The Good Work and Care Conundrum

The Good Work and Care Conundrum

If I were to ask any council or employment and skills partnership about their employment and skills recovery plans, I bet all of them have referenced the importance of Good Work and the role of health and social care as a key sector for employment.  I know this because I have spent the last year supporting councils and researching recovery strategies to understand how places are responding to the employment and skills challenges. 

Can Good Work be achieved in the Care sector?

Pre-pandemic the health and social care sector played an important role in employment and skills strategies, in part due to the volume of vacancies, the need for care provision and the numbers of residents employed in the sector. In areas where there was nearly full employment recruiting into health and social care positions was difficult. When I worked on a sector strategy for health and social care back in 1998, the sector, although important, was considered then to be a poor relation compared to construction, technology, manufacturing and logistics in terms of focus for growth. I am not convinced that this view had changed much since. But Covid-19 has shone a light on the health and social care sector and brought its critical role and opportunities for employment recovery into sharp focus.

However, the sector has always struggled with recruitment and retention, and domiciliary care is a particular challenge. The 2019/20 research from Skills for Care [1] highlighted that there are over 50,000 vacancies in domiciliary care at any one time, vacancy rates were at 35% and 178,000 left the sector that year. 42% of the domiciliary care workforce are employed on zero-hours contracts rising to 56% for care workers. This picture has hardly changed in the past eight years. Although there have been moves to promote a Real Living Wage, pay still lags behind. A report by the Institute for Employment Studies for the Health Foundation on Covid-19, government policy and the sector highlighted the financial challenges faced by workers who have to go off sick and rely on Statutory Sick Pay [2]. Anecdotal evidence from a consultation we led into domiciliary care workers highlighted issues of over-working and not taking sick leave even though they had a health condition.

The issues are endemic and the precarity of work in care is not a new phenomenon.

We know that having flexibility around work can be really helpful. But I do think that the care sector, particularly domiciliary care, where 84% of carers are female, the workforce is ageing and 54% work part-time, we cannot ignore that reconciling the ambitions for Good Work, care commissioning and moving people into the sector as part of economic recovery is a big challenge for places. And an issue of inequality of ethnicity (in places, London has a high proportion of workers from ethnic minorities), gender, age, health and income.

So what can be done?

Although most domiciliary care workers are in the independent sector, local authorities have a role to play as commissioners of care. We have seen commitments to embedding the Real Living Wage into contracts in London and pay has increased. But this is one dimension to applying Good Work. Carers need better conditions and greater security of their income as we know that financial insecurity is a key contributing factor for impacting on mental health [3]. We also know that the hours carers work, shift work and lack of planning can add to carers stress in moving from client to client and not having sufficient time for self-care. The pay rates set by local authorities for domiciliary care are tight and do not have sufficient flex in them to provide the kind of employer support and help permanent workers get. This results in a vacuum of support for carers that probably need it most, especially as they are generally sole workers and have limited opportunity for socialising and meeting their co-workers.

The Scottish Government recently committed to a number of fair work measures for Scottish care workers including the Real Living Wage, improving the working conditions for staff, and giving staff an effective voice about workforce conditions. The challenge ahead in Scotland will be how to fulfil these promises within the already strained financial situation of the Health and Social Care Partnerships in Scotland who will be expected to implement these commitments. [4]

Since before the pandemic we have been wrestling with how to tackle this challenge and what could be the drivers for change. There is a business case to be made to make working conditions better to tackle the high staff turnover experienced in the sector and to ensure continuity of care for people, but this will cost money.  There is also a case to be made on in-work about ensuring the health of care workers and the support they need to manage their financial situation and stay out of poverty. Again this requires investment but with constrained public finances, fulfilling Good Work promises within the sector seem to be both unrealistic and undeliverable.

Some ideas for change

Despite this we think there are opportunities for changing the status quo. Our learning from delivering the Challenge Fund for the Work and Health Unit, tested innovations for supporting people with health conditions to remain in work. This highlighted that simple and low cost solutions such as advice for employers, providing wrap around support for people who needed financial help and getting early access to support were key to prevention.

Here are some ideas for how to bring Good Work and care work closer together.

Firstly, we need to take a place-based approach to understand the dynamics of the sector and how to respond. Our study, although small, highlighted that most care workers lived and worked in the same local authority meaning that reaching out to them and connecting them to existing support becomes easier. This includes both advice and guidance, mental health, financial and other in-work support.

