some appalling experiences of unfavourable treatment of young care workers on the basis of their age. This behaviour among their managers and colleagues was attributed to pressures within the sector that place a great strain on staffing, resources and time for those managing or working in social care. It was also, more commonly, associated with prejudices about what young people are capable of and what they bring to the role and deliberate efforts to undermine newcomers to the sector until they had ‘proven themselves’ and ‘earned’ respect.  

• Very few young people envisaged they will remain in care worker roles indefinitely but they also struggled to identify a trajectory for the next leg of their working lives. In general, they were looking for work that was fulfilling, offered a better work–life balance, and where they felt valued for what they do – both personally and financially. 

Introduction

The King’s Fund has been exploring the role of young people in the social care workforce and, specifically, the question: what can social care do to recruit and retain more younger workers? At a time when social care vacancies stand at 131,000 and young people are particularly underrepresented, we have undertaken a programme of research exploring the potential answers to this question. Following initial data analysis and interviews to understand the perspective of social care providers, this final long read considers the perspective of young people currently working in, or who have recently left, social care.

The diagram below summarises the different phases of the research and the key findings we have uncovered along the way.

In many instances, the young people we interviewed said it was important to have the opportunity to tell their story in the hope that it may benefit young care workers in the future. Their stories are relayed as fully as possible in the findings that follow.

Our findings

Young people generally fall into care work by accident

Care work was not something that the young people we interviewed had longstanding ambitions to pursue. Rather, it was common for young people to say they fell into care work by ‘accident’. Typically, they had very limited awareness or understanding of what care work was, tending to associate it with ‘spending time with older people’.

Commonly, the young people we interviewed said they had been unclear and undecided about their career options. Some knew that they were ready to leave school and do something more ‘hands on’. Others had a strong sense of wanting to work in a caring role of some kind owing to their own or family members’ experiences of physical and mental health struggles and neurodiversity. They felt they had a lot to offer by way of empathy and hoped this would allow them to ‘be themselves’ at work in a more authentic way than in other more ‘professional’ environments. Where young people had received support from health and care professionals in the past, they said it was important to them to ‘give back’.

Some of the young people had studied for the Health and Social Care NVQ, which they felt would open doors to a range of potential job opportunities, such as childcare or becoming an allied health care professional. Those who had undertaken placements in social care settings while studying for their NVQ said these experiences left a lasting impression on them and led them to consider care work more intentionally as a prospective career.

Generally, though, the young people we interviewed said they had simply found that care worker roles were a readily available route into paid work or work experience.

Although the young people we interviewed were not encouraged into social care by their friends and family members, this did not dissuade them from applying. Their family members tended not to know very much about what care work is and were broadly supportive of young people’s decision as long as they were happy and earning money. Friends and peers were generally less convinced and could not see the appeal of what they perceived to be a demanding and unpleasant job (and as the quote below demonstrates, female-dominated).

The application process was short and almost ‘too easy’ 

The young people we interviewed told us that the process of finding a job in care work was very light touch – so much so, in fact, that some said in hindsight this was probably a ‘red flag’. The time span from finding a role to submitting an application to having an interview and receiving a job offer was usually around two weeks. This was typically followed by a one-month period in which young people underwent a DBS (Disclosure and Barring Service) and other identity checks. 

Almost all the young people we interviewed said they had found their first care worker roles on the website Indeed, which was abundant with care worker job listings. Young people either submitted a one-click application (uploading a copy of their CV) via the website or clicked through to the provider’s website and completed an application form.

As for the job advertisements themselves, those we interviewed reflected that they were light on detail about what the job entails, using phrases such as ‘helping people’ or ‘getting out and about in the community’, and did not explicitly mention personal care. For those interested in homecare roles, they realised only once they started the job that the advert had omitted the fact that their travel time would not be paid.

