I started as a care worker in August 2012, a year after a BBC Panorama documentary exposing abuse at Winterbourne View sent shock waves through the social care system. During my time care working, between 2012 to 2014, Panorama released two more documentaries exposing neglect and abuse in care homes. With each new documentary, more scrutiny was put on care workers across the sector, yet nothing was done to consider how they could be better supported or trained to improve the quality of care and to put an end to neglectful or abusive practices.
Another three-part Panorama series, Crisis in Care has highlighted the continuing social care crisis in recent weeks. This time, we must change the debate and do more to support our care workers – otherwise, we are doomed to repeat the same mistakes. After all, good care is dependent on good care workers.
The value of care
As a home care worker, it was my job to get people up in the morning, help them wash and dress, make their food, remind them to take their medication, tidy their home, do laundry, help them get to bed at night, and for one family, train their dog. I was there for my clients when they were happy and when they were sad. Sometimes I was the only person they saw all day. I knew their hopes for the future, learned about their past, and for some, I was there right until the end.
It is a difficult job which should not be underestimated. The average care worker is paid £7.38 an hour – lower than the National Living Wage of £8.21. The pressure faced by care workers is overwhelming, pushing some to breaking point. The Office for National Statistics found both male and female care workers face a risk of suicide that was twice the national average. Sometimes I felt undervalued and under-trained, and I wonder whether this affects a person’s ability to value the people they are looking after.
Without the right training for looking after people with more complex needs, such as those with learning disabilities or dementia, you can find yourself in situations which spiral out of control.
Through others in the profession, I heard about the story of a man with dementia, a widower who became more and more confused after the death of his wife. He was, however, delighted with the stream of women coming to his house to look after him – 82% of all care workers are women. He would invite them to stay overnight with him, sometimes making sexually explicit proposals.
One of his carers found this behaviour unacceptable and got angry, telling him to leave her alone. They got into an argument which culminated in him insulting her with a racist slur.
After I left my job in care and moved in to research, where I was trained in understanding the meaning behind behaviour in dementia, I reflected on what I’d heard about this incident. I realised the man was lonely, he missed his late wife and propositioning the care workers was an attempt to ease his loneliness.
Breaking the cycle
As it stands, care providers are not required to provide a minimum level of training for their care workers. But good training can help to break the cycle of bad practice and help care workers feel more comfortable in their jobs.
One training programme, called WHELD aimed at care workers looking after people living with dementia, was studied in a randomised control trial in 67 care homes in the UK. Researchers found that nine months of training improved the quality of life of care homes residents in addition to reducing their levels of depression and agitation. They also found that fewer people died in care homes which received training than care homes that didn’t.
But most importantly for me, if care workers are given the skills to manage difficult situations, they are less likely to get frustrated and lash out at the person they’re caring for. Rather than policing the system with more frequent and harsher checks from the Care Quality Commission, the care home regulator, the UK needs to take proactive measures to invest in its workforce of care workers.
The crisis in social care is deepening and will continue to do so without action from the government. Care workers are on the front line of an unsustainable system of care, they are frustrated, underpaid and pushed to their limits. There are a handful of truly terrible people working in care, as exposed by Panorama, but they are absolutely a minority. Most care workers are decent people doing their best in an impossible system.
As the debate continues, we must include them, we must understand the challenges they face, and we must do more to give them adequate training and support. It is a matter of life and death.