Social care has been in national headlines regularly since the COVID-19 pandemic hit the UK, highlighting the acute health risks faced by workers in the sector. With older people being a high-risk group, workers in care homes face a particularly high risk of COVID-19 infection. Between 9th March and 25th May, 268 workers lost their lives in the course of their jobs, with a statistically significant higher rate of death for male workers.
Data shows care workers are some of the lowest paid workers with high risks of exposure to disease. The first deaths of care workers from COVID-19 were reported in April alongside stories of PPE shortages in care homes. Because of this, even those who avoided infection may have experienced trauma, grief and fear of infection, especially in those hard-hit care homes. Early guidance led to thousands of patients discharged to care homes, without testing and without the need for a negative test result, resulting in almost 20,000 deaths involving COVID-19 between 2nd March and 12th June, with 23,393 more deaths compared to the same period last year. As guidance shifted regularly and “90% of the PPE” required was sourced by the social care system itself, 1.6 million social workers were forced to put their lives at risk to help the vulnerable, often on minimum wage and with no sickness cover.
Even before the crisis, care workers often faced extreme insecurity at work. Median hourly pay for independent sector care workers was just £8.10 in March 2019, just above the National Living Wage, and around £1.50 per hour less than those employed by local authorities. But when the Government announced a pay raise for public sector workers in July, care workers were not included. In addition to low pay, care workers are also much more likely to be on zero-hour contracts (ZHCs) than workers in other sectors. Estimates range, but roughly 35% of adult social care workers in 2018/19 were on ZHCs. While some workers prefer such flexibility, not having regular hours can make planning childcare and family responsibilities difficult and limits access to sick leave and Statutory Sick Pay – acutely important amidst a pandemic.
Social care is also a diverse sector, especially in London, with a large portion of workers born outside the EU, and migrant workers face additional forms of insecurity, such as barriers to services and eligibility for social security. Some of these workers may be on visas requiring them to pay an Immigration Health Surcharge (IHS) - an up front payment to access NHS care which is set to increase this year. Additionally, most migrants on visas have ‘No Recourse to Public Funds’, which prevents them accessing benefits if they are unable to manage on their low wages or periods without guaranteed hours.
Care workers have been cast as ‘essential’ and ‘key workers’ during the pandemic, yet the latest white paper updating the new Points Based immigration system describes care workers as ‘low-skilled’ and excludes them from proposed exemptions that would make it easier to recruit from abroad. Given the sector’s existing high representation of migrant workers, these exclusions could enhance existing trends of high numbers of vacancies. The sector already had a 9% vacancy rate (77,000 vacancies) and a 39.5% turnover rate prior to the crisis, , which had been steadily increasing in recent years. With an ageing population and a sector already under strain, social care is reaching breaking point.
To help meet the high demand for workers in this crucial role during the COVID-19 pandemic, in April the Government launched a campaign to attract new recruits to the sector called Care for Others, Make a Difference, which offers some initial free training to those looking to move in to social care. While it is positive to see Government recognise the need to invest in the care workforce, other measures will be needed to improve working conditions for existing and future workers to enable the sector to grow sustainably in line with demand.
The Prime Minister recently recommitted to his 2019 promise to “fix the crisis in social care once and for all,” but a lack of funding has plagued the social care sector for many years. Between 2009/10 and 2016/17, public spending on social care fell by 8%. As part of the PM’s plans, proposals are now being discussed to fund social care by increasing taxes on people over 40. This, and the increased funding for councils provided earlier this year, could help ensure individuals have access to care and councils to increased budgets. However, more needs to be done to address insecurities still being faced by social care workers.
The COVID-19 crisis has highlighted that care work is an integral and growing field that urgently needs further investment and reform. While many care workers are employed by private companies, the Government still has a pivotal role to play in commissioning services. Investing in care through targeting funding to local authorities through the Comprehensive Spending Review could support and improve work in a key sector during and beyond the crisis.
The forthcoming Employment Bill, which aims to protect low-paid workers also presents an opportunity to improve working conditions in the sector. As we look to recognise the role played by this sector through the crisis, it is time to move from applause to meaningful and long-term workforce strategy for the sector which gives weight to retention and progression as well as the essential planned recruitment drive.
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