165,000 vacant positions across adult social care in England. Staff turnover rates averaging 28.5% annually, rising to 35-40% in domiciliary care. One in three care workers leave the sector entirely within their first year. The median hourly wage for care workers sitting at £11.05 – barely above National Living Wage and substantially below comparable NHS roles requiring similar skills.

These aren’t projections or worst-case scenarios. These are Skills for Care’s current workforce statistics for 2024-2025, and they’re getting worse, not better. Add to this the government’s decision to restrict care worker visa sponsorship from April 2024, removing approximately 120,000 potential international recruits from the available workforce pool, and you’ve got a staffing crisis that’s moved beyond “challenging” into “existential threat to service viability.”

If you’re running a care service right now, the workforce is probably your single biggest operational headache, financial pressure, and business risk. Understanding how to structure workforce strategies that actually work in this environment has become the difference between providers who survive 2025 and those who don’t.

Why People Are Leaving

The narrative that care workers leave for “better opportunities” obscures what’s actually happening. They’re leaving because the job has become unsustainable on multiple levels simultaneously.

Pay is the obvious factor. A care worker earning £11.05 hourly whilst watching their rent, energy bills, and food costs climb by 20-30% over two years isn’t making a lifestyle choice to stay in care. They’re making a survival calculation about whether they can afford to continue. When supermarkets, warehouses, and hospitality offer £12-13 hourly for less emotionally demanding work with better shift patterns, the mathematics of staying in care don’t work.

But it’s not just pay. It’s the cumulative burden of emotional labour with inadequate support. A domiciliary care worker in Essex described her typical day: eight visits, 30 minutes each, 15-minute gaps between them that are actually 5 minutes once travel time is accounted for. No time to decompress between seeing someone who’s dying, someone who’s verbally aggressive due to dementia, and someone who’s desperately lonely and wants her to stay longer than the commissioned time allows. She lasted nine months before moving to retail.

Organisational support varies wildly, but providers under financial pressure increasingly can’t afford the supervision frequency, training investment, and genuine professional development that retains good staff. You get your Care Certificate, maybe annual refreshers if you’re lucky, and supervision that’s primarily administrative box-ticking rather than reflective practice or emotional support.

Zero-hours contracts remain prevalent despite their unpopularity, because providers facing unpredictable referral patterns can’t commit to guaranteed hours. Staff need income security. Providers need flexibility. Nobody’s worked out how to reconcile these competing needs at current funding levels, so staff bear the insecurity burden until they find employment elsewhere offering more stability.

The Sponsorship Rule Changes That Broke Everything

The government’s decision to restrict care worker visa sponsorship wasn’t a minor policy adjustment. It removed overnight a recruitment route that many providers, particularly in London, Southeast, and urban areas with high living costs, had come to depend on.

The rationale was preventing exploitation and ensuring UK workers filled care roles. The reality is UK workers aren’t filling those roles in sufficient numbers regardless of visa availability, because the fundamental job conditions that make care work unattractive to domestic workers haven’t changed.

International recruitment wasn’t exploitation in most cases – it was matching people who wanted to work in UK care with employers desperate for staff. Yes, some agencies and sponsors behaved appallingly. The solution wasn’t wholesale closure of the route but better regulation of sponsors and protection of sponsored workers.

Providers who’d built staffing models incorporating international recruitment now face impossible choices. Reduce capacity, decline referrals, increase reliance on agency staff at unsustainable cost, or hope domestic recruitment suddenly becomes viable when nothing fundamental has changed to make care work more attractive to UK workers.

One London domiciliary provider employing 45 international care workers on sponsored visas when the rule changed has seen 23 leave as their visas expired or they moved to other sectors where sponsorship remains available. Domestic recruitment has filled seven positions. They’ve reduced coverage area by 40% and stopped taking new contracts because they simply cannot staff the work. Their local authority is threatening contract breach whilst offering no solution to the workforce problem the government created.

Understanding how to navigate workforce challenges whilst maintaining service viability and contract compliance has become an essential survival skill for providers in high-cost areas where domestic recruitment is particularly difficult.

