DIGNITY TO THE CAREWORKER
'If staff do not recognise dignity, if they feel taken for granted,if their self-esteem is dented, then it becomes more difficult for them to deliver dignified care.
....Tadd et al, 2011'
To improve the value and status of carework, to support mutual respect between people who provide care and people who recieve it.
A care worker is a person who is employed to support the independence of individuals in need of that support due to disability, illness or frailty.
COMISSIONERS & PROVIDERS SHOULD
Allocate adequate resources to produce the best outcomes for people using services. Low pay is unlikely to motivate workers or improve the status of the work. The alternative may be costly in terms of recruitment, retention and reputation.
Ensure that staffing levels and time allocated for home care visits allow workers to carry out their work properly in a way that respects the individual.
Promote autonomy for care workers, moving away from task-centred and time-restricted work schedules and reflecting the wishes of people using the service.
Ensure care workers are provided with the training they need to do their job well. Training should be structured, ongoing and largely work-based, focused on the needs of the people using the service and provided, at least in part, by people who use services and those with experience of frontline care work.
Ensure that care workers are supported by other professionals (e.g. social workers, community nurses, occupational therapists, dieticians, continence advisors) who can provide practical and emotional support, develop their knowledge and skills, and enable them to cope with difficult situations e.g. challenging behaviour and family conflict.
Respect the experience and the knowledge care workers have of the people they work with.
Care workers provide a range of services including practical assistance, personal care, and emotional support.
Careworkers provide these services in residential or nursing care settings, in the person’s own home or in the community.
PROVIDERS SHOULD:
Assess applicants’ attitudes at interview and regularly monitor thereafter.
Provide a clear definition of the care worker role and a clear career path, from induction onwards, associated with training, learning and skills development. The framework for progression should reward achievement and be linked to pay and other benefits.
Promote and reward quality time spent on compassionate, person-centred care. Ensure the complaints procedure also encourages compliments.
Provide strong leadership, regular supervision and ongoing practical and emotional support to frontline care staff.
Provide training and awareness-raising, to reduce any negative effects of cultural and racial differences (including language and accent) between care workers and people receiving the service.
Ensure that abuse against care workers is taken seriously and that policy and procedures, as well as training, supports people to understand and respond to challenging behaviour in positive ways.
Involve care workers in day-to-day decision-making and service improvement.
Ensure workers do not feel isolated, either by working in isolated services or, for home care workers and personal assistants, by the nature of their work.
Promote connections with other community services and peer support groups.
Promote awareness of how to raise concerns about safeguarding and whistleblowing.
WHAT THE CARE QUALITY COMMISSION SAYS
The CQC is the independent regulator for health and social care services. It has set out Essential Standards of Quality and Safety (CQC, 2010) for all those registered to provide health and social care services. There are 28 outcomes relating to the different aspects of care provision.
What CQC outcomes say about care workers:
Outcome 12 requires registered providers to have ‘effective recruitment and selection procedures in place’ and to ‘carry out relevant checks when they employ staff’. The recruitment process should ensure that staff are suitable. CQC suggests that providers consider whether prospective workers are ‘honest, reliable, trustworthy and treat the people who use services with respect’.
Outcome 13 seeks to ensure that there are sufficient staffing levels to meet the needs of people using the service. This is vital for care worker wellbeing because if the demands on them are too high the quality of their work and possibly their interactions with individuals may suffer.
Outcome 14 requires registered providers to provide the right support to workers ensuring ‘that staff are properly supported to provide care and treatment to people who use services….that they are properly trained, supervised and appraised and [enabled]… to acquire further skills and qualifications that are relevant to the work they undertake.’
DIGNITY FOR CAREWORKERS -
KEY POINTS FROM POLICY&RESEARCH
Despite some of the negative aspects of care work, many workers report high levels of job satisfaction (Skills for Care, 2007; Robinson and Banks, 2005; Lucas et al 2008).
Stress and low morale, resulting from the way that care staff are treated, can have a direct impact on service quality and cost (Rose et al. 1998, Hatton et al 2001,Thomas and Rose, 2009; Bromley and Emerson 1995).
Stress and low morale, reported by some care workers, can lead to high sickness rates and staff turnover (Thomas and Rose, 2009; Hatton et al, 1995).
High staff turnover can be very costly due to wasted training resources and recruitment costs (Hatton et al 2001; Mittal et al 2009).
Workers who feel that they put more into the job than they get out are more likely to detach themselves emotionally from their work leading to the ‘depersonalisation’ of people using the service (Thomas and Rose, 2009).
Care workers sometimes experience verbal or physical abuse from clients or their families (Skills for Care, 2007).
Workers who are already experiencing stress may be more likely to respond negatively to challenging behaviour (Gilbert and Osborne, 1989 in Thomas and Rose, 2009).
One of the key components of ‘Developing social care: service users’ vision for adult social care’ was to ensure better funding and resourcing of social care and social care workers (Beresford et al, 2005).
Job satisfaction and retention of care staff can be directly affected by status, inclusion in decision-making, respect for the role, good management and supervision (Stone, 2001).
Care work would benefit from pathways for career development supported through induction, training and supervision (Eborall and Griffiths, 2008; Land and Himmelweit, 2010; Manthorpe and Spencer, 2008; Stone and Wiener, 2001).