Care workers’ lack of power at work behind tolerance of poor pay and conditions, finds report

Sense of vocation, low union membership and lack of alternative flexible employment options reducing workers' ability to challenge poor work environment, finds Resolution Foundation

Care worker putting a bandage on a man's arm in his home.
Photo: dglimages/Adobe Stock

Care workers’ weak power in the workplace helps explain why they put up with poor pay and conditions, a report has found.

Their sense of vocation, low levels of trade union membership and a lack of alternative flexible employment options reduced their bargaining power with employers, found the Resolution Foundation study.

This resulted in wages being persistently low and some domiciliary care workers being paid, unlawfully, below the national minimum wage (NMW) or national living wage (NLW), because their travel time was not recompensed.

The report – based on data analysis and focus groups with three groups of staff – also raised concerns about the impact of high vacancies on workloads and staff safety, and the working conditions of personal assistants (PAs), which it said were often “insecure and informal”.

The think-tank called for a wage floor for care work that was £2 per hour above the NLW, or in the case of those aged under 23, the NMW, to both tackle understaffing and reduce the risks of staff being paid unlawfully low wages. It also urged tougher enforcement of minimum wage laws in the sector and minimum employment standards for PAs.

Social care losing ground to other low-paid sectors

Drawing on Office for National Statistics data, the Resolution Foundation said the median hourly wage for frontline care workers, as of April 2022, was £10.90, less than for low-paid jobs in offices, call centres, transport and the NHS.

At the same time, the pay premium social care had previously enjoyed over other low-paid sectors  – including retail, hospitality and cleaning – had fallen from 5% to 1%, from 2011-21, according to the government’s Migration Advisory Committee.

The Resolution Foundation also highlighted the lack of reward for experience, which was flagged up in Skills for Care’s annual report on the workforce for 2021-22, which showed that experienced staff earned just 7p per hour more than newcomers.

While average wages for domiciliary care staff (£11.07 per hour) were higher than for residential care staff (£10.50 per hour), their effective pay rate was often depressed by not being paid for travel time.

Unlawful pay

While time spent travelling counts as working time, it is lawful for employers not to pay staff for this so long as their wages are not driven below the NMW or NLW as a result.

However, based on previous Homecare Association estimates that home care staff spend a fifth of their time travelling, the foundation calculated that those on median pay would effectively be earning £9.20 an hour, 30p below the current NLW.

The report also cited 2017 research that found that care staff were more likely to report “going above and beyond”, feeling exhausted and experiencing a high level of tension in their work than those in other sectors.

Staff in the focus groups linked this to workforce shortages, which have got much worse recently, on the back of a 52% rise in vacancies in 2021-22.

For PAs specifically, it said that the unregulated nature of their work suited some, but left others “highly exposed to poor and potentially unlawful treatment”.

It linked this to the fact that one in ten were classed as self-employed – meaning they were not entitled to the NMW or NLW, holiday pay or notice period. The report said this was questionable as it was not easy for PAs to substitute another worker for themselves, a key test of self-employment.

High levels of job satisfaction

Despite their pay and working conditions, care staff enjoyed relative job security, because they were in high demand, with rates of redundancy and dismissal being much lower than those for other low-paid roles, the report said.

In addition, home care and care home staff and PAs in the focus groups reported high levels of job satisfaction.

This was based on the positive difference they made to people’s lives, the relationships they built up with the people they cared for, their feeling that they were doing a skilled job, with high levels of responsibility, and their sense of autonomy in their roles.

This was backed up by 2017 research, which found that 88% of care staff were satisfied in their job, compared with 83% of staff in other low-paid roles.

The foundation linked this to the fact that, despite high turnover in adult social care, staff were relatively unlikely to quit the sector altogether. Between 2011 and 2020, 1.5% of staff moved out of frontline care work per quarter, lower than for other low-paid sectors.

Low bargaining power

The report said this sense of vocation was one reason for care workers’ lack of bargaining power with employers in relation to their working conditions.

However, this was also caused by a lack of alternative employment, in the context of the workforce being predominantly female, with about 20% being women with dependent children, which was relatively high compared to other occupations.

Focus group participants said that social care work offered the flexibility to fit working patterns around childcare that they could not find elsewhere.

The report also said that the low rates of union membership – 20% overall and about 15% in the private sector – limited care workers’ bargaining power.

