Anne-Marie—a self-employed care worker from Swanley, Kent—recently started travelling to work by bike instead of using her car. Her decision was partly motivated by a desire to get fitter, but also because she couldn’t stomach the petrol costs.
The social care system in England has always had staffing issues, but the pandemic has tipped an overstretched sector off the edge. England’s ageing population means more people need care, and many are opting to stay at home to receive it. But the cost-of-living crisis has put such a strain on carers, that some are calling in sick as they can’t afford to travel to clients.
Levels of staff sickness in domiciliary care have increased significantly over the past two years, to an average of 7.2 days lost to sickness in June 2022 from 5.5 days before the pandemic. And the understaffing crisis is only set to get worse—the World Health Organisation estimates there will be a global healthcare workforce gap of 15m by 2030. Despite the UK government launching a campaign called “Care for Others. Make a Difference,” the number of vacancies in the sector has risen by 52 per cent within a year, to 165,000 according to charity Skills for Care.
“It’s so stigmatised, people look down on the job”
The general secretary of Unison Christina McAnea recently warned that petrol prices have a big impact on people with jobs that mean they must travel for work. She said, “We’re actually hearing of people who would rather phone in sick because they don’t have the money to fill up their cars and do their jobs.” Fuel rates have risen astronomically this year along with the prices of energy and food: in June 2019 it cost £50 to fill up a 40-litre petrol tank, now it costs £70—an increase of 40 per cent while wages stagnate.
When I spoke to workers on the frontline, it was clear that they were worried about their jobs becoming unaffordable. Laura, 42, from Bexley, London, has worked as a full-time domiciliary care worker for ten years and says the rise in fuel prices means carers are forced to choose between their clients, sometimes cancelling on those for whom care isn’t essential. Calls to people who are isolated and mainly need a chat are the first to go. “Some people aren’t seeing anybody… which isn’t fair.”
And it isn’t just clients feeling the brunt of the cost-of-living crisis: “You’re working to live—you’re not working to have a life anymore,” Laura says. She now sometimes pays upwards of £100 per week for petrol, compared to around £60 per week last year, and also has to cover the maintenance of her car which has gone up. Fortunately, her care company will help those struggling to cover the fuel cost with a loan, but carers still need to pay the full amount back over time.
Anne-Marie believes that society should place higher value on her profession in order for vacancies to be filled. She says, “It’s so stigmatised, people look down on the job—it’s not the most glamorous, but one day you might get old, and need help yourself one day.” Many care workers feel undervalued—and after working through the pandemic many are frustrated with the lack of help or praise given to them.
Domiciliary care allows clients to have their independence by staying at home
Both Anne-Marie and Laura have concrete ideas about how to make their jobs more viable. Laura says: “I think we should have a discount card for petrol, even 10 per cent to give us some appreciation. Without us a lot of these people wouldn’t be at home and hospitals would be worse off.” Anne-Marie also believes the mile allowance that care workers currently receive towards their petrol should be increased. McKinsey, a management consulting company, recommends governments rebuild their public health sectors by putting staff wellbeing and progression at the forefront, instead of focusing on quick hires. They also recommend ditching short-term campaigns to attract temporary staff during health crises.
Recent data from the Care Quality Commission shows that low staffing levels are not just a problem for clients in domiciliary care. Three quarters of the care homes in England that were downgraded from “good” to “inadequate” by the regulator this summer were struggling with staff shortages. In some cases, clients endured neglect such as being left in their rooms for 24 hours a day, left soaking in their own urine, or not given a shower for a week. 10 per cent of homes whose ranking dropped had enough staff but were found to have failed to recruit safely—not checking criminal records, getting references or giving adequate training.
When I worked as a mental health support worker for a year during the pandemic, staffing levels were at their highest, but even then, care homes were understaffed and had to rely on agency workers. The current issues surrounding stigma, pay and the cost-of-living crisis spell disaster for the care sector. Domiciliary care allows clients to have their independence by staying at home—but with care assistants unable to afford petrol costs to travel to clients’ homes, this choice may be stripped for some. During my brief time working in care, I was stunned by how little workers were paid considering the responsibility they have for people’s lives and wellbeing. The cost-of-living crisis can only mean the care sector will plummet even further in its ability to safeguard and protect those vulnerable in our society.
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