Findings from the first report of the Social Care Regulation at Work team at University of Kent highlight that care workers stand at a crossroads between poverty and Covid-19. Their choice of which way to turn can affect their health, their families and the people for whom they provide care. 

At the beginning of the year we began to explore how the legal rules that govern social care provision impact on the quality of care workers’ jobs. The coronavirus crisis has given our research added urgency and a sharp focus on the emerging gulf between regulatory standards and real life.  Led by Professor Lydia Hayes, our team has analysed survey data collected by UNISON North West, from 2,600 workers employed across over 1,000 care settings. We found that 8 in 10 care workers felt that they would not be paid their wages if they had to self-isolate.

This is a historically low-paid group who are unlikely to have any savings. A statutory sick pay (SSP) income of £95.85 would drive them further into poverty, and the fear of trying to get by on statutory sick pay (SPP) was palpable. As one respondent noted: “SSP isn’t enough to live off. Our wage is bad enough.” Others reported that and their colleagues were not self-isolating when they felt ill or when family members were symptomatic, precisely because of their fears around poverty.

Given the intimate nature of care work – which requires close contact with multiple people on a daily basis – the risk to virus transmission rates is obvious. Others said they couldn’t self-isolate because of feeling that they would be pressurised to go into work, or would have future work removed from them as a form of punishment, or would even face disciplinary action for non-attendance. 

Before Covid-19, the care sector was in trouble. Years of cuts by successive governments, further compounded by a decade of austerity, have left care services underfunded, under-resourced and, consequently, hugely over-stretched. This has been accompanied by aggressive marketisation and the consequent fragmentation of the care sector, with providers competing in a race to the bottom in the supply of low-cost care.

Women comprise the vast majority of the workforce. Cost-saving measures have translated into the widespread and gendered use of zero-hour contracts and jobs are insecure and low paid. In-work poverty is common to care workers, who often see their already inadequate wages diminish further as employers fail to pay for sleep-ins, travel time, and additional hours needed to provide good quality care. But that was before Covid-19. 

The unfolding pandemic serves not only to highlight these dire working conditions, but also leaves care workers facing impossible choices between health and poverty. It is working-class women who are at the sharp end of this outbreak. By analysing responses to the UNISON survey, we know that care workers are describing themselves as ‘terrified’: for their families, themselves and the people for whom they care. 

The advance of Covid-19 serves as a lens through which the exploitation of care workers becomes visible in new ways. Treated with disdain by successive governments for years, this essential group of well over a million low-paid workers are now positioned at the centre of the UK’s response to the pandemic. It is a responsibility which puts considerable added pressure to a sector already at breaking point.

The government’s reaction to this crisis has been insufficient for care workers; a great deal of platitudes, but little in the way of a tangible, practical response. Secretary of State for Health and Social Care Matt Hancock, recently thanked care workers for their “courage in this battle” while introducing the care badge, which he described as a “badge of honour.” The idea behind the care badge is that it will allow care workers to be afforded the same recognition as NHS staff. Recognition of the hard work involved in care is welcome, but as others have pointed out, this is no substitute for proper pay and conditions.

Perhaps more meaningful would be for the government to adopt one of the recommendations of our research report, to guarantee care workers access to occupational sick pay. This would be a small step towards affording care workers material recognition that are as valued as NHS staff. Quite rightly, when NHS workers are ill and need to self-isolate, they are paid wages as part of an NHS occupational sick pay scheme. 

Care workers, on the other hand, are not afforded this same basic recognition of the need for income protection. In the UK, employers are not legally obliged to provide occupational sick pay; hence in the social care sector, most don’t. However, occupational sick pay is not a perk, it is a very basic acknowledgment of employers’ responsibilities for the costs of social reproduction. All workers are human beings who can get ill and when employers’ provide occupational sick pay, they acknowledge this reality.  

In social care, particularly at a time of heightened risk of infection as an occupational hazard, lack of financial protection is causing enormous stress and worry to care workers. The fear of getting sick with Covid-19 is compounded by a knowledge that they may be spreading the illness to their loved ones, become ill themselves and be unable to care for their families, or be forced to self-isolate with devastating financial consequences.

In their  responses to the survey, many care workers revealed they were struggling with the work-family balance under the pressures of Covid-19. As one care worker said: “Mentally, I’m struggling as my children are at home looking after each other while I work. I’m a single parent. Also worry about paying bills if I have to go off and I only receive ssp”. 

Women’s unpaid domestic labour is vital to the functioning of the economy, and we know that women provide the majority of unpaid care, looking after elderly parents, ill or disabled relatives, and children. The Covid-19 outbreak has served to intensify the pressure of these responsibilities, and care workers in the survey said that they were scared of passing the virus to their families, particularly those with family members in the high-risk category. The fact that social care employers are not providing occupational sick pay has a potentially devastating impact on working-class women and their families.

News reports are raising public awareness that coronavirus can rip through care homes like wildfire. In the last few days, the horrific story of the Pio Albergo Trivulzio care home in Italy has made headlines in the UK for the ‘massacre’ of 190 residents. Closer to home, similarly horrific scenarios are unfolding. Last weekend, Care England reported 7,500 care home residents may have already died of the virus.

Meanwhile, the government is under increasing pressure to release the known figures on deaths in care homes and explain any underreporting. Hidden within these stories is the untold anguish of care workers, who feel they are stood at crossroads between poverty on the one hand, and Covid-19 on the other. Our research suggests that economic barriers to self-isolation should be taken seriously by the government.

At the most frightening of times, decades of disinterest that have left care workers highly vulnerable to poverty and to risks to their mental and physical health. On behalf of our project team, Professor Lydia Hayes has written to Secretary of State for Health and Social Care, Matt Hancock, urging him to step in on public health grounds to guarantee care workers’ pay for self-isolation.