Key statistics
- the 2021 Census indicates around 5 million people in England and Wales provide unpaid care
- the estimated economic value of unpaid care is £162 billion
- the dashboard draws on data from both the 2011 and 2021 England and Wales Censuses
- the tool allows comparison of unpaid care patterns across local authorities and over time
Key messages
- unpaid carers play a central role in the health and social care system, providing substantial economic and social value
- the characteristics of unpaid carers vary across local areas, including differences in age, ethnicity, employment and health
- the amount of care provided and the health of carers can change over time, reflecting wider social and demographic trends
- the dashboard enables analysis of how unpaid care intersects with socioeconomic factors such as employment and education
- improved access to data can support better understanding of local care needs and inform service planning
Policy implications
- use local data to identify areas with higher levels of unpaid care and target support accordingly
- recognise unpaid carers as a key part of the health and social care system in planning and resource allocation
- develop services that reflect the demographic and socioeconomic profile of carers in different areas
- support integrated care systems to use data for service planning and business case development
- improve access to data and insights for local authorities, commissioners and providers
Gaps
- the dashboard is based on Census data and may not capture more recent changes in unpaid care patterns
- potential underreporting of unpaid care in Census data
Commentary
This dashboard provides a useful overview of unpaid care across England and Wales using Census data. It highlights the scale of unpaid care and the important role carers play in supporting people with long-term conditions, disabilities and older age.
One of the main strengths of the tool is its ability to show how unpaid care varies across different places. Users can explore differences between local authorities and see how patterns of care have changed over time. This helps identify where demand for support may be higher and where services may need to be adapted.
The dashboard also shows how unpaid care is linked to wider social and economic factors. For example, it allows comparison of carers’ health, employment and education with the general population. This helps highlight how caring responsibilities can affect people’s lives, including their ability to work or maintain good health.
From a care equity perspective, the dashboard is essential because it makes visible the uneven distribution of unpaid care. Some areas and population groups provide more care than others, often alongside higher levels of disadvantage. Without targeted support, this can contribute to inequities in both carer wellbeing and access to formal services.
Overall, the tool supports better use of data in planning and decision-making. By improving understanding of who unpaid carers are and where they are located, it can help inform more equitable and responsive health and social care services.
Key messages
- quality of care in residential homes is closely linked to available resources
- workforce culture shapes daily routines and philosophies of care
- care workers play a central role in translating organisational priorities into practice
- time pressures influence how care is delivered to residents
- divisions of responsibility within care homes affect staff experience and care outcomes.
Policy implications
- resourcing levels directly affect the capacity to deliver high-quality care
- workforce culture should be considered alongside staffing numbers
- clearer allocation of responsibilities may support safer and more consistent care
- time allocation per resident is a critical factor in care quality.
Gaps
- limited exploration of how responsibilities are divided across staff roles
- need for further research on time pressures and their impact on care delivery
- findings are based on residential care settings only
- wider system-level influences on care home resourcing are not examined.
Commentary
This study provides a detailed account of how care work is organised and experienced within residential homes for older people. By focusing on everyday routines and interactions, it shows how care quality emerges from the interaction between resources, organisational culture and staff practice.
The findings emphasise that good care is not solely a function of individual commitment. Workforce culture and material conditions shape what care workers are able to do, how time is prioritised and how responsibilities are distributed across teams.
From a care equity perspective, the study highlights how under-resourcing and time constraints can create uneven care experiences for residents. When staff are required to ration time or negotiate unclear responsibilities, some residents may receive more attentive care than others. These dynamics reflect broader inequities in how care is funded and organised, rather than individual failings of workers.
Overall, the paper stresses the importance of viewing workforce conditions as central to equitable care. Ensuring fair allocation of time, clarity of roles and adequate resources is essential if residential care homes are to provide consistent and dignified care for all residents.
Key statistics
- residential care workers make up around 40% of the adult social care workforce
- residential care workers are twice as likely to experience poverty and food insecurity compared with health workers
- around 1 in 10 residential care workers experience food poverty
- the adult social care sector is projected to need approximately 600,000 additional workers by 2031.
Key messages
- low pay and insecure working conditions place many residential care workers at risk of poverty
- deprivation among care workers is significantly higher than among comparable health workers
- cost-of-living pressures exacerbate existing financial insecurity
- workforce shortages are expected to increase demand for residential care workers
- demographic factors shape exposure to poverty and deprivation within the workforce.
Policy implications
- improving pay and working conditions is central to workforce sustainability
- targeted financial and employment support is needed for residential care workers
- workforce planning must consider living standards as well as recruitment targets
- addressing poverty among care workers may support retention and quality of care.
Gaps
- the report focuses on residential care workers rather than the wider social care workforce
- limited exploration of regional variation
- longer-term impacts of cost-of-living changes require monitoring
- further research is needed on the effectiveness of targeted support measures.