Secondly, most Councils are supporting local businesses through grants, business advice and support. Targeting investment and tailoring support for care businesses would be a practical way of supporting them with their recruitment and retention.

Thirdly, we think that any local investment or strategy needs to be scrutinised through a Good Work Assessment Lens, where councils and their partners can use all of their levers such as commissioning, social value and other gifts to ensure that Good Work can be achieved in practice across all sectors and through all pathways.

Finally we think that levelling up also needs to focus on sectors where pay and conditions lag behind others. True change can only be achieved if there is the financial will and means to make it happen. Someone recently mentioned at an event on future work that they felt the care sector is broken, if this is the case then lets make that investment work better.

We are really interested in talking to others about how to bridge the gap between Good Work and other sectors where pay and conditions make it difficult to do, like self-employment. Please get in touch if you would like to know more.

Caroline Masundire is a Director of Rocket Science based in our London office. You can contact her at caroline.masundire@rocketsciencelab.co.uk

We need to prevent Covid-19 halting the progress we have made on health and work.

We need to prevent Covid-19 halting the progress we have made on health and work.

Caroline Masundire reflects on our learning and experience of innovations in health and work and what we can do to minimise impacts Covid-19 will have on employees with health conditions

 

Covid-19 aside, May was quite a momentous month for me. For the past two years I have been leading Rocket Science’s role in managing the Government’s Work and Health Unit’s Challenge Fund and in May, I completed our overall programme and learning reports.

The Fund, launched in the summer of 2018 was designed to test innovative approaches to help people with Musculo-skeletal and/or mental health conditions stay in work, avoid long term sickness and unemployment. It was part of the Government’s ten-year strategy to get a million more disabled people into work.

We worked closely with 19 Initiatives, ranging from providing rapid access to occupational health support in clinical and community settings, through to direct support and advice in workplaces to capture their learning, understand their impact and identify what worked and what did not. During this time we were also working with other organisations on health and employment issues, including evaluating Fair Start Scotland. All of this experience combined illustrated the difficult challenges both individuals and employers face when managing health conditions at work.

The Challenge Fund was launched at a time of near full employment, we can argue about the quality of employment, but nonetheless the policy and funding focus had shifted to supporting people in work to stay in work and progress or to help those furthest away from the labour market move towards work.

During the Fund, the disability gap was closing (by 5.6 percentage points from July -September 2013) reducing by 1.6 percentage points just in 2019. Evidence was developing about the role of work in giving people the motivation to better manage their health condition and slow down its progression keep them in work for longer and improve their health. There was increasing recognition of the role of good work and conditions in helping to manage workplace wellbeing, reduce staff turnover and help reduce the skills gap. Mental health was widely talked about and supported and funds such as Access to Work provided a lifeline to help people to stay in work.

The arrival of Covid-19 will seriously impact on the progress we have made on health and work.

As services shift to get Britain back to work and the need to prioritise those that can get back to work quickly, the focus and resources supporting those furthest from the labour market are at risk. Our fortnightly Covid, Coffee and Catchup sessions with people in employment services is highlighting how precarious the situation is and the risk that resources will inevitably have to be redeployed to focus on those who are ready for work. There is also the risk that any announcements for the Chancellor in his emergency budget on support programmes will focus on helping people who can easily get back to work more quickly.

We are yet to understand the impact of Covid-19 on the employment rates of people with health conditions, but it is fair to assume that furloughing will have had an impact with the potential for redundancy and likelihood of unemployment for some. Older people are more likely to suffer from health conditions and the latest data on Universal Credit claims showed that around a fifth of people claiming were over 50.

Some people will also have been at a greater risk of contracting Covid-19 because of their work, statistics from the ONS in May 2020, highlighted that 15% of key workers who had a health condition were at moderate risk of contracting the virus. This begs the question on how sustainable is ‘key work’ for people with a health condition, especially if there is a second wave.

 

These are uncertain times and we are still finding our way on the road to recovery, but we cannot afford to lose sight of the progress we were making and the learning we were developing on how to keep people with health conditions in work.

At the heart of any  approach must be how we:

• support employers to protect employees with health conditions already in work
• help those who have been made redundant or need to change careers because of their health condition
• assist those in need to access other services and support so they don’t fall into crisis.

Three things we can do!

1. Our learning from working with employers is that they are more likely to engage if they need help with a particular issue. As local authorities and other agencies are supporting employers to provide them with grants and business support, it is an ideal opportunity to work with them to identify employees who are at risk of losing their job and because of their condition will find it more difficult to find an alternative role. This includes reviewing workplace adjustments so they can be adapted to new rules of working, negotiating working hours if people need to reduce or increase working hours and offering help to the employee so that they can stay in work.

