The pay and working conditions of our predominantly female care workforce are already a national scandal. Cuts to council budgets can only make matters worse
The crisis in our care services is widely acknowledged and uncontested. White after green paper, royal commission after law commission, select committee after academic reports have all highlighted the looming funding and human crises in adult social care.
Alongside concern over future funding there is rightly a growing demand for more personalised, quality care, while essential, publicly-funded support services like meals-on-wheels and day centres are disappearing.
The Local Government Association’s ‘Funding Outlook for Councils 2010/11 – 2018/20′ said that expenditure on social care would exceed 45% of council spending by 2020 ‘eating up other budgets as it does so’. Since the number of those receiving funded care has already dropped by 40% since 2009, many more will slip out of the safety net by the end of the decade.
The service has been fragmented and privatised too. 85% of councils in England now only provide care when need is ‘substantial’. Two thirds of domiciliary care comes from myriad private and voluntary sector organisations, 4% by the NHS, 21% by personal assistants and just 9% by councils.
Amidst the genuine angst and policy twists and turns surrounding social care, carers themselves rarely get much of a mention. UNISON asked our members employed in home care what had happened to pay and conditions over the last year and how cuts have impacted on the service.
Their responses and personal testimonies in our ‘Time to Care’ survey released on 6 October paint a shocking picture of an exploited, underpaid and unrewarded workforce and a service creaking at the seams. Without the underpaid and unpaid goodwill of women, many of our elderly would receive just the bare essentials of care, stripped of those human touches that often make life bearable.
An important 2011 study by Dr Shereen Hussein of the Social Care Workforce Research Unit highlighted the problem of poverty pay. It showed that between 150,0000 and 200,000 people in the social care workforce were earning below the National Minimum Wage. In essence employers are breaking the law which requires them to pay a minimum wage of £6.20 pence an hour from this month, up from £6.08 pence last year.
UNISON’s survey shows that for 56% of respondents pay has continued to decline over the last year, with the same percentage earning between just £6.08 and £8 an hour for complex and demanding work. 60% had had their hours cut and 52% had been given additional duties within the same working hours.
Nowhere is the exploitation of the homecare workforce clearer than in the failure of many employers to pay for travel time between visits or adequate fuel allowances. A shocking 58% of our members surveyed are not paid for travel time, with a marked distinction between local authorities and external providers: just 19% of the latter paid compared to 89% of councils paying up. 25% spend over 6 hours each week in unpaid travel time.
This puts many employers are in breach of National Minimum Wage regulations – a fact confirmed by HMRC in response to a complaint by UNISON. Travel time between visits should be considered as working time, so failure to pay for it frequently tips the hourly rate below the legal minimum. Add to this cuts in fuel allowances and this is what you get:
‘ Petrol not enough to cover mileage. 10 minute calls for meds normally should be 15 minutes. Not paid for travelling from client to client…every hour a carer works on average (she) will lose 15 mins pay with travelling’
‘Currently proposing to drop mileage allowance from 40p per mile to 30p per mile and also want to stop paying travel time’
‘No travel time between clients and no lunch time’
Casualisation of a predominantly outsourced workforce is also evident in our survey. 56% of those working for private or voluntary sector employers are on zero-hours contracts, as are 22% of local authority employees. 61% of all respondents have varying amounts of monthly pay, making it difficult to budget or make expenditure plans. This inability to plan or seek other work makes life stressful. It also means frequent changes in carers for clients – a deeply unpopular aspect of the service:
‘ A zero hours contract means that in practice I may receive my rota for the week just one day in advance, and sometimes less. This makes it impossible to plan my week and leaves me feeling anxious and stressed. The low pay and unpredictable hours also means I have to be continuously in search for other work, although it is very difficult to commit to a regular second job due to the unpredictability of the weekly hours offered.’
‘Time to Care’ also reveals other shocking findings: only 40% of those employed by external providers receive sick pay, compared to 91% in councils. Although 71% of our members received some ongoing training, 41% received no training to deal with specialist needs such as dementia, strokes or stoma care. 24% have to administer medicines or carry out medical procedures such as changing colostomy bags without specialist training too.
But while declining pay and conditions and lack of training are very serious problems faced by homecare workers, our survey also throws a spotlight on the impact that ‘austerity’ is having on the the time they have to care and hence the quality of service. Carers rarely spoke just about themselves, but also about the impact that cuts and under-funded commissioning are having on the service they can provide. This was frequently a cause of stress and great concern. Most carers do the job because they want to make a positive difference to clients’ lives. Take just one comment:
‘Homecare is very task orientated and the amount of tasks we are expected to perform in half an hour is ludicrous. I have an 86-year old lady with slight dementia, arthritis, mobility and continence problems. The morning visit means first getting the lady out of bed- which can take quite a while as she is stiff and disorientated. I escort her to the bathroom and on to the toilet, assist with a full body wash and dressing, clean her teeth, brush her hair and leave her to use the toilet while I make the bed, changing soiled sheets. I escort my client downstairs to the lounge or kitchen, make her breakfast and drink. I put soiled bedding into the washing machine after hand sluicing. I prompt medication, observe my client taking her meds and leave drinks for the morning.’
‘Call cramming’ is now endemic in domiciliary care, with 15-minute visits becoming the norm for many providers. The UK Home Care Association says that 73% of visits in England are now below 30 and 28% below 15 minutes. 79% of our members surveyed have to rush to clients or leave them early in order to get to the next one. Almost half have to do this ‘a lot’.The consequence is that 52% of those working for private providers and 38% employed by local authorities work in their own time to provide a service they consider nearing acceptable.
