Each year Skills for Care publishes a report on The state of the adult social care sector and workforce in England, in which the scale of the recruitment and retention challenges are laid out. The report also tells us about care worker pay, which, with the introduction of the national living wage, has seen noticeable improvement over the past seven years: from an average of £6.78 an hour in September 2012 to £7.89 in March 2018.
However, this increase hides a less cheerful picture. In order to meet the national living wage commitments, hard-pressed social care providers have had to hold down the overall pay bill in other ways. An increasing proportion of the workforce is now paid at or around that minimum level and the pay differential between care workers with less than 1 year of experience and those with more than 20 years of experience has reduced to just £0.15 an hour.
And as all other sectors have had to meet the national living wage commitment, this increase has not made pay for social care work more attractive. For example, the average hourly pay for care workers is below the basic rate paid in most UK supermarkets (see chart below). Staff are also lost to the NHS, and one estimate suggests the social care workforce would need around £1.7 billion of investment to match the recent NHS pay deal.
Pay is clearly not the only factor which influences the type of job you choose to do. Care workers are typically deeply committed to their work, appreciate the autonomy it offers, enjoy working with the people they meet and take pride in doing what can be a very difficult job well. But it would be naïve to say that for most of us pay isn’t a significant consideration – we all need to pay the bills at the end of the month.
So how have we ended up with a social care workforce, which provides essential, practical and emotional support to some of the most vulnerable people in our society, that is so poorly paid?
Part of the answer is that spending on publicly funded social care is in real terms £700 million less than what it was in 2010/11. Some of that spending reduction has been achieved by local authorities, who commission the care from independent sector providers, holding down the rate they pay those providers. Social care is a people industry, simply employing people to do the job will be the biggest area of expenditure for most, if not all, care providers. Without other significant areas of spending to absorb some of the funding pressure it is often care worker pay that ultimately bears the brunt of this reduction. This is seen not just in overall pay but most acutely in the long-running and bitter dispute over pay rates for staff who work overnight on so-called ‘sleep-in shifts’.
Lack of funding may not be the only reason for low pay, however. Social care work is also under-valued. A scoping study for a national recruitment campaign in social care found the public had poor understanding and negative perceptions of the sector, and saw jobs in it as low status. This is perhaps not surprising when much of the media coverage of social care focuses on crisis and neglect. The frequent – and to people in the sector, infuriating – references to care workers being ‘low skilled’ do not help, either.
This is not new news (it was highlighted in the Kingsmill Review in 2014, for example), but as the Prime Minister promises to tackle the issue of social care reform ‘once and for all’ it is essential that additional funding will both restore access to social care services and enable social care workers to be paid fairly for doing a job that is difficult, skilled and absolutely vital. We need to create an environment where employers can offer competitive terms and conditions that reflect the value of the work, and avoid social care workers being swept up into jobs in supermarkets.
My son aged 47 has worked in a care/ nursing home for several years. We works nights and as a senior member of staff has responsibilities which include supervising staff. He enjoys the work and feels it is valuable and appreciated by the patients. He recently got a bad bacterial infection in his throat and had to take a week off work, his first in the job. He was not paid sick pay as the business does not do that. This is just an example of poor working conditions in the care system.