The home care crisis

New research from the RSA reveals the scale of the problems faced by care workers.

Justina* wakes up at 4am, to prepare her children’s schoolwork before a 15-hour shift. During the day she will have to travel between dozens of clients, caring for older people and those with mental health problems. Her list of clients used to be split between three people, but now is covered by two. As a result, she sometimes has to cut visits to vulnerable people short to fit everyone in. She recently suffered an injury while working, but without occupational sick pay, her family faces surviving on just £96.35 a week.

By now, many of us will be well-versed on the issues that have afflicted care homes during the pandemic: sick workers being forced to work across several different locations at the same time, and infected patients being discharged into back into care homes. Another vital form of support received less attention: home care workers like Justina face different but no less serious problems.

Today, an investigation by the Bureau of Investigative Journalism reveals that many councils are failing to meet the terms of a charter designed to ensure minimum standards for working conditions and pay.

43 local authorities have signed Unison’s Ethical Care Charter, pledging to provide care workers with basic protections and paid wages at rates set by the Living Wage Foundation. And yet the Bureau finds that 37 of these have offered home care jobs at below the real living wage. Some providers pay as little as £8 an hour, a figure below the legal minimum for adults.

Analysing thousands of jobs listed on Reed.co.uk, the Bureau finds that across the UK 60% of home care jobs are paid less than the real living wage (£9.50 per hour for the UK, and £10.85 for London). This rises to nearly three quarters in Wales, despite a recent pledge from the Welsh government to increase wages.

As part of the investigation, the RSA is releasing new data on the crisis afflicting care workers in the UK. Our Economic Security Observatory has been tracking the impact of the pandemic on key workers. With YouGov, we’ve been asking a representative sample of key workers how they’ve fared over the course of the pandemic. The latest instalment, carried out in March, reveals that care workers are among the most impacted by mental health issues and stress as a product of their jobs, increasing over the course of the pandemic.

Proportion of social care workers who have found it more difficult to maintain their mental health as a result of the pandemic

July 2020: 61%

November 2020: 63%

March 2021: 67%

Care workers have further struggled to take time off when unwell – our latest poll suggests that a quarter of care workers are faced with this problem, creating obvious difficulties for containing the spread of the virus among vulnerable adults.

With rising cases and many employers facing staffing shortages due to workers isolating, issues with sick pay will continue long past the lifting of restrictions. This has changed little over the course of the pandemic.

Proportion of workers who would find it difficult to take time off if unwell as a result of coronavirus

July 2020: 29%

November 2020: 29% 

March 2021: 26%

Previous RSA research has shown that the ability to isolate also correlates with financial security, with less secure workers finding it more difficult to take time off. In December we found that across all key workers, those with less than £500 in savings were twice as likely to find it hard to isolate than those with more than £20,000.

As part of our investigation, we spoke to care workers and those close to the care system about the challenges they have been facing. John has seen how this has affected the level of care his mother receives. She lives in London and has multiple sclerosis, schizophrenia and learning disabilities. “There’s always a different carer or there are shortages ... There’s a Deliveroo-style system of carers who are shipped to our house,” he said. “They’re on minimum wage, they work ridiculous hours for the pay they have – and they’re not given the time to do a good job.”

Others feel systematically undervalued, including when it comes to costs incurred on the job. Emma*, a care worker in Hull, said that about a quarter of her take-home pay goes on petrol. "You’re never in one area. A few years ago we asked about money for petrol, [the care provider] replied by saying that was what the extra 0.30p was for in our hourly pay. It’s so disheartening."

Care work is a growing profession: while we often view jobs in technology as the jobs of the future, certain ‘hi-touch’ vocations are rising just as fast. Over the past decade, care work has become increasingly ‘gigified’, with care workers forced to accept similar terms of employment to those in sectors popularly associated with the gig economy, such as food delivery and logistics.

Problems in the sector have been pushed to the limit during the pandemic, but they aren’t going away any time soon, as a broader section of the population begins to require support.

At the RSA, we call for a real living wage for key workers, and argue that the UK Government should temporarily use the furlough scheme to pay 80% of the wages of self-isolating employees who are too sick to work or cannot work at home. In the longer term, we’d like to see more wholesale changes to the sector, including meaningful training and development and comprehensive rights for care workers.

Increased visibility during the pandemic has done little to remedy low wages, poor working conditions and general unresponsiveness from Westminster - support for care workers must go beyond public displays of gratitude.

The next instalment of the Economic Security Observatory will be released in August. See more information on our Future Work programme.

*Names have been changed.