In a CHP exclusive, professor Martin Green OBE, CEO of Care England, looks at what needs to be done to ensure carers are paid a fair wage
Social care has always been a Cinderella service and neither the governments nor the general public acknowledge the tremendous contribution that social care makes to people’s lives and to local economies. This is particularly evident when it comes to the pay remuneration of front-line staff, who are, in many cases paid as minimum wage employees. Despite the fact people are not paid properly, they are doing a very skilled and complex job. In many ways the skills needed to work in social care are at a higher level than many of the roles in the NHS, partly because NHS staff are surrounded by such a huge support network, yet social care staff are dealing with the same issues, often in isolation and without much support from other medical professionals.
There is absolutely no doubt that we need to change this and we need to acknowledge the complex and difficult job that care workers do. Secondly, we need to start paying people on the basis of a career structure rather than seeing social care as a job.
One of the reasons why social care staff are so poorly paid is because of the funding of social care by the government at both national and local level. In many local authorities the going rate to support people in residential care is under £4 an hour. For this, care providers must deliver accommodation, food, activities, personalised care and pay and train their staff. The comparison with the NHS could not be starker, with the unit cost for inpatient care being 10 to 15 times the rate for social care, and on top of this, there are enormous amounts of resources put into training and development. The disparity in funding also translates into a disparity in the recognition and status of social care staff compared to those of the NHS.
I was musing recently on why NHS staff have such a good public profile, particularly when the service has been engulfed in several scandals, such as Mid Staffs, Morecambe Bay and Gosport, to name but a few. This positive feeling about NHS staff is partly due to the plethora of different TV programmes put out by the media, all of which present NHS colleagues as saints, and if anything goes wrong the default position is to blame the government not the staff. I am not suggesting that NHS staff do not deserve this public support, but I really wish it would also be extended to social care workers who do a very similar and very important job.
In order to change how social care is perceived we need to do some things that will help us underline the important role social care workers play, and we must ensure that social care is seen as the profession it is, rather than just a job. We need to start with a clear skills and competencies framework and this needs to be unified across health and social care. If we are going to have a truly integrated system, we need staff to be able to move between health and social care just as citizens do and for this, we need more unified training and development with a more aligned pay and conditions policy.
Before this happens, many social care organisations are thinking about how they incentivise people to work in their services and develop their careers in adult social care. I have seen great examples of care providers who are really nurturing their staff and offering flexible working and better remuneration. One of the areas that social care needs to focus on is how they develop a much more flexible offering and then they can encourage people who are currently not in the workforce to be able to make careers in social care, whilst also having family and other caring commitments. I have also seen some great examples of care employers offering a range of support to staff through the development of money-saving schemes and health insurance products. However, because of funding, it is difficult to compete with the NHS on salaries and pensions, so care providers must constantly think about how they make their services good places to work that acknowledge and reward people in other ways than just through money. The levels of autonomy and the satisfaction that people get when they are freed from huge bureaucratic organisations, is something that social care can offer and we should be much clearer about this and extolling the virtues of a working environment where you can make a difference and use your skills in creative ways.
I believe social care is a great place to work and there are many fantastic employers who will offer a great deal to their workforce. I have talked to so many social care staff who tell me that the satisfaction they get from their work is priceless and they really feel they are making a difference to people’s lives. These are the things that we must champion about our sector, whilst at the same time exhorting government to do the right thing and develop a proper remuneration and funding strategy with an integrated workforce approach, which uses all the resources of the system to ensure that our staff are rewarded and acknowledged for the tremendous work that they do.