In our latest ESRC-sponsored Ask the Expert seminar, Jill Manthorpe, Professor of Social Work and Director of the Social Care Workforce Research Unit at Kings College London, discussed the key policy challenges facing the social care workforce.
By Andrew Barlow, SMF Research Intern
Ask the Expert seminars are an hour long, with a half hour presentation followed by a half hour Q&A. This was a particularly fitting format for our seminar on today’s key social care policy challenges, as Professor Manthorpe pointed out at the start of her informative presentation. Half an hour is generally the length of time of a home care call; the length of time that social care workers get with their service users each week to try and build a relationship, change sheets, empty catheters, throw out old groceries and often cook a meal too.
There are several trends that have shaped the social care policy landscape in recent decades. Perhaps most significant is the development of robust data on the workforce. Twenty years ago, the social care sector was considered a data desert. Thanks to the efforts of Skills for Care, we now have the National Minimum Data Set for Social Care covering thousands of care worker’s roles, locations and the circumstances in which they work and commute. Professor Manthorpe considers it ‘a triumph of engineering, confidence and collaboration’.
The decline in unemployment in the general population has had fairly profound effects on the way the sector recruits and retains staff. Full employment is making itself felt on social care. On the other hand, the national living wage has made an appreciable difference to the quality of life for many care workers; significant numbers of employers who had insisted they were unable to pay their staff more have found it possible to pay living wage rates after all. Although a majority of managerial roles within the sector now have wages that roughly correspond to those in the NHS, there are still large numbers of vacancies. The importance of managers in establishing and entrenching values in organisations cannot be overstated, which makes these vacancies in the sector a particularly pressing issue.
The tension between the NHS and the social care sector regarding recruitment persists. The former continues to view the latter’s workforce as a perfect recruiting ground due to the skills and experience that care workers have. Professor Manthorpe strongly criticised the view that people should be given a job in social care work so they are ‘NHS ready’, suggesting that if anything it should be this paradigm should be reversed.
Finally, aspects to the job have become incredibly – and perhaps overly – demanding. Care workers are now expected to provide concentrated care, which involves household work like cooking, cleaning and changing sheets, with personal care, much of which is often highly skilled. There is simply not enough time to attend to all the needs of a service user in half an hour when they also require peg feeding, are double incontinent or need help with intravenous medication. This on top of a rise in reports of physical strain, as increasing numbers of service users have heavy medical machinery which needs moving.
Professor Manthorpe then turned to the policy solutions.
If the major issues are ones of recruitment, then the focus must be on apprenticeships and age friendliness.
- Skills for Care are conducting research on whether apprentices continue in the social care workforce or go on to supplement other workforces. If their findings suggest the latter, an overhaul of the structure and direction of social care apprenticeships might be required to ensure that the social care sector is not simply training employees of other workforces.
- Recent research by the Social Care Workforce Research Unit at Kings’ found that elements of age prejudice exist in the sector, with young people often viewed as too unreliable and inexperienced to deliver proper social care to service users, and old people viewed as lacking technological skills and resistant to change. These serve as barriers to workforce participation and progression and foster an unwelcome culture in the sector.
More have argued, however, that the issues facing the social care workforce are ones of retention, not recruitment. Research suggests that the solutions to these issues, and the options that policymakers should be most actively pursuing, lie in appreciable differentials. That further training and accreditations are not seen as simply good for the individual in some tangential way, but result increased responsibility and larger pay packages.
- Currently, senior care workers and assistant managers very often earn only slightly more than their staff. There’s no incentive to shoulder the extra responsibility that comes with those roles – roles often termed ‘the glue’ that holds a social care organisation together, who are there on shift responding to crises when and as they happen.
- The reward system must become more person-centred. One idea touted would be to introduce reward cards similar to the NHS 70-year anniversary cards which gave holders discounts at a variety of shops and restaurants.
Professor Manthorpe ended the presentation with the findings of a recent report by her unit. Surveying 144 care workers revealed an abject failure to deliver parity of esteem in the sector. One of the most common phrases used was ‘I’m only a care worker’. More worryingly, many reported that their children had been told if they don’t work hard they would end up working in care. Very few reported working in social care was an ambition. The lack of esteem has been internalised. The findings are a call for action. The conditions, pay and the way our society views care workers must improve to sufficiently reflect the demands of the job and the important role it plays in the lives of so many.