Caring about Homecare

Caroline Wiemer and Kerry Harman from the Centre for Social Change and Transformation in Higher Education discuss the ongoing challenges faced by homecare workers since the homecare sector was privatised in the 1990s.

A carer with and elderly person in a carehome

Photo courtesy of Matthias Zomer

The invisibility of women’s work has been documented by feminist scholars for decades (see DeVault, 2014) and here we are in 2020 and, for paid homecare workers in the UK (and many other countries), the situation has not improved. Indeed, things have gotten a lot worse. While the COVID-19 crisis has drawn attention to the importance of ‘key workers’, particularly those employed in the care sector, proposed government immigration policy which prevents ‘low skilled’ workers entering the UK, including care workers, makes the weekly ‘clap for our carers’ feel like shallow rhetoric. Indeed, Hayes and Walters point to ‘the exploitation of care workers for political profit’ during the pandemic.

So what do we know about these homecare workers that, until quite recently, have been largely invisible? Annual reports on adult social care workforce data provide an overview of the workforce in England. Approximately 295,000 care jobs are in care home services with nursing; another 305,000 jobs in care only home services and the majority of jobs are in homecare, with 520,000 employed in this work. In other words, the provision of paid care is a major industry in the UK. Of the homecare workforce, approximately 50% were employed on zero-hours contracts, 84% were female, the average worker was 43 years old, 83% were British, 7% were EU (non-British) and 9% were non-EU. Across the care sector, there are large variations in ethnicity by region with London having the most diverse workforce (67% BAME) and the North East the least diverse (96% white). So homecare workers are likely to be more mature women, on precarious employment contracts, and Black or from a minority ethnic background if they work in London and white if they work in the North East.

While the outbreak of COVID-19 has contributed to a recognition of the ‘crisis in care’, a number of reports over many years indicate the homecare sector was in crisis well before the pandemic (BBC Panorama, 2019; Gardiner, 2015; Holmes, 2016; Koehler, 2014; UNISON, 2016). A shift to the outsourcing of this work to the private sector by local authorities during the 1990s had resulted in a race to the bottom in terms of hourly rates of pay and overall employment conditions for homecare workers (Hayes, 2017). This is exacerbated by an aggressive tendering process which often forces smaller, local agencies to eventually close their doors. The experience of working in the sector and changes that have taken place since the 1990s is provided in the following account by one of the authors:

I started working in the care sector 31 years ago when I got a part-time job as a ‘home help’ with the local council. My role was to help elderly disabled people in their own homes and to maintain their independence by doing shopping, laundry, housework, getting medications. The pay and conditions were good, with paid annual leave and sick pay. It was a satisfying job to strike up a relationship with the people I helped, hearing their stories of the past. I had time to have a conversation with them, which they enjoyed as sometimes I was the only person they might see that week. Then after a few years we were renamed ‘homecare workers’. With this title came changes –service users times were cut and they started to charge for their care. We had to do more in less time.

When the council outsourced homecare we were transferred to a non-profit organisation and we all had to take a pay cut. Our hours were cut, as well as sick pay and annual leave. If we did not take these cuts we did not have a job. You keep going because the vulnerable need your assistance. It’s not their fault we now work for less than previously. Then the non-profit organisation lost the contract and we were transferred over to a profit making company. I cared for a lady called Edna for just over ten years and she saw the changes with me. Edna had no family and I became her family. I used to get half an hour in the morning to give her a bath, dry her, help her dress, give her a drink, breakfast and medication. I used to go in earlier, just so I didn’t have to rush, as I knew I could not do all that in the time I had been given. We would have our conversation while I was carrying out my tasks. I would do all the things she no longer could because she was hard of hearing, like making phones calls. I’d organise appointments to doctors, hospital, medications and go with her in my own time. I’d make sure she had food, clean clothes – all things we able people take for granted. Over the years carers have lost pay, conditions, working hours and time to care.

