Why is paid home care important and what skills are needed to do the job? Does the status of home care workers reflect these skills and, if not, why not?

University Degree Subjects allied to Medicine

JOANNE RATCLIFFE K100

Y9804429 TMA01

Why is paid home care important and what skills are needed to do the job? Does the status of home care workers reflect these skills and, if not, why not?

To exemplify the importance of ‘paid home care workers’, the ‘skills’ of the role will be examined along with the ‘status’ afforded to this workforce. The evidence presented will serve to establish why paid home care is important, what skills are needed to do the job and also demonstrate the status of home care workers does not reflect these skills.

It could be fair to say that more and more individuals who need care are continuing to live in their own homes, and as such, the position of the home carer has become increasingly important. Home carers facilitate independent living for many and for those, who, before the reforms bought in by the NHS and Community Care Act in 1990, could have possibly found themselves institutionalised in one form or another. Home carers can work with children, people with physical or learning disabilities, older people or families. ‘The major objectives of the NHS and Community Care Act 1990 was to promote the development of services enabling people to live in their homes whenever possible, to ensure that practical support for informal carers was a priority and to make a proper assessment of need at an individual level’ (Hughes, 1995, p.6) (Unit 3, p.143). Home care can, therefore, provide people with more control over their lives and consequently they or their families can gain a greater sense of wellbeing. To illustrate this point, the instance of Marian, a woman in her late eighties, living independently, for whom arthritis was a huge burden is used. This crippling ailment increasingly prevents Marian from dressing herself and cooking her own meals. Home care workers are employed to assist Marian three times a day, for dressing and preparing breakfast, for lunch and for preparing supper and getting ready for bed. Having the assistance of ‘home carers’ is extremely important to Marian’s independence and, for Marian, the fact that she is still living in her own flat, is a huge symbol of this. Although the care workers have not replaced Marian’s family, they serve to alleviate the worry for her family in relation to whether Marian would be eating regularly. This example serves to evidence how important home care workers can be in the community.

The skills needed to competently perform the role of a ‘Paid Home Care Worker’ are wide-ranging and varied. These skills could easily be categorised into three skill sets,’ tasks that any person would normally carry out in their everyday life’, such as washing, making a drink and turning on a light; ‘specialist skills’ such as lifting and handling clients and treating pressure sores; ‘life skills’ such as tolerance, patience, empathy, the skill to know when to act and when to get advice and the ability to cope calmly with unexpected situations. It could be said that a number ...

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The skills needed to competently perform the role of a ‘Paid Home Care Worker’ are wide-ranging and varied. These skills could easily be categorised into three skill sets,’ tasks that any person would normally carry out in their everyday life’, such as washing, making a drink and turning on a light; ‘specialist skills’ such as lifting and handling clients and treating pressure sores; ‘life skills’ such as tolerance, patience, empathy, the skill to know when to act and when to get advice and the ability to cope calmly with unexpected situations. It could be said that a number of of the everyday skills and life skills listed above could easily be transferable to the role of ‘paid home care worker’. Nevertheless, the skills required to carry out the role of the ‘paid home care worker’ do not stop there. Cultural awareness and the awareness of learning disabilities are other important skills; there are also health and safety guidelines and codes of practice that need to be followed. Although ‘formal qualifications’ are not needed to become a ‘home care work’, taking these facts into account, there is without doubt far more to being a ‘home care worker’ than just assisting someone in need of care with ‘basic’ everyday tasks.

We need to consider whether the status of ‘paid home care workers’ reflects these skills. In considering what paid carers do, as illustrated above, it is useful to take into consideration this idea according to Phillips and Taylor ‘Far from being an economic fact skill is often an ideological category imposed on certain types of work by the virtue of the sex and power of the workers who perform it’ (Phillips and Taylor, 1980, p.82) (Unit 3, p.160). This serves to evidence that some people have the power to decide ‘what is and what is not a valued skill’ (Unit 3, p.160) and substantiates the statement ‘Care work is a classic example of socially important work being accorded little economic value because it is defined as unskilled or semi-skilled’ (Unit 3, p.160). Although it could be said there is little need of formal qualifications to work as a ‘home care worker’, there is little evidence to suggest that if such qualifications were gained this would raise the ‘status’ of the ‘home care worker’.

As well as the NHS and Community Care Act (1990) seeking to develop services to enable people to live in their own home, it also introduced a market model to social care. The introduction of this market model aimed to promote competition between health providers and drive down costs. Therefore health providers are in competition with each other to tender for contracts and as a result are under heavy pressure to drive down costs in order to obtain the most lucrative ones. With this in mind, ‘home care workers’ are generally paid the national minimum wage. To offer a perspective on this perceived low pay, it is interesting to note that the government job centre web site is currently advertising a washing up assistant post with unsociable hours, which is paying a salary in excess of the minimum wage and requiring a lesser skill set than home care workers (). It is said that ‘Care plans may specify a certain minimum of care work but some home carers provide for clients’ social needs too, and this emotional labour is not reflected in their contracts of employment or wages’ (Unit 3, p.165), and as such the role of a ‘carer’ can be perceived as attaining job satisfaction rather than monetary reward. Consequently, both low pay and wanting to attain job satisfaction could be seen as contributory factors to the ‘status’ of ‘home care workers’ not corresponding with that of their ‘skills’.

In summary, ‘Paid Home Care Workers’ are without doubt a fundamental part of the community, they assist in providing independence to many different individuals and as a result provide a greater sense of wellbeing which otherwise could not be achieved by those needing care. The skills required to carry out the role of ‘paid home carer’ are largely unrecognised, and the monetary reward is low. The market is competitive and there is a need to drive down costs. When the skills and tasks carried out by home care workers are compared against the status they hold in society, it could be fair to say that the two do not equate. These are just some of the factors that demonstrate that the ‘status’ of ‘home care workers’ does not reflect the ‘skills’ required to carry out the role.

Word Count: 1156

References:-

Hughes, B. (1995) Community Care and Older People, Open University Press, Buckingham

Phillips, A. and Taylor, B. (1980) ‘Sex and skill: notes towards a feminist economics’, Feminist Review, vol. 6, pp. 79-88.

Walmsley, J, (2005) ‘Social Care in the Community’, ‘The Open University, Milton Keynes, K100 Understanding Health and Social Care, Block 1: Who Cares?, Issue 4.

www.jobcentreplus.gov.uk

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