Manchester Met’s Faculty of Business and Law influences new Welsh Government strategy in 2018
Domiciliary care is an important service that supports people to continue living in their own homes. And in an aging population, the demand for domiciliary care provision is on the rise. However, providers can struggle to recruit and retain enough domiciliary care workers to meet this increased demand, making it difficult for both providers and care workers to deliver the quality of service required.
Research commissioned by the Welsh Government led Professor Carol Atkinson (Faculty of Business and Law) and researchers from Decent Work and Productivity to author a report advocating a series of policy recommendations that the Welsh Government could adopt to boost the recruitment and retention of domiciliary care workers in the independent sector.
Published in March 2016, the report informed a Welsh Government consultation, which sought views about the changes it might take improve both the quality of domiciliary and the recruitment and retention of domiciliary care workers. The consultation received 108 responses from a wide range of stakeholders and the subsequent findings had a direct and significant impact on subsequent Welsh government policy and strategy around social care reforms in 2018.
There are an estimated 19,500 domiciliary care workers in Wales delivering around 260,000 hours of care a week to 23,000 people. Yet, zero-hour contracts are impacting the ability of care workers to provide an effective level of care to service users. Inadequate funding levels and commissioning models have also led to low hourly rates. Our research findings show that employment contracts such as these increase anxiety around job security and hamper reliability in the independent care sector, creating strain and dissatisfaction with service provision.
‘It is clear that domiciliary care workers in Wales are doing a fantastic job, motivated by a sense of altruism to provide the best care possible. However, they face a mix of pressures that affect their ability and motivation to deliver domiciliary care to the standard they aspire to.’Professor Carol Atkinson
As with many developed and developing countries, Wales’s aging population is likely to generate an increasing demand for domiciliary care. A well-trained, well-paid, and secure workforce with appropriate working patterns is required to both recruit and retain care workers, and to deliver a high quality of care.
“Better working conditions and recognition of the value of the domiciliary care workforce will attract new entrants to the profession and help retain staff for longer periods, so that quality is improved for those who rely on care and support”Social Care Wales (January 2018)
Our research findings suggest these are not conditions widely experienced outside of local authority employment in the domiciliary care workforce.
Indeed, to use England as a comparison, while the number of people working in adult social care sector is estimated at 1.45 million – 24% of which are recorded as being on a zero-hour contract – more than half of care workers (56%) and registered nurses (55%) in domiciliary care services are employed on zero-hour contracts .
On the resulting Welsh Government consultation, Rebecca Evans, Minister for Social Services and Public Health, wrote in a statement:
‘In September 2015, the Welsh Government commissioned important primary and secondary research from Manchester Metropolitan University on the relationship between the terms and conditions of domiciliary social workers and the quality of the care delivered. This research concluded there was a clear and convincing link.
‘Proposals consulted on included matters relating to zero hours contracts, compliance with the national minimum wage, travel time, call clipping and length of calls, career structure, development and training, occupational status and health and safety.
‘I have asked the Care Council for Wales to consider and use this report in the development of their five-year strategy for domiciliary care in Wales. This work, commissioned by the Welsh Government, will deliver a sector-led plan for improvement in social care…’
The report’s findings had a directand significant impact on the Welsh Government’s policy and strategy on social care reforms. In June 2017, the Welsh Government’s Phase 2 Consultation document laid out plans for new proposals directly informed from the research undertaken by Manchester Metropolitan University. And in April 2018, the Welsh Government introduced new regulations requiring employers to give domiciliary care workers a choice of contract after three months of employment.
‘There is a very clear link between the use of zero-hours contracts and a reduced quality of care due to issues around the continuity of care and communication between workers and those they support.’
Huw Irranca-Davies, Social Care Minister.
The research also underpinned a study commissioned by the Greater Manchester Combined Authority (GMCA) to propose policy solutions to address low pay and productivity in Greater Manchester, with a specific focus on adult social care. This forms part of the local Industrial Strategy evidence base to be submitted to central Government in March 2019.
 Griffiths, D. et al (2017) The State of the Adult Care Sector and Workforce in England. Leeds: Skills for Care. (accessed 22 June 2018).