A raw deal for care workers

Today care providers warned that coronavirus may be in more than half of nursing homes. It’s unclear how many care home residents have died from the virus as government figures only report hospital deaths, but there are fears the number could be as high as 4,000.

Care workers have been saying since the start of the outbreak that they are working with little to no personal protective equipment (PPE). While many of us hunker down within our own four walls, they are spending their days in other people’s houses, supporting both those in care homes and those in their own homes. Social distancing is not an option when you are helping people get out of bed, washed and dressed every day.

Their work at the frontline of the struggle against coronavirus has been widely recognised as essential. But the plaudits have not been matched with adequate promises to protect them, or the people they support. The government has finally said that tests will be made available to care home residents and staff. This gives little reassurance, however, to people receiving care in their own homes or the care workers who visit them. And there are still reports of PPE shortages across the sector.

A group of care workers have set up a campaign with UNISON North West to stop the spread of the virus. As well as more testing and PPE, they are calling for full pay for care workers who become ill, have to self-isolate, or need time off to look after family members. They point out that the threat of losing pay means that many may have to choose between feeding their children, defaulting on rent payments or working whilst ill.

Social distancing is not an option when you are helping people get out of bed, washed and dressed every day

Things should never have got this bad. But social care was in crisis before the pandemic began. The pressures of a severely underfunded, outsourced and fragmented service have been pushed onto care workers, and the threat of coronavirus is now faced by a precarious workforce. Mean hourly pay for care workers is below the real Living Wage, and nearly 60% of those providing home care are on zero-hours contracts. Turnover is high, with 40% of care workers leaving their jobs each year and roughly a third of those leaving the sector. The vast majority of care workers are women and many are women of colour. One in five are migrants, who face higher risks of exploitation because of restrictions on their rights.

One reason why it’s been possible for these working conditions to develop and persist is the lack of bargaining power that care workers have. Union membership is relatively low in social care, especially compared to the NHS. Another is the ease with which government can pass the buck. Lines of accountability for the care workforce are murky: care workers are predominantly employed by a fragmented market of more than 20,000 providers, with local authorities responsible — in theory — for ​‘shaping’ the market and the workforce. Their powers are weak and their leverage over providers is limited, especially when they are dealing with large chain companies, sometimes with opaque financial structures, that operate in a standardised way across the UK. Moreover, a decade of cuts has left them firefighting, constantly grappling with the impossible question of how to cut services without putting people’s lives in danger. The recent changes to the Care Act made by the Coronavirus Bill admit and accept the possibility that local authorities may find themselves in a position where they are forced to concede they can no longer meet their basic statutory duties. Instead of pledging to do ​‘whatever it takes’ to support social care in the face of coronavirus, the government seems to be choosing to let services buckle under the strain.

Allowing the status quo to continue is not a serious option. The first priority for the government is to listen to care workers, and take immediate action to protect them and the people they support. But the response can’t stop there. Before coronavirus it was clear that a functioning social care service couldn’t be run on the back of cheap, insecure labour. Now, with key workers in the spotlight, there is a growing consensus that it is not right or fair to value their jobs so poorly. We haven’t heard enough from the government to signal a decisive break with the mistreatment of the care workforce: more than 1.6 million people, many in precarious jobs with poverty wages, doing vital work on which society depends. More public funding for social care has to be part of the solution. So does a commitment to shift towards a system with much greater public accountability, where more power lies with care workers, people using services and their families.

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