In part two of four of our new blog miniseries on shared ownership in business, our Director of Learning & Influence Genevieve Maitland Hudson explores the challenges of domiciliary and care work, and the opportunities a change in delivery model could bring for the industry.
In one of his first speeches after his appointment as Health Secretary, Matt Hancock raised the thorny question of the health and social care workforce. He touched on key areas that have relevance for many: recruitment, the quality of management and the ability to access ongoing training and to progress. Care work is a growth sector, but it is also a sector with low pay, variable standards and little public or political capital. It has been hit hard by austerity since most social care is delivered by local authorities, and these have been facing significant year-on-year cuts, with many soon to be entirely without central government funding.
In this context, there is a significant need to rethink the delivery model for both carers themselves and those accessing care in order to better the sector for all involved. Both carers and those accessing care are vulnerable populations, with carers at the forefront of widespread labour inequality.
The Office of National Statistics assesses caring as the lowest paid sector in the UK economy, and in their 2017 bulletin noted that there are many at the lowest end of the pay scale for care work who are being paid less than living wage.
There also exists a gender pay gap. The majority of care workers are women – and despite the fact that few men work within this sector, the minority are financially better off.
82% of care workers are women, and many are also from BAME backgrounds. In London 68% of the care workforce is BAME. BAME women are the least likely to achieve a living wage, and reasonable job security, in any sector of the UK economy, so that care work is at the intersection of multiple factors that contribute to economic disadvantage. Around a quarter of the overall care workforce are on zero hours contracts. This rises to 47% of domiciliary care workers, a figure comparable to that of young people in the gig economy (53%).
This is, therefore, a crucial area for the social economy in which we must work harder to achieve workforce equality.
As with the hospitality sector, care work is expected to grow significantly in the coming years. Skills for Care estimate that there will be a need to increase the workforce by 31% by 2030, through a further 500,000 jobs. The domiciliary care workforce has already increased by 19% since 2009. These factors taken together point to a sector and a workforce that is in need of sustained effort of revaluation to retain, and improve, service levels, but importantly too to offer the workforce a far more equitable share of national median earnings.
There are some interesting differences between the care workforce in general and the domiciliary workforce in particular. Notably, there are differences in pay, with home care workers earning more than workers in publicly funded roles.
These already slightly higher wages may be crucial in developing shared ownership models that can aspire to profit-making - if not for redistribution, then at least for reinvestment. It remains very difficult, as discussed above, for organisations working in health and social care to earn meaningful profits from even large-scale operations. The costs and overheads remain so high, even at scale, that margins are inevitably tight, and where there was a potential profit that has largely been swallowed by continual cost savings exacted by public sector commissioners.
Much of the Skills for Care estimated increase of 31% by 2030 will be in domiciliary care that is not arranged directly through Local Authorities or institutional healthcare settings, and is therefore unregulated.
Be Caring (formerly CASA Ltd - who we supported in 2016 and 2018 through our then-Access Reach Fund and Big Potential Advanced programmes) SMart and the DWA has already demonstrated in different ways, this is a sector that is well-suited to shared ownership. Workers are dispersed, disadvantaged, and have little access to formal representation and support. The sector itself is growing. These features make this social care workforce particularly suited to the self-organising model of cooperatives and hybrid shared ownership that blends advocacy with accessible professional services such as contracting and HR.
Domiciliary care work may offer a particular opportunity for local mutualised groups working within regional or national networks to create shared ownership that would support services, staff development and improve quality and standards.
This is the approach that has already been pioneered by organisations like Be Caring, but which could be extended and encouraged by a targeted programme of development of the kind initiated by Inspiring Scotland, to create non-competitive supply chains of care services. As with the opportunities that we highlighted in the hospitality sector in last week’s blog, Social Investment Business is keen to support and explore the ways in which social investment can open up opportunities in this sector, and strengthen resilience from within – particularly for those sections of the workforce who need empowering the most.