England & Wales Health and social care

Viewpoint: Clare Pelham – A fairer deal for home care workers


Image supplied by: Leonard Cheshire Disability

Good care is about valuing people; both those receiving care and those providing it.  Care workers are our greatest asset at a time when more of us need care either in later life or due to disability. Our staff are critical in determining the quality and safety of the care provided to thousands of disabled and older people every day. They are the difference between good care and bad care.

At Leonard Cheshire, the skill, passion and commitment of more than 7,000 care workers who support disabled people in our services continually inspires us. But we know that they, and 1.5 million other care workers across the country, work in a profession that faces significant challenges and that they deserve much greater recognition for the incredible work they do.

Over the past few months I have been working with the Commission on the Future of the Home Care Workforce looking at the work that home care staff do across the country supporting people in every aspect of their lives. Not only the practical support they provide, helping people to get up, get dressed and eat and drink but also the emotional and social support that they provide and the strength of the relationships they build.

Every day home care workers change people’s lives for the better, helping them to live the lives they choose in the way they want. But, despite its many rewards, this work is not easy and it is not for everyone.

It takes a special kind of person to have the compassion, energy and patience that are all essential qualities for home care work. Too often we think about care as ‘just’ a physical or practical job – helping someone in and out of a bath, or to get dressed. But what makes some care great is the way that staff perform these so-called ‘basic’ tasks – building long-lasting relationships with people, gaining trust even when people are very vulnerable and often overcoming significant communication barriers. We need to acknowledge the skills that care workers need and respect staff for their contribution. This is a job that is often challenging and stressful, and at times exhausting and distressing. Like many other important roles – medicine, social work, teaching – it takes tremendous skill to do it well.

Yet all too rarely do care workers get the recognition and reward they deserve. Opportunities for career progression in social care are negligible: skills and experience are often poorly recognised with a lack of formal accreditation, and pay is unacceptably low. This can lead to high staff turnover and low morale.

The sad truth is that very often talented, experienced care workers leave because they simply cannot afford to stay. This is often devastating for the people they support who tell us all the time they value their care workers and they want the rest of us to do the same. It’s not unreasonable that people who need support at home want to get to know the people who support them, to see the same faces each day, rather than having to open their front door to a different person every day.

Care workers deserve a better deal — fair pay and working conditions, and the right training and support for the difficult, amazing work they do.

That means, among other things, all of us telling national and local politicians that we expect fairer rewards and more respect for care workers.

We need councils to pay enough in their contracts to pay all care workers a living wage. Why should we expect someone to do this extraordinarily important job on anything less than that? But without councils providing funding, care providers simply can’t give staff what they deserve. Councils in turn should put pressure on central government to take account of the cost of behaving decently to care staff in the local government settlement. It can’t be right that we fund austerity cuts from the wages of poorly-paid care staff.

But fairer pay alone won’t give care workers the deal they deserve. We also need career progression and recognition of the skills that people are using day-in and day-out. That means building on the Care Certificate to establish a minimum level of training across the sector, independently accredited and leading to a licence to practise. And just as people should be conferred with a licence to practise to recognise their skill and dedication, in the rare cases where care workers don’t uphold the right standards then this licence should be revoked, barring them from the profession.

Recognising care workers with a licence to practise will go some way to giving them the professional recognition they deserve, valuing the work they do in line with other professions, such as nursing, where work is critical to people’s safety.  It will also allow care workers to move easily between care providers, reducing time spent duplicating training and meaning employers can be confident that all these staff meet a minimum standard of competence from day one. It will also allow for easier career progression, allowing people to move more easily between care services and the NHS, developing their skills, building experience and creating a more flexible, effective and responsive workforce. But most of all it will hopefully provide a higher status for care – a profession that people want to stay in and that young people aspire to.

At one time or another almost all of us will call on the dedication, skill and compassion of a care worker when we are most in need of care and support — after an accident or an illness or as we get older. We must make sure that care is right both for the recipients of care and for the people providing it. The quality of our lives and of those we love are likely to depend in part upon the quality of the care they receive. And we should behave as if we fully understand just how important care workers are to us and to millions of families up and down the country.

Clare Pelham is the Chief Executive of Leonard Cheshire Disability and is a member of the Burstow Commission on the Future of the Home Care Workforce.  The final report Key to Care was published last week.