What Actually Works (And What Doesn’t)

Providers experimenting with workforce retention strategies report mixed results. Some approaches show promise. Others are expensive failures that don’t meaningfully impact turnover.

Paying above minimum wage helps, but not as much as you’d hope. Providers offering £12-13 hourly report modestly better retention than those at £11, but they’re still losing substantial numbers to sectors offering £14+ or better conditions at similar rates. Pay matters, but it’s not sufficient alone to solve retention when other job factors remain problematic.

Guaranteed hours contracts significantly improve retention where providers can afford offering them. Staff knowing their income with certainty makes an enormous difference to their financial security and wellbeing. The challenge is that many providers can’t commit to guaranteed hours given fluctuating referral patterns and commissioner funding that doesn’t accommodate this employment model.

Genuine career progression matters more than providers expect. Care workers who see realistic pathways from support worker to senior, to coordinator, to manager positions stay longer and perform better. Those stuck at entry level indefinitely with no advancement opportunity leave faster. The problem is many providers operate too small to offer meaningful progression, or financial constraints prevent creating senior roles that would provide development opportunities.

Peer support and team culture appear crucial based on what staff say about why they stay despite difficult conditions. Providers fostering genuine team environments where staff support each other and feel valued as individuals retain staff longer than those treating workers as interchangeable labour. This costs relatively little financially but requires management time and emotional investment many overstretched providers struggle to provide.

Flexibility that’s actually flexible helps. Not zero-hours “flexibility” where the employer gets flexibility and the worker gets insecurity, but genuine flexibility where staff can influence their schedules, swap shifts easily, and balance work with other life demands. Providers using technology to enable staff-controlled scheduling report better retention than rigid rota systems.

The Strategies Providers Are Using to Survive

Providers who haven’t closed or significantly reduced capacity are employing various approaches, with different success levels.

Some have moved upmarket, focusing on complex care at premium rates where they can pay staff better and recruit more selectively. This works in areas with demand for high-acuity care but leaves standard domiciliary care underserved and puts providers competing for the limited pool of more experienced staff.

Others have radically reduced geographical coverage, concentrating operations in smaller areas where travel time between visits decreases and staff workload becomes more manageable. This improves job satisfaction and retention but reduces business scale and makes services more vulnerable to local market changes.

Technology adoption helps some providers manage smaller teams more efficiently. Better scheduling systems, mobile working tools, and electronic care planning reduce administrative burden on frontline staff, giving them more time for actual care delivery that’s why they entered the sector. The investment cost creates barriers for smaller providers already financially stretched.

Partnership approaches where multiple small providers share back-office functions, training programs, and sometimes staff pools show promise but require trust and coordination many competitors find difficult. The providers making this work report efficiency gains that improve their sustainability whilst maintaining service quality.

At AssuredBID, we work with providers across these different strategic approaches, and increasingly the successful ones are those who’ve made difficult decisions about their service model rather than trying to sustain traditional models in conditions that no longer support them. If you’re struggling with workforce sustainability and questioning whether your current model remains viable, book a consultation to discuss realistic options for your specific circumstances and market position.

The Uncomfortable Reality

The workforce crisis won’t resolve without fundamental change to pay, conditions, and career structure in social care. Government policy so far has made things worse, not better. The visa restrictions removed supply without addressing why domestic workers don’t want care jobs. The pay rises discussed in policy never materialize in funding. The “valued workforce” rhetoric doesn’t translate into conditions that demonstrate value.

Providers can’t fix sector-wide problems through individual action, but you can make strategic decisions about your service model, target market, and operational approach that improve your specific workforce sustainability even whilst broader crisis continues.

The providers surviving are those accepting that care delivery in 2025 requires different workforce strategies than 2019, rather than hoping conditions return to some previous baseline that’s not coming back.

For practical strategies on workforce retention and sustainable service models, explore our sector analysis and provider guidance covering workforce, funding, and operational sustainability.