The job interviews took place online, over the telephone and in person. The young people’s impression was that the interview was intended to get a measure of their character and their interest in care – as one person put it, gauging their potential and ‘what I have to offer’ – rather than a test of knowledge or prior experience. Sometimes they were given more information about what the role entailed, but again, details were often vague – for example, ‘supporting people in their day-to-day life’. Often, the young people were offered the job on the spot.

For their second, third and fourth jobs in the sector, personal contacts and relationships became much more important as a route to hearing about and being nominated for care worker roles. Some young people said they maintained good relationships with former managers and colleagues and heard about job opportunities directly from them; others said they ‘followed’ former managers and colleagues where they had a good experience of working with them and where they heard that pay and conditions were slightly better elsewhere. In these instances, the recruitment process was even more light touch, perhaps an informal conversation with the manager who seemed to take recommendations in good faith.

The first few days were often very tough, but the role became rewarding

The interviewees had visceral memories of their first days in care work. ‘Shocking’ was the most common word used to describe their experiences during this period. For some, this was the first time they had seen people without any clothes on or going to the toilet. Some were faced with what they felt was an unprecedented level of responsibility for other people’s lives, whether managing their medication or learning how to operate a ventilator.  

Induction and onboarding was valuable but typically too brief 

To begin with, the young care workers underwent an induction period that comprised some e-learning modules and shadow shifts with their colleagues. This shadowing period ranged in duration from one day to two weeks, after which young people were expected to work independently. Commonly, young people said they felt their induction period was too brief and that they would have appreciated a longer period of co-working with their colleagues so that they could learn on the job in a more supportive way.

The young people acknowledged that care work has to be learnt on the job rather than in a classroom. But in order to learn and develop, they needed to be able to ask their colleagues questions, receive feedback, have regular check ins with their managers and feel that their requests for adjustments or support were heard. Some young people were taken under the wing of older, more experienced colleagues. These mentors were instrumental in recognising and appreciating the skills and qualities that young people bring to the role, helping them gain in confidence and to feel that they were making a positive difference.

Most, however, did not receive this support. Often, the young people perceived uninterest and unwillingness on the part of their colleagues to offer help and facilitate their learning – indeed, common for young people to feel like they were a ‘burden’. Some young people found themselves in highly challenging situations very early on in their role (including aggressive behaviour from residents with dementia, falls and, in one instance, a suicide attempt) that they felt unequipped and unsupported to manage. Some said they had witnessed other young people leave within the first couple of weeks as they felt unable to continue in the role.  

A sense of fulfilment developed as young people learnt to cope with the role’s challenges

As time went by, the young care workers we interviewed found that the job could be a source of enjoyment, fulfilment and pride. They found they were capable of rising to whatever challenges each day presented. For example, one young person told us that they successfully de-escalated an interaction that would otherwise have resulted in a resident being restrained. The job was necessarily hard, they said, but brought its own reward.

In particular, young people said they developed some very strong relationships with people who drew on services. Being embedded so intimately in people’s lives, and understanding and anticipating their needs, shifted their perspective of the nature of the care worker role: it came to be characterised less by the shock and surprise of providing personal care and more by the possibility of making a difference to people’s quality of life. As one young person put it, care work became ‘more than a job for me’.

Some young people felt that their age had been an enabler to cultivating good relationships with a range of different client groups; in some cases, it led to relationships that were mutually nurturing and beneficial, where people receiving care offered guidance and support to the young people about how to navigate challenges in their own lives.

Not only that but, commonly, the young people we interviewed recognised that they were good at what they did. They found they had suggestions and ideas that improved the experience for people receiving care, and some said they had challenged what they perceived to be non-person-centred practice within their teams.

