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Care home regulators should assess staff pay levels, says charity


Pay and working conditions in care homes should be assessed as part of an extended remit of regulators in the sector, according to a critical report by a charity that looks at the “crisis” in UK care homes for older people.

The report, published by the Joseph Rowntree Foundation, called on the government to ensure regulators look at worker salaries – as well as staffing levels, commissioning practices and the transparency of tariff systems – because these factors “directly impact on quality of care”.

It also urged the government to ensure all care managers were registered and licensed to practise through a professional body.

This professional body for care managers should set professional standards, have disciplinary powers and provide a voice at a national policy level, said the report, to give assurance and to raise the status of the profession.

Joseph Rowntree Foundation

John Kennedy

Funding for care homes has resulted in “bare bones” staffing levels and “appalling” pay, meaning the “sector is structured to fail”, claimed the report.

It points to recent statistics by think tank Demos, which showed that 78% of frontline care staff earn an average of £6.45 per hour, just 14p more than the minimum wage based on 2013 figures.

Meanwhile, funding for the adult social care sector in 2012-13 was £12bn – or 1.8% of the government’s total annual spend on services – while the NHS received £102.6bn (or 15.3%), highlights the report.

“The care sector is inadequately resourced to step up to effectively supporting the NHS in an ageing society”

John Kennedy

“This is not a satisfactory or sustainable situation. The care sector is inadequately resourced to step up to effectively supporting the NHS in an ageing society,” it added.

Integration of health and social care is “essential” but requires significant shift in resources, status and attitudes, noted the report, adding: “Acute hospitals have no relationship with the care homes in their locality. They have a transactional collision every so often, when a resident is admitted to hospital or the discharge team wants to discharge, but it is not a functioning partnership”.

The report was written by the foundation’s director of care services, John Kennedy, following a year-long inquiry looking at existing research and new testimonies from workers across the sector, those using care home services and the general public.

As part of his recommendations, Mr Kennedy called for improved pay and reduced paperwork for care workers.

He called on care homes to “resist defensiveness” and be more transparent around their failings, and urges the government to declare the sector of primary national strategic importance.

Mr Kennedy said: “Real change is needed to end the neglect of our care home sector. Currently the system is set up to fail, with the minimum resource, effort and value placed on care homes.”

He added: “How many more reports of failing care do we need to hear about before we decide to act? We need to make our care homes better now. We need to have a system that maximises the potential of all care homes to be good.

“The government, regulators and care home providers need to come together to improve funding and pay, cut bureaucracy and inject humanity back into the system we rely upon to look after our loved ones and ourselves,” said Mr Kennedy.

The Care Quality Commission has required care homes to register with it since 2010, backed by inspections.

Around 40 care homes have so far been visited under the CQC’s new inspection regime for adult social care providers, which is currently being rolled out across England.


Readers' comments (3)

  • Well done Rowntree Foundation.It's about time these issues were addressed.I work i n a care home at the moment and the owner is so obsessed with profit he employs minimum staff to the bare legal level and wages are atrocious.The manager backs him up at every opportunity-and she is a nurse!
    I hope that if Care Managers have to register with a Professional Body then this will be separate from the \nmc if they are nurses as well.

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  • I'd agree with all the above, I worked in Challenging behaviour/ forensic for over 10 years(where pay was slightly higher) for a housing association that was set up and run by current (then) and ex NHS senior staff who saw the chance when care in the community came in( incidentaly many of the higher staff have long since retired on healthy packages some returned to their homelands extremely rich rarely paying little tax).
    I worked alongside NHS on different terms and conditons they had enhancements we had none, they had far more sick pay and holidays too.
    We ran several projects to keep the clients, patients, service users or whatever they are called this week and we would visit all other care homes owned by them in the area doing gardening/ building work alledgedly done by service users but in fact carried out by staff who were all ex building/ engineering guys.
    During visits you saw many cases of possible neglect and bad practice which WERE reported though what happened who knows?
    On starting my current job because of my previous experience I had to visit many care homes in central England the council owned ones were always the best staffed and cleanest( you rarely smelt faeces) the private run care homes were nearly always understaffed and poorly run affairs, staff were often though not always ex factory workers and though most were caring some definately were not, profit was definitely held above all else.
    As to inspections they are a joke no matter what anyone says I can tell you for a fact we always knew when an ispection was coming and so all T's were crossed and I's dotted, staffing was up to full strength and activities were laid on, with diffiult clients/staff removed from site this was and no doubt still is common peanuts get monkeys!

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  • This is what happens when you privatise the industry,profit comes before everything.

    The old 'insitutions' where not ideal but they had their advantages in that clients mixed with like, on site 24 hr medical care and support was available unlike private care homes.
    Personal care and grooming were also available free or cheap as opposed to trips to the barbers etc which are not.
    There werer many things not taken into account with care in te community, such as personal spending, contributions to vehicle upkeep, and worklife balance.
    All of our clients in the end decided it was their right not to wash or do any of the work projects and also to stay up until 2 in the morning watching questionable tv channels, but " it was their right" we were told, in the end all ended up in debt /overdrawn and obese as they no longer wanted to do anything save watch tv.

    The downsides were insitutionalisation which definately need addressing but that was do able, more community visits and interactions and on site satelitte homes would be good for the more capable clients.

    As for the old institutions being expensive there is no way in real terms that it is cheaper today than it was then, we had many clients 'in the community' on 2 to1 24-7 staffing with personal budgets around the £250K area!

    I found expectations from clients once in the community were artificially high made worse by advocates who pretty much believed everything told to them by the client but rarely read or had access to their case notes leading on occassion to possible dangerous situations.
    I worked with one chap once who deemed it perfectly acceptable to move his bedroom around 192 times in one year usually around 3 am in the morning, the elderly couple next door loved that I am sure, almost as much as the young family with small children on the other side who saw the same client 'entertaining' himself at his bedroom window during the summer holidays whilst their children were in the paddling pool.

    Things like the above were not uncommon and I am told still go on.

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