Homecare is a low paid job and carers are not recognised for what they do . All I ever wanted was to have time to care, to give the person that I care for their dignity and independence – make them feel valued as a person and that they matter. Carers are everything to our service users – we are carers, nurse, secretary, friend, relative, the go to person who can sort everything out. Most of it is done in our own time. Sadly, my Edna passed away. She was classed as a vulnerable adult, but how vulnerable did she have to be to get the time and care she should of had? How long can carers go on giving their all and not being recognised and respected, on low pay and zero hours contracts? Carers look after the vulnerable but who looks after the carers?

(also listen to Caroline at a recent ‘How might we recognise the value of homecare provision?’ event at Birkbeck)

The ongoing ‘crisis in care’ resulting from the privatisation of the care sector since the mid-1990s points to the urgency of public policy interventions, backed by the resources to enable local authorities to bring homecare services back in-house. This would make it possible for fair wages to be paid and better working conditions for homecare workers across the country. Public policy interventions would also make it easier for trade unions to organise care workers, which is extremely challenging in the private care sector.

Another possible solution to the crisis in care in the UK has been a call for the professionalisation of the sector and this is usually accompanied by proposals for training and development. However, will more training and development get to what we believe is the heart of the problem, which is the ongoing failure to attend to the often embodied skills and knowing that homecare workers have developed in and through their everyday practices and experience at work? Indeed, many training and development programmes are underpinned by the same set of assumptions on what counts as ‘good care’ and who knows about ‘good care’ that work to make the everyday knowing in practice of homecare workers invisible.  As Weimer points out above, carers are also: ‘nurse, secretary, friend, relative, the go to person who can sort everything out’ and this is not ‘low skilled’ work.

During 2018/19, a participatory project with homecare workers was started in two boroughs in London called the ‘Invisible work, invisible knowledges?’ project. The authors met during that project. The purpose of the project was to make contact with homecare workers and find out more about their everyday experiences at work as part of a planned larger project on ‘Reimagining care’. One of the authors met with 13 homecare workers overall, in either individual or small group meetings, and the conversation usually started with: ‘Can you tell me what happens during a normal day at work? Is there such a thing as a ‘normal’ day?’ She was interested in hearing from homecare workers about what they actually do and, as part of these conversations, the homecare workers would often talk about the challenges they experience in their daily work. The resounding problem identified by care workers was the lack of time in the Care Plans[1] they are given to complete their work in a way that enables the people they care for to be treated with dignity and respect. This has resulted in many homecare workers providing additional hours of unpaid care to provide a level of care to care recipients that they consider adequate. As one care worker said, ‘If you see that there’s no food in the fridge, are you going to let someone go hungry?’ This is a reminder that, sometimes, care workers are the only point of contact that care recipients have with the outside world.

Another issue raised was the precarity of homecare workers’ employment contracts. The majority of care workers in London are employed by private agencies, with a large percentage on zero-hour contracts. Many care workers spoke about contracts that had eventually dwindled to very few hours work each week and the need to look for work elsewhere. A reduction in weekly hours was often connected with concerns raised by the care workers about the welfare of their clients/their working conditions. This is an issue that has been raised recently by the MP for Nottingham East, Nadia Whittome.

One outcome from the first stage of the project has been establishing a core group of homecare workers who are interested in documenting their embodied skills and knowledges which are so often overlooked. A crucial aspect of the research is recognising these workers as active producers of knowledge on care rather than passive recipients of knowledge produced in the academy and it is for this reason that homecare workers must be paid as co-researchers on the project. We are hoping the research will contribute to changing the ways care is able to be imagined as well as more democratic processes for developing policy on care, which includes homecare workers getting a seat at the policy making table.

To find out more about the ‘Reimagining Care’ project contact Kerry Harman.

