Among the grand job titles enjoyed by government officials, Jeff Jerome’s surely ranks as one of the most impressive: “National Director for Social Care Transformation” – wow! The expectations such a description raises are matched by Mr Jerome’s unique employment status. He works for a consortium of bodies, the Association of Directors of Adult Social Services (ADASS), the Local Government Association (LGA), and the Improvement and Development Agency (IDeA), with the support of the Department of Health. His role is to lead local councils’ contribution to implementing “Putting People First”, the December 2007 Concordat which brought together central and local government, the NHS, the regulators and the providers in a resolve “to transform people’s experience of local support and services”. This is seriously ambitious.

So when Mr Jerome, speaking recently on an expert panel at a conference, expressed the view that social care would not merely have to operate with a largely unqualified workforce for the foreseeable future but should actively welcome the opportunities this poses, I checked with him that I had not misheard. Far from being repentant, he happily agreed to expand on his thinking in an exclusive interview for Caring Times.

Mr Jerome does make a distinction between what he called “the formal workforce and the less formalised workforce”, groups roughly parallel to the “regulated and the less regulated”. The contribution of relatives, friends and neighbours, he points out, depends more on empathy than qualifications; personal assistants, indeed most homecare workers, need to take such carers rather than conventional professionals as their models. He quotes both the contribution of Community Service Volunteers and his own early experience as a care assistant – “I did a pretty good job” – as examples the care industry should follow. In hospitals, he points out, many staff, though well-trained, can give a poor care service.

Mr Jerome sees current demographic trends as an ally in his argument, and happily accepts that the social care workforce will be dependent on “more younger people because there is a proportionate slimming down of the middle-aged group”. Nor is he greatly worried that many young workers show little inclination to stay for long: “we need to attract people of the right calibre even if they’re coming for just one or two years”, but “we have to be careful in talking about careers when what we need is hands-on, person-to-person support”. It follows that career progression is normally reserved for “the glossier side of the service – the social workers, the commissioners and so on”. At the grass roots, we should embrace transience; “it’s a difficult job to do long-term if you’re looking after highly dependent people”.

Mr Jerome believes, again without regrets, that most good person-to-person support requires no qualifications, and that the lower levels of NVQ are “fairly basic”, a fact he does not deplore. “Training should not be ‘over-training’. The more you train people, often the less willing they are to listen to the person they’re looking after”. He returns to the central importance of “getting hold of the right sort of people” – “having empathy is more important than having qualifications” – though he quickly adds that good management is the other vital ingredient.

He concedes, oddly in my view, that “in care homes you may need a higher level of training than working one-to-one with someone who is in control of their situation in their own home”. This view reverses conventional wisdom, since homecare workers have less ready access to supervision and are potentially much more of a threat to vulnerable service users. This was the case consistently deployed by the Department of Health, the General Social Care Council and others in arguing that priority for registration should be given to homecare. In the event, further workforce registration has been indefinitely postponed, partly because the encouragement of privately employed assistants, which is central to the personalisation policy, is obviously at odds with trying to compile a comprehensive list of officially approved care staff.  

When I asked Mr Jerome whether his views are consistent with the Government’s Social Care Workforce Strategy, he replied “probably no”. In launching the scheme to attract 50,000 long-term unemployed into social care and adding 1,300 new apprenticeships, the Strategy speaks of “giving them the skills and experience they need for a permanent career in the sector”.

“There’s been an overemphasis on assuming that training will be the answer”, says Mr Jerome. “We will always be dependent on a high number, around 40-50%, of people who are going to work in one-to-one care for only two to three years. In any case much of the most important support will also come from family members, friends or neighbours, who are certainly not qualified in social care.”

Mr Jerome stresses that these are personal views and not those of ADASS or LGA, but there must be some concern that someone in his highly influential position in local government is promoting policies which run clear counter to those espoused by many in social care’s leadership. Martin Green, chief executive of the English Community Care Association “finds it incredible that on the one hand the Department is talking about professionalising the workforce . . . whilst the narrative from another bit of government is about an untrained transitory workforce”. He believes that “the social care workforce should increasingly be professionalised and trained”, a view echoed by Des Kelly, chief executive of the National Care Forum, who finds it worrying that “40% of staff stay only for about a year” and looks to “building and retaining a skilled and qualified workforce”. Nadra Ahmed, who is both a provider and the vice-chair of Skills for Care, accepts that “there is a debate to be had about skills and qualifications” but argues that it is important “to attract young people into the sector who believe that social care is a long term career option”.

And what about regulation? Will the Care Quality Commission be satisfied with an organisation providing services for seriously vulnerable people which operates with few qualified staff? The National Minimum Standards, drafted nearly a decade ago, laid down the requirement that at least half of care workers should have NVQ level 2 or equivalent by 2005, but this target has still not been reached in many homes and in any case those Standards will disappear in October. 

In their place the new Regulation 13 on Staffing states merely that there should be “sufficient numbers of suitably qualified, skilled and experienced persons employed”, and CQC’s guidance in its Essential Standards of quality and safety goes no further than to repeat that fairly vague expectation. Since these documents cover services as diverse as acute hospitals and homecare agencies, they depend on the precise level of staff training required for each setting being spelled out elsewhere. The medical, nursing and therapeutic disciplines have their royal colleges and professional associations, but there is no equivalent authority for social care.

It is beginning to look as if hopes for a fully qualified workforce were no more than a rather sad twentieth century dream. Perhaps Jeff Jerome is leading us into a harsher, more realistic world.