Adult social care is built around the wellbeing of other people.
Every day, care workers help individuals feel safe, remain independent, manage complex conditions, maintain relationships and live with dignity.
They respond when someone becomes distressed.
They recognise subtle changes in health.
They reassure families.
They manage risk, medication, mobility, personal care and increasingly complex clinical responsibilities.
They are expected to remain patient, attentive and compassionate, often while working under considerable operational pressure.
Yet there is a question the sector has not always asked with the same consistency:
What does delivering care cost the person providing it?
The latest national workforce research offers a more detailed answer than the sector has previously had.
Published by the Department of Health and Social Care on 2 July 2026, the second wave of the adult social care workforce survey examines life satisfaction, anxiety, financial security, workplace relationships, safety, development and intentions to leave.
There is genuine improvement within the findings.
Life satisfaction is higher.
More workers feel happy and believe what they do is worthwhile.
Financial security has improved.
Fewer people say they intend to leave as soon as they find another job.
These changes should be recognised.
But the data also reveals a workforce still carrying a significant hidden burden.
Two in five workers report high anxiety.
More than half lack sufficient financial security.
Almost half regularly worry about work outside their paid hours.
Physical violence, harassment and abuse remain widespread.
And among people considering leaving their jobs, stress and burnout remain the most commonly reported reason.
The message for providers is not that the workforce is failing to cope.
It is that too much of the system continues to depend on people coping with conditions that should be better understood, managed and improved.
The Picture Is Improving — But the Starting Point Matters
The survey’s most encouraging finding is that overall wellbeing has improved across three of the four measures used by the Office for National Statistics.
The proportion of the adult social care workforce reporting high or very high life satisfaction increased from 41% to 51%.
High happiness rose from 45% to 55%.
Almost two-thirds of respondents, 63%, now give a high or very high rating when asked whether the things they do in life feel worthwhile, up from 52%.
These are meaningful gains.
They reflect the purpose many people find in care, the strength of workplace relationships and the work providers have undertaken to rebuild services after an exceptionally difficult period.
But the report itself provides an important warning against overinterpreting the improvement.
The first survey was conducted in the aftermath of the COVID-19 pandemic, when adult social care was experiencing extraordinary levels of pressure. Some of the recovery may therefore represent a return towards greater normality rather than the resolution of deeper workforce problems.
That distinction matters.
A workforce feeling better than it did during one of the most difficult periods in its history is not necessarily a workforce receiving everything it needs.
The question for providers is not simply whether wellbeing scores have risen.
It is whether the organisation has created working conditions in which those improvements can continue.
Care’s Greatest Strength Remains Its Sense of Purpose
The strongest findings in the survey relate to the human relationships at the centre of care.
Nine in ten workers report having good relationships with the people they support.
A similar proportion, 92%, believe they have the skills and knowledge needed to perform their role.
Three-quarters say they can make a difference in people’s lives.
Nearly nine in ten report good professional relationships with colleagues.
These figures help explain why people remain in adult social care despite the pressure surrounding them.
Care offers something many roles cannot.
The outcome of the work is visible.
A worker can see when someone feels calmer because they arrived.
They can recognise when consistent support has prevented a hospital admission.
They can watch someone regain a skill, develop confidence or participate in something that once felt impossible.
That sense of purpose is a significant workforce asset.
But it should not be used as a substitute for fair employment, safe working conditions or effective support.
Purpose can motivate people.
It cannot indefinitely compensate for exhaustion, financial insecurity, poor management or an unmanageable workload.
The strongest providers will protect the meaning people find in care by addressing the conditions that can gradually erode it.
Anxiety Remains Deeply Embedded
Although life satisfaction and happiness have improved, anxiety has barely moved.
Two in five members of the workforce, 40%, continue to rate their anxiety as high. The corresponding figure in the first wave was 42%.
This should not be treated as a general wellbeing statistic sitting outside normal service management.
Anxiety can affect:
- sleep and recovery;
- concentration;
- confidence;
- communication;
- absence;
- decision-making;
- emotional resilience;
- and willingness to accept further responsibility.
