Reforms must not ignore the challenges facing the social care workforce

Paid care workers are key to delivering the government’s reforms, yet the white paper pays them scant attention, By Nick Johnson

It is difficult to feel confident about the care and support white paper. This is not just because of the lack of funding to deliver its aspirations, but because it fails to address the challenges facing social care workers.

Both the white paper and the draft bill that would enact it recognise people who use care and support services as individuals who deserve a personalised approach. What the Social Care Association (SCA) has been trying to get strategists to acknowledge is that care workers must be recognised as individuals in the same way.

Achievement of most, if not all, of the stated outcomes for service users will depend on another human being. In many cases, this will be an informal, unpaid carer. They are widely referenced in the documents and their position will undoubtedly improve if the bill is enacted. Similarly, in full “big society” mode, there will be money available to develop community capacity to deliver the extras that make good support excellent through local volunteer programmes.

However, with 76% of us likely to need some kind of care and support in later life, it is inevitable that paid care workers will continue to play a central role. Yet the white paper pays them scant attention other than almost passing references to “workforce”.

The focus under both the current and last governments on development of personal budgets, direct payments, shared lives support models and so on has meant this previously “wholesale” workforce is being dismantled into the “retail” response model required by these kinds of service. Cost reductions being achieved through these models are primarily savings from the infrastructure that monitors, controls and supports service delivery.

In response to this, the sector’s trade unions are the weakest they have been for many years. And even when the British Association of Social Workers and the College of Social Work finally get their act together, they will assist only a tiny fraction – perhaps 8% – of all social care workers.

There are a few relatively small professional bodies, of which the SCA is one, attempting to support the other 92%. As far as I know, none of us has been included in any of the quality initiative groups mentioned in the white paper and draft bill. Corporate trade bodies and more powerful lobbyists have of course been included, yet it is the paid social care workers – currently more than 1.5 million individuals – who will be the key to delivering this agenda.

We had hoped also that the Department of Health would seek to know the social care market in the same way that Sir David Nicholson, NHS chief executive, knows and maintains weekly contact with the health service. The market is, after all, bigger in numbers than the NHS and not so long ago we were being prepared by a Labour government for creation of a national care service.

The reality is that if the department’s social care division was a bank, it would be in trouble for its lack of control. It does not have the most basic information about whom we are dealing with – who the customer base is – even via its arm’s length regulator.

When failures occur, the workers concerned are (quite rightly) rounded on and pilloried. But when the dust settles, they become the “workforce” again. The veterinary nurse who looks after your cat is better regulated and trained, as standard, than the person taking care of your grandmother with dementia – there’s a thought. Oh, and they are probably better paid.

Nick Johnson is chief executive of the Social Care Association