Social Care Regulation at Work

Case study

The care workforce is overwhelmingly made up of women and many care workers experience in-work poverty. The Social Care Regulation at Work research project seeks to contribute to the design of a future world in which law is used effectively to reduce inequality of gender, disability, race and class, as well as to address broader issues of poverty, precarity, democracy at work and access to education.

The research team is Professor Lydia Hayes, Dr Alison Tarrant, and Dr Hannah Walters; we are funded by the Welcome Trust and based in Glasgow, Cardiff and Kent. International evidence tells us that highly quality care and support is provided by staff who feel secure in their jobs, are paid fairly, feel respected and are well trained. Our research speaks to the reality for care workers across the UK: their work is low paid, insecure, of low status and training is often inadequate.  Amongst other things, our research will make recommendations about how the legal powers of the Scottish Government might be better used to regulate social care in ways that improve both the quality of care and support services, as well as the quality of care workers’ jobs.

To fix problems with care quality, the problem of low-quality terms and conditions of work in social care must be fixed too.  Scotland, Wales and England do not currently have legal powers to make their own laws about employment standards because this type of law can only be made by the Westminster Parliament.  However, the devolved nations do have responsibility for the regulation and oversight of social care provision and our research explores the different legal rules that apply in England, Scotland and Wales.  We are identifying differences in the devolved regulation of social care and assessing how that regulation might have an indirect effect on the quality of care workers’ jobs. To properly understand the effects of law, our research goes beyond what the legal rules say on paper, to look at how those rules are understood, used and applied in practice – by regulators, providers, and care workers themselves.

Our focus is on six issues, each is fundamental to the quality of jobs and the quality of care and support:

1.Low pay and insecurity of work
2.Health and Safety
3. Fit and Proper Persons
4.Safeguarding
5. Staffing Levels
6. Training and Supervision

We are testing the hypothesis that regulatory systems that are designed to improve care, might also have the capacity to drive up terms and conditions for care workers. If care work can be more highly valued, and the problem of poor-quality jobs can be addressed, the lives of hundreds of thousands of care workers and the people who rely of them for care and support would be considerably improved.

The Equal Pay Act 1970 was intended to deliver equal pay between men and women. However, 50 years later we know the Act has not put a stop to low wages in care work. Equal pay law has not eradicated the gendered and sexist stereotypes which subordinate the contribution of women’s caring labour to the economy and society. We can learn from the tremendous equal pay campaign by care workers and others at Glasgow City Council that legal rights need to be accompanied by effective campaigning and trade union representation. On its own, our equal pay law cannot deliver long term change; additional strategies, rights, and freedoms are required.

The initial stages of our research were conducted as the Coronavirus pandemic began to impact harshly in care settings across the UK.  We partnered with trade unions UNISON and GMB, and we analysed survey data to assess the views of 2,600 care workers about health and safety in the initial stages of the pandemic.  Their data revealed many breaches of health and safety laws as well as breaches of care standards.  Care workers said that a lack of necessary Personal Protection Equipment (PPE) at work showed that they were given no respect. We found that 8 in 10 care workers expressing a view believed that they would not receive any wages if they needed to self-isolate (for up to two weeks according to official guidance).  Many had a considerable fear of poverty and said they would not be able to afford to self-isolate. A lack of occupational sick pay was effectively forcing care workers to continue working when they were ill. This is one of several factors that increased the risk of coronavirus transmission between care settings and the community.

The finding on sick pay is an example of how our research connects care standards regulation to matters of employment. We have shown that occupational sick pay (an employment issue) is critical to the quality of care and the safety of people in need of care and support. However, the legal rules that are designed to ensure safe care in England, Scotland and Wales are not currently ensuring that occupational sick pay is available to all care workers. We are undertaking further research to understand how regulations and legal rules are understood by care workers, employers, care inspectors and commissioners of care.  We want to know why it is that the importance of employment issues like occupational sick pay is overlooked in the implementation of legal standards about social care.

Trades unions, employers and Scottish Government are often engaged in dialogue and negotiation over issues like occupation sick pay and other employment issues. However, our research is looking at the link between care quality and terms and conditions of work and our focus is on the capacity of regulatory systems to promote change.  We hope to contribute to a future Scotland in which women and girls, as well as men, can pursue an important, meaningful career in care, without having to sacrifice pay, conditions, and good quality employment.

Visit our website to compare what care standards regulation says in relation to important issues of care quality in Scotland, England and Wales: https://research.kent.ac.uk/social-care-regulation-at-work/.

Our first report, Care and support workers’ perceptions of health and safety issues in social care during the COVID-19 pandemic, can be found here: https://media.www.kent.ac.uk/se/11148/CareworkersHealthandSafetyreport15042.pdf

The next stage of our research is based on surveys and interviews with care professionals across the UK. If you work in the care sector and would be interested in participating, please email L.J.Hayes@kent.ac.uk

Our website: https://research.kent.ac.uk/social-care-regulation-at-work/

Our Twitter: @SCRaWork