However, there was a physical and emotional strain attached to doing the job well 

Being so invested in their work took a physical and emotional toll on the young people we interviewed – they frequently told us that care work is ‘exhausting’. It was painful for them to witness the difficulties faced by those with whom they had cultivated close relationships and, in some cases, their deaths. It was common for young people to be on their feet for 12-hour shifts, or longer when they were asked to cover other shifts. In their desire to do a good job, they soon found that there was not enough time in the day to fulfil all the requirements of their role (including paperwork) and spend quality time with people. Long working hours and continuous pressure had a knock-on effect on young people’s personal relationships and they found that they spent less and less time with their friends outside of work.

It was common for the young people we interviewed to experience doubt in their ability to do a good job, particularly owing to their age and relative inexperience, even more so where they did not feel supported by their managers or colleagues. Some raised their concerns with their managers but tended to feel they were neither heard nor taken seriously. As a result, this translated into a sense of powerlessness – or, as one young person put it, their ‘crack-at-it attitude dimmed a little bit’ – as they found themselves unable to make the difference to other people’s lives that they would have liked.

Support from colleagues and managers was vital but often lacking

For many of the young people we interviewed, their working conditions and workplace culture was the aspect of their experience that they were most keen to share with us. Often, they had worked in more than one care provider organisation and experienced the care worker role in different settings. They told us that the environment and relationships within these settings could vary quite considerably – and that it could make the difference between their staying or leaving.

In some places, those we interviewed said they had experienced supportive and warm team environments. These environments were characterised by:

• nurturing and protective colleagues. This included instances where young people felt they had found a mentor in an older colleague.

• mutual support and fairness. We heard how members of the team brought different strengths and were able to help each other. One young person explained that they would do the more physically strenuous tasks in people’s homes and read the small print on medication while their older colleague would prepare meals and clean. This negotiation and distribution of workload left the young people feeling like equal and valued members of the team.

• receptivity and responsiveness. In particular, some young people spoke with gratitude about managers who had proactively checked in with them to ask how they were feeling, to offer advice and guidance, to discuss their views and preferences about the types of work and shift patterns that worked best for them, and to explore their ideas about doing things differently. These managers were responsive to young people’s requests for additional support or adjustments owing to their physical or mental health, neurodiversity or personal life. As a result, the young people were able to continue to come to work rather than having to take sick leave.  

Almost all young people had experienced poor management and unsupportive colleagues  

Unfortunately, supportive relationships with managers and colleagues were the exception. Often we heard the opposite. Almost all the young people we interviewed had experienced unpleasantness in their relationships with managers and colleagues, with some severe instances of bullying and harassment.

Generally, the interviewees spoke with alarming stoicism about some of the behaviour they had encountered within their teams: it seemed to be an accepted fact that the sector was ‘cliquey’, ‘gossipy’ and ‘bitchy’. They became aware very early on of the dynamics and hierarchy within their teams and learnt to manoeuvre within these as best they could. Having said that, it was common for young people to tell us about experiences of unfavourable treatment. This included being the subject of jokes, name calling, criticism and being given the ‘crappy’ tasks. At its worst, we heard several instances of persecutory behaviour in which more established older care workers and managers ‘ganged up’ on their new, younger colleagues, ‘picking holes’ in their work, making false accusations of poor practice, and humiliating them in front of the wider team.

Within these team dynamics, the young person’s relationship with their manager was a crucial one that often determined whether or not they felt able to stay in the role. Often, the young people we interviewed said they felt that their managers did not care about staff wellbeing. We heard examples where young people requested adjustments at work and were ignored, or called in sick and were treated as an inconvenience.

Some young people felt their managers’ behaviour was symptomatic of being overworked and under immense pressure. They had noticed that ‘the high ups’ within their organisation faced a struggle in making ends meet, both financially and logistically (for example, ensuring all shifts were adequately staffed). As a result of this pressure, the young people found that their shifts or visits were changed at the last minute and without any room for negotiation (including on the part of the person receiving care). They were also asked to work longer shifts fairly regularly. This left our interviewees feeling overstretched themselves and unable to spend the time and energy they would like with the people receiving care. It also left some young people feeling that they themselves were not valued or cared for. As one young person put it: ‘you’re just a care worker so you do as you’re told’. Another described feeling as if they were treated like ‘a number’ rather than a person.