Making care jobs good jobs

It concluded that the negative aspects of care work were not inherent but “the result of how we fund and organise the sector” and amenable to policy change.

In a report last year, the Migration Advisory Committee, which advises ministers on immigration and the labour market, said that social care needed a minimum wage at least £1 an hour above the statutory wage floor, to tackle its recruitment challenges.

The Resolution Foundation said there was a case for going further, and giving the sector a £2 wage premium, meaning minimum pay would rise to £11.50 an hour now (compared to an NLW of £9.50) and £12.42 in April, when the NLW rises to £10.42.

It said this would lead to more than half of care staff seeing an improvement in their pay and lift the sector clear of other low-paid occupations in the labour market.

It would also make it unlikely that domiciliary care staff would be paid below the NMW or NLW.

The recommendation, it calculated, would require an 8% rise in adult social care expenditure, though the Treasury would gain half of this back in increased tax receipts and lower benefits payments.

‘Until wages rise, the sector will be in crisis’

In response to the report, UNISON head of social care Gavin Edwards said: “This research is spot on. Care workers love their jobs and the people they look after, but they’re not being treated very well by ministers or many employers.

“Until care wages rise, the sector will be forever in a state of crisis. In these tough times, many staff are reluctantly leaving care for jobs paying significantly more.

“An enhanced minimum wage and payment for every hour worked in care would help improve the sector’s dreadful vacancy rates.”

Poor pay ‘rooted in commissioning practices’

On behalf of home care employers, the Homecare Association said it had long argued that staff be paid in line with band 3 healthcare assistants, whose gross pay is currently equivalent to £11.12 an hour.

Chief executive Jane Townson linked poor pay to commissioning practices, saying: “70% of homecare is commissioned by the public sector and 70% of the costs are staffing.

“Poor commissioning practices by local councils and the NHS have led directly to poor pay and employment terms and conditions for care workers. Homecare is regularly commissioned on a minute-by-minute basis for direct contact time, often at fee rates significantly below the cost of delivering quality care.

“In some circumstances this is even below the direct cost of employing a care worker at minimum wage plus statutory employment on-costs, never mind contributing to the other costs of running a homecare agency. ”

She added: We call on the government to provide sustainable funding for homecare, to ensure fair treatment of care workers, compliance with regulations, and financial viability of providers, so that quality services are maintained for the benefit of individuals and communities.”


One Response to Care workers’ lack of power at work behind tolerance of poor pay and conditions, finds report

  1. Chris Sterry January 26, 2023 at 4:32 pm #

    In many instances I do agree with this report, especially of the low pay of care workers and the lack of effective travel pay to cover all expenses as while distance could be covered, time may not be. In some instances the timing between caring for one person and the time needed to get to another, is virtually impossible to do, especially where traffic conditions are far from good.

    Yes, some care providers could do much more for the care workers they employ, but as their funding comes mainly from Local Authorities (LAs) and a fair proportion of LAs funding comes through the Government grants to LAs, which has been considerably reducing in real terms since 2010 due to the Tory imposed Austerity Cuts. But, in effect was social care really correctly funded before 2010, I feel not as social care has never been sufficiently funded.

    A great mistake was not to include social care within the NHS in 1948 and with hindsight this should have occurred, then there wouldn’t have been to ‘toing and froing’ between LAs and Continuing Health Care (CHC) as to who should fund what and the duplicity of some work would also have been mitigated.

    Not saying that the funding would have improved greatly as the NHS has also been seriously underfunded to some extent over the years.

    What does need to be done is to greatly improve the pay rate for all care workers and I would say at least £15 per hour as this would encourage more to enter the care profession. But also allow more immigration so many non-UK persons can come to the UK to also enter the care profession. In doing so also improve the travel expenses and other working terms and conditions, such as recognised holiday pay, sick pay and others.

    All are needed as for some times many persons in need of social care have not been receiving any or if some, nowhere near the required amounts. Demand for social care is forever increasing while in real terms the funding has been reducing. Much of this lack of social care has been taken on by family carers well past when their own health has deteriorated, in which case this again increases the demand and need for social care and eventually much more care within the NHS.

    This Government and all future Government have to listen and take this on board as no Government has done previously, if at all, for not to do so will not just be the demise of Social Care, but also the NHS.

    The start of this has been happening for years, but now it is much more evident, but still this Government is not listening, is it because they are failing to see the problem or, more likely no wish to see the problem.