Commentary
This report provides a stark account of the financial realities faced by residential care workers in the UK. By documenting high levels of poverty and food insecurity, it challenges assumptions that employment in care provides a stable route out of deprivation.
The findings highlight how poor pay and insecure conditions are embedded within the structure of residential care. As demand for care grows, these conditions risk undermining recruitment and retention, placing further strain on an already stretched workforce.
For care equity, the report exposes a contradiction at the heart of the care system. Workers who provide essential support to older and vulnerable people are themselves disproportionately affected by poverty and deprivation. These disparities are not incidental but reflect how care work is valued and funded, with implications for workforce wellbeing and continuity of care.
Overall, the report argues that improving outcomes for people who draw on residential care cannot be separated from improving the living and working conditions of the workforce. Addressing poverty among care workers is a prerequisite for building a fair, resilient and sustainable adult social care system.
Key messages
- care workers identified pay and working conditions as central concerns
- systemic and structural issues shape everyday experiences of care work
- participants highlighted limited influence over decision-making processes
- organising was seen as a way to make care workers’ experiences more visible
- informal practices and collective action were used to address workplace issues.
Policy implications
- decision-making in social care should better reflect frontline experience
- mechanisms to support worker voice could strengthen workforce sustainability
- pay and conditions remain key levers for recruitment and retention
- engagement with care worker organisations may improve policy relevance.
Gaps
- findings are based on qualitative interviews
- the study does not assess the impact of organising on outcomes
- experiences may vary across regions and care settings
- longer-term analysis of organising efforts is needed.
Commentary
This study provides insight into how paid care workers in England understand their working conditions and the role of organising in addressing long-standing challenges. Participants described organising as both a response to low pay and poor conditions and a way of asserting professional identity within a marginalised sector.
The findings show that care workers often feel disconnected from decision-making structures that shape their work. Organising activities were framed as efforts to make everyday realities visible to employers and policymakers, rather than solely as formal union activity.
Considering care equity, the study highlights how unequal power within the workforce affects both workers and the people they support. When care workers’ voices are excluded from policy and practice, inequities in pay, security and conditions are sustained. These workforce inequities have downstream effects on continuity and quality of care, particularly in a sector employing large numbers of women and people from marginalised groups.
Overall, the paper suggests that supporting care worker voices is not only a labour issue but a care issue. Strengthening avenues for collective input may contribute to fairer working conditions and a more equitable and stable care system.
Key statistics
- between 38% and 78% of people with severe mental health conditions report seeking mental health information online
- 90% of UK households had internet access at the time of the study
- smartphone ownership among UK adults increased from 52% to 85% over a five-year period
Key messages
- digital technologies are increasingly used for mental health support, including self-monitoring, online information seeking and remote interventions
- co-production with clinicians, frontline staff and people with lived experience is important to design tools that are relevant and usable
- digital tools can improve access to support, particularly for people who may not engage with face-to-face services
- there are significant barriers to adoption, including lack of staff training, limited digital literacy and unequal access to technology
- concerns about data privacy, confidentiality and how information is used can reduce trust in digital platforms
- some staff and service users are concerned that digital tools may weaken therapeutic relationships or replace face-to-face care
- digital interventions are developing faster than the evidence base, creating challenges for evaluation and implementation
Policy implications
- invest in digital infrastructure and training across the health and social care workforce
- embed co-production approaches in the design and implementation of digital mental health tools
- develop clear governance frameworks for data security, privacy and ethical use of digital health data
- ensure digital tools are used to complement, not replace, face-to-face care where needed
- address digital exclusion by improving access to devices, internet connectivity and digital skills support
- support ongoing evaluation of digital interventions to ensure they are effective and safe
Gaps
- limited high-quality evidence on long-term effectiveness of many digital mental health interventions
- digital tools are often developed without a clear theoretical framework explaining how they work
- lack of consistent evaluation methods, with traditional trials often too slow for rapidly evolving technologies
- limited research on how digital approaches affect therapeutic relationships and care quality over time
- insufficient focus on how digital exclusion affects access for different population groups
Commentary
This paper looks at how digital technology is changing mental health care. It shows that more people are using the internet and smartphones to find information, track their symptoms and access support. For some people, this can make it easier to get help, especially if they feel uncomfortable with face-to-face services or live in areas with limited provision.
However, access to digital care is not equal. While many people now use the internet regularly, not everyone has the same level of access, confidence or skills. Some people may not have reliable internet or devices, while others may struggle to use digital tools. This creates a risk that digital approaches could widen existing inequities if they are not designed and implemented carefully.
