#CareFitForCarers: Parity for Social Care

Social care is integral to our Covid-19 response. It is responsible for protecting and providing for some of the most vulnerable in our society. It is absolutely central to the government’s shielding strategy. And there is no exit strategy that will not rely on a strong social care sector.

Yet, public awareness of social care has often been low. There is significant confusion about the nature of social care services – particularly, where health ends and cares begins. If anything good comes from Covid-19, it will be a heightened awareness of our essential care sector and of social care workers – epitomised by the 8pm ‘Clap for Carers’ every Tuesday evening.

While a greater focus on social care is welcome, it must come alongside a frank recognition that many workers in the sector get a bad deal. More than a decade of severe funding pressure, driven in particular by austerity, has driven down wages. Progression and training are almost non-existent. And worker conditions can be poor, even exploitative.

This means social care workers and providers enter the Covid-19 crisis with significant problems around capacity and resilience. There are over 100,000 vacancies in the social care sector, and a staff turnover rate of over 40 per cent. Now more than ever, the government must act to better support the sector.

After all, if we do not do right by social care workers, we make it harder for them to do right by us.

To better understand what social care workers need during this crisis, IPPR ran a consultation through the sector. This provided 34 detailed responses from social care workers – on the frontline, in middle management and in senior roles. They shared the significant and diverse needs in the sector. This was integral to our call for #CareFitForCarers in our full report, released today.

Here, we explore the consultation response in more detail, outlining what Care Fit For Carers means in the social care setting. We argue workers need government to intervene, to ensure their safety through PPE and priority and testing. But we also highlight other key health and welfare needs, which must be met head on if the sector is to sustain its already remarkable efforts in the weeks, months and years to come.

PPE, Testing and Safety

Care workers and managers talked about the fear in the sector, linked in particular to a lack of PPE provision.

“Staff are frightened of what could happen. PPE is a concern, and they have gone into isolation after completing an NHS assessment…[staff] are frightened to come to work.”

A senior care manager

“Stress has increased, people are scared. It is likely to get worse. People are physically tired as they have to physically cover others who are self-isolating, many of whom could be at work but the lack of testing means they have to isolate.The lack of PPE is horrific. Lambs to the slaughter.”

A Managing Director in the care sector

Responses highlighted the range of PPE that social care providers lacked. For example:

“The government need to go more with regard to support with PPE most especially hand sanitizer that is out of reach for most providers. We need more support with aprons, gloves, wet goggles, and facemasks”

A Registered Manager

[I have] concerns over if PPE is effective. Difficult to concentrate. Feel emotional and drained whilst trying to stay positive for clients. Feel it’s going to get worse”

Home carer/domiciliary for the elderly

Government have already missed a number of pledges to provide the social care sector the protection they need. As a consequence, a significant number of care settings, particularly care homes, have reported Covid-19 outbreaks. Government must now move further and faster in increasing supply, and improving distribution.

Mental and Emotional Health: Anxiety, Stress, Fear and Burnout

They must also look to address a looming mental health crisis, hanging over the sector. People regularly highlighted the anxiety, stress and trauma caused by working during the outbreak – particularly, where they were not confident in their personal safety.

Further, a lack of testing has meant many staff who could be working, cannot. In a sector that already has over 100,000 vacancies and a 40 per cent turnover rates, this has increased workload and associated stress levels.

“There is a section of staff who have been immediately impacted by Covid-19 who have suffered increased levels of anxiety and fear due to the way in which social media, mainstream media and the government have handled this. There is another section for whom I am more worried who will deal with Covid-19 now but who will likely have some form of PTSD at the end of all this due to impact of deaths of people they support, colleagues and also the social, financial and emotional toll on their families and friends.”

A Chief Executive Officer

This was compounded by impact on relationships – with people not able to access their normal support network.

“Not having access to extended family and friends has put a strain on all. The long-term implications will not be seen for some time”

Registered Manager

It is well documented that disease outbreaks have a severe psychological impact on frontline staff. Extending bespoke and personalised interventions – including therapy – to the care sector will be a critical intervention.

