Presentation for Social Policy Association

1. 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

2. 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
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3. 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)
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Image from Learn to become a carer website

4. Majority are women
Gender
Men WomenSource: Buchanan et al, 2012
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5. 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
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Image from 123RF photos

6. International recruitment
82%
5%
13%
Nationality
British EEA Other countries
Source: Buchanan et al, 2012)
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7. 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
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8. 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
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9. 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
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10. 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
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11. Care work as body work
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Social Policy Association Annual Conference
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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

12. 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.’
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13. 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
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14. 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
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15. The zero hours contract
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16. 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
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17. Pay (1)
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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

18. 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
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19. Public scandals
 Rising media coverage
about standards of care
 Also affects NHS
 Francis Report
 Winterbourne View private
hospital
 Confidence in regulator
CQC
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20. 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.’
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21. 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’
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22. A job others wouldn’t do
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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

23. The precariat (Standing, 2011)
 Precariousness is the ‘new
normality in globalised
labour markets’
 Members are ‘internally
divided’
 ‘Villainisation of migrants
and other vulnerable
groups’
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24. 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

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25. 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 
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26. 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
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