Promoting the Health of Women Working in Home Care: towards an inclusive Women’s Health Strategy

Caroline Emmer De Albuquerque Green, NIHR ARC South London Post-Doctoral Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce, introduces a new report on the promotion of the health of women working in home care, which she co-authored with Unit Director Prof Jill Manthorpe.

Women make up the majority of the home care workforce. They provide essential support to people in the community with social care needs. But, the specific health needs of women working in home care have largely gone unrecognised and unmet. The health of home care workers is not just of interest at times of pandemic; it matters in addressing staff turnover, continuity of care for their clients, sickness absences but also the long-term impact on women’s later lives.

In our report, Submission of evidence on the specific health needs of women in the adult social care workforce in London with a focus on home care workers, we summarised what is known about the specific health needs of women working in home care. The report is co-produced with the assistance of the Proud to Care Board of the Association of Directors of Adult Social Services (ADASS) London which includes home care providers, London Boroughs and other stakeholders.

We submitted it as evidence to the Department of Health and Social Care’s consultation on a new Women’s Health strategy. From what is known, we concluded the following points to consider in such a new strategy:

  • Research is needed to see how home care occupations can be health-enhancing not health damaging. How can risks be minimised and positive aspects of the work amplified? Serious consideration should be given to the health of the social care workforce in any reform of adult social care and workforce health and wellbeing should be emphasised in this and in the proposed Women’s Health Strategy.
  • London’s home care workforce offers much learning for other places and sectors. The majority are not UK born and are from an ethnic minority; if we get women’s health right for them then we will have learned much about addressing inequalities and how to ‘level up’.
  • As well as addressing specific health problems, multiple problems or long-term conditions need to be recognised in any Strategy.
  • Coronavirus pandemic support will need to be long-term for people who are in work, need to change their work and who may contribute to society in other ways.
  • The Strategy needs to address why social care systems are so reliant on zero-hour contracts and acknowledge their health impacts so that it can support changes that are more health enhancing for women, and others.
  •  A Women’s Health Strategy could support dementia prevention but also needs to support the largely female dementia care workforce by acknowledging its skills and needs for recognition, reward and further work-related capacity building.
  • The pandemic highlights the urgency of answering questions around specific health needs and behaviours of women in adult social care from non-white ethnic backgrounds. Consultation on the ‘right’ questions and approaches should involve care workers, and managers.
  • More specific evidence is needed on the impacts of the pandemic on the health and wellbeing of women working in adult social care generally and in home care specifically to inform any future crisis but also recovery from the pandemic.
  • The impact of Long Covid on home care workers needs exploring so that effective support and readjustment can be offered. Data from Wales (linking individual health records and home care worker registration) are likely to be useful in the Covid-19 period but also subsequently for policy makers and employers.
  • The Strategy must build on the evidence to best support women working in the sector to receive the Covid-19 and other vaccinations for their protection against the on-going health threats of viruses and other infections.

The full report is available to download here.

Caroline Emmer De Albuquerque Green is NIHR ARC South London Post-Doctoral Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce.

Managing dementia where there is challenging behaviour

Esme Moniz-Cook and Jill Manthorpe summarise the findings from a study on the management of dementia. (609 words)

  • Help for family carers supporting people with dementia who are distressed is much needed but services struggle to provide effective responses
  • Both families and care home staff need more support to help them to care for people with dementia – especially when the ‘going gets tough’

Bookshelf_NBK447072-page-001The findings from a large research study on the Management of Dementia with clinically significant challenging behaviour at home and in care homes led by the University of Hull and Humber NHS FT are published today (11 August 2017). The research was funded by the National Institute for Health Research (NIHR), Programme Grants for Applied Research (PGfAR). The study examined the records of over 5,300 older people and their families who were referred for specialist help to NHS mental health services across England. Nearly two thirds (61%) of those with dementia and distressing behaviour had a mild dementia rather than severe dementia. Practitioners did not always recognise that people at this stage were experiencing problems such as agitation, aggression and distress; and over a six month period, they did not manage to reduce the difficulties faced by these families. Families bore most of the care costs, and many were untouched by the evidence, guidelines and scope that services should provide them with timely individually-tailored effective responses to their challenging circumstances. Continue reading

Helping quality improvement in social care – listening to Registered Social Care Managers’ voices

Caroline Norrie Dr Michelle CornesCaroline Norrie (left) and Michelle Cornes are, respectively, Research Fellow and Senior Research Fellow at the Social Care Workforce Research Unit. (735 words)

Members of the Cumbria Registered Social Care Managers Network (CRSCMN) met recently to discuss what support is needed to help social care services make quality improvements in care homes and domiciliary care agencies.

Care home and home care managers were joined by a representative from Care Sector Alliance Cumbria who has responsibility for the recruitment and retention element of workforce development in this rural county. Michelle Cornes from the Social Care Workforce Research Unit (SCWRU) is Facilitator of the CRSCMN. SCWRU researcher Caroline Norrie, who has recently been working on two projects about adult safeguarding including whole-home investigations, also attended. Continue reading

View from the Frozen North

Last July we heard from the Cumbria Registered Social Care Managers’ Network (What can the city banks learn from social care?). At their most recent meeting, Network members discussed issues associated with providing care closer to home. (732 words)

Tim Farron, MP for Westmorland and Lonsdale, braved icy conditions to attend the Cumbria Registered Social Care Managers’ Network on Friday 16 January 2015. The aim of the meeting was to explore from social care mangers’ perspectives some of the challenges of delivering care closer to home. Given the pressures currently facing the hospital acute sector and especially Accident and Emergency Departments, discussions of care closer to home are especially topical as it explores how community health and social care staff can work together to keep people out of hospital where appropriate or to help them come home earlier. Continue reading

Shifting policy attention to the social care workforce

Dr Shereen HusseinDr Shereen Hussein is Principal Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. (956 words)

The year 2014 has seen growing attention given to the social care workforce, with a number of high profile reviews being published, including the Kingsmill Review ‘Taking Care’, the Unison report into home care ‘Time to care’, the Demos review of residential care and, launched today, the Burstow Commission review on the future of the home care workforce, ‘Key to care’.

The question of how to maintain a high quality social care workforce has received academic scrutiny for many years, with research highlighting the lack of career progression, low pay and status, and the inability of the sector to attract young and diverse groups of workers as some of the key issues. There are many reasons why we are in this state of ‘crisis’ but at the core is the assumption that care work is something that can be performed by ‘anyone’—it does not require a vast amount of skills and we can always find a willing worker to do it. While these assumptions go unspoken, they underline how the sector operates and derive from the perception of care work as ‘women’s’ work that comes ‘naturally’; if the family can do it why do we need a skilled professional to do it? Continue reading