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07 / Wider employment conditions

Updated: Dec 1, 2023

“The working conditions of Care Workers are among the worst of any in England” (Kingsmill, 2014, p.3)

Zero-hours contracts

It is common for home care workers to be employed on zero-hours contracts. This means there are no guaranteed working hours from one week to the next.

Zero-hours contracts suit the uncertainty that comes when a homecare agency cannot be sure how many client visits will be needed from one week to the next, given that clients may pass away or more visits may be taken on. For some homecare workers, particularly those who fit work in around caring responsibilities for children or other family members, the flexibility provided by zero-hours contracts is preferable to having a contracted amount of working hours each week (Koehler, 2014, p.7).

However, zero-hours contracts go hand in hand with financial insecurity and disadvantage. Aside from the obvious - you are not given enough hours to pay the bills - it is extremely difficult to secure financial products such as loans, including mortgages, when you have no guaranteed income. This makes home care workers vulnerable to debt, including falling foul of unscrupulous loan sharks, and locks them into renting rather than owning property.

That employers have no obligation to provide work to those on zero-hours contracts also discourages homecare workers from speaking out against poor working conditions. If wishing to make a complaint to HMRC about underpayment of the National Minimum Wage, home care workers must identify themselves in the complaint, which may put them off if they are on a zero-hours contract. Moreover, when a care worker is unsure what hours they will be given from one week to the next, this makes them more likely to rely on state assistance inn the form of benefits:

"the lack of income predictability is keeping people who could work more on benefits. Unsure if they would always have sufficient hours to qualify for working tax credit, they prefer to ensure that they stay below the 16 hours of employment that is the maximum for income support. Either way, the government is subsidising providers to pay care workers less than they could reasonably live on" (Koehler, 2014, p.7)

Unsociable hours

Mornings and evenings are the times of day when the majority of care visits are needed, as many clients require support getting ready for the day and ready for bed. Lunch and tea visits are common for clients who cannot prepare food independently , or need assistance with personal care throughout the day.

A typical working day for a full-time home care worker therefore begins at 7am and does not finish until 10pm; often starting at 7am again the next day. Whilst there are usually gaps in the middle of the day, such working patterns make for unsociable working hours. Care is needed seven days a week, meaning homecare workers must work at weekends, too. There is some variation in how homecare agencies organise weekend work, but it is normally the case that all employees must be available to work every other weekend.

“Care services are demanded exactly when care staff’s personal and family care demands are highest and also extend into conventional personal and family weekend time” (Rubery et al., 2016, p.757)
“Not only do care staff need to get out to work in the early morning, often six and sometimes seven days a week, but they also have to be willing and prepared to turn out for work several times a day after unpaid break periods. Care staff have to tolerate a high degree of work interference in their personal and family lives as they juggle family and work demands through the waking day” (Rubery et al., 2016, p.768-769)

As such, homecare work can be physically and emotionally draining, particularly if working full-time hours. If you do not get home from work until 10:30pm and need to wake up for tomorrow’s shift at 6am, that’s only 7.5 hours of potential sleeping time, including the time it takes to get ready for bed, complete any household jobs and fall asleep. Now imagine that is the norm multiple days a week. It is no wonder people burnout.

This graph in a report by the Resolution Foundation shows the high levels of exhaustion and tension at work experienced by social care workers (red line) compared to those in other low paid jobs (blue line) and the average across all jobs (black line):

And yet, we are paid so little.

Limited opportunities for career progression

When you become a homecare worker, you become part of a team of homecare workers. Among the team will be individuals who are very new to the job and others who have done it for years. The high likelihood is that you will all receive the same rate of pay as one another, regardless of your level of experience. It is rare to find a homecare agency which has a system for recognising seniority among its care workers.

This means that, unless you wish to take up a position in the office (these do not come up often) and move away from client care in doing so, there are limited opportunities for you to progress in terms of job title or pay. There should be opportunities for great homecare workers to progress in their career which do not involve taking them away from the clients they support: opportunities that drive up the overall quality of care available to people by supporting committed care workers to remain in their role:

One home care worker said: “We get fed up that there is nowhere to progress. We know our job inside out, so some get apathetic.”... “I have done this job for 26 years and haven’t progressed anywhere since. I’m in the same place. The agency pays on just what hours you do.” (Cavendish, 2013, p.30)
“Treating all care workers the same in terms of pay or accreditation devalues the fantastic care and skill of the many very good care workers" (Koehler, 2014, p.19)
“The majority of the evidence we received highlighted the lack of a defined career path for social care workers as a significant problem for both the recruitment and retention of social care staff” (Health and Social Care Committee, 2020, p.21)

Quality and availability of care plans

When a homecare worker visits a client for the first time, they should not need to go on a fact-finding mission to work out what they need to do during the visit. This is especially important when the client in question has difficulty communicating, which is often the case when working with clients who live with dementia or have suffered a stroke.

Care plans should always be made available to homecare workers in advance of visiting a client to ensure quality of care. There is not enough time within the visit itself for homecare workers to be expected to acquaint themselves with a client’s care plan and carry out that care to a high standard. Yet not all homecare agencies supply their workers with this information ahead of time.

Every care plan should contain tailored and up to date information about what needs to be achieved on each visit. There should also be as much information as possible about the client’s life story, relationships and background, to allow homecare workers to quickly establish rapport with the individual they are there to support. Again, this is of particular importance when a client has difficulty communicating. It is unfair on clients and their family members to be quizzed by new homecare workers about the same things time and again, as it is unfair to expect care workers to work from a blank slate.

The office: us versus them

When colleagues of mine have left for pastures new, it very often follows a period of poor relations with staff at the office. This post looks at why the relationship between homecare workers and ‘the office’ is so important, both for the wellbeing of individual staff members and the quality of care delivered to clients.

Whilst the nature of homecare work itself feels like a calling to many, the employment conditions that go with it undermine it as a long-term career option for many people with a caring nature. Here is a quick guide to possible ways that working conditions in home care could be reformed.

Supporting quotes:

“The provision of paid care at home is absolutely essential to meet the care needs of older and disabled people in contemporary society yet employment rights abuse in the homecare industry is widespread and terms and conditions are poor” (Hayes, 2017, p.5)
“Many Care Workers don’t even know what hours they’ll be working from week to week – exploitative ‘Zero Hours Contracts’ play a huge role in the sector and destabilise workers’ lives” (Kingsmill, 2014, p.3)
“The HMRC requires a named individual to make a complaint. For an individual care worker on a zero-hours contract – meaning no guaranteed work – that is a daunting prospect" (Koehler, 2014, p.5)

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