These unpaid acts of love are keeping an underfunded, fragmented and outsourced care system ticking over, but time is running out.
‘Time to Care’ is available from UNISON. Contact M.Egan2@unison.co.uk for details
No matter what happens at national or regional level on social care issues, the bottom line is that care workers deliver care services to the vulnerable who need support and care in their daily lives.
It is time for a radical rethink and national debate on social care focusing on that front line delivery. In what other area of social policy would we expect underpaid workers to deliver key services? Imagine the scandal if this were the case in education or health.
One of the usual ways of justifying care worker pay is to compare it with that of retail workers, yet how, in any way, can the two really be compared.
If we want to have world-class support and care for the most vulnerable then we need to recognise the work of those who deliver it and make social care a true profession and pay the wage it deserves.
Three years ago my daughter, who was Production Planning Manager at a well-known manuafacturer, was made redundant when sales dropped substantially because of the financial crisis. As a stop-gap, she became a care worker, employed by an agency which receives its funding through local authority contracts.
She can confirm what has been said in this article — it is not exaggerated. During her two and a half years with the agency, she lost the payment for time spent travelling, consecutive appointments could be 40 miles apart, her hours were cut (sometimes to her contractual minimum which was 16 hours a week), her final pay was below the national minimum wage, she was expected to work ‘split shifts’ (start very early in the morning, long gap during the day, then evening work), she was told each Friday what her appointments for the following seven days were to be (which meant she could not plan any social life), and client contact time was inadequate to be effective.
I’m very pleased that she got a ’9 to 5′ office job last month, though nothing like as responsible as the one she had before she was made redundant, and she’s much happier. Indeed, I admire her for doing the care work for so long with so little complaint — I’d have given up after a week.
Great article, Heather.
The scandal of low pay now being amplified by zero hours contracts (not to mention the ‘shares for rights’ ideas from George Osborne) are impacting on the quality of services.
Services for vulnerable people – whether purchased by a local authority or through direct payments or indeed self-funding – should be of the highest quality delivered by care staff who feel valued, are properly trained and qualified, are paid a decent and realistic salary, and who have time and purpose to serve their clients.
The future of social care and more significantly the lives of many people are at risk if wages and salaries are pushed to the lowest possible level (in effect below even the national minimum wage let alone the living wage) and if staff are demotivated and the best leave the profession.
Whether employed in the public, business, third, social enterprise or co-op sectors Heather you are right to argue and press for decent remuneration, fair terms and good employment conditions.
I fear that too many local authorities and national government have forgotten the strong posiitve correlation between these employment standards and quality of service.
So the public sector at local and national level has to uses its procurement. contractual, employment and regulatory powers to protect vulnerable service users – a still wealthy country should afford this.
I’ve seen the impact of this with the care for my own relatives. The care worker who came in last night had worked 14 hours the day before but would only be paid for six as this is the ‘contact time’ with the client. she also had to pay her own travel expenses to each client. Surprise, surprise she has handed in her notice. In the four weeks my relative has had care he has had 11 different staff because turnover is so ridiculously high. Unfortunately these people have no voice. Did any of the broadcast media cover this report? I think we know the answer…
I care for my mother who has cop d and my sister who is mentally handicapped. I gave up work in nov 2011 and moved in to look after them both. I am 57, my husband is 72 and we get help from my sister Margaret’s carer 70 hours a week although he is really paid and employed for 35 hours he is our youngest brother so he does more. He takes our sister two nights a week to sleep at his house to give us a break. I claim basic careers allowance just over £200 per month. I gave up my job as a chef at our local college because I couldn’t do both yet I’ve been told the reason care allowance is so low is because I can earn on top of this when ?
So sad.
I have been a carer with the same company for 9 years, I am still on a zero hour contract, the company has just put the rates up to £15 per hour but put our wages down to £6.30 or £3.15 per half hour, no traveling time or petrol allowance. I have stayed for the service users but have now got to look for another job as the petrol rises mean we are on far less than the minimum wage. I believe these companies should be named and shamed then maybe they would reconsider their slave labour policies.
I work for direct payments and have been given a new contract to sign the new contract is £3.48 per hour less than what iam getting now I haven’t signed the contract as its a paycut of over 30 percent + the last 3 years pay freeze I want to know if the people who are giving me this sort of pay cut are taking this sort of pay cut themselves I THINK NOT
I have worked in the care sector for over 21 years. I have met and worked with great staff. When will organisations learn that to provide a QUALITY service you have to listen to your customers, internal and external? Internal customers, staff, will stay if they are treated with respect and value, given training and support, reasonable notice over hours to work, proper pay that reflects what they do, time to do a proper job of care, and reasonable pay for travel.
In turn the external customer will benefit from having time to be cared for properly and consistent and trained staff to work with them. We know there is a crisis looming and that more and more people will need small blocks of care in their own home, but staff have a life too with responsibilities. Do not offer staff an hour here and and hour there. Offer block hours, and pay for travel time. Any decent manager will know that retaining staff is cheaper and more beneficial for the organisation. Too often now with personalisation I am seeing untrained and unsupported staff looking after vulnerable clients. Little monitoring is done and to be honest I am waiting for another scandal to hit the headlines before anyone in Government takes note.
I work for both the local authority and have worked for private care agencies, and the difference in attitudes and quality of care is astounding! At the agency the push is to see as many people in as short amount of time as possible, to make a profit for the owners of the agency. At the council, the emphasis is on doing as much as possible for as little money as possible. Despite work being hard and demanding for staff with the council, compared to working for a agency it is heaven! At least you go home without the guilt of thinking you should have done more, and knowing the quality of care received by the service user is being considered by management.