Employment in social care at a time of austerity needs, opportunities, fairness and risks Dr. Shereen Hussein Senior Research Fellow Kings College London.

Employment in social care at a time of austerity

needs, opportunities, fairness and

risksDr. Shereen HusseinSenior Research FellowKing’s College London

What is social care?For adults and older peopleSocial care supports people of all ages

With needs arising from physical, cognitive or disabilities

Assist in carrying out personal care or domestic routines (activities of daily living).

Helps sustain paid or unpaid work, education, learning, leisure and other social support systems.

Supports people in building social relationships and participating fully in society.

A bit of demography: Needs

Population ageing (fertility, mortality and life expectancy)

Medical advances

Longer life expectancy to children with certain illnesses and disabilities

Social changes

Family dynamics

Life style (nutrition and quality of life)

Female (primary traditional informal carers) labour market participation

Co-residency; migration and geographical proximity

Formal and informal spheres of care

Sociology of care

Norms and traditions

Individual, society and government responsibilities

Working with other forms of support (social security, health and housing)

Complement, intersect but do not substitute one another

Welfare state:Means-tested system.

Very broadly, people with assets over £23,250 receive no financial state support (fund their own care).

The level and type of state support for people with assets below this threshold depends on their needs and income.

The Government currently spends £14.5 billion p.a. on adult social care in England. Just over half of this is on services for older people.

Reforms, Dilnot commission report possibly not happening?

What is social care as a labour market sector?

Traditional and new forms of markets

Dealing with a special kind of ‘commodity’

Expanding consumers base

Expanding ‘products’ (to meet variety of needs)

Interaction with other labour markets (e.g. technology, leisure, etc.)

Competing for certain groups of the workforce

Local, regional and international markets

The share of social care in the labour market

At least 7% of the total active labour force is estimated to be working in the (adult) social care sector

‘Recession proof’ sector

Continues growth in the market share

Wide range of job roles

72% involves direct care but other professional roles are important

Share of the private sector- profit and business case

A bit of statistics

Estimates of growth in users’ demands (with at least 2 million users)

At least 2 million people are estimated to be working in the sector in the UK

Migrants (especially non-EEA) constitute considerable portion of the workforce

Estimated around 20% with 40% to 60% in major cities

Source: SCWP Issue (12)

A bit of sociology: How a society value and ‘cost’ care

Value of ‘care’ work to the society

Gendered; emotional; for granted !

Responsibilities and duties of care

Assumed or planned

Pricing ‘emotional’ work

The position of the care sector and labour dynamics

Secondary labour position

Pay and working conditions

Recruitment and retention

Attraction of ‘flexible’ working patterns

Changing structure; place; nature, interaction with health services

Links to government funding (means tested)

In focus: payOne of the main sectors to benefit from the introduction of NMW in 1999

Estimates of 40% of the workforce earned below NMW before the introduction

Most recent estimates indicate that at least 12-15% (150,000 to 200,000) of direct care workers are paid under the NMW

Wages significantly lower in the private sector

Ethnic and gender pay-gaps are evident both within higher and lower paid groups of workers

Recent concerns of the effect of austerity measures on individual pay levels

Travel time and cost; increased responsibility; calculating shift duration

Source: SCWP Issue (6)

Social care provision

Estimated 17,300 organisations in England alone

With number of local units estimated at 40,600

Current profile of providers

While there are some ‘big’ private employers- local units are usually ‘small’ businesses

74% of local units are run by the private sector, 19% the voluntary sector and 7% by local councils

Recipients of direct payments

Users as employers

Estimated at 114,500 in 2009

Example of a care provider: Four Seasons Health Care

Major provider of ‘health care’

Operating over 500 care centres

Employs over 30,000 people

Provides services to at least 25,000 people

Annual turnover (2010): £503.6 million

CQC verdict (some of the branches)

Failed standards of caring for people safely & protecting them from harm

Failed staffing requirement

CQC is taking action against this employer

The social care workforce

Traditional profile

More demand on increased and specialised skills

Understand technology

Understand and meet the needs of specific illnesses and conditions (e,g. dementia)

Empower users- community integration, work participation etc.

Retention and relationships with quality of care

Workforce supply

Image and status

Current profile

Age and gender

Nationality and ethnicity

Qualifications/ training

Local and international supply

Migrant workers and immigration policies

Grey economy and domestic workers

In focus: men in the social care workforce

17% of the workforce

Trend of increased prevalence (from 2000 to 2009)

Slightly younger and more evenly distributed across 30-50 years

Proportionally more of them report disabilities

Larger proportions of migrant workers are men (24%)

More likely to work with adults with LD, MH and ASD

Nature of care workJob demand and control

Responsibilities and pressures

Reward and job satisfaction

Assumptions

Work dynamics

Support, interactions and isolation

Cultural/language sensitive

Care models

empowerment and choice)

Economics and business case

Funding

Return – large and expanding consumer base; must have commodity

Share of the labour market

Interacting with different sectors

Opportunities of cross-working

Growth

Labour market composition

And .. Few bits of politics

Funding (Dilnot review); austerity measures

Big society

Re-debating responsibilities and duties

Mutual and co-operative models of services

Personalisation agenda

Health and Social Care Bill

Implications

Tighter public purse reduction in funding

Immigration cap difficult access to ‘skilled’ migrant workers

Austerity measures higher unemployment rates, larger pools, suitability of recruits

Interface between social care sectors and other sectors, especially health

Risks: workforce

Stress and burnout

Rights

Trade unions/ registration

Pensions

Exploitation/abuse

Deskilling

Discrimination

Opportunities: workforce

Increased demand may open up employment opportunities for non-traditional groups

Men

Younger people

Migrants (transit or establishing a career) – EEA migrants, learning about language and culture

Short-term and long-term opportunity

Innovative thinking!

Risks: service users/carers

Quality and continuity of care

Length of visits

Institutional and individual ageism

Respect and dignity

Abuse and neglect

Intentional or un-intentional

Responsibilities (as employers)

Opportunities: service users

More control and choice (individual budget)

New types of workers- may enrich service experience

Technology- self-managed care

Both opportunities and risks

Detachment from certain individual workers (less stable workforce; more temporal)

Cultural encounters

Impact: wider labour market

Boundaries between care and health sectors

Possibly other sectors as well, such as leisure and technology

Circular labour or stable workforce

Stepping stone

New types of employment

Interface with other labour sectors

ConclusionWorkforce representation

Documented and grey economy

Unions, regulators and professional bodies

Workforce quality and stability

Funding and the increasing role of the private sector

Business case and opportunity

Organisational Structure

The share of individual employers

Users’ outcomes and quality of care

Thank you

[email protected]

For latest workforce analysis, see the Social Care Workforce Periodical

http://www.kcl.ac.uk/sspp/departments/sshm/scwru/pubs/periodical/index.aspx