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Changes in the content & delivery of social care
 

Changes in the content & delivery of social care

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    Changes in the content & delivery of social care Changes in the content & delivery of social care Presentation Transcript

    • All in a day's work: changes in the content and delivery of social care Jo Moriarty, Michelle Cornes, Shereen Hussein, Martin Stevens, Jill Manthorpe
    • Outline  Background  What we know about the social care workforce  Methods  Findings  Data collection and analysis are ongoing so themes not final  Discussion  Links with earlier papers 9 July 2013Social Policy Association Annual Conference 2
    • Size of workforce  1.85 million adult social care jobs in England  1.63 million people (Buchanan et al, 2012)  About 10% of UK jobs (Moriarty, 2010) 9 July 2013Social Policy Association Annual Conference 3 Image from Learn to become a carer website
    • Majority are women Gender Men WomenSource: Buchanan et al, 2012 9 July 2013Social Policy Association Annual Conference 4
    • Age  Mean age is 43  Started working in sector around the age of 35  All ages including those aged 65 and over Buchanan et al, 2012 9 July 2013Social Policy Association Annual Conference 5 Image from 123RF photos
    • International recruitment 82% 5% 13% Nationality British EEA Other countries Source: Buchanan et al, 2012) 9 July 2013Social Policy Association Annual Conference 6
    • Pay  Care worker pay rates range from £6.09 to £12.03 per hour Buchanan et al, 2012  Most paid at lower end  Near National Minimum Wage  Estimated 9-12% paid below Hussein, 2011 9 July 2013Social Policy Association Annual Conference 7
    • Methods (1) Four locations Midlands, London, South, North Simple random sample of social care providers (sampling frame CQC website, mix private/local authority/voluntary) 68 employers interviewed (mixture size and types of service user supported) Face to face interviews 2008-2010 Re-interviewed 2010-2012 9 July 2013Social Policy Association Annual Conference 8
    • Methods  Interviews with staff 2011- ongoing  Interviews with service users and carers  Online/postal survey of workers via employers  National online survey via other sources  Approvals  Ethical approval from King’s College London  Support of Association of Directors of Adult Social Services  Research governance in four sites 9 July 2013Social Policy Association Annual Conference 9
    • Data analysis  Interview transcripts read by members of research team  Agreed consensus on codes  Data-driven and concept driven coding  Analysed using NVivo  Discussed with members of the Unit Service User and Carer Advisory Group 9 July 2013Social Policy Association Annual Conference 10
    • Care work as body work 9 July 2013 Social Policy Association Annual Conference 11 Because it’s very hard to say... when some people see you naked... at one time…, I was naked with three support workers, because one was being trained, there was a manager, it was all very strange. When people see you naked, you are most vulnerable. And you don’t feel able to give requests… ‘Can you please pass me that, can you please not do this?’ Picture from NHS photo library
    • Negotiating Impact of Mental Capacity Act ‘If they’ve not had a shower for a few days you have to intervene, let’s say, because then it goes to their dignity. Would you want to walk round smelling, wet, [in the] same clothes for two or three days? … It’s not pleasant for everybody involved basically.’ 9 July 2013Social Policy Association Annual Conference 12
    • Working hours  Communal settings have always provided 24 hour support  Now more people living at home with very complex needs  Implications for hours that people need support 9 July 2013Social Policy Association Annual Conference 13
    • Working hours Impact of need for flexible working on recruitment Shifts [might generally be] 3-10s[pm]s, or 7[am]- 3[pm]s, or whatever. However, if an individual wants to go out and do something specific then the rota will change to reflect that individual’s needs. I’m very clear with people about that at interview. Yes, you may be doing 3-10 shifts, but I may ask you to work a 6[pm]-12[am] shift because somebody wants to go out for the evening and it might be somewhere further that they need to travel to 9 July 2013Social Policy Association Annual Conference 14
    • The zero hours contract 9 July 2013Social Policy Association Annual Conference 15
    • Zero pay What zero hours really means You are doing split shifts a lot of the time and they vary as well … because we have a zero hours contract …. [the council] only pay us the work that the carers [care workers] do. If a client goes into hospital, that’s their whole work gone for the week. As a carer [care worker] you need to say yes to absolutely everything, because you are not sure if your clients are going to be in hospital and you’ve not got any work. So we ask an awful lot and we don’t give that much back. But as a private organisation we can’t just pay people guaranteed contracts if we’ve not got the clients 9 July 2013Social Policy Association Annual Conference 16
    • Pay (1) 9 July 2013Social Policy Association Annual Conference 17 We are paid by the minute that we are at each call and we log in and we log out at each call.… I agree with [this monitoring] to a certain extent … [but] if you are held up in a call for any reason and it goes over the time that they [service users] are allowed, you don’t get paid for that From workinstyle.com
    • Pay (2)  Some employers linked pay to possession of vocational qualifications  Skills for Care have shown this premium is comparatively small  Small businesses had more flexibility especially if all/most people using services were self funding  Needed to find other ways of creating loyalty and team spirit 9 July 2013Social Policy Association Annual Conference 18
    • Public scandals  Rising media coverage about standards of care  Also affects NHS  Francis Report  Winterbourne View private hospital  Confidence in regulator CQC 9 July 2013Social Policy Association Annual Conference 19
    • Impact on workers Distress and concern about public perceptions ‘It pretty devastated a lot of us to hear it. It was quite upsetting, and everybody talked about it … And everybody was fairly upset and said how disgusting and how awful it was, and how could people be like that. And they give the rest of us a bad name as well, and they bring bad publicity, it reflects on us for a little while.’ 9 July 2013Social Policy Association Annual Conference 20
    • Pride Finding meaning and value in the work ‘On our unit we pride ourselves because when they’ve come down from up on the other units, and it’s no disrespect to them, the families have come down and they’ve said, “What a difference.” We make sure they’re clean and we don’t just chuck any clothes on them. They’re co-ordinated’ 9 July 2013Social Policy Association Annual Conference 21
    • A job others wouldn’t do 9 July 2013Social Policy Association Annual Conference 22 And then obviously from looking after my Nan and granddad to doing nothing, I felt a bit like I wanted to do something for other people to help them as well. That is how I got onto care. My mum used to be a carer as well. I’ve followed her (LAUGHS). She is a lovely person. She is very caring and I think that’s where I get my nature from.... Just helping people in general is what I want to do Image from Swansea council website
    • The precariat (Standing, 2011)  Precariousness is the ‘new normality in globalised labour markets’  Members are ‘internally divided’  ‘Villainisation of migrants and other vulnerable groups’ 9 July 2013Social Policy Association Annual Conference 23
    • Forms of labour security 1(p10) Type of security Examples Social care Labour market security Adequate income earning opportunities  Employment security Protection against arbitrary dismissal, regulation on hiring and firing  Job security Retain niche in employment, career progression  Work security Protection against accidents/illness at work, unsocial hours  9 July 2013Social Policy Association Annual Conference 24
    • Forms of labour security 2 Type of security Examples Applies to social care Skill reproduction security Opportunities to gain skills through training, apprenticeships etc  generally Income security Adequate stable income  Representation security Collective voice in labour market  9 July 2013Social Policy Association Annual Conference 25
    • Disclaimer The Longitudinal Care Work study is funded by the Department of Health. We acknowledge funding from the Department of Health Policy Research Programme. The views expressed here are those of the authors and not the Department of Health 9 July 2013Social Policy Association Annual Conference 26