Bring our careforce in from the cold
Published on 06 November 2020 12:00 AM
Under embargo till 00.01hrs 7th November 2020 - or for Saturday’s papers
Time for Government to bring our care workforce in from the cold, says Charity in new report
Recent statistics show that despite providing a vital, life enhancing service, care workers still earn 24p less an hour than shop assistants
Age UK calls for pay equalisation with the NHS for the same job, after care workers tell Charity they were under supported, under rewarded and under protected during the first wave
A new report published today by Age UK shows how tough life has been for care workers during the pandemic. The report, ‘Time to bring our care workers in from the cold’, highlights the extent to which care workers have often had to put their own health and financial worries at the bottom of the pile while battling to keep the virus at bay and their clients safe and well.
Download the report
Those on the front line of this crisis have rightly been lauded as heroes, but for our care workers these have too often been merely warm words. The Charity is calling on the Government to do more to recognise their enormous contribution by improving their salaries so they are the same as those for people doing the equivalent job in the NHS, and by supporting their physical and mental wellbeing.
Today, care workers are still labouring on the frontline, working long hours to help older and disabled people, while being extremely tired and, in some cases, still coming to terms with the suffering and loss they witnessed and tried valiantly to prevent earlier in the pandemic.
Despite being roughly equivalent in size to the NHS workforce, the 1.65 million strong care workforce[i] has seen only relatively limited support put in place. While the NHS has been prioritised for PPE, testing, mental health support, priority access to shops and pay rises, offers to social care have been more limited and have generally only arrived late in the day.
On top of this, many care workers are left struggling to make ends meet, with the average salary for a care worker being only around £15,000[ii] about half the UK average. This means care workers are paid 24p less an hour than shop assistants, despite the vital nature of their role and the skill required to help people with complex needs. Meanwhile, their counterparts in the NHS have been awarded a real-terms pay increase up until 2020/2021.
As one Care Home Manager told us
“Money is always the elephant in the room, if I’m paid the bare minimum to deliver care safely, I can only pay my staff the bare minimum to do their jobs and the work that my staff have done, particularly at the moment, deserves better. Our care staff have to work an 80 hour week to earn £2500 per month, and in that 80 hour week every week, they are at risk of catching [Covid-19], and they work so hard.”
If terms and conditions are not urgently improved, Age UK delivers a stark warning for the future of care for older people. Even with a recent recruitment drive, the care sector in England still needs to fill around 122,000 job vacancies[iii] – a huge task. It was also estimated prior to the pandemic that to meet the needs of an ageing society the care workforce would need to grow by 2.6% every year until 2035, to a total of 2 million jobs. Need has been increased by the pandemic so that startling statistic is now in all likelihood an under-estimate.
The facts:
- Four in five social care workers reported that their mental health had been damaged by their work during the pandemic[iv]
- 42% of healthcare workers felt the Government had not done enough to support their mental health[v]
- One in ten care workers said they were aware of colleagues who continued to work, despite having COVID-19 symptoms[vi]
- 8% - percentage of respondents to Unisons’ survey of care workers who were told they would receive no pay at all if they had to self-isolate or were off sick[vii]
- 54% - percentage of care workers who were paid less than £8.72 prior to the New Living Wage rise
- £15,000 – the average salary of a care worker
- £4.18 million – the extra cost faced by providers for PPE for the months of April to September[viii]
- 1000% - the increase in the cost of masks reported in April [ix]. The cost of gloves increased by 30%, aprons by 166%[x].
- 122,000 – estimated number of care workforce vacancies before the pandemic
- 25% - average percentage of frontline care staff unable to work by the end of March[xi]
- 6.35 million - extra days that providers lost to staff sickness in March and July, more than twice what is usually expected[xii]
This national health emergency has thrown into sharp relief how poorly care workers are supported to do their work. During the pandemic we clapped for care staff to thank them for their amazing contributions, often carried out at risk to their own health. This richly deserved gratitude must now translate into practical improvements in care workers' terms and conditions.
Age UK believes the Government must:
Treat care workers fairly by:
- Implementing nationally set pay scales that providers must meet, that achieve parity with the NHS for the same roles, paid for through extra Government funding
- Making an improved learning and development offer to care workers so they are better equipped to care for people with increasingly complex needs.
- Ensuring that any new immigration system allows for overseas workers, including those from the E.U. to enter the country easily, to take up a role working in social care
- Support the physical and mental wellbeing of care staff through a national initiative, locally implemented, as the NHS has done with its ‘People Plan’.
