The human cost of inequalities in social care

Jabeer Butt

Jabeer Butt OBE, CEO, Race Equality Foundation

The death of 45,632 people in care homes with a COVID-19 infection has rightly garnered national attention and a push for an inquiry.  Similarly, the deaths of over 839 healthcare workers with COVID-19 has rightly secured front-page news and calls for action.  However, there was another tragedy that was less well reported: the deaths of over 1,290 social care workers.

Perhaps with the NHS being seen as a single organisation that has become part of the British psyche, it is no surprise that the deaths of healthcare workers generated significant attention.  The amorphous nature of social care, with thousands of organisations, ranging from local authorities, to charities to multinational companies, perhaps leads to less attention on these groups of workers, even though there are more people employed in social care than healthcare.

But perhaps other factors are at play too.  Frontline social care staff, are more likely to be employed on zero-hour contracts, more likely to be women and in many locations, more likely to be of Black, Asian and minority ethnic origin.  Whilst the Equality and Human Rights Commission’s recent inquiry struggled with securing data to paint a national picture, the Inquiry was still able to identify practices that should worry all those who care about social care.  The inquiry reports that for workers in the ‘independent sector’, ethnic minority workers were more likely to be on zero-hours contracts then their White British counterparts.  This led the Inquiry to conclude that there is a ‘two-tier’ workforce with ethnic minority staff more likely to be in ‘lower-paid, commissioned-out and outsourced roles’.  The Inquiry further notes that for some groups of social care staff, particularly homecare workers, this was combined with a lack of knowledge of employment rights, which manifested itself in failure of employers to observe minimum employment rights such as the provision of payslips and/or paid leave.

Noting that for social care there is no equivalent to the NHS annual staff survey, this makes it difficult to explore how widespread any evidence on racism from colleagues or from people being supported is.  Nevertheless, the Inquiry does suggest that ethnic minority staff reported being treated poorly in comparison to their White colleagues, including receiving future shifts.  This was combined with unsupportive line managers, with some workers suggesting that their mental health had been impacted.  Worryingly, some reported racism from service users in the form of openly racist ‘attitudes and remarks’. The pandemic appears to have seen a continuation of discriminatory experiences, with ethnic minority staff reporting that they were less likely to be given suitable personal protective equipment, a point the Inquiry suggests is supported by wider research.

In this context, we were glad to see that the Government supported the development of the Workforce Race Equality Standard for Social Care, to an extent mirroring the NHS, as well as commissioning 20 pilot sites.  Furthermore, the commitment to rolling out this standard that is contained in the People at the Heart of Care White Paper is ground breaking.  However, the delays in publishing evaluations of the pilot sites and, more importantly, delays in setting out a timeline for the roll-out of this new workforce standard does not bode well.  We also need to use existing levers to improve the experiences of Black, Asian and minority ethnic workers.  This includes the Care Quality Commission looking more closely at the terms and conditions of staff, more enforcement action from HMRC to ensure minimum wage legislation is implemented, combined with more enforcement action from the EHRC to eliminate racial discrimination using their existing powers.

Those intimately involved with frontline social care staff are unlikely to be surprised by the findings of the EHRC Inquiry.  Nevertheless, it remains shocking that Black, Asian and minority ethnic people involved in caring do not appear to be cared about.  Frontline social care work is poorly paid compared to many sectors, but it appears that even here there is a division with Black, Asian and minority ethnic people experiencing the poorest pay and related conditions.  This continues, even when we know that happy and fulfilled workers provide better and safer care.


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