It may be connected to work, finances, health, caring responsibilities or circumstances outside employment.
Often, several factors are operating together.
The survey also shows that the experience is not evenly distributed.
Disabled members of the workforce report lower life satisfaction and considerably higher anxiety than non-disabled colleagues. Workers who have unpaid caring responsibilities also report lower wellbeing and higher anxiety than those without those responsibilities.
A single organisation-wide wellbeing offer may therefore be insufficient.
Providers need to understand which groups are experiencing the greatest pressure, what is driving it and whether existing support is genuinely accessible to them.
A poster displaying an employee helpline is not the same as a workforce wellbeing strategy.
A strategy begins with listening, evidence and a willingness to change the conditions contributing to distress.
When Work Continues After the Shift Ends
One of the most revealing findings concerns what happens when employees leave the workplace.
Just under half of the workforce, 46%, say they often or constantly worry about work outside working hours. Among registered managers, the proportion rises to 71%.
Workers supporting people with dementia, brain injury, stroke, mental-health conditions, sensory impairments and physical disabilities are also more likely than average to carry that worry beyond their paid time.
This is an understandable human response to work involving responsibility for another person’s safety and wellbeing.
A worker may replay an incident.
A manager may worry about the following day’s rota.
Someone may question whether they noticed a developing health concern quickly enough.
A team leader may remain concerned about an employee, resident or family conversation.
But when this becomes constant, it suggests that the emotional boundary between work and personal life is no longer functioning effectively.
That creates a different kind of unpaid labour.
The worker may have left the building, completed their visits or logged out of the system, but the demands of the role remain active in their mind.
Providers should therefore consider:
- whether responsibilities are clearly handed over;
- whether employees receive reassurance after difficult events;
- whether managers can escalate unresolved concerns;
- whether people feel confident that someone else has taken responsibility;
- and whether working practices allow genuine psychological separation at the end of a shift.
This is particularly important for managers.
The data shows that registered managers report relatively positive professional relationships and support overall. Yet among those considering leaving, 70% identify the effect of stress and burnout on their health and wellbeing as a reason.
A manager can feel valued, capable and supported while still carrying an unsustainable volume of responsibility.
Those two realities can exist at the same time.
Almost Half Cannot Consistently Look After Themselves at Work
The workforce survey defines self-care at work in practical terms: having enough time to eat, drink, rest and take comfort breaks.
Almost half of respondents, 48%, say they are only sometimes or rarely able to look after themselves in this way.
This is not primarily a conversation about wellness activities.
It is about whether the basic design of work allows people to meet ordinary human needs.
A wellbeing programme cannot compensate for employees repeatedly missing breaks.
A mindfulness application cannot correct an unmanageable rota.
A resilience course cannot create enough time to travel between visits.
A wellbeing day cannot undo months of excessive workload.
Individual support has value, particularly when someone is experiencing poor mental health or a personal crisis.
But the first responsibility is to examine the work itself.
NICE recommends that employers adopt a preventive, organisation-wide approach to mental wellbeing, considering workload, job quality, autonomy, culture and the design of work before relying on individual interventions alone.
For care providers, that means reviewing:
- staffing levels;
- shift design;
- travel planning;
- handovers;
- administrative duplication;
- availability of rest areas;
- access to food and drink;
- escalation routes;
- and the amount of unpaid work being carried outside scheduled hours.
The aim is not to remove all pressure from care.
That would be unrealistic.
It is to prevent avoidable operational pressure from becoming a permanent feature of the employee experience.
Financial Insecurity Is a Workforce Wellbeing Issue
The new data shows progress in financial wellbeing, but it also exposes the scale of the remaining problem.
The proportion of the workforce reporting financial security increased from 32% to 44%.
That is a substantial improvement.
But it still means that 56% say they have insufficient or no financial security.
More than two-thirds believe the cost of living is too high.
Almost half say their hourly rate is too low.
More than a third identify a lack of sick pay.
Workers also report uncertainty about future income, insufficient payment for night work and sleep-ins, and inadequate or absent payment for travel between visits.
The effects extend beyond dissatisfaction with pay.