Protect social care workers and those they care for throughout the pandemic by:
- Publishing a workforce plan which addresses minimum staffing ratios and how to increase the number of staff working in care
- Ensuring PPE of appropriate quality is readily available to all social care providers and really does reach everyone on the front line, not only those working in care homes
- Continuing to distribute money via the Infection Control Fund to support providers to meet the extra costs of PPE, and to allow care staff to remain on full pay if they have to self-isolate
- Tasking Skills for Care and the CQC to work with social care providers to spread good practice in managing and supporting care staff through the remainder of the pandemic.
Caroline Abrahams, Charity Director at Age UK said:
“We owe so much to the care workers of this country, who labour day in, day out to support millions of older and disabled people. They have had a torrid time during the pandemic and now we need to properly reward them for their staying power and their commitment.
“Older people often tell us how grateful they are for the help they receive from care staff and I know from the experience of my own Mum that they make a life-changing difference. But how have we allowed a position to be reached in which you can earn more working in a supermarket than providing vital care, and enjoy better terms, conditions and career opportunities in the NHS for doing precisely the same job?”
“The lack of Government funding for care often translates into exploitative working conditions for care staff, which in turn undermine the quality of care on offer to older and disabled people. Social care is above all a people business and if you don’t value the men and women who provide it you are undervaluing those who receive it too.”
“For the sake of everyone who needs social care as well as all those who deliver it we are calling on the Government to treat care workers fairly and provide the funding for them to get a decent wage. Their pay and conditions need levelling up to match those of similar roles in the NHS.
“The pandemic has shown how much we rely on social care and how badly it needs to be reformed, and a good place to start is by paying the workforce properly.”
Case Study:
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Isobel is 83 and a retired teacher living in London. She had a knee replacement in 2010, and a further knee operation in 2012. Isobel pushed for care support to help her get back on her feet, but unfortunately it wasn’t as good as she had hoped. Although the carers were very nice, and worked hard, Isobel felt that the care was minimal and the carers were put under too much pressure, with huge caseloads and limited support, pay and training. Years later she received NHS Rapid Response care after an eye operation, which she thought was outstanding.
Isobel believes that the system must be linked up with both physical and mental health services, with better terms for care workers which would result in better care for her friends who are receiving care right now, and for herself if she needs care in the future.
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“For goodness’ sake, join up medical care, mental health care and social care. I was touched by how inadequate that was - nobody knew I’d been in hospital, nobody knew what social care I was getting, or my mental health support. It’s all disconnected, it’s terrible.”
“I think the basic thing is to pay carers properly. There’s an attitude that they’re unskilled, but they are not. They are skilled workers. They need to be properly trained and paid properly.”
“I still see one of my carers on the estate, nice woman, how she does it all I’ll never know! I think there should be more publicity about the good work they do. You don’t see them on TV, do you?”
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I live alone in central London, just around the corner from Age UK Camden. I’m a retired teacher – I taught Geography initially and then became a Deputy Head so I was more focused on the admin and curriculum. I then went to Germany to teach English. I came back after 5 years, and I was 60 by then so I retired. God it was hard, it’s even harder now!
Experiences of receiving care
I had a knee replacement and I was sent home with no care at all, even though I live on my own. I think I asked for it at that time and they said “oh well you’re not 80 yet, you can’t have it because you’re not 80.” But I had a friend who used to work in the social services system and she told me I should have it. So it was taken up with the hospital and I eventually got some care and I had it for 6 weeks for free.
The carers I got were all women and they were very good, but they were run off their feet! It was crazy. When they had to go to their next appointment they had to walk there or pay their own fare to get there. And they were badly paid – I don’t think they were even getting the living wage. One of the carers was ill herself with terrible arthritis so she couldn’t do much. The care I got was good but it was minimal.
Then my replaced knee became infected which was horrible. I had to go back into hospital for a wash out, and I had care after that as well. The treatment didn’t work, and meanwhile my mental health was deteriorating, and I was in a fairly rotten state really. When I was in hospital I mentioned I was getting anxious and asked for some psychological help and I got nothing from the hospital so I had to find that myself. It took me ages to get any mental health support.
For goodness’ sake, join up medical care, mental health care and social care. I was touched by how inadequate that was - nobody knew I’d been in hospital, nobody knew what social care I was getting, or my mental health support. It’s all disconnected, it’s terrible. Eventually I got mental health help through a group for older people at the Peckwater Estate and they were marvellous.
