Engage: What to do about poor working conditions in adult social care

Baroness Kingsmill’s independent report for the Labour Party paints a disturbing picture of working conditions in the adult care sector. Her findings highlight underlying issues that have not been fully addressed in the wider debate about the pressures on social care services. They remind us that, whatever the future pressures, current services are being delivered only because the staff on whom the system depends are generally far from well-rewarded for their efforts.

The Baroness’s report suggests that:

  •     between 160,000 and 220,000 care workers are unlawfully paid less than the National Minimum Wage
  •     investigation into 80 Care Providers found that almost half were not compliant with National Minimum Wage regulations
  •     around 307,000 care workers, or a fifth of the workforce, are on ‘Zero Hours Contracts’, meaning they do not have stable hours each week or a stable income

The report also points to evidence that many care sector apprentices receive no general training, and that nearly a half of all care workers get no specialist training on the specific needs of people with conditions such as dementia and stroke-related disabilities.

The report goes on to say that the pressures of 15 minute care slots, low pay and exploitative working practices make it harder to attract, motivate or retain the workforce, with reported turnover said to be 19% a year in residential care, and 30% in domiciliary care. The sector also struggles to attract young people, with nearly half of employees aged 46 or older.

Recommendations in the report focus on the need to improve the status of the profession with a Licence to Practice for all care workers, introduced , in the first instance, for care managers, and with systems to support staff progression. The report also calls for a CQC-led Care Charter to guide procurement processes.

But the nitty-gritty of the recommendations calls for:

  •     enforcement of the National Minimum Wage
  •     the outlawing of ‘Zero Hours Contracts’
  •     the ending 15 minute Care slots
  •     and aiming to achieve the Living Wage for care workers

There are comments in the introduction to the report that suggest some improvements can be made without adding to the overall care bill. But I think that ducks the issue.

We have a funding system for social care that is universally recognised as inadequate, both in its structure and in the volume of resource it delivers to the sector. There is widespread recognition that pressures in the system will grow rapidly over the coming years. The debate about how to address those problems has pretty steadfastly refused to recognise that the pressures are there, even though we get the labour for the system very much ‘on the cheap’

If we want to maintain services in the light of those pressures, and improve conditions for the staff working in the service – that must have a cost, and that should be properly recognised. The failure to meet minimum wage obligations, and the use of zero-hours contracts and 15 minute time slots, are – like it or not – how much of the system currently gets by.

Unless profits in the private sector, where most providers operate, are unduly high, or their businesses are otherwise inordinately inefficient, getting rid of these practices must have a cost to commissioners, and, in the end, to you and me, as tax-payers.

If we don’t face up to those facts, the danger is that politicians, of all parties, will continue to focus on the wider funding equation, keeping their fingers crossed that no-one will notice the poor pay and conditions on which the system is built.

About the Author

The article was written by Jim Kennedy who is Editor at CareKnowledge.

CareKnowledge is a web-based portal that supports professional workforce development across social care and health. It contains up-to-date information about policy, practice and research developments in social care and health and is published by Pavilion Publishing and Media Ltd.

To follow the blog, visit: http://www.careknowledge.com/ck_blogs.aspx

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