Changes in demographic and regulations in social care in England are expected to alter the social care landscape and increase pressure on people working in the adult social care sector, especially those who deliver direct care services. While significant work has been done to understand the demand side of the adult social care system, work on the supply side is considerably limited and analysis has been dominated by methods such as macro- and micro-simulation. This paper demonstrates that system dynamics modelling can be used to understand the dynamics of the social care workforce who deliver direct care services in the formal sector, specifically, to identify the main feedback loops that govern the dynamics of the system, to identify sensitive and influential factors, and to show non-linearity in the system. Therefore, system dynamics should play a more important role in the analysis of adult social care system.
For the first time in history, the number of people over 65 in England is greater than those under 16 (Department of Health, 2009). This significant change in demographic poses a real challenge to providing quality social care for this population. In 2007/08, there were around 1.75 million adults using social care services and this number was expected to rise significantly (Department of Health, 2009). It is estimated that by 2026, 1.7 million more adults in England will use social care services (Care Quality Commission, 2010). Regulations since 2000, like the Care Standards Act, have been instituted to ensure that this burgeoning population receives good quality of care. A number of reforms in social care have been created in response to the current socio-economic situation. One of these reforms is the personalization agenda, in which care users will have more choices and control over their care. These regulations and reforms are expected to dramatically alter the social care landscape and to put increasing pressure on people working in the adult social care sector, especially those who deliver direct care services (i.e., help care users to perform the everyday activities such as getting out of bed, getting dressed and into work, choosing what and when to eat, getting out of the house, etc).