Licence to practice for care workers will improve status of the profession, says Demos Commission

A licence to practice would help to ensure consistent, good quality care across care work, according to the Demos Commission on Residential Care.

The commission’s report, published today, outlines a new vision for the future of residential care and follows a year-long inquiry that brought together sector experts, academics and care providers.

One of the report’s key recommendations is the introduction of a registration system for care workers in England. The commission says this would maintain standards and ensure all care workers receive a minimum level of training before they are able to support people without supervision.

Paul Burstow MP, former care minister and chair of the Commission, said: “We need a minimum training standard, the certification of which is independently accredited and portable across the sector. In short, a licence to practice. Those not meeting the basic standard would not be able to work in the sector, nor would those struck off for malpractice.”

The licence to practice recommendation echoes previous calls for the registration of social care workers, including the findings of the Labour review into the exploitation of care workers and the Health and Care Professions Council’s (HCPC) recent proposals for a negative register.

Des Kelly, executive director of the National Care Forum and member of the Commission, said: “Part of the difficulty that we have had for a long time is that care workers are seen as a low paid, low skilled and low status workforce.

“If we want a workforce that is highly recognised and professionalised then a licence to practice and the standing that goes with being a registered practitioner needs to be part of that package.”

The Commission’s report also calls for residential care to be made a living wage sector, in order to gain greater recognition for the profession. It argues that enforcing the living wage will boost staff morale, reduce turnover and help tackle the negative perceptions that have damaged the reputation of the sector.

Stephen Burke, director of online ratings service the Good Care Guide, welcomed the proposals: “Care staff are the key to the quality of care and I would welcome a licence for all care workers so they have a minimum level of training, as well as a living wage for care staff. They need to be well trained and properly paid, as well as supervised and led by good managers.”

A planning revolution

The report also proposes that NHS trusts sell surplus land next to hospitals to allow the construction of more care homes and supported living apartments to meet increasing demand.

It states that less than 40% of land held by NHS trusts is currently being used for hospitals, leaving more than 5,000 hectares of land potentially available for care homes or supported living accommodation.

The Commission calls for the introduction of incentives, such as accelerated planning permission or reduced purchases prices, to sell surplus land to providers who are willing to reserve space for state-funded care or to contribute to local authority services.

It also says that co-locating care settings with educational institutions or community centres would help to change negative perceptions of care homes.

According to the report, only 24% of people would consider moving into care if they became frailer in old age, compared with 43% who would not.

“As we are living longer lives, housing with care [residential care] is going to become increasingly important in helping us to stay independent, happy and healthy,” said Burstow.

“It is vital that government wake up to this reality sooner rather than later and helps create the right incentives to ensure older and disabled people have a genuine choice when they need to move.”

Other recommendations include:

• Removing the term ‘residential care’ from registration, local commissioning and national policy and replacing it with ‘housing with care’ to better describe the options available to service users
• Expanding the role of the Care Quality Commission to include the inspection of local health and care commissioners, not just providers
• Requiring all care providers to publish and respond to official feedback and complaints about their services via their website to encourage a culture of transparency and accountability

John Kennedy, director of care services at the Joseph Rowntree Foundation, also welcomed the report: “Preparing properly for our ageing society is a crucial task we cannot afford to shirk and how we manage and support care homes is a crucial part of the debate. The Commission’s recommendations provide an important challenge to us all.”

Claudia Wood, chief executive of Demos, added: “The Commission is calling for bold changes in the way residential care is inspected, commissioned and built to ensure the sector is fit for purpose and can meet the needs of an ageing population.

“Only by thinking big can we ensure that a 21st Century vision for care will be reached.”