Many young people had experienced bullying linked, at least in part, to their age

Some of those we interviewed acknowledged that their experiences were probably also shared by other colleagues. But many gave examples of bullying and harassment specifically on the basis of their age. Often, the young people said they could not help but notice that they were one of the youngest, if not the youngest, members of the team. One young person said that, in their experience in the sector, ‘with age comes respect’.

Some felt compelled to ‘act older’ or conceal their age so that they would be taken seriously. They reported feeling self-conscious about their age and affected by self-doubt, something that was reinforced by the comments and behaviour they experienced from their colleagues. These included being called names (‘baby’) and feeling scrutinised by colleagues who never seemed satisfied with their work. Even when young people progressed into team leader roles, they said their colleagues did not listen to them. This treatment eroded some young people’s confidence and left them doubting their ability to make the difference they wanted to make at work.

Some wondered if these experiences were an ‘initiation’ of sorts: that their colleagues set them unpleasant tasks and challenges to overcome in order to see if they could ‘prove themselves’. This meant they often tolerated the behaviour in the hope that it would cease once they had earned the respect of their colleagues.

It was only as time went on and young people began to feel that they really were good at their jobs that they realised this treatment was not acceptable. Even then, however, it was rare for them to speak out or stand up for themselves. Where bullying escalated, some young people raised the matter with their managers with varying degrees of success. In some cases, their manager was affiliated with the clique responsible for the bad behaviour and so no further action was taken; in other cases, the care workers involved in the bullying behaviour were dismissed or moved into other roles. Usually, however, as young people reached breaking point, they chose to leave their role, and sometimes even the sector, altogether.

Although the chief focus of this research was the significance of age in young care workers’ experiences, we must also acknowledge what some young people shared with us by way of their experiences of discrimination and harassment on the grounds of other characteristics. For young people who felt minoritised in the workplace along lines of race, gender, religion, mental health or neurodiversity, there were shared experiences of being made to feel that they did not belong in the sector. They felt they faced higher levels of scrutiny and less favourable treatment than their colleagues.  

Few young people want to stay in a care worker role and many plan to leave the sector entirely

When thinking about the future, the young people we interviewed broadly fell into three categories: those who planned to stay in the sector, those who planned to leave, and those who had left or who planned to leave imminently.

Young people planning to stay in the sector don’t have clear career plans

Among the young people within this group, there were broad ambitions about progressing into more senior roles in order to be in a position to ‘solve problems’ within the sector, including those relating to issues of working conditions and workplace culture. Having said that, the young people we interviewed rarely had clear ideas about the course that their careers might take. In fact, some young people said they had already ruled out moving into a management position because this would take them away from direct work with people who draw on services, which they enjoyed, and because they perceived the role to be immensely stressful. Instead, they spoke about moving into other types of roles, for example safeguarding. One young person hoped that they might be able to influence the design and implementation of policy in the sector one day. For now, though, these young people said they loved their jobs and felt supported enough to stay in care work for the time being.

Many young people will probably leave the sector because the work takes a physical and emotional toll

For the young people in this category, the care worker role brought them a great deal of joy and fulfilment, but they felt it had a shelf life. The job took such a physical and emotional toll that they imagined doing a less demanding, more sustainable job in the long term. This group was typically unsure what else they would do: they saw themselves at the outset of their working lives and were open to trying new things, including working with other client groups (including children) and animals. Largely, they anticipated that they would continue to work in interpersonal helping roles of one kind or another, with some considering a move into other health care roles, such as nursing.