Financial insecurity can influence whether someone:
- takes time off when ill;
- accepts unsafe levels of overtime;
- can afford reliable transport;
- remains in a role with variable hours;
- accesses healthy food;
- pays for childcare;
- contributes to a pension;
- or feels able to manage an unexpected expense.
It can also intensify anxiety that originates elsewhere.
The provider may not be able to control every economic pressure affecting employees.
Commissioning rates, public funding and market conditions impose genuine limits.
But there remains a meaningful difference between pressures a provider cannot remove and those it can understand, reduce or manage more fairly.
That may include:
- checking that all working time is paid correctly;
- improving visibility of available benefits;
- offering greater predictability of hours;
- reviewing travel and mileage arrangements;
- ensuring training time is paid appropriately;
- providing early access to earned income where suitable;
- improving pension communication;
- offering confidential financial guidance;
- and identifying emergency-support routes.
Financial wellbeing services, payroll technology, benefits platforms and specialist advisers can all contribute.
But their role should support fair employment practice rather than distract from it.
The starting question must remain:
Are our people being paid accurately, transparently and fairly for the work they perform?
Employment Conditions Shape Whether People Can Stay
When workers were asked which employment benefits mattered most, paid annual leave was the most frequently selected.
Flexible working that fits personal and family life was also highly valued, alongside paid training, guaranteed hours and additional pay for antisocial working times.
These are not peripheral benefits.
They determine whether a role can be sustained around real life.
A parent may value a predictable pattern more than occasional overtime.
A worker with unpaid caring responsibilities may need greater flexibility.
Someone living alone may require guaranteed hours.
An employee managing a long-term condition may place particular importance on sick pay and supportive adjustments.
The wellbeing conversation therefore needs to move beyond asking employees whether they are happy.
It should ask whether the structure of employment allows them to remain.
Providers should understand which conditions matter most to different parts of their workforce and where the greatest mismatch exists between employee need and organisational practice.
This does not mean every preference can be accommodated.
It means that workforce decisions should be informed by evidence rather than assumptions.
Violence and Harassment Cannot Become an Accepted Part of Care
Some of the most serious findings concern workplace safety.
Two in five members of the adult social care workforce report experiencing physical violence from someone they care for or support at least once during the previous year.
More than half of those affected experienced violence on at least three occasions.
Harassment, abuse and bullying from people receiving care were reported at a similarly high level.
Workers also described harassment, bullying or abuse from colleagues, managers and relatives of people receiving support.
There is important context.
Aggression may arise from dementia, brain injury, mental ill health, distress, communication difficulty, trauma or unmet need.
A person displaying behaviour that places others at risk may not intend harm in a conventional sense.
That requires compassionate, clinically informed and person-centred support.
But understanding the cause does not mean the effect on employees should be ignored.
Workers still require:
- suitable risk assessments;
- adequate staffing;
- appropriate training;
- access to specialist advice;
- reliable incident reporting;
- post-incident support;
- and meaningful review of what could prevent repetition.
Where incidents become frequent, they should not be normalised as simply part of the job.
Repeated exposure can affect confidence, mental health, absence and retention. Survey participants who experienced violence reported lower care work-related quality of life, and the longitudinal analysis found an association between experiencing or witnessing violence and later leaving the sector.
Providers should expect safety, training and technology partners to help produce identifiable outcomes.
That may mean faster incident escalation, stronger lone-worker protection, better behaviour-support planning, improved learning after events or greater confidence among staff.
The goal is not only to record what happened.
It is to reduce the likelihood and impact of it happening again.
The Workforce Is Carrying More Clinical Responsibility
The survey also provides new insight into delegated healthcare activities.
Three in five workers in direct-care roles say they sometimes or often undertake activities delegated by regulated professionals.
These can include pressure-ulcer care, blood-glucose monitoring, physiotherapy exercises, post-operative support and helping someone follow a mental-health plan.
Most workers delivering these activities report confidence in doing so.
However, 85% receive no additional pay for carrying them out, and only 2% say their hourly rate increased when they assumed the responsibility.
This finding should prompt a wider discussion about how the role of the care worker is changing.
