Just days after Age UK released a report warning that the social care system risks “total collapse”, care homes across the country celebrated Professional Care Workers’ Day on 4th September. Organised by the National Association of Care and Support Workers (NACAS), the annual event is part of their campaign for care work to be recognised as a skilled and respectable profession. The sector is desperately undervalued, not least by politicians: Boris Johnson may have pledged to fix social care “once and for all”, but the green paper – first promised in 2017 – is still yet to be published, with reform plans now unlikely to be revealed until next year. So what needs to happen for care and support work to be valued, not only by government, but also in the eyes of society?
According to NACAS, it comes down to professionalisation: care workers should receive thorough, in-service training and a better salary. Although the Skills for Care Certificate was introduced in 2015 as an induction for adult social care workers, it was never accredited – and its application varies across providers. For Karolina Gerlich, care worker and founding director of NACAS, it is no longer fit for purpose:
“The issue with the Care Certificate is that it can either be two days or three months long – there is no quality assurance from one Care Certificate to another. There are some care providers who make it a good qualification, but this is on an individual basis.
“Considering how complicated the skills are in social care, the industry really needs an approved and accredited qualification, and this should be standardised across the sector.”
Without good staff training, those in care are inevitably left at risk – not only because mistakes are more likely, but also because care workers who feel undervalued and underpaid frequently move on. According to HFT’s 2018 Sector Pulse Check report, 80% of care providers cited low wages as the biggest barrier to recruiting and retaining staff. The number of providers who said agency fees is their biggest financial pressure also rose sharply from 13% to 63% last year, as providers struggled to fill their rotas and had to take on more agency workers.
Yazmina Suleyman worked for two care agencies in Brighton and Hove for two years, doing homecare visits and going into retirement centres and supported living homes. She says the only training she received at both agencies lasted two days, and was not sufficient to support the range of individuals she was caring for.
“When you’re dealing with such a cross-section of people with complex needs, it doesn’t matter if you’ve had training on how to use a hoist, for example – what about mental health?
“For instance, I’d never received any training on how to support a paranoid schizophrenic. I was working at a day centre for drug addicts and one of the ladies there said to me: ‘Oh, you’ll be fine with Colin – just remember not to turn your back on him.’
“I had to go into this incredibly damaged man’s room, with no training on how to dispose of needles. I met people who said: ‘Oh yeah, I got pricked in Colin’s room.’”
Yazmina’s experience of limited face-to-face training is not unusual. Cleo Dibb has worked in supported living services for 13 years, and her first job was at a private care provider in Sussex. All of her induction training was online:
“When I started I was made to read the company policies, and then do loads of e-learning. It’s scary that you can just do an online module, and then you can give someone medication.”
Now the Service User Involvement Manager at The Grace Eyre Foundation, Cleo has received in-service training over the years and believes this should be a core part of any care provision. She says the common lack of in-person training is down to limited funding, which has worsened in recent years due to increased cuts to councils:
“Even at Grace Eyre, 90% of our funding still comes from the local authority. So where does the squeeze hit? When training is not enforced or regulated, that’s what gets cut.”
Cleo believes another part of the problem with care work being undervalued lies with the term ‘carer’ itself, as it suggests this ability is the most fundamental part of the job:
“I think we’ve relied on this notion for too long, and that’s partly why it’s been underfunded for so long. I’ve always harshly said that I don’t ‘care’ – and while that’s not the truth, I say that because I believe the reason I’m a good support worker is because of the training I had, and not my ability to care.
“If you think about women being seen as ‘natural’ care-givers, and then you think about the industry being overrepresented by women, that makes you draw parallels with mothering or caring being constantly undervalued by society – but caring isn’t actually what makes a good support worker.
“When you’re working with people with challenging behaviours, you don’t want to rely on your natural instincts – you need a measured, well-thought out response which is consistent across your team. And that requires training.”
As well as the need for better quality training and an accredited qualification, Boris Johnson could look to Northern Ireland for ways to improve the health of the sector in England, and introduce the compulsory registration of care workers. A report by the Department of Health in Northern Ireland earlier this year shows how the introduction of professional standards and the registration of the workforce has reduced risks for service users, and 73% of providers believe it has improved the quality of care. Registrants reported feeling more confident in their roles, and more accountable.
This week, some of the care workers from around the country were able to take advantage of free consultations with physiotherapists, psychologists and financial advisors at the Professional Care Workers’ Day well-being festival in London. Karolina at NACAS is hopeful for change, but knows it could be a long time before care workers get the recognition they deserve:
“The whole sector is frustrated about how little the government is interested. There is a lot of learning to be done on the politicians’ part – if you continue underfunding social care, then that is detrimental to the health service, and quality of care is simply not going to improve without more funding.
“If I am honest, I do not think it is going to happen soon. But we are trying to make things better at the moment without the government.”