Social care: Ending exploitation, improving care quality
Yesterday marked 15 years of the National Minimum Wage, the establishment of which was a landmark achievement for the trade union movement. The NMW has provided a wage floor for millions of workers. But many are still slipping through the net. None more so than in social care.
So it’s right that we use Fair Pay Fortnight to highlight the prevalence of poverty pay and exploitation for those workers who are looking after and caring for the most vulnerable in our society.
This week UNISON submitted its response to the Kingsmill review into exploitation in the care sector, much of which focused on care providers failing to comply with minimum wage legislation.
Based on earlier estimates, more than 220,000 direct care jobs in the UK are now paid below the minimum wage. HMRC found that a shocking 48% of providers were non-compliant, and this is a problem in residential care as well as homecare.
To compound matters, the government’s approach to enforcement has been woefully inadequate and reporting mechanisms for staff are not fit for purpose.
At a roundtable convened by UNISON to hear directly from members about their experiences, it was clear that some groups of care workers are particularly vulnerable. A number of appalling examples surfaced of the exploitation of migrant workers, as a result of unscrupulous employers operating with relative impunity in an under-regulated sector.
The union’s submission included 25 policy recommendations that a future government should consider in order to make the social care sector sustainable.
In the short-term, the increasingly high-profile Ethical Care Charter should be promoted to all local authorities to improve the delivery of their homecare services. This would ensure that zero hours contacts are not used in place of permanent contracts; that 15-minute visits are not generally used, as they undermine the dignity of clients; and that staff are paid for their travel time, the single biggest reason for NMW non-compliance in the sector.
In the longer term, however, more profound changes are required. And these include the need for a “whole system” approach of proactive challenge to minimum wage non-compliance in the sector. This would mean measures such as a new formal third party role for unions (and other agencies), which treats union reports of breaches of the NMW as a formal complaint.
Local authorities could be given greater responsibility to enforce the NMW, alongside HMRC. Funding for enforcement work needs to be dramatically increased, and there should be greater penalties for breaches of the NMW.
In addition to naming and shaming care providers which breach the NMW, HMRC should also name councils that commission care from such providers; and both councils and providers should become liable for non-payment of the NMW.
Beyond this, the ambition for the care sector should be to move further, with a third of councils having already adopted the Living Wage and a third more considering doing so.
Think tanks have suggested the Treasury would benefit to the tune of £3.6bn as a result of introducing a statutory Living Wage. Research for UNISON pointed out that this would create “an economic win-win on a number of levels”.
Of course, the single biggest problem in the sector is the lack of proper national funding for social care that is passed on by local authorities to providers and by providers to staff.
The time has come for a major Wanless-style review of exactly what funding the sector needs to become sustainable. Then the political and moral case needs to be made to provide this funding, with a clear explanation of the fate that awaits the sector if it is not forthcoming.
In terms of provision, there is a need for a paradigm shift within the sector, with quality always placed above price.
Local authority employed care staff almost always enjoy better terms and conditions than those within the private or community and voluntary sectors, so in-house provision should no longer be considered untenable.
Finally, we need a systematic approach to tackling commissioning problems at source.
The Care Quality Commission should be obliged to regulate local authority commissioning practices – as outlined in the original version of the Care Bill before a government u-turn backed away from this in favour of a piecemeal approach of examining rushed care visits.
This should then be used to bring about a step change in the way local authorities commission services, by moving away from framework contracts and blocking reverse bidding.
Staff working in homecare, residential services and in the community are clear that the exploitation of the workforce is having a massively detrimental impact on service users.
The time has come for a new approach that properly values care workers and properly funds the services they provide.