Welfare, Pay and Finances

Pay in the social care sector is very low. A 2018 IPPR report showed that the average pay for a social care worker was just £9.14 per hour. That is 28 per cent lower than the median pay across the economy as a whole. For a senior care worker, that rose only slightly: to £9.62. This level of pay means the social care workforce is vulnerable to shocks – such as disruption to welfare services or unexpected sick leave.

Our consultation showed support for increased pay for the social care frontline – from both managers and care workers:

“I think [government could] uplift in fees, so we can pay our staff more in this situation, ensure the supply line of PPE will work and ensure people feel secure in their work”

Registered Manager

“It has impacted greatly…on how they will manage lives in general and pay bills etc”

Director

“I do not people who have been affected with finances (one lost both her jobs)”

Domiciliary Care Administrator

“[We need] help towards the increase in water bills due to extra hand washing, showering and washing of uniform. Holiday pay is based on average of 13 weeks prior and with lower client runs over time means lower holiday pay”

Home Carer

Covid-19 has highlighted how valuable their work is. It is time to better manage pay in the social care sector. This should benchmark social care worker pay against NHS pay scales – providing pay regulation and progression – funded by central government. Government should also fund a 10 per cent pay rise for frontline staff – recognising how they have gone above and beyond during this period of national crisis.

Outside of pay, consultation respondents often discussed the limits of their safety net. The financial impact of unpaid care commitments was highlighted:

“Some of the staff have had to self isolate to take care of members of their family…this takes a great toll on their earning, not being able to meet mortgage payment, rents, utility bills, council tax and other financial commitments.”

Registered Manager

“Childcare is an issue for staff, as is public transport. Some staff who have been unable to work will be on statutory sick pay so mortgage relief would be useful”

Chief Executive Officer

Extending existing childcare provision - as in Wales – will help keep social care workers in work, and reduce anxiety on the frontline.

Recognition and Sector Parity

Finally, respondents of all grades highlighted the need for reward and recognition. Social care workers have too often been categorised as unskilled – and most earn the minimum wage. Yet, their response to this crisis shows just how incredibly valuable the work they do is.

“A little ‘thank you’ compensation would go a long way and could actually encourage more people to work (who can work…)”

Domiciliary Care Administrator

“[We need] Greater recognition of care workers in general, most of whom are on NLW [National living Wage] but caring for the most vulnerable in society”

Social Care Business Development Manager

“[We need to] Reward our staff that are going into clients that are symptomatic or Covid-19 positive. Remember, these care workers only receive NLW and SSP [Statutory Sick Pay] (due to poor funding from local authority]”

A Director and Nominated Individual

A badge is not enough. The pay award described above is a more meaningful way to recognise this sector. Further, introducing a new bank holiday from next year – to recognise health and care workers alike – would be an excellent way to embed the sentiment of the 8pm claps into our everyday lives.

Care Fit For Carers

In summary, social care needs Care Fit for Carers – and in particularly government to:

• Upgrade PPE and testing capacity, so safety can be guaranteed for all health and care workers
• Provide care workers accommodation, near work, if they need it – already (partially) available to NHS workers.
• Cover rental arrears for carers if they need help – recognising many are taking huge risks, but are often only entitled to Statutory Sick Pay if they get ill.
• Extend mental health provision to the social care sector, so everyone gets personalised support
• Pay workers in the health and care sector their full salary, if they fall sick, rather than a pitifully low Statutory Sick Pay.
• Provide a government-funded Covid-19 pay award of 10 per cent, and – in the longer-term – benchmarking social care worker pay against NHS Band 3.
• Extend funded childcare provision available to social care workers, to help them stay in work.

This cannot be a replacement for bringing much needed stability to the social care market. IPPR have previously called for better regulation, and provision of free universal personal care. But at a time of crisis, it will give our frontline the support they need to keep us – and our most vulnerable people – as safe as possible.

The blog follows the release of Care Fit For Carers – IPPR’s new research paper on supporting the health and care workforce during and beyond the Covid-19 crisis. You can find more reactions and join the debate on twitter using #CareFitForCarers.