Last week Audit Scotland published a social care briefing analysing the state of the sector and the challenges it faces. We encourage all staff in Health and Social Care to read this and provide a brief overview in the following article.
The findings confirm what Unite CEC Branch has long believed: that social care staff are low paid, overworked and undervalued, and that the current staffing crisis is not caused by external circumstances, but exposed by them. The cause of the crisis is historical poor treatment and undervaluing of social care workers.
The briefing raises further alarms about the marketisation of social care, which is particularly worrying as the SNP’s National Care Service (NCS)—or National Commissioning Service, as would be more accurate—is on the horizon. Proponents of the free market would argue that competition between companies increases standards and increases the range service users can choose from, yet the briefing reports with concern that
commissioning focuses on cost rather than quality. Competition between providers has been at the expense of collaboration and quality.
And later in the report
The focus on costs leads to poor terms and conditions for staff and contributes to recruitment difficulties, rising sickness absence and high vacancy levels. This presents a risk to the capacity and quality of care services
This is the ‘race to the bottom’ that the NCS threatens—both for workers and service users—with its focus on commissioning services from the private sector, rather than investing in public services.
Social care workers
The briefing explains that the sector suffers from issues with
- recruitment and retention
- high vacancies
- lack of Fair Work
- poor terms and conditions.
Broader workplace issues are impacted by
- high turnover of senior staff in councils
- short-term posts
- ageing workforce
- cultural differences between partner organisations preventing collaboration.
Key stats for social care staff include:
- 20% are not on permanent contracts
- 11% are on zero hour contracts
- 13% work over 50 hours a week
- 15% do unpaid overtime
- 73% of home care and care at home staff do training in their own time
- £9.79 is the average hourly pay
Women in social care
Social care accounts for around 8% of employment in Scotland and around 85% of the workplace are women.
The majority of care in Scotland is provided by unpaid carers, with the majority being women. The briefing recognises that many unpaid carers are forced to quit their job so they can provide care. This is made worse by difficulties in accessing respite and support services—which are forced to close due to budget cuts.
This is startling proof of the super exploitation of women—facing poor pay and terms and conditions in the workplace while providing massive amounts of unpaid labour, oft times which they are forced into due to cuts to public services and the poor pay and conditions of work available.
In Edinburgh
The findings of the briefing ring painfully true and there have been all too many examples to support these findings.
Members from across various areas of Health and Social Care have raised concerns that their service is being ‘run into the ground’ and that management are not addressing pressing problems. One could imagine that in some areas the Council hopes it’ll soon be able to get rid of the service and leave it up to the market when the NCS comes in.
As the briefing covers in the latter section, this ‘wait and see’ approach cannot continue. Issues need addressed now or consequences may be grave.
It shouldn’t also be a case of simply fixing issues. The Council has the opportunity to set the standard of services for the National Care Service. It is cynical politics on the SNP’s part—and a flagrant disregard for the public’s welfare—to underfund local authorities, drive down service quality, then launch commissioned services that will be compared to the services driven into the ground, allowing a great fanfare. We ought to be working for the opposite: providing gold standard services, so that when the National Care Service is looking to commission services, the bar is high and the whole project must then stand on its own merits.
Workforce: fair pay and fair pay now
This year, we will be entering talks on pay and reward in the Council. One of our proposals will be a radical change to the grading system and the job evaluation scheme to focus on ensuring the jobs we need are properly valued and that the staff receive the pay deserving of such crucial roles.
The Council’s gender pay gap can be most effectively tackled by a new job evaluation scheme, that places importance on the social value of the job, while recognising the risks to wellbeing—mental as well as physical—that such roles often entail. As the vast majority of low paid workers in the Council are female, the Council can make good on their commitments to tackle poverty and promote equality in one move—improve pay for low grades.
The findings on the lack of Fair Work are upsetting, but not surprising. Despite a commitment to being a Fair Work employer, time and time again we see staff excluded from decision making and kept in the dark about significant changes to their job. The managing change policy sets out the right principles for how to manage change, and the risks of not doing so effectively, but it is scarcely used, unless there’s an organisation review.
Management are reluctant to let staff have an effective voice. Services suffer—as the input of the workers doing the job is crucial—and so too do the workers themselves, who feel sidelined and full of anxiety when they are excluded from changes. We have seen this with changes to how staff can meet vulnerable service users or proposals to outsource parts of a service.
Your branch will make sure your voice is heard and will continually fight to ensure that work in the Council includes the Fair Work principles:
- effective voice
- respect
- security
- opportunities
- fulfillment.
Citizens: choice, if you can afford it
The second key message of the briefing is that “service users and carers do not always have a say or choice about what support works best for them.” We have seen this in the debate about care homes, with the Edinburgh Integration Joint Board (EIJB)’s attempt to remove all publicly owned and operated residential care homes from the city and pursue a ‘home first’ model of care—all without consulting workers or the public. Read more about the Save Our Care Homes campaign.
We worked with trade unions in the Council and across Edinburgh and community activitists—like Another Edinburgh is Possible—to successfully pressured the EIJB to consult the public on social care, before they decide on the fate of the care homes. The fight goes on, and as it does it’s important to remember that this principle of choice over care is supposed to be one of the 5 Health and Social Care Standard from the Scottish Government. But if the only option for residential care is an expensive private provider, then there’s only choice for those that can afford it.
Conclusion
Audit Scotland’s briefing is a clear-sighted analysis of the problems in social care. In its focus on the poor outcomes from commissioning, it sets out a warning for us to bear in mind as the NCS approaches—with primary legislation to bring this about expected this year.
But, unlike some politicians, it realises that the NCS is not the solution to all our woes and that waiting for it without taking action is not an option. It presses home the need to act now to address the crisis in social care.
There’s a lot of talk of ‘person centred’ work in social care. We need to remember that it is person delivered work—thus the condition of social care workers is of foremost importance.
Fair pay and fair work in social care now!