Jo Steel gives a provocative account of working at the frontline of the care industry…
The names in this piece, including that of the author, have been changed
Rachel Sampson is a support worker for the living support charity, Outward. I first met her at the debating society I go to, where the speakers usually concentrate on politics or philosophy – so imagine my surprise when I heard her deliver the following speech on the state of the care industry:
“The situation at the moment is that we’re facing cuts to our pay and terms and conditions. The cuts made by local authorities are being passed along to our staff and our service users, and that’s making it increasingly difficult for us to maintain good staff in caring positions in the organisation.
“Staff are being forced to choose between the job they love and really care about doing, and having enough money to pay their bills and look after their families; whether they should stay in their role, or if they should look for higher paid employment. That’s going to have a big effect on our service users, [many of whom] have built relationships with staff who are forced to leave for jobs with higher pay.”
Imagine you are on a tram looking after three severely autistic men, one of whom has epilepsy and often wanders off looking for sweetshops. Another staff member is there to help you, yet she falls asleep not once, not twice but three times. Surely the right thing to do is report this to my manager?
Well, this actually happened, I reported it, and this woman is still a carer – despite nodding off several times while on duty. The truth is that our managers do not have the luxury of choosing their staff. It is very difficult to fire people. If day centres are not fully staffed they can get into legal trouble.
Managers fight an endless battle against staff using smartphones at work. In our residential home, the management threatened to confiscate any smartphones being used at work. The timing of the announcement could hardly have been worse, since the staff had just learned that their unsociable hours bonus was going to be phased out. All the smartphone action achieved was to make staff more bitter – many simply carried on using them as soon as their managers’ backs were turned.
Instead of trying to eradicate smartphone use, perhaps staff could be encouraged to download useful apps that can be used to assist with their daily activities?
Issues of trust
You may well ask, why don’t managers just recruit better staff? Well, it’s easier said than done – staff turnover in the care industry is huge.
Five years ago, another company I used to work for was in the process of training a new staff team. In the middle of it they were told that they had to sign new, less favourable contracts. Only two of the new staff intake stayed.
I myself had been working for them for six years and barely thought about getting another job. What changed my mind? It wasn’t the relatively low wages – £7.47 an hour isn’t much, but more than enough for me to live on. It was the fact that the previous summer, my colleagues and I had noticed that we weren’t getting our holiday pay in April as we always had.
It turned out that head office had decided we would only get holiday pay if we asked for it. Needless to say, no one had thought to tell the workers; we only found out about it from each other. I managed to get mine – others weren’t so lucky – but this was the last straw. I left there to join a care agency, so that I wouldn’t have to rely on a company I could no longer trust.
On the whole, work incentives in the care industry are poor. Drivers get no extra pay. We are paid the same for working with both gentle and aggressive service users. Lazy staff are paid the same as the hard workers.
Who has the final say?
Furthermore, care industry governance is Byzantine. Staff, service users, managers, parents, politicians and lawyers all exert influence on how things are run, but which of them is in charge? In practice, it’s parents who tend to exert the most pressure, but they rarely seem to use their power in the most helpful way.
There are positive sides to working for my current employer. It is currently running a successful scheme which helps service users find employment, and I know of two such service users who got good jobs as a result. One now works for John Lewis, the other writes computer software.
It’s an organisation that also organises good workshop sessions by employing skilled freelance tutors, including one tutor who teaches filmmaking to a group of high-functioning autistics, of which he is one himself.
This tutor has, however, had some bad experiences. “A member of staff spent most of the session on their mobile phone, not acting in a professional way or providing the care a service user deserves,” he told me. “They weren’t actually phoning anyone, but they were absorbed in it and oblivious.”
In this instance, action was swiftly taken. “The manager took appropriate action with that member of staff, and they were never my assistant again,” the tutor recalls. “The people that run the centre know which staff will be best suited to help with my sessions.
“Most weeks, I see certain members of staff show real commitment and understanding towards the vulnerable adults we support. They show a great generosity of spirit and a lot of patience, they are willing to go the extra mile for the well being of service users. In the past, there were loads of crap staff, I wouldn’t trust them to put my bins out, but now it’s the other way round. The good staff are worth their weight in gold and add real value to the service.”
For my part, I have suggested many ways in which the organisation can save money without cutting standards of care or staff wages. Managers could videoconference, instead of wasting time and petrol commuting to endless meetings. Public transport can be used instead of cars for all but the most violent service users. I know of three service users who live a bus ride away from their day centre. They have Freedom Passes – as do some staff – and are rarely aggressive, yet they are still driven from their homes to the centre every day.
Rachel Sampson also has an idea for saving money: “I think money can be saved [by introducing] the concept of co-production, sharing resources between different organisations and though better understanding of disability in the communities.”
Ultimately, I believe that for the care industry to be seen and treated as more than a babysitting agency, two things are needed. Staff need to be paid more, and they need to be fired more easily when proved guilty of negligence.
Are day centres for everyone?
There are two types of service user who will particularly benefit from attending a day centre – hyperactive people needing exercise, and shy service users who can pick up social skills by immersing themselves in small groups.
Day centres are not suitable for those already capable of working, or those who ‘switch off’ when pressurised. If the service users and/or staff lack motivation, then any attempts at organising successful activities simply won’t work.
The only proof that activities have taken place – and whether or not they are successful – are the records that staff make. In theory, we could write anything we like and no one would know. I’ve seen for myself how many day staff stopped keeping any written records at all once they found out that they were being thrown away without even being read.