The social care workforce: Overworked, undervalued and poorly paid
On 27 April 2022, Public Policy Projects (PPP) hosted a roundtable entitled The Social Care Workforce: Averting a Crisis as part of its report series The Future of Social Care. The PPP Social Care Network, made up of senior cross-sector stakeholders in social care and a Lived Experience Panel, sought to find practical solutions to the challenges relating to the workforce.
The crisis facing social care is fundamentally a workforce one, and low pay and poor working conditions are impacting the experience of staff and end users alike.
One Network member described the long journey they have had with trying to find carers for their son, and how “the problems with the social care workforce have now caused [their] son to receive inadequate care”. For the Network member, it was evident that poor conditions for workers make it difficult to consistently provide high levels of care.
Social care: A fulfilling and worthwhile career
The Network members emphasised that social care can be a fulfilling and worthwhile career. However, one member expressed that “Nobody talks about it.”
“Nobody talks about the difference they’ve made to somebody’s life, somebody who lived at home and couldn’t manage independently anymore, and their friends and family were under enormous pressure,” they explained.
A social care career is a skilled and challenging career route, but tends not to be publicly regarded as one. Social care must become a more attractive and respected career path for students.
Network members with experience working in universities noted that very few students harbour ambitions to go into social care, with greater ambition being shown towards childcare, social work, the NHS or physiotherapy. Put simply by one network member, “there is simply no ambition to be an adult social care worker”.
Improved advertising campaigns offer one solution. One network member shared a heart-warming TikTok showing the day-to-day life of a carer supporting a disabled adult, showing that his profession was not simply that of a support worker, but a “gym buddy”, a “swim coach”, a “karaoke performer”, a “culinary professor”, and a “Lego architect”.
The video showcased the bond he has with the individual he cares for and the varied tasks in his working day, demonstrating the positive aspects of a career in social care. The Network member suggested that it “might inform recruitment campaigns” for social care in England.
A clear career trajectory
Network members were in general agreement that social care requires a clearer career trajectory. If there was a visible route for progression within the system, the sector would be more attractive to young, bright school leavers and university graduates. It was suggested that cross sector career paths should be formed.
“No one in any career expects to progress without spending time in different departments; we need to do the same in social care and for its providers”, said one member.
To attract more people to the sector, there needs to be greater clarity of the differentiation in provision. Not every member of the caring profession does the same job there are a variety of roles, areas of expertise, and levels of seniority which people should be made aware of.
We must make caring into a proud profession in its own right, not something that is ancillary to nursing.
Recognising social care qualifications
A career in social care may be more attractive if it were formally recognised. One Network member criticized the care certificate as it is not an accredited qualification. The only way that the care certificate would be accredited through the QCF would be through the employer hiring a qualified assessor “and the cost of that for the employer is astronomical, so most employers don’t do that”. This makes the care certificate “almost redundant and it certainly doesn’t attract young people to the sector to see it as a long-term career”.
One network member mentioned that Florence Nightingale is generally crediting with “professionalising” the role of nurses, and that the Royal College of Nursing was later founded at a time when, arguably, nurses were performing many of the hands-on caring jobs performed today by care assistants.
The network member added “as far as I can ascertain, They Royal College of Nursing does currently admit some care assistants, but only those working in roles directly supervised by nurses .This excludes most care workers. We must make caring into a proud profession in its own right, not something that is ancillary to nursing”. The network member added that there is perhaps a case to be made for the establishment of a College of Care Assistants or workers.
Care workers should be paid fairly for the value of their work, and the level of skill and expertise required.
Better pay for care staff
Across the Network, there has been a consistent consensus that carers must receive better pay, and the latest meeting showed no change of course on this point.
It was described as “scandalous” that professions such as retail work and cleaning are paid more than social care, despite being less technically and emotionally demanding. One Network member, as a provider of care, expressed outrage that “[they] get to pay £10 an hour in a town where you can get £15 for dog walking, how can this be conducive to successful recruitment and retention?”
While there was widespread agreement on the fact that carers are underpaid, some Network members warned against the idea of increasing pay to be a cure all to the current workforce crisis.
“There is an unnerving conflation between the rate at which staff should be paid for their skills, and whether that will attract them to work in the sector. These two things are being confused. Care workers should be paid fairly for the value of their work, and the level of skill and expertise required, which is not the same as raising pay in the hope that the system would receive an influx of workers.”
This point serves to emphasize that any changes to the workforce must start with a fundamental change in attitudes toward social care work, and “this will then lead to a conversation about what we pay our professional staff”.
Support and collaboration
The latest MHA care workforce report showed a 23 per cent disparity exists in pay between the NHS and comparable roles in social care. “A big part of that gap is salary, but a significant portion comes from disparities around sick pay, payment for additional hours worked, and pensions, which are all benefits that social care providers cannot hold a candle to.”
It was broadly agreed that the social care system should mirror the NHS Agenda for Change pay scale. If the NHS and social care are to work more closely within integrated care systems (ICSs), then staff must undoubtedly be paid the same for equivalent roles.
One network member highlighted that this would facilitate the better collaboration of multidisciplinary teams, ultimately enabling better care. They also promoted the concept of new “cross-sector roles”, working across different departments in health and social care, which would help to facilitate easier patient flow throughout the system.
Without the right support structures in place, the social care workforce will continue to face a struggle in providing quality of care. In order to successfully implement meaningful changes, the PPP Social Care Network could all agree that a fundamental change in attitude to value the social care workforce is necessary.
The roundtable concluded with a sentiment shared by the Network, “Carers need to be paid more money, they need to be supported and valued more highly by society so that they can lead full and active lives”.
For more information on PPP’s work on social care, please contact policy analyst Mary Brown at Mary.email@example.com