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Care work, skill and responsibility: different ways of ascribing value.

Updated: Nov 14

'Skill' comes up a lot when people talk about social care. Care work is low paid, you don't need any qualifications to do it (the Care Certificate is not accredited as a qualification), and because it mirrors a role performed informally by unpaid carers, this has historically led to a conclusion that care work is unskilled. Yet in recent years, and particularly since the pandemic, there has been a significant shift in how influential figures and organisations in the world of social care talk about care work and skill. Nowadays, it would be frowned upon to say that care work is anything but a skilled occupation. This revised conception of care work was formalised when the government added it to its skilled occupation list, which was necessary to enable overseas recruitment of care workers.


The reason I'm writing about this, is that as a 'frontline' care worker I have often felt unsure about whether the work I do should be considered skilled. If I wasn't a 'frontline' worker, I'd be too nervous about causing offence to bring this up, so in case this is a discussion that others would like to have, I thought I could be a good person to raise it. Having done a lot of thinking about this question of skill, my view is this:


From a practical point of view - care work does not require much in the way of skill. Responsibility? Yes, and more on that in a bit. But practical skill? There are very few people who would be unable to safely use a hoist or administer medication following a basic amount of training. When most people think of skill, the default is to think in terms of the practical skillset required. If, like me, you sense an instinctive uncertainty about care work's designation as a skilled occupation, this could be why. 


Yet the real skill required for high quality social care is social rather than practical in nature. The clue is in the name! Empathy, patience, kindness, compassion and the ability to adjust your communication style depending on the person you are with and how they are feeling that day.


Care workers are the only professionals who spend meaningful time with the people they support on a daily basis. As Kathryn Faulke notes in Every Kind of People, physios, GPs, OTs and all other professionals are fantastic at what they do, but unlike care workers who must stay the course, they are able to deliver their treatment or advice and then walk away. This is why you cannot overstate the importance of us having sound social skills.


Unfortunately, social skills are not easy to measure, test or quantify, which is why it's so hard to secure material recognition for them. Doubly unfortunate is the categorization of such skills as 'soft' rather than 'hard'. The language of 'soft' and its connotations of weakness immediately designate these skills as somehow inferior in value to their 'hard', ostensibly 'stronger' counterparts.


The upshot is that we end up with people becoming care workers who do not possess the social skills necessary to do the job well. It's like hiring someone who's never used a chisel before to build a chair. You might end up with something that technically meets the criteria: you can sit on it - job done! Yet the person seated may feel uncomfortable, frightened that everything could collapse and unimpressed by the lack of aesthetic appeal. Social care done well is a precious thing, and can truly be beautiful in its constant yet unpredictable, messy yet intrinsically humane nature. Sure, anyone can be a care worker as far as practical skill is concerned, but it takes genuine skill to do it in a manner that respectfully meets the needs of the person drawing on support. That’s where projects emphasising the importance of values-based recruitment in social care come in (see Curious About Care).


Going back to a word that came up just now: responsibility. This should really play more into the valuation of job roles. Often, care work is talked about in the same breath as other low-paid work, such as ‘public’-facing roles in hospitality or retail. Since, as a society, we generally only attach high monetary value to jobs that require a rigorous level of formal qualification (see ‘knowledge economy’) or practical skill, all of the above roles end up occupying the same ‘low-paid, entry level’ bracket. Indeed, social skills dictate the quality of your performance in any ‘public’-facing role, whether you’re a waiter, a shop assistant or a care worker (though they are arguably more essential in social care due to the nature of the work itself). Hence, there is little differentiation in the material proposition of becoming a care worker, or taking up a job in hospitality or retail. Yet a major differentiator exists: the level of responsibility involved. 


When I was 16, I worked at McDonalds. It was fast-paced. Quite often, it was stressful. You had to be nice to people who were rude to you, or clearly looked down on you, and that was an eye-opening and sometimes tough experience. But having been a domiciliary care worker for a number of years, the thought that somebody doing that same role as I did at McDonalds is being paid the same as my colleagues are for our work in care (often more when you consider our unpaid working time), feels like a gut-wrenching injustice. 


We support people day-in, day-out when their life has been turned upside by a stroke. We think of appropriate things to say to people in their final days of life. We are the only human contact a kind 94 year old will have all day long, every day. If we make an error with someone’s medication, the consequences could be life-threatening. If the strap of a sling is frayed and we haven’t noticed, someone could be injured falling from a hoist. If the skin on somebody’s heels breaks down as a result of prolonged pressure and we don’t pick up on this, there are serious, real-world consequences for all involved. How can it be that a job with this level of responsibility is valued so poorly?


I wonder if the key to convincing those who have never done 'frontline' care work that our roles are worth more than the minimum wage, is to talk in these terms of responsibility, rather than continuing to push water uphill in an attempt to achieve recognition for our anything-but-soft skills?


 

I run Homecare Workers’ Group, which is a free peer support network for homecare workers in England. We host a secure online group as well as a WhatsApp community and regular online and in-person meetups. Just sign up at homecarewg.org.


If you’d like to involve 'frontline' homecare workers in your work but don’t know how to reach us, do get in touch via the form at the bottom of this page. We let our members know about all sorts of opportunities to participate in relevant events and research.

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