Anyway, the washing out didn’t work so I had to have my knee taken out and I didn’t have a knee for 6 weeks. I had a spacer in, so of course I needed care then. As you can imagine, my mental state wasn’t getting any better. I’d learnt by then to ask for social care though, and social care was set up for the day I arrived home. But my big complaint, and it’s the same from everyone I know, was that it was a different carer almost every day and you don’t have a consistent carer, so you have to tell them time and time again where everything is.
The carers were good, but again, it was minimal. From what I asked them about their training, it didn’t sound like they were very well trained – maybe they had a day or something of training. And the whole question of their parent company coming out to monitor things – well it was minimal.
Another time, I fell over and my left eye was very damaged and I was taken to Moorfields Hospital. I went there, and we decided I should have it removed. While I was there, my neighbour rang and said don’t forget to get social care. It was very good because Moorfields phoned and I got a team called the Rapid Response and that was very good; there was someone waiting for me on the pavement when my ambulance came in and they were excellent. They were from the NHS, they were properly trained and they knew what they were doing. It’s only ever for 5 days, it’s for really short-term needs, but that’s the kind of service you need. So I had good care there, but the thing is was that it was in-house with the NHS, and there was no private profit there, so I think that tells a whole story.
What I think needs to change
I’m ardent about the care system and linking it up into an integrated system, ever since I had my own experience of it. The system isn’t easily accessible, and I don’t know where to go to find out what little things I can get help with.
What’s happened with care through Covid, well I think ‘yeah I could have told you about those problems!’ And thank goodness it’s all come forward and I hope we get something done about it!
I think the basic thing is to pay carers properly. There’s an attitude that they’re unskilled, but they are not. They are skilled workers. They need to be properly trained and paid properly. And they’ve got to have as few cases on each person as possible so that they can spend time with the person. Paying for their own travel is ridiculous, their basic conditions must be improved. There should be more feedback to and from their managers too.
A basic but quite wide reimagining of what a carer’s job and role can be needs to happen. They have low pay, low time and lack of understanding in some ways. Companies are just recruiting them and giving them a few basics. There’s got to be a national curriculum and standard for the training of carers.
The pay is terrible. It’s disgusting what they pay them. The Government can find those funds. I do wish it was all under the NHS, I really do.
I still see one of my carers on the estate, nice woman, how she does it all I’ll never know! I think there should be more publicity about the good work they do. You don’t see them on TV, do you?
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Notes to Editor
References.
[i] Skills for Care. (2020). Workforce Intelligence 2019-2020. Accessed via: https://www. skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/ documents/Size-of-the-adult-social-care-sector/Size-and-Structure-2020.pdf
[ii] Skills for Care. (2019). Workforce Estimates 2018/19. Accessed via: https://www. skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/ publications/The-state-of-the-adult-social-care-sector-and-workforce-in-England.aspx
[iv] GMB Scotland (April 2020) survey of 1000 social care workers in Scotland Accessed via: https://commonslibrary.parliament.uk/insights/ mental-health-awareness-week-the-impact-of-coronavirus-on-health-and-social-care-workers/
[v] IPPR (2020) Care fit for carers. Access via: https://www.ippr.org/files/2020-04/care-fit-for-carers-april20.pdf
[vii] . Unison. (2020) Accessed via: https://www. unison.org.uk/news/2020/03/protection-equipment-care-workers-essential-says-unison
[viii] (https://www.adass.org.uk/social-care-providers-face-more-than-6bn-in-extra-covid-19-costs)
[ix] https://www.theaccessgroup.com/blog/hsc-the-rising-cost-of-ppe-in-social-care/.
[x] Based on analysis for April to September if the detailed guidance is followed on its use and some current costs of PPE continue. ADASS (2020) Financial pressures in adult social care Information provided to the Minister of State for Care accessed via: https://www.adass.org. uk/social-care-providers-face-more-than-6bn-in-extra-covid-19-costs
[xi] Skills for Care. (2020). Covid-19 Workforce Survey. Accessed via: https://www.skillsforcare. org.uk/adult-social-care-workforce-data/ Workforce-intelligence/publications/Topics/ COVID-19/COVID-19-survey.aspx
[xii] Skills for Care. (2020). ASC-WDS Tracking. Accessed via: https://www.skillsforcare.org.uk/ adult-social-care-workforce-data/Workforce-intelligence/publications/Topics/COVID-19/ASC-WDS-Monthly-Tracking.aspx