Some young people who have already left would return – but only if the working environment changed  

For the young people within this group, care work was either a stop along their journey towards a career path in health care (for example, as work experience as part of their university studies in nursing, physiotherapy or medicine) or it was a sector that no longer felt tolerable. Some young people had left the sector when they found it was no longer emotionally, practically or financially sustainable for them to continue working in it. In some cases, they had been encouraged by their loved ones to leave because of the detrimental impact of the role on the young person’s wellbeing and relationships. Often, young people had moved around a number of provider organisations and found that conditions were similar in different places and so leaving the sector altogether, even if it was to work in a call centre for a while, felt like the only option. Some were open to returning to the sector one day albeit on their own terms, for example working as a physiotherapist within a care home or perhaps even setting up their own care agency. Crucially, they mentioned that the working environment would need to feel very different for them to consider returning.

Low pay is seen as a confirmation of low value

Across all three categories, the young people we interviewed envisioned that over time they would move towards a line of work in which they feel fulfilled, recognised and able to enjoy their lives outside of work. As one young person put it, the care sector would most likely ‘drive away’ many young people as they searched for a job that offered more by way of a work–life balance and the possibility of earning enough to buy a home or go on holiday.

Pay did not always come up in the interviews, but for some young people the fact that they are paid minimum wage for the vital work that they do left them with the sense that their work is not valued. While some said they did not come to work for the money (care work gave them a sense of reward beyond the financial), they struggled to reconcile the amount they are paid relative to their friends working in supermarkets. Their level of income precluded all sorts of possibilities, including moving out of their parents’ home, saving, maintaining a car (particularly for those working in domiciliary care roles) and being able to go out with friends. 

Conclusions

Our previous long read indicated that social care has a problem with young people and this research offers little to counter that statement. It portrays a social care sector that can be a very difficult place for younger staff: one where some staff hold strong negative stereotypes about younger people.

Overall, this programme of research (including the 16 interviews with young care workers and our analysis of the available data for the sector as a whole) indicates that there are a number of points at which prospective young care workers are lost to the sector. We illustrate these moments of departure in the diagram below. These losses are a symptom of low levels of awareness of, and familiarity with, social care to begin with; a lack of outreach and wraparound support for young people at the point of their first contact with the sector; and unpleasant experiences with managers and colleagues. Certainly, care work is not for everyone – as the young people we interviewed said, you have to be ‘a certain somebody’ to be a care worker. But the great shame is that those who discover a calling in care work end up leaving owing to intolerable working conditions that make them feel unvalued and unsupported. Without a co-ordinated strategy for identifying and engaging those whose calling lies in social care, who knows how much potential remains untapped and how much is lost over time.

This research does not sit easily with the views of providers – that the main reason young people leave is because of the challenging nature of the role. While this is no doubt true in many cases and as the job takes a toll over time, the young people we interviewed had coped, indeed thrived, with the challenge of the role over a number of years. They left, or planned to leave imminently, because they felt unsupported and had experienced toxic work cultures, not because they couldn’t cope with the job.

There is a risk that providers create a self-fulfilling prophecy in which beliefs about the unsuitability of younger people, driven by wider societal attitudes, lead to assumptions that they will not stay long in social care. As a result (and also because of capacity pressures within the sector), young people are left without the support they need, making it even more likely that they will leave. This in turn reinforces assumptions about the unsuitability of care work for young people.

Despite this, there are grounds for optimism. The notion (as borne out in some of what we heard from providers) that young people are difficult, outspoken, unreliable and forever on their phones was not substantiated within the cohort of young people we interviewed. They were articulate, impassioned, thoughtful and able. They also endured appalling treatment at the hands of their colleagues and managers and did not feel able to speak up. It was a group that had found a calling in care work. The challenge and opportunity for the sector is to find more of them and make sure they stay. Below, we set out some recommendations that may help that process. 

Recommendations

There are a number of recommendations that are borne directly from this research and also some that emerge more broadly from our earlier research with providers.

