employment in social care at a time of austerity needs, opportunities, fairness and risks dr....
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![Page 1: Employment in social care at a time of austerity needs, opportunities, fairness and risks Dr. Shereen Hussein Senior Research Fellow Kings College London](https://reader035.vdocuments.site/reader035/viewer/2022070306/551772b755034645368b4ce8/html5/thumbnails/1.jpg)
Employment in social care at a time of austerity
needs, opportunities, fairness and
risksDr. Shereen HusseinSenior Research FellowKing’s College London
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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.
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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
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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
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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?
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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
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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
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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
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Source: SCWP Issue (12)
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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
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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)
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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
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Source: SCWP Issue (6)
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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
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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
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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
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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
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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
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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)
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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
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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
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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
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Risks: workforce
Stress and burnout
Rights
Trade unions/ registration
Pensions
Exploitation/abuse
Deskilling
Discrimination
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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!
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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)
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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
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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
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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
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Thank you
For latest workforce analysis, see the Social Care Workforce Periodical
http://www.kcl.ac.uk/sspp/departments/sshm/scwru/pubs/periodical/index.aspx