The paper also highlights concerns from staff and service users. Some worry that digital tools could reduce human contact or be used as a cheaper alternative to proper care. Others are concerned about how personal data is collected and used. These concerns can affect trust and willingness to engage with digital services.
Another key issue is the gap between how quickly digital tools are being developed and how slowly they are evaluated. Many tools are introduced before there is strong evidence on how well they work or who they work best for. This makes it harder for services to know which tools to adopt.
From a health and social care equity perspective, digital technology has both potential and risk. It can improve access by reaching people in their everyday lives and offering flexible support. At the same time, if issues like digital exclusion, workforce readiness and trust are not addressed, it may reinforce existing inequities.
Overall, the paper suggests that digital mental health care should be developed alongside, not instead of, wider investment in services and support. A balanced approach is needed so that technology improves access without reducing the quality or equity of care.
Key Stats:
- Almost two thirds of social workers stated that their service did not operate with a ‘staff-to-service ratio’.
- over 75% staff who have taken between 11 to 20 sick days from work are respondents who stated they do not work in a safe ‘staff-to-service’ ratio work environment.
Key Messages
- England has the highest proportion of staff working in unsafe staff-to-service ratios, followed by Northern Ireland.
- Staff in unsafe conditions are twice as likely to leave their organisation compared to those in safer environments.
- Workload pressures are increasing, with insufficient staffing to meet care needs, leading to unsafe working conditions.
- Staff report compromised practice, poor decision-making, and inability to follow procedures due to being overstretched.
- There is no capacity to cover absences or annual leave, resulting in frequent overtime.
- Staff are forced to prioritise administrative tasks over direct care, reducing time with those they support.
- Wellbeing is impacted: staff feel burned out, less resilient, and overwhelmed by unmanageable caseloads.
- Post-COVID pressures persist, with unreasonable demands from management and lack of understanding of burnout. Staff feel ignored by managers, with delayed responses and insufficient support from senior leadership.
- High turnover and intentions to leave the profession are driven by daily pressures and feeling unheard.
Commentary
This paper highlights the increasing pressures faced by the social care workforce due to limited capacity and insufficient administrative support. Staff report burnout from covering understaffed shifts, receiving low pay, and being unable to take annual leave without burdening their colleagues. These conditions compromise staff wellbeing and restrict their ability to move beyond crisis management, limiting opportunities for training, skill development, and career progression. While staff remain committed to meeting the needs of those who draw on care and support, the current staff-to-service ratios are unsustainable. Many report having less time to provide personalised care, with the shortfall directly impacting people who are drawing on services. This is recognised as a national issue, not just an organisational one, with widespread capacity challenges across the sector.
This article calls for urgent action to address workforce capacity, improve training, and support newly qualified social workers, who experience particularly high turnover rates. Current practice falls short of BASW’s guidance, which recommends 80% of time spent engaging with service users and 20% on administration. Limitations of the study include a homogeneous sample in regards to ethnicity and an overrepresentation of respondents from Northern Ireland. Additionally, authors note that findings may not be representative of all social workers, as those who responded to open-ended questions likely held strong views on the issues discussed.
Key Statistics:
- 13% of social care staff stated that they are unable to solve a problem with a device or digital service using online help if they were asked to do this
- 9% of staff stated they could not check if information they found online is accurate
- 7.1% of staff stated they would not be able to buy and install apps on a device if they were asked to
- The average confidence score to use technology, which includes desktop computers, laptops, smartphones, and tablets across different job groups show that: Social care workers have a confidence score of 3.84 out of 4; Social workers have a confidence score of 3.35 out of 4; Social work students have a confidence score of 3.70 out of 4. The overall score for all groups is 3.70 out of 4.
- A total of 14% of respondents aged over 65 shared that they were not confident at all in the use of some technologies at work
Key Messages
- Digital skills are reported to decline with age, and confidence in using technology is closely linked to self-reported skill levels
- E-learning is widely valued by social care staff for its flexibility, time efficiency, and peer support, though most use it at home rather than at work due to time constraints and limited managerial support.
- Face-to-face learning is still preferred, but many staff are already engaging in informal digital learning through websites and mobile apps, indicating a shift toward blended approaches.
- A small group (9.9%) are resistant to e-learning, often due to minimal digital skills, and lack of confidence. Staff are in need of more tailored support to improve their digital skills.
Commentary
Particular focus should be given to members of the workforce within all job roles who indicated that they were only slightly confident or not confident at all in the use of technology. The authors tell us that although the majority of responses are positive, it is clear that there is a proportion of the workforce who would benefit from increased training in the use of technology. This is critical to ensure that every member of the workforce is able to benefit from the potential of digital learning and development and that a digital divide is not created. These findings suggest that offering training to increase digital skills and technology confidence, in addition to raising awareness of the benefits of the use of technology for learning and development, may increase the overall engagement with digital learning and development solutions.