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It’s Time to HelpCare: A European Crisis

Dr Carolyn Downs from Lancaster University Management School - a partner organisation involved with the Helpcare project - explores the initiatives’ latest

recommendations calling for better formal education and training in the care sector, to create a career path for carers.

The care crisis that makes the headlines in the UK is actually an issue across the entire European Union, with problems in recruitment, retention, training, development and funding common in all partner countries. In addition to these problems, the UK is predicted to need between 20-54% more care workers by 2025.

In response to this the Helpcare project is working on the recruitment and retention of care workers across five countries (UK, Greece, Italy, Poland and Bulgaria). The project is entering its final year, but our findings so far have been striking.

Our study of over 700 care workers, informal carers, employers and commissioners, including 100 in depth face-to-face interviews, found that care workers are often not able to access training and have a significant training shortfall, with over 400 training needs identified. Examples of excellent practice were identified, but these are poorly shared or the result of short-term interventions or pilot projects, which then end. Hertfordshire County Council has some outstanding schemes, organised through the HCPA and Devon County Council is developing innovative practices in care but in both cases the underlying problem of funding acts as a barrier to sustained innovation in best practice.

We found that care workers suffer low self-esteem and high burn-out rates, particularly when working full- time. In some settings care workers

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receive little or no training before commencing employment, despite the introduction of the new care certificate. The sector employs over 1.4 million workers in the UK, but staff turnover rate in the sector is around 25%, with a very high rate of staff ‘churn’, where care workers remain in the sector but move between employers. These problems add significantly to the costs of the care sector and reduce the quality of care offered.

Sadly for many, care work is seen as an unattractive career option, a ‘last resort’, and often people recruited do not have the soft skills or empathy needed for this demanding and important role. Most care givers felt valued, but a quarter felt their role was not appreciated or understood by society while around the same proportion believed they were treated as ‘second-class workers’ (according to one Polish care-worker). One carer working in the UK reported feeling ‘ashamed to say I am a carer’.

The study found that one of the reasons behind the poor recruitment and retention in the sector was that few carers saw any potential for the development of a career in care, and most were very pessimistic about the opportunity for personal