Adult social care is supporting people with greater complexity.
Care teams are increasingly involved in activities that sit across traditional health and social care boundaries.
This can be positive.
Appropriate delegation may help people receive timely support from a familiar worker, avoid unnecessary appointments and remain safely at home.
But it also creates questions about:
- competence;
- accountability;
- supervision;
- workload;
- recognition;
- training;
- documentation;
- and reward.
A worker may be proud to develop a new skill while also feeling that the increased responsibility has not been recognised.
Providers need a clear framework showing which activities are delegated, who authorised them, how competence was assessed, when it will be reviewed and whether the employee’s role and remuneration still reflect what is being asked of them.
Learning providers, clinical educators, digital care systems and competency-assessment specialists can help create that assurance.
But the outcome should be more than completed training.
It should be a workforce that understands its responsibilities, feels confident performing them and is recognised appropriately for doing so.
Wellbeing and Retention Are Directly Connected
The strongest case for action comes from the survey’s longitudinal analysis.
Workers with high care work-related quality-of-life scores during the first wave were considerably more likely to remain in the same role with the same employer two years later.
Among those with high scores, 74% remained, compared with 56% of those reporting low scores.
Workers with higher life satisfaction were also more likely to remain in the same role.
Career-development opportunities showed a similar relationship: 82% of workers who previously believed they had opportunities to progress were still with the same employer, compared with 69% of those who did not.
This is important because it moves workforce wellbeing beyond moral responsibility alone.
Supporting staff is unquestionably the right thing to do.
It is also connected to:
- retention;
- continuity;
- recruitment costs;
- agency dependency;
- absence;
- management capacity;
- quality;
- and organisational resilience.
Wellbeing should therefore appear in workforce dashboards, board reports and service-improvement plans.
It should not be delegated entirely to HR or discussed only during awareness weeks.
CQC’s workforce wellbeing and enablement quality statement expects providers to recognise and meet the wellbeing needs of staff so that they can deliver safe, effective and person-centred care.
The regulatory connection is clear.
Workforce wellbeing is part of care quality.
Why Wellbeing Initiatives Sometimes Fail
Many providers are already investing in wellbeing.
They may offer:
- counselling;
- employee-assistance programmes;
- wellbeing applications;
- mental-health training;
- recognition schemes;
- staff events;
- benefits platforms;
- or access to financial guidance.
These can all be valuable.
The difficulty arises when the intervention is disconnected from the cause of the pressure.
An employee may be offered counselling while continuing to work an unpredictable rota.
A manager may attend resilience training while carrying an unmanageable caseload.
A team may receive wellbeing resources while repeated incidents remain unresolved.
A care worker may be given retail discounts while struggling to understand why their wages vary each month.
Support offered at the individual level cannot permanently correct problems created at the organisational level.
The strongest wellbeing strategy therefore works in three layers.
Prevent pressure where possible
Review workload, working patterns, staffing, communication, pay accuracy, safety and job design.
Identify developing pressure early
Use supervision, employee feedback, absence patterns, incident information and manager observation to recognise when people are beginning to struggle.
Provide timely specialist support
Ensure employees can access confidential mental-health, occupational-health, financial or practical support when they need it.
NICE recommends this tiered approach, with organisation-wide prevention forming the foundation before individual and targeted interventions are added.
This creates a more honest standard for providers and solution partners.
The question is not:
What wellbeing activity have we introduced?
It is:
What workforce pressure are we trying to reduce, and is the situation improving?
The Manager Cannot Carry Everyone Alone
Managers are often the first people expected to notice when an employee is struggling.
They are asked to listen, reassure, make adjustments, resolve conflict, respond to absence and maintain morale.
At the same time, they may be experiencing some of the highest levels of work-related worry themselves.
A sustainable wellbeing approach must therefore support managers without making them solely responsible for the emotional wellbeing of the entire workforce.
Managers need:
- practical training in supportive conversations;
- clear escalation routes;
- access to HR and occupational-health advice;
- permission to make reasonable adjustments;
- reliable workforce information;
- peer support;
- protected supervision;
- and somewhere to take concerns that they cannot resolve alone.
