By Clare Pelham, chief executive of Leonard Cheshire Disability and a member of the Demos Commission on Residential Care
Good care is about relationships between people; those receiving care and those providing it. Care workers are critical in determining the quality and safety of the care provided to thousands of disabled and older people every day. But we know that the 1.5 million workers across the country deserve much greater recognition for the work they do.
Over the past year, I have been working with the Demos Commission on Residential Care to look at the work of care staff. We have considered not only the practical support they provide – helping people to eat, drink or with personal and medical care – but also the emotional and social support and the strength of the relationships they build.
In many ways it confirmed exactly what I already knew. Care work is one of the most rewarding jobs around. Every day care workers change people’s lives for the better, helping them to live the lives they choose, in the way that they want. But it also reminded me that it is not easy and it is not for everyone.
Not only do many people lack the people skills – the compassion, energy and patience that are all essential qualities for care work – but we often fail to acknowledge the complexity of care work and the tremendous skills required to support people, often with very high needs, safely and with dignity. This is a job that is often challenging and stressful, and at times exhausting and distressing.
Recognition and reward
Yet all too rarely do care workers get the professional recognition and reward they deserve. Opportunities for career progression in social care are negligible, skills and experience are poorly recognised with a lack of formal accreditation, and pay is unacceptably low. This leads to high staff turnover and low morale.
Currently 78% of frontline care staff earn around £6.45 per hour – just 14p more than the minimum wage. The stark truth is that very often talented, experienced care workers leave because they cannot afford to stay and this is often devastating for the people they support.
At one time or another almost all of us will call on the dedication, skill and compassion of a care worker when we are most in need of care and support. If we are serious about making sure that care homes offer the kind of care that we would one day choose for ourselves or our families, we must pay a fair price for safety and quality, provided by highly-trained and motivated staff.
License to practice
One of the Commission’s recommendations is that social care must become a living wage sector and that care work must get the professional recognition it deserves. That means establishing a minimum level of training across the sector, independently accredited and leading to a license to practice.
And just as people should be conferred with a license to practice to recognise their skill and dedication, in the rare cases where care workers don’t uphold the right standards then this license can be revoked barring them from the profession.
Recognising care workers with a license to practice will go some way to giving them the professional recognition they deserve, valuing the work they do in line with other professions such as nursing, where work is critical to people’s safety. It will also allow care workers to move easily between care providers, reducing time spent duplicating training unnecessarily and meaning employers can be confident that all their staff meet a minimum standard of competence from day one.
But most of all it will hopefully provide a higher status for care – a profession that we want young people to aspire to and for all of us to admire.
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The licence to practise is not the most compelling response to the issues facing care workers and care work.
I would have hoped to see Demos expressing their concern at the implications of the rapidly increasing out-sourcing of residential, domiciliary and supported housing care and provision by public sector ‘commissioners’ to for-profit providers: privately owned, unaccountable and often with deliberately obscure financial and ownership structures. It is these companies who (along with cutting the residents’ food bills and skimping on maintenance) drive down the wages ( a very clear measure of the value of people’s work, and the esteem – or otherwise – in which they are held), cut training, reduce staffing and annual leave in the highly-skilled, labour-intensive ‘industry’ that is care work.
Demos could more usefully lend its support to the striking Care UK workers, defending their wages and conditions – and thereby residents’ standards of care – against a rapacious employerand indolent council interested only in the bottom line.
A step in the right direction. Hopefully such licensing and recognition will also empower the legion of dedicated people delivering hands on care.
So often dedicated and caring employees are abused by the pressures brought to bear on them by employers, managers, and systems. Often those least in a position to challenge or change what’s wrong in their work environments. There are assumptions made about the suitability and competences of employers and managers simply because they are in the most powerful roles and due to their professional qualifications and the safeguards presumed to apply in having such qualifications. These assumptions are sadly so often just that.