Care Worker Wellbeing - Why It Belongs on the Board Agenda

The Care Quality Commission's Single Assessment Framework, introduced in 2023, made workforce wellbeing a scored domain under ‘Well-led’. Inspectors now assess whether leaders demonstrate a positive culture that is person-centred, open, inclusive and empowering. Staff experience is evidence and wellbeing is inspected.

The Worker Protection (Amendment of Equality Act 2010) Act 2023 extended employer duties on harassment prevention, with particular relevance to a sector where the Care Workers Charity reports that abuse comes not only from people being supported but from family members, colleagues, and managers.

In 2025, Casey Commission on Social Care, named workforce conditions as a structural risk to system sustainability. The government's 10-Year Health Plan, published the same year, identified social care workforce stability as a prerequisite for NHS pressure relief. These are policy frameworks that will shape commissioning, inspection, and funding decisions.

What was once considered a matter of organisational culture is now a matter of regulatory compliance and strategic risk.

The Care Workers Charity's report, drawn from a webinar with frontline care workers and providers during Care Workers Week, puts numbers to what many in the sector already know but rarely say out loud.

Care workers stated being paid below the real living wage, not receiving pay for travel time between visits, working six days a week not by choice but because the hours are inconsistent and unpredictable. One care worker described a colleague who could earn more per hour as a cleaner, another described the impossible arithmetic of home care - sent to a 30-minute call with tasks that cannot be completed in 30 minutes, then written up as non-compliant.

The underfunding of commissioning sits behind all of this - agencies cannot pay more than the rates they receive.

Care workers describe exposure to dementia, end-of-life situations, self-harm, and acute mental health crises – sometimes alone and without time to process one call before arriving at the next. The report captures the experience of home care workers who go from visit to visit with no colleague to debrief with, no time between calls, and no formal check-in for months. The emotional labour is constant while the support is not.

Physical safety is a governance gap, with the 25% figure on violence is striking, but the qualitative evidence is more so. It also raises the question of whether providers are moving quickly enough to withdraw from packages where safety cannot be assured? The answer, in many cases, is no.

There have been situations where care workers are told that if they do not come in on their day off, the person they support will have no one, or if they miss a call, a care package will be cancelled. This, unfortunately, is a pattern that sits at the intersection of workforce shortage, commissioning pressure, and the absence of boundaries culture. But it is also a governance risk, as a workforce operating under this kind of pressure cannot consistently deliver safe, person-centred care.

The connection between workforce wellbeing and care quality is not theoretical. Under the CQC Single Assessment Framework, staff feedback is one of six formal evidence categories that feed directly into ratings.

An NIHR-funded study using Skills for Care and CQC data found that care worker pay has a significant positive effect on CQC ratings: a 10% increase in average hourly wage raised the likelihood of a Good or Outstanding rating by 7%.

For registered providers, this creates a direct line from workforce conditions to regulatory risk. A provider whose staff are experiencing financial insecurity, mental health strain, physical safety gaps, normalised boundary violations, is a provider whose ‘Well-led’ rating is at risk. That is not a people management problem.

It is a board-level governance problem.

The legislative environment reinforces this. The Worker Protection Act places proactive duties on employers.

The new harassment provisions apply to a sector where, as the report notes, the workforce is predominantly women, and where abuse from multiple directions - people supported, family members, colleagues - is documented and underreported. Boards that have not reviewed their policies in light of this legislation are carrying legal exposure they may not have assessed.

The financial case is equally direct. Skills for Care estimates the cost of replacing a care worker at up to £3,600. The sector's overall turnover rate was 23.1% in 2024-25, with the rate for frontline care workers running higher at 31.5%. For a provider with 100 staff, that is a recurring replacement cost running into six figures annually, before accounting for agency cover, quality dips during transitions, or the CQC risk that comes with high churn.

The Care Workers Charity report signals about what works.

Proactive wellbeing culture - There are times when providers wait until someone is struggling before offering support. By that point, the person has often already decided to leave. Wellbeing has to be built into supervision, team meetings, and into the everyday texture of management.

Regular, meaningful supervision - Supervision needs to cover more than task completion and progression misses the point. ‘How are you really feeling?’ is a question when the answer determines whether that person stays in the role and whether the people they support receive consistent care.

Safety as a non-negotiable – A question is raised about the times where providers are unable to withdraw from packages where staff safety cannot be assured. The answer requires a governance framework.

External support that workers will actually use - That workers are often reluctant to use employer-provided mental health support because of stigma. Providers who have addressed this offer external routes - employee assistance programmes, mental health first aid from trusted peers, coaching from outside the organisation. The design of the support matters as much as its existence.

The Care Workers Charity's data describes a workforce under sustained pressure - financial, emotional, physical, and relational. The regulatory framework now requires providers to demonstrate that they are addressing this pressure and that legislative environment are creating legal duties that go beyond good intentions.

The question for providers is whether the board has the data, the governance structures, and the accountability mechanisms to act on it.

A care worker who goes to work anxious, exhausted, financially stretched, and without adequate support cannot consistently deliver the care that the people they support deserve. That is an unfair expectation placed on the system that has not given them what they need to meet it.

Governance is how organisations make sure that gap gets closed.

The data in this article draws on the work of the Care Workers Charity, a UK charity dedicated to supporting paid care workers. Since 2020, the CWC has provided over £7 million in crisis grants to more than 14,000 care workers. In 2025 alone, it awarded hundreds totalling £366,316, processed in an average of nine days.

Forty-five percent of those grants went towards essential daily living costs, a further 17% covered car repairs and transport, a particular pressure point for domiciliary workers for whom a vehicle is not optional.

The Access Group is a proud partner and sponsor of the Care Workers Charity, contributing to fundraising efforts and helping raise awareness of the support the charity offers to care workers, through events like including skydiving, quarterly quizzes, and coffee pop-ups.

If you work in social care and are facing financial hardship, the Care Workers Charity offers crisis grants, mental wellbeing support, and signposting to further services.