References

DeVault, M. L. (2014). Mapping Invisible Work: Conceptual Tools for Social Justice Projects. Sociological Forum, 29(4), 775-790. doi:10.1111/socf.12119

[1] These are the plans which are put together, usually by an Occupational Therapist, after conducting an assessment with the person requiring care. They specify how many visits per day are required, the duration of each visit and the key activities to be undertaken at each visit.

 

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COVID-19 induced travel restrictions are not enough to mitigate crises like climate change. Could a circular economy be the answer?

Research by the Department of Management’s Dr Fred Yamoah and colleagues points to a new way to rebuild the global economy in the wake of the coronavirus pandemic.

Image of a reuse logo

There is no doubt that COVID-19 is first and foremost a human tragedy, resulting in a massive health crisis and huge economic loss.

While the impact on life as we know it has been unthinkable, a side effect of the way of life forced upon us by the pandemic is an unprecedented reduction in global carbon dioxide emissions, which are projected to decline by 8%. If achieved, this will be the most substantial reduction ever recorded, six times larger than the milestone reached during the 2009 financial crisis.

However, these changes should not be misconstrued as a climate triumph. They are not due to the right decisions from governments, but to a temporary status of lockdown that will not linger on forever; economies will need to rebuild, so we can expect a surge in emissions in the future. Indeed, the relatively modest reduction in emissions prompted by the COVID-19 pandemic has proven that zero-emissions cannot be attained based on reduced travel alone; structural changes in the economy will be needed to meet this target.

The case for a circular economy

Before coronavirus prompted this dramatic shift in our way of life, it seemed that the world had been waking up to the need for change to protect our environment. The linear model of our industrial economy – taking resources, making products from them and disposing of the product at the end of its life – jeopardizes the limits of our planet’s resource supply. Girling (2011) found that around 90% of the raw materials used in manufacturing become waste before the final product leaves the production plant, while 80% of products manufactured are disposed of within the first six months of their life. Similarly, Hoornweg and Bhada-Tata (2012) reported that around 1.3 billion tonnes of solid waste is generated by cities across the globe, which may grow to 2.2. billion tonnes by 2025.

Against this backdrop, the search for an industrial economic model that satisfies the multiple roles of decoupling economic growth from resource consumption, waste management and wealth creation, has heightened interests in concepts about circular economy.

What is circular economy?

Circular economy emphasises environmentally conscious manufacturing and product recovery, the avoidance of unintended ecological degradation and a shift in focus to a ‘cradle-to-cradle’ life cycle for products.

In our current situation, there has never been a better time to consider how the principles of circular economy could be translated into reality when the global economy begins to recover. Strategies to combat climate change could include:

  • material recirculation (more high-value recycling, less primary material production)
  • product material efficiency (improved production process, reuse of components and designing products with fewer materials)
  • circular business models (higher utilisation and longer lifetime of products through design for durability and disassembly, utilisation of long-lasting materials, improved maintenance and remanufacturing).

Building back better

A circular economy could also act as a vehicle for crafting more resilient economies. The pandemic has forced a rethink of the way our global economy operates, revealing the inability of the dominant economic model to respond to unplanned shocks and crises. The lockdown and border restrictions have reduced employment and heightened the risk of food insecurity for millions.

To prevent a repeat of the events of 2020, it is necessary to devise long-term risk-mitigation and sustainable fiscal thinking, moving away from the current focus on profits and disproportionate economic growth. Circular economy concerns optimised cycles: products are designed for longevity and optimised for a cycle of reuse that renders them easier to handle and transform. Future innovations under this model would focus on the general well-being of the populace, alongside boosting the market and competitiveness.

This economic model would also support the achievement of social inclusion objectives, for example by redistributing surplus food from the consumer goods supply chain to the local community.

The benefits of a circular economy are therefore obvious in that it strives for three wins in terms of social, environmental and economic impact. The pandemic has instigated a focus on the importance of local manufacturing for a resilient economy; fostered behavioural change in consumers; triggered the need for diversification and circularity of supply chains and evinced the power of public policy for tackling urgent socio-economic crises.

