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Reflections on the visibility of the social care workforce

Dr Erika Kispeter revisits a report by the House of Lords Adult Social Care Committee, entitled ‘A “gloriously ordinary life’’: spotlight on adult social care’, published in December 2022, to explore what could be missing.

Elderly man smiling at a volunteer

Reflections on the visibility of the social care workforce

Summary

This commentary revisits a report by the House of Lords Adult Social Care Committee, entitled ‘A “gloriously ordinary life’’: spotlight on adult social care’, published in December 2022. While Kate Hamblin has commented on the report’s key points and reflected on the experience of giving evidence to the Committee, Erika Kispeter discusses what is missing from the Committee’s report. She argues that if we want to improve the lives of people who receive care, we must better understand the paid work of providing care. As a step in this direction, we plan to publish a third commentary summarising how care workers reflect on the Committee’s report drawing on their lived experience of providing social care.

The invisibility of social care

Those who follow the news would think that issues around social care are regularly reported, either in their own right or because they are linked to another topic, ranging from the Government’s Autumn Statement, through A&E waiting times to the Archbishop of Canterbury’s New Year’s message. Every time social care was mentioned in the media in recent months, it reminded me that the House of Lords Adult Social Care Committee had published a call for evidence. Their aim was to remove the ‘invisibility’ of adult social care; however, looking at the extensive news coverage, I wondered if social care was really invisible.

A “gloriously ordinary life’’: spotlight on adult social care

The publication of the Committee’s report in December 2022 settled my internal debate: the report’s authors acknowledged that social care had recently become more visible, adding that this was, to a large extent, explained by the disastrous effect the Covid-19 pandemic had on the social care sector. However, the report asserts that the visibility created by the pandemic was partial in that it was almost entirely limited to the shortcomings of the social care system, or, to adopt a phrase favoured by the media, the ‘crisis of social care’. The report then argues that this partial in/visibility is highly problematic because it perpetuates what they call “a flawed understanding of who adult social care is for and what it can achieve” (p 10).

To contribute to building a better public understanding, the authors have decided to place unpaid care (also known as informal care) at the centre of their analysis, stating that it is the least visible and most vulnerable element of the adult social care system. Indeed, we would all agree with the authors that unpaid care is vital to the functioning of the care sector and the working of the health service and society as a whole. Nevertheless, the report’s focus on unpaid care has prompted me to reflect on the (in)visibility of the paid social care workforce. This is not to say that the report ignores the paid workforce. The sheer number of care workers (the care workforce is larger than that of the NHS) is cited in the report as evidence of the sector’s importance. The section entitled ’Facing reality: funding and workforce’ describes how staff shortages lead to work intensification and how low pay affects care workers’ everyday lives, adding to the burnout many suffered during the worst of the COVID-19 pandemic. The report calls on the Government to create and implement a properly resourced plan for supporting and valuing the social care workforce as part of a realistic and long-term financial settlement.

However, I would argue that the report is focussed entirely on the challenges facing care workers (also known as the ‘workforce crisis’), rather than the contributions the paid workforce make to the wellbeing of those who use social care services or the experience of working in social care. What is more, the workers themselves remain voiceless in the report, even though representatives of the workforce have given evidence to the Committee.

Click here to read the Committee report, ‘A “gloriously ordinary life’’: spotlight on adult social care’

Care workers in the media

In contrast to the report, the news media has recently made the working lives of care workers more visible. A quick search on UK news sites has revealed that news reports and analysis about the often include short ‘human interest’ stories, with workers typically talking about issues such as their low pay and the challenges they face in their working lives. However, these mini-stories (see examples from the BBC and Sky News) also tell us about their motivation to work in adult social care, their commitment to their jobs and the people they support. Many stories reveal the sadness and frustration care workers and managers feel when they are unable to take on more work and help people who need care services, adding details, names and faces to news reports and academic papers about ‘unmet care needs’. Finally, the stories of staff leaving care jobs, whether to take up administrative or hospitality jobs or to train as nurses and paramedics, highlight the importance of career progression within social care.

Research Group on Care Workforce Change

The workforce problems highlighted in the Committee’s report and in the news are central to the inquiries of the Research Group on Care Workforce Change. Our inquiries are designed to understand better the organisation of care, jobs and skills and how all these aspects of the paid work of care are changing in response to external drivers (for example, the COVID-19 pandemic or new rules about migrant workers) and innovation. We also want to make the paid work of care and the workers themselves more visible and represent their views in our publications.

There are significant gaps in our understanding of the paid work of care to the extent that the most reliable report about the size of the workforce is based on estimates – this is perhaps less surprising if we consider how large, varied and undefined the social care sector is. Skills for Care, the strategic workforce development and planning body for adult social care in England, uses information collected from employers of care workers, which means that we do not have reliable information about self-employed care workers. Sarah Barrett at the Office for National Statistics (ONS) has explained that additional data can only be retrieved from alternative sources, such as the Census or the Annual Population Survey. However, this can only be achieved if there is a clear definition of what occupations can be classified as part of the social care workforce and which workplaces can be classified as part of the social care sector. The Research Group is collaborating with the Care Data Infrastructure team and our partners, the ONS and Skills for Care to have more and better data about care workers – striving to fulfil the Committee’s ambition to have a more nuanced understanding of the ‘landscape’ of social care.  This is vital not only for the workers but also for the quality and reliability of the care provided and, ultimately, for everyone who draws on care to have an ordinary life.

Care Workforce Change

We study change, innovation and challenges in paid care work: recruitment, organisation, conditions, digitalisation and their effects on job and service quality.

Read moreabout Care Workforce Change
Care Data Infrastructure

Improving the social care data and analytical infrastructure.

Read moreabout Care Data Infrastructure
Erika Kispeter Researcher, The London School of Hygiene and Tropical Medicine

Erika is interested in different aspects of work and care. She has conducted research on topics ranging from the impact of work-care reconciliation policies on women’s labour force participation to digital skills. Erika is particularly interested in how gender inequalities are created at the intersection of work and care and how women’s working lives are shaped by different institutions, such as the labour market, work organisations and the family.

As part of the research group that focuses on the changing social care workforce in the UK, Erika is involved in projects exploring the regulation and organisation of paid care work, care worker recruitment and conditions, and efforts to improve job and service quality in care.

Care Matters podcast

Press play below to listen to Baroness Andrews (Chair, House of Lords Adult Social Care Committee) discuss the report, ‘A “gloriously ordinary life’’: spotlight on adult social care’ with Centre for Care Co-Investigator, Kate Hamblin. Transcript available here (click).

The Centre for Care Impact Specialist, Rachael Black, met with unpaid carers Liz Naylor and Chris Sterry to discuss the ‘invisibilities’ of Social Care. Drawing on their experiences, they explore the misunderstandings and stigma attached to Social Care, and share their thoughts on how Social Care could be changed to improve wellbeing amongst those giving or receiving care. Press play below to listen to the episode, transcript available here (click):

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