Care workers should be registered and licensed, recommends Labour review

Care workers should be registered and licensed and the Care Quality Commission (CQC) given powers to prosecute any providers employing unlicensed staff, a report commissioned by Labour leader Ed Miliband has recommended.

Miliband asked Labour peer Baroness Denise Kingsmill in 2013 to conduct a review into exploitation in the care sector, including the use of zero hours contracts and growing prevalence of 15-minute time slots.

At the launch of her report on Thursday, Kingsmill said hearing about the poor standards of care resulting from rushed visits and overworked, undervalued staff made her “furious”.

She said the sector was full of “committed, caring people as a whole, but they are largely invisible” because they are unregistered and not properly regulated. “Most of us will require this kind of care at some point in our lives, and look at the mess [the system is] in.”

In her introduction to the report, she notes that low pay is another factor making it harder to attract “ambitious and compassionate young people” to the sector, creating instead a low-skilled workforce that is particularly vulnerable to exploitation.

Speaking at the launch, Liz Kendall, shadow care minister, revealed that half of the 201 providers inspected by HMRC to date have failed to pay the national minimum wage – meaning care workers are owed at least £1m in arrears.

Kingsmill’s recommendations are:

1. All care managers must be registered and have a licence to practise. This should be extended to care workers, by widening the remit of the Health and Care Professions Council (HCPC) to regulate this group of staff. The CQC should be given powers to prosecute any providers employing unlicensed managers or staff.
2. The CQC should be required to monitor non-payment of the national minimum wage and HMRC should take a more proactive approach to enforcing the law.
3. Exploitative zero hours contracts, such as those preventing staff from working for other employers, should be banned, and staff should be paid for “standby time” if the employer requires them to be available for work at short notice.
4. The CQC should be responsible for ensuring local authorities follow the principles of a care charter, putting an end to 15-minute time slots.
5. Skills for Care’s role in tackling poor standards and raising levels of training should be strengthened.
6. The remit of the CQC should be extended to protecting care workers from exploitation.

Responding to the recommendations, CQC pointed out that it already has the power to take regulatory action against providers if it finds during its inspections that visiting times are not sufficient to meet the level of care needed.

A spokesperson added: “Rather than making a judgement on whether 15 minutes is enough, our new approach to inspection – which we are consulting on until June – is based around what matters most to the public (are services safe, caring, effective, well-led and responsive to people’s needs) and so, we will explore whether they allow enough time to ensure care is delivered compassionately and in a way that treats people with dignity and respect.”

The HCPC has looked into the regulation of care workers and proposed setting up a negative register, similar to a barring scheme.

A spokesperson said: “The Law Commissions [who recently recommended that the government should have powers to establish barring schemes, to be run by the health and social care regulators] concur with our view that barring schemes are a proportionate and cost effective alternative to full statutory regulation and ensure higher levels of public protection than voluntary or self-regulatory arrangements.”