They also need support for their own wellbeing.
A manager who is permanently available, constantly covering gaps and unable to switch off cannot provide unlimited emotional capacity to others.
Technology can help by reducing repetitive administration, making information more visible and identifying patterns earlier.
External expertise can help with difficult employment, health or wellbeing situations.
But the most important protection is organisational: responsibility must be shared.
Listening Must Lead to Visible Action
Staff surveys are useful only when employees believe that honest feedback produces a response.
Providers should gather information through several routes:
- short pulse surveys;
- supervision;
- team meetings;
- exit interviews;
- absence reviews;
- incident debriefs;
- anonymous feedback;
- wellbeing champions;
- and workforce data.
But collection is only the first stage.
Leaders must explain:
- what employees said;
- what the organisation learned;
- which actions will follow;
- what cannot be changed immediately;
- and when progress will be reviewed.
This closes the feedback loop.
It also builds trust.
Repeatedly asking people how they feel without changing anything can make disengagement worse.
A smaller number of visible actions may create more confidence than an extensive wellbeing plan that employees rarely see.
Skills for Care’s practical workforce resources encourage providers to adopt structured, evidence-led approaches rather than relying on isolated activities. Its wellbeing-champion model is presented as a scalable route to improving morale and creating a more stable workforce when properly planned and sustained.
What Should Providers Be Measuring?
Wellbeing cannot be fully reduced to a dashboard.
Human experience is more complex than a score.
But providers still need enough visibility to identify risk and evaluate whether action is working.
Useful measures may include:
- employee wellbeing and engagement responses;
- sickness and short-term absence;
- stress-related absence;
- turnover by service and role;
- first-year retention;
- overtime and additional hours;
- missed or shortened breaks;
- rota changes;
- incidents of violence and harassment;
- use of employee-support services;
- supervision completion;
- financial-payroll queries;
- grievances;
- career-development participation;
- and reasons for leaving.
The data should be examined by location, team and role.
An organisation-wide average can conceal a service experiencing much greater pressure than the rest of the group.
Leaders should also avoid treating high use of a support service as evidence of failure.
It may indicate that employees trust the service and know how to access it.
The more useful questions are:
- Is help being reached early?
- Are recurring causes being identified?
- Is the support appropriate?
- Are organisational changes happening alongside individual assistance?
- Are outcomes improving over time?
A Practical 90-Day Workforce Wellbeing Review
Providers do not need to solve every workforce issue immediately.
But they can create a disciplined starting point.
Days 1 to 30: establish the real picture
Bring together workforce data, employee feedback, incidents, absence, overtime, turnover and payroll concerns.
Identify the services, roles and groups experiencing the greatest pressure.
Review whether existing support is known, trusted and accessible.
Days 31 to 60: address the most preventable pressures
Select a small number of priorities.
These may include rota instability, missed breaks, weak post-incident support, manager overload, inaccurate pay, limited supervision or poor communication.
Assign responsibility and define the outcome expected.
Days 61 to 90: measure and embed
Review whether the intervention has changed the employee experience.
Share progress with staff.
Continue what is working, adapt what is not and place the agreed measures into routine workforce governance.
This approach turns wellbeing into a continuous improvement programme.
It also creates a clearer basis for deciding where specialist external support is genuinely required.
What Should Providers Expect from Wellbeing Partners?
The adult social care workforce challenge creates a legitimate role for organisations specialising in:
- employee assistance;
- mental-health support;
- occupational health;
- financial wellbeing;
- staff benefits;
- workforce analytics;
- rostering;
- payroll;
- learning and development;
- incident management;
- lone-worker safety;
- leadership development;
- and employee engagement.
But providers should expect these organisations to understand the operational realities of care.
A credible partner should be able to explain:
- which workforce pressure it addresses;
- how employees access the support;
- how confidentiality is protected;
- what burden it removes from managers;
- how it works for shift-based and dispersed teams;
- how impact will be evaluated;
- and what outcome should improve.