1. There is an urgent need for cohesive sector-wide leadership to address the issues affecting the recruitment and retention of young people. The social care sector is a hugely diverse group of around 18,000 independent providers (supported by 10 provider representative bodies), commissioned by 153 local authorities (and 42 NHS bodies), regulated by the Care Quality Commission, and supported by organisations such as Skills for Care and the Social Care Institute for Excellence. National policy is led by the Department of Health and Social Care, but other departments and arm’s length bodies (such as the Department for Business and Trade and Department for Education) lead or are actively involved in some policy areas affecting young people working in, or training for, adult social care. Without a joined-up programme of work involving all these organisations, it is unrealistic to expect the on-the-ground experience of young people in social care to change significantly. Skills for Care’s adult social care workforce strategy calls for a 10-year attraction plan for underrepresented groups, including younger people. This would be a good starting point for this work.

2. Collective leadership does not absolve individual organisations of the need for action. Each individual employer needs to examine and address attitudes and behaviour towards young people in its organisation. There is a serious need to increase awareness of bullying and persecutory behaviour towards young people and take action against those responsible. It cannot be assumed that young people will express their needs or stand up for themselves. We also know that some managers are complicit in the unacceptable treatment of young people. More broadly, we heard that other minoritised groups within the workforce experience discrimination and exclusionary behaviour. There is a role for regulatory bodies and care provider associations to offer support, training and other interventions to identify and address difficult and exclusionary working environments. There is also an opportunity to recognise and celebrate examples of good practice, where providers demonstrate that they take care of their younger staff and that this reaps rewards by way of recruitment and/or retention.

3. There is a need for more work on organisational culture in adult social care to explore the contributions of workplace culture and leadership to the wellbeing of those working in the sector. Within health care, studies have found that there are clear connections between leadership, culture, staff wellbeing and patient outcomes. There is no equivalent body of literature for social care, despite the fact that it is a hugely demanding place to work and staff are faced with anxiety-laden, sometimes life-and-death, situations on a daily basis. Social care is also distinct from the health sector in its focus and configuration. It is a sector underpinned by statutory directive to provide person-centred care, prizing the forging of relationships with people who draw on services in order to understand their needs and wishes and fulfil them accordingly. This type of work requires staff to have both the time and the emotional bandwidth to engage in their work wholeheartedly. In addition, the vast majority of the 18,000 or so providers are small- and medium-sized private businesses that do not have a dedicated human resources or people function. Some of the young people we interviewed told us that their experience of the management of these businesses intersected their experience of how they felt they were treated and, in turn, their ability to deliver the best quality care.

4. There is a need to improve the onboarding and induction for younger people in social care. More than half of workers under 20 leave social care within the first year. Our research suggests that some do so because of a lack of support from their managers and colleagues. This support could be provided at a number of different levels within care provider organisations, ranging from peer support (such as other young people acting in the capacity of a buddy) through to mentors, as well as more formal, perhaps even external, channels to enable young people to raise and escalate concerns. Leaving younger staff to sink or swim is not a successful or humane strategy to adopt.

5. The lack of obvious pathways into social care for younger staff has to be addressed. There is a group of young people for whom care work is a natural fit. But simply recruiting younger staff who stumble across the sector by accident is not a sustainable way of building the workforce that the sector needs for the future. This is not just an issue for providers but also for government: there is a need to create the pathways that identify and inspire younger people to work in the sector and encourage collaboration between education providers and social care providers so as to raise awareness and familiarity with the sector. This then needs to be followed by clearer stepping stones, rewards and career pathways once young people join.

6. Underlying issues around underfunding and low pay will not go away without action. While the key problems identified by this research cannot simply be excused by a lack of resourcing in the sector, it undoubtedly plays a role. Under-funding leaves providers over-stretched – something that was noted by a number of our participants. Low pay is a disincentive in its own right, but also because it suggests to younger people that social care roles are not valued. Governments’ long-standing tendency to defer funding reform also leaves a sense that the sector is not a priority. The current government’s proposals for a ‘fair pay agreement’ in adult social care are therefore welcome in principle but will need to be fully thought through and fully funded.