We found that businesses including SMEs do want to engage, they just need help to understand what they can do to help and a positive experience leads to greater opportunities to support them with staff and workplace practice.

2. We know that for employees who are working insecure, temporary or low paid work, reductions in their income can be make or break for them. The rise in Universal Credit claims illustrates that people are using this safety net, but we know that people will need help navigating the complexities of this as well as help with income maximisation.

Our learning has showed that the kinds of support offered to people to help them get into work such as benefits, housing and debt advice is equally important to help people in work avoid crisis. This can be effective in helping them sustain their employment as well as support their mental health.

3. Finally we need to help people to think broadly about their skillsets and the types of alternative work they can do, especially if they have been out of the jobs market for some time. We know that focusing on an asset-based approach can help people to think more broadly about what they can bring to a role, open their eyes to opportunities they would normally dismiss and support them with job search.

Building people’s skills in job search is really important as is giving them coaching and support to work through the role, the workplace adjustments they might need to have in place and to be confident in having these discussions with their employer.

We can go someway to minimise the impact of Covid-19 for those more vulnerable workers, but we must ensure longer term, that this does not become a reason to stop the progress we were making on healthy work.

Get in touch to find out more about our work.

Caroline.masundire@rocketsciencelab.co.uk

Caroline is an Associate Director at Rocket Science based in our London office.  You can check out her profile here.
Covid, Coffee and Catchup – join in the conversation!

Covid, Coffee and Catchup – join in the conversation!

Over the past month, we have been holding informal discussions with employment leads in Local Authorities, providers and funders to think about what employment support responses are needed as we move from crisis to recovery.  We have done some thinking about the need for greater coherence locally and the role local authorities can play as well as re-thinking what employment services need to look like.

We have produced a guide for local authorities on what they should be looking out for and their planning over the next six to twelve months and produced a note of our last discussions which you can access here.

 

We are here to help and facilitate conversations and sharing ideas. 

If you want to join in contact Caroline.Masundire@rocketsciencelab.co.uk

The next session is on the 6th May 2020 at 11.00 and every other Wednesday at the same time.

Look forward to meeting you!

 

Caroline is an Associate Director at Rocket Science based in our London office.  You can check out her profile here.
Three words that could transform the employment and skills system

Three words that could transform the employment and skills system

Yes, just three words but you’ll have to read on to find out why.

 

My interest in employment and skills spans three decades. I have seen policies and programmes come and go, employment go up and down and the provider market wax and wane in response. 

The issues we are facing today are the same issues we faced twenty years ago – apprenticeship take-up, long-term youth unemployment, lack of access to quality careers advice and guidance for all ages.   The difference is that the economic and operating context is constantly changing and will continue do so, and at a faster pace than we could ever have imagined, meaning our responses need also need to keep pace.

Reflecting on our experience of reviewing employment and skills programmes, designing local plans and consulting on future need, I have returned to the conclusion I made a long time ago, that we need to reboot the employment and skills system.  Easier said than done? Well, maybe, but I think it could be done a lot easier now than five or ten years ago.

What is out there?

One of the main tasks of any employment and skills review is understanding ‘what is out there’.  All the clients I have worked with have found the complexity and messiness of employment and skills provision in their area impossible to understand.  There is so much ‘out there’, commissioned in different ways, funded by different organisations and aiming to work with different groups of people and employers in different ways. You could waste a whole year trying to understand who is delivering what to whom, when, where and why in a local place and still not have a complete picture.  

To help a client understand their place in the employment and skills ecology, we mapped European Social Fund (ESF) funded provision in a London borough and created what has become fondly known as the ‘map of messiness’

Tracing information through various sites including Department of Work and Pensions, Skills Funding Agency, Building Better Opportunities Fund and through provider and tender announcements, we were able to identify what was being provided where and for whom.  We tracked which provider held different contracts in the borough and the Contract Package Area as a whole.  But it was not easy and took a long time.

Although the client knew what had been commissioned within its own boundaries, we identified that over £2 million of funding through 12 programmes, had been commissioned to deliver employment and skills services in the borough that they were not aware of. This in a borough where there was already little investment in comparison to other places in London.  Imagine what this picture would like if you added all the various programmes and funding in a borough and multiplied this by 32 to try and get a picture of London-wide investment?