That outcome might be:
- earlier access to help;
- reduced absence;
- more accurate pay;
- improved manager confidence;
- safer lone working;
- fewer repeated incidents;
- greater rota predictability;
- improved retention;
- or stronger employee feedback.
The solution should not simply add another portal, application or telephone number.
It should make support easier to reach and a difficult part of working life measurably better.
Questions Care Leaders Should Be Asking
Owners, boards, nominated individuals, registered managers and workforce leaders should now be asking:
- Which parts of our workforce report the greatest anxiety or pressure?
- How many employees regularly work without adequate breaks?
- Where is work being carried beyond paid hours?
- Do our rotas and employment conditions support a sustainable working life?
- Are employees being paid accurately for training, travel and additional responsibilities?
- What happens after an employee experiences violence, harassment or a traumatic incident?
- Are managers equipped and supported to hold effective wellbeing conversations?
- Can staff access confidential specialist support quickly?
- Do employees believe their feedback creates change?
- What evidence shows that our wellbeing activity is improving retention, safety or quality?
These questions connect wellbeing to the operation of the service rather than treating it as an isolated workforce initiative.
Caring for the People Who Care
The new workforce data contains reasons for optimism.
More people report satisfaction, happiness and a sense that their lives are worthwhile.
Most feel skilled.
Most value their relationships with the people they support.
Fewer say they plan to leave immediately.
Those are important signs of recovery.
But the hidden cost of caring remains high.
Anxiety is widespread.
Financial security is absent for much of the workforce.
Work follows many employees home.
Violence and harassment continue to affect large numbers of people.
Managers carry responsibility beyond their working hours.
And stress and burnout remain the leading reasons given by workers considering departure.
The answer is not to portray the workforce as damaged or unable to cope.
Adult social care has repeatedly demonstrated extraordinary capability and resilience.
The answer is to stop relying on that resilience as an unlimited resource.
A stronger care workforce will be built through fairer work, safer environments, better management support, meaningful development, timely specialist help and genuine attention to what employees are saying.
Wellbeing is not separate from retention.
It is not separate from quality.
And it is not separate from the experience of the people receiving care.
When workers feel safe, supported, recognised and able to recover, they are more able to offer the patience, judgement and consistency on which good care depends.
Caring for the workforce is therefore not an additional promise made after every other operational priority has been met.
It is one of the conditions that allows those priorities to be met at all.
Frequently Asked Questions
What does the latest adult social care workforce wellbeing data show?
The 2026 publication shows improvements in life satisfaction, happiness, financial security and intention to remain. However, 40% of the workforce still reports high anxiety, 56% lacks sufficient financial security and 46% often or constantly worries about work outside working hours.
What is the biggest reason care workers consider leaving?
Among survey respondents considering departure, the most frequently selected reason was the impact of stress and burnout on health and wellbeing, reported by 60%. Low income, lack of recognition and not feeling valued or supported were also major factors.
How can care providers improve workforce wellbeing?
Providers should begin by addressing organisational causes such as workload, rota design, working conditions, pay accuracy, safety and management support. Individual services such as counselling, occupational health and financial guidance should then be added as accessible and targeted support.
Is workforce wellbeing relevant to CQC assessment?
Yes. CQC’s workforce wellbeing and enablement quality statement expects providers to promote staff wellbeing and support employees to deliver safe, effective and person-centred care.
Does better workforce wellbeing improve retention?
The longitudinal survey found that 74% of workers with high care work-related quality-of-life scores remained in the same role with the same employer, compared with 56% of those with low scores. The findings demonstrate a strong association between wellbeing and retention.
Editorial sources
This feature has been developed using evidence available by 6 July 2026, preserving the integrity of its backdated publication position.
- Department of Health and Social Care, The work-related quality of life of the adult social care workforce in England in 2025, published 2 July 2026.
- Department of Health and Social Care, executive summary of the wave-two adult social care workforce survey.
- Care England, analysis of the new adult social care workforce survey, published 3 July 2026.
- Skills for Care, Workforce Strategy for Adult Social Care in England.
- Care Quality Commission, Workforce wellbeing and enablement.
- NICE, Mental wellbeing at work: recommendations.
