Course introduction

Training module 1:
Improving the quality of employment for care workers

425 million
The number of people over the age of 80 is projected to triple from 137 million to 425 million by 2050 (United Nations)

Populations are ageing around the world and the fastest growing segment is the very old. People are living longer and healthier lives than ever before.

Read the United Nations Briefing Note on Social Care here

This is great news. But it also means that demand for social care will increase.

In some cases, families will provide care. But there will also be an increased reliance on professional care workers.

In the UK, for example, the number of people who will need professional social care is set to double over the next decade to 3.1 million people.

Not only is demand increasing. Care work itself is becoming more complex. Most elderly people are living with at least one and in many cases several long-term health issues, including heart conditions, limited mobility and dementia.

The result? Care workers now carry out increasingly important and skilled work.

“There is a critical shortage of trained [social care] personnel. In 2015, it was estimated that there was already a global 13.6 million shortfall of formally employed caregivers…In fact, in countries where long-term care is lacking, the inappropriate use of acute care hospital services and emergency rooms is higher, and costs are therefore higher, too.” (UN Department of Economic and Social Affairs [1])

We need to change how care work is valued

In the UK, 104,700 care workers are low paid (meaning they are paid less than two-thirds of median income)
Read about the social care reforms in Northern Ireland here.

A further 18,000 are underpaid (meaning they are not paid for time which they should be paid for, such as work-related travel)
Society relies heavily on care workers. There is an obvious case for ensuring care services are providing jobs to care workers that are skilled, rewarding, healthy, and deliver clear career pathways.

However, this is not always the case.

Care workers are often facing precarious work that is both stressful and mentally demanding.

Increasingly, families, government, and advocacy groups recognise that a transformation is needed in how care work is structured and valued.

“We need to find a way of supporting, understanding and valuing the carers role more explicitly and honestly. Considering the immense contribution carers make, we neglect or exploit them at our peril.” (Northern Ireland Power to People report [3])

Who is this course for?

This training module is aimed at all stakeholders, including:

  • Employers
  • Trade unions
  • Government
  • People who use care services and their families
  • And care workers themselves.

Its aim is to help you all to begin a dialogue on improving the quality of work for care workers. 

Who are ‘stakeholders’?In the UK 82% of care is commissioned by government, including local authorities and Health and Social Care Trusts as part of the National Health Service. So, while employers play a central role in managing care workers, these other stakeholders also shape their work environments and job roles.

What is the course based on?

It is based on research sponsored by Academy of Science Malaysia (ASM), the British Academy and Newton Fund and is based on two case studies: Northern Ireland (UK) and the public residential care in four different states in Malaysia.

In both Asia and Europe, stakeholders are reforming social care work to ensure that workers feel valued, rewarded and motivated.

Using their experiences, this course will help to answer two questions:

  • What does quality work look like in social care?
  • And how can it be delivered?

To answer the first question, we spoke care workers to learn from their experiences and hear their aspirations.

And to answer the second, we spoke with people who have a role in employing care workers, receiving care, and public and third sector bodies which commission care.

In Malaysia, social care for older persons is provided by the public, private, NGOs and also faith-based organisations. The public sector mainly provides welfare-based residential care for abandoned elderly and those without family members. Challenges to the quality of care include:

  • A very high admission rate compared to the staffs or carers per centre
  • Lack of interest in social care among younger people.

The Northern Ireland case study covers a review of multiple dimensions of social care, focusing on ‘building a professional workforce’. This includes:

  • Care funding
  • Integration of health and social care services
  • Informal care
  • Building resilient communities of care.

We spoke with care workers in eight workshop discussions as well as stakeholders from the Department of Health, Belfast Health and Social Care Trust, employers and the union UNISON. We asked care workers five questions:

  • How can the quality of daily working life for social care workers be improved?
  • How can social care work be made into a rewarding career?
  • How can social care workers be given more control and voice over how they carry out their jobs?
  • What can be done to ensure that social care workers are working in healthy work environments?
  • What is the most important innovation that can be made to enhance the quality and status of social care workers?

Why is this course relevant to me?

This training module is based on these real-life discussions. That means it is training on care work from the perspective of care workers themselves, in their own words.

Course objectives

Completing this course will help care workers and others to:

  • Understand why people decide to pursue a career in care work.
  • See the reality of working in the care sector and why people ultimately decide to find work elsewhere.
  • Find ways to make working in the care sector more attractive to workers of all ages, and thereby provide solutions to the chronic skills shortages that care service providers face.

Making the most of this course
Throughout this course, make sure you always:

  • Reflect on what you have just learned
  • Explore how it is relevant to your own role
  • Identify potential actions you can take.

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    1. UN Department of Economic and Social Affairs, The Growing Need for Long-term Care: Assumptions and realities. 2016.
    2. Low Pay Commission, Non-compliance and enforcement of the National Minimum Wage. 2017, London: Gov UK.
    3. Kelly, D. and J. Kennedy, Power to People: Proposals to reboot adult care and support in NI. 2017, Belfast: DoH.