 

 

This lack of knowledge of what is being delivered locally I believe, is the major factor in the duplication of services, time and effort and waste of resources in the employment and skills system. It is so difficult for professionals to navigate, never mind a Londoner!

Is it making any difference?

The second challenge clients face is understanding ‘what impact are all these programmes having?’ are they really helping people get into sustainable employment or giving people of any age the skills and qualifications needed to thrive in the labour market? The answer is a definite ‘who knows’!  Individual programmes are evaluated (sometimes) yet this complex picture of different investment and approaches makes it impossible to understand if the provision is being used in the first place, the quality of what is being offered and if it is reaching the people it was intending too – never mind the collective impact of funding in improving the employment opportunities in places.  How can we tell if £2 million of funding commissioned by six different funders in 12 different programmes is making a difference?

Rocket Science is currently working with the Greater London Authority to consult on the development of the Skills and Employment Knowledge Hub, an ambition set out in the Mayor of London’s Skills for Londoners’ Strategy.

We are coming to the end of our initial scoping and consultation phase and what is clear is the overwhelming need for data and intelligence on what is already out there.

Transformation needs to start by democratising data and information about what is out there by compelling commissioners to publish accessible and usable data on what they have commissioned.   

Three words?

The three words that I believe can start to transform the employment and skills system? OPEN DATA STANDARDA standard that is within the gift of commissioners to sign up to and provide transparent, usable data and intelligence on what they are funding.

Just five years ago 360 Giving was formed. in response to improving the transparency of funding information ie who was being funded, by whom, where and for what purpose to reduce duplication and better target the needs of communities.  Using an Open Data Standard,360 Giving now have 109 Funders signed up  providing information on over 300,000 grants. 

I believe we need a 360Giving equivalent for employment and skills to help us understand what is out there, reduce duplication and better target need. Otherwise how can we possibly transform what we do not know into an employment and skills system fit for the future?

For more information about the consultation contact Caroline.masundire@rocketsciencelab.co.uk.  There are still places for our final consultation workshop on the 10th July 2019 in SE1 – get in touch if you would like to book a place!

 

 

Caroline is an Associate Director at Rocket Science based in our London office.  You can check out her profile here.
Building financial resilience in young people and families

Building financial resilience in young people and families

Rocket Science held an event on how to build finanical resilience in young people in May, find out more about the discussions, learning and access event notes and presentations.

 

Building financial resilience in people of all ages is critical to help them manage their working lives now and in the future.  Traditionally much of the support provided to help people manage their money and debt has been as a one off intervention, usually at a point of crisis.  However if people are to survive the challenges of managing their income when they are in insecure or low paid employment they are really going to need to have good financial education.

Last year Rocket Science was commissioned by four charities; Centrepoint, National Skills Academy for Financial Services, Quaker Social Action and Shelter Scotland to conduct an evaluation of their financial capability projects funded through the Money Advice Service What Works Fund.

The projects were testing new ideas and approaches to building financial capability, two of which focused on building the skills and offer for vulnerable young people and those facing transition.  One is working with families through coaching and training to develop a family approach to money management and the other has supported health care professionals in their work with people facing a combination of health and money challenges.

The event brought the learning from the evaluations, published this month, to a non-financial capability audience, including funders, commissioners and organisations working with people to improve their employment, education and life chances.

Discussions revealed that people still find talking about money or thinking ahead really hard to do.  Some of this is down to a lack of education, learnt behaviours (from parents) and in many cases being in a place where considerations about money management are just not a priority.

 

This means that people will only ask for help when they are in crisis.  Many services are designed and funded to provide one-off support, rather than as part of an on-going offer.  Often services also tend to resolve issues for people rather than giving them the skills and confidence to do it themselves.

These projects have looked at ways in which you can build better attitudes towards money management and in turn create behavioural change.

A key learning point has been the need to have an on-going trusted relationship with an advisor and recognition that people often face multiple transitions, meaning that good intentions can be derailed by life events and impact on mental health.

The main take away point for me, was that financial education needs to be recognised as a key life skill.  Importantly, we need to ensure that this becomes integral to the support we provide people of all ages to manage their personal and working lives.

The notes from the event can be found here Financing and planning for an uncertain future event note May 2018, alongside the  Presentation slides and details of the organisations who presented Information and contact details.

If you would like to find out more about our work in this area, please get in touch.

Caroline

caroline.masundire@rocketsciencelab.co.uk

 

Caroline is an Associate Director at Rocket Science based in our London office.  You can check out her profile here.