Thomas More Institute

By Dr. Matthew Knight & Robert Stephenson-Padron

We are in an age of ‘crises’ – a glance through newspapers over the last few weeks produces recognition of no fewer than seven varied crises currently in play: economic; humanitarian; demographic; moral; and those concerning refugees, care generally, and healthcare…

In some respects the greatest challenge of all is presented by the crisis in provision of care for the vulnerable elderly and disabled. The UK faces a severe demographic challenge within forty years, with an advancing age structure likely to result in a ratio of working-age people to each person of State Pension Age and over falling from 3.2 in 2010 to 2.0 by 2051.(1)

The poor state of home-based care and of hospital care has been subject to much press attention and concern in recent years, especially since the publication of the Francis Report in February 2013.(2) The scale of the problem is only now becoming manifest: poor care has in fact become endemic and even accepted as the norm.

With increasing pressure from an ageing population, provision of quality professional care at home becomes ever more difficult. The Guardian Social Care Network and Department of Health’s recent homecare survey(3) found that one of three key factors in offering good homecare is ‘friendly, respectful, capable care workers’. Therefore, in a nutshell, fundamental to improving care at home is attracting into the care profession, and retaining, those special people who have a ‘vocation to care’ – not just folks ‘looking for a job’.

Inspired by our own experiences of both good and bad care, I and a healthcare research analyst decided to set up in Hampstead, north London, a homecare provider whose focus was to be on implementing a comprehensive set of ethical practices that would help attract and retain such special people.

Our solution for provision of high-quality care was in the end quite simple: to select staff based upon human qualities and a desire to work in the care sector, to train them well, to pay them a Living Wage, and thereby to create a sense of professionalism, and appreciation for the hard work care entails. We had deduced that all-too-often care workers have been underpaid and undervalued.

‘The London Living Wage’ has been calculated as the minimum hourly rate upon which a full-time worker can survive in the capital. This is now £8.80 per hour. A determination to pay this in a sector that struggles even to comply with the National Minimum Wage(4) was, we have felt from the outset, essential to achieving our goal of really delivering a caring service to those in need.

It is in practice rather difficult to teach friendliness and respect, and so the very best thing is actually to hire care workers already in possession of those qualities. Our decision to become a Living Wage Employer has helped us attract excellent workers like Perrine (who recently appeared in Living Wage foundation literature). She is a degree- educated young woman who discovered her vocation to care while looking after the infirm in Lourdes, France. She is a model worker who is friendly, respectful, and capable. She has been enabled to pursue her vocation at Penrose Care precisely because we pay her a Living Wage.

This is not just about social justice for employees, but, more than that, about improving society for all. The Equality and Human Rights Commission(5) has linked low pay with high staff-turnover and with non-continuity by care staff. The latter it has classed a major threat to the human rights of the elderly.

By reducing staff turnover and thereby improving continuity, we have become able to deliver a better service to those for whom we care, at the same time as reducing the costs and disruption associated with constant appointment of new staff. In other words, our experience of having become a Living Wage Employer is that ultimately everyone benefits, and this is a view that is widely shared in the recent literature.(6)(7).

A great benefit of the voluntary nature of the Living Wage, which is part of a more comprehensive social care ethical charter launched by Citizens UK in October 2013 – the ‘Social Care Charter’ (with which Penrose Care is compliant) – is that it provides companies with a credible mechanism to signal to the public that they are ethical. If we are to expect social care workers to be caring, we should naturally expect their employers, too,  to be caring.

This is fundamental as direct increase of funding in the care system does not necessarily result in care providers being more ethical. Even Sweden, a country with a notoriously high level of social-care funding, has been rocked by care scandals(8) arising from independent-sector enterprises.

Western societies face many difficult questions about provision of care for the elderly over the next fifty years, but it is quite clear already that standards in social care must improve before challenges become even more overwhelming.

Penrose Care looks forward to continuing work alongside the Living Wage Foundation and Citizens UK in a genuine promotion of ethics in social care. We should welcome your views.* Comments to Robert.padron@penrosecare.co.uk

References

1.    Summary – Chapter 2: Population Change: 16 February 2012 (Office of National Statistics), pg 1. Available here.
2.    Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry – Executive Summary: 6 February 2013 (Mid Staffordshire NHS Foundation Trust Public Inquiry), available here.
3.    ‘Time, pay and lack of training are main challenges for homecare staff’: 30 October 2013 (The Guardian), available here.
4.    ‘Care budget cuts by councils put older people’s rights at risk, says report’: 8 October 2013 (The Guardian), available here.
5.    Home care commissioning practices by local authorities must protect older people’s human rights: 8 October 2013 (Equality and Human Rights Commission), available here.
6.    Paying the Living Wage benefits business as well as employees: 4 November 2013 (The New Economics Foundation), available here.
7.    An independent study of the business benefits of implementing a Living Wage policy in London: February 2009 (London Economics), available here.
8.    ‘Stockholm elderly care scandal widens’: 2 Novmber 2011 (The Local), available here.