Governments are recognising the need for national-level circular economy policies in many aspects, such as:

  • reducing over-reliance on other manufacturing countries for essential goods
  • intensive research into bio-based materials for the development of biodegradable products
  • legal frameworks for local, regional and national authorities to promote green logistics and waste management regulations which incentivise local production and manufacturing
  • development of compact smart cities for effective mobility.

Post COVID-19 investments needed to accelerate towards more resilient, low carbon and circular economies should be integrated into the stimulus packages for economic recovery being promised by governments, since the shortcomings in the dominant linear economic model are now recognised and the gaps to be closed are known. The question is no longer should we build back better, but how.

This blog was adapted from T. Ibn-Mohammed, K.B. Mustapha, J. Godsell, Z. Adamu, K.A. Babatunde, D.D. Akintade, A. Acquaye, H. Fujii, M.M. Ndiaye, F.A. Yamoah, S.C.L. Koh, ‘A critical analysis of the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies’ in Resources, Conservation and Recycling, 164. Available at: https://doi.org/10.1016/j.resconrec.2020.105169

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Ethical consumerism in the time of COVID-19 

Has climate change fallen off the public agenda due to the coronavirus pandemic? According to Birkbeck’s Dr Pamela Yeow, it’s more relevant than ever. She explains her latest remote research project exploring ethical consumerism.

Paper coffee cups

Amidst the current coronavirus pandemic that’s engulfing our global consciousness, one may wonder if research to do with the United Nations Sustainable Development Goals (UNSDG) is a tad too irrelevant and insignificant.

After all, coffee chains, which had previously encouraged customers to bring in reusable mugs (and in return benefit from a discount), no longer allow such practices to help tackle the spread of the global virus.

However, it has been shown that during this pandemic, issues surrounding climate change and sustainability have continued to be raised. Global records have demonstrated that carbon emissions have reduced as a result of lockdowns worldwide and many reports suggest an increase in birdsong, brighter and clearer skies, cleaner air and less pollution.

So it is clear that research to do with sustainable consumption should be as relevant as ever  and it would be interesting to see, in a live experiment (given that we are living through it as we write), how consumers behave and react to embedding sustainable consumption patterns.

Just before the lockdown in the UK, my colleagues and I were awarded an Eastern Arc grant to run a pilot workshop on understanding sustainable ethical consumerism from the householder’s perspective. In particular, we were keen to address the UNSDG 12.5 which states “By 2030, substantially reduce waste generation through prevention, reduction, recycling and reuse.” 

Previous research that we had conducted concluded that “both individuals and institutions play a significant interaction role in encouraging a sustained behavioural change towards ethical consumerism”. We suggest that embedding behaviour is a gradual process. one with a series of stages and factors that can impede the transformation of attitudes into behaviour.  

This time round, building on that understanding of processes and journeys, we were interested to understand  the householder’s journey toward ethical consumerism and whether there would be any clarity in how they might embed and substantially reduce waste generation through prevention, reduction, recycling and reuse. 

The UNSDG website states that The current crisis is an opportunity for a profound, systemic shift to a more sustainable economy that works for both people and the planet...COVID-19 can be a catalyst for social change. We must build back better and transition our production and consumption patterns towards more sustainable practices.”

Our research project aims to consider how we might begin to embed these practices by understanding where householders are nowAs researchers, we too have had to adapt due to COVID-19: instead of hosting a workshop to answer our questions, we’re asking participants to keep a photo journal of single use plastics in the home to better understand how these items are entering the household and to promote awareness among users of their consumption habits.

This project is still in the early stages, but one thing is clear: more needs to be done to promote sustainability rather than less. We need to continue to understand behaviours and attitudes toward sustainable consumerism so that we can build a better, more sustainable economy and society for us and the future generations.

Dr Pamela Yeow is a Reader in Management at Birkbeck and Course Leader of the Central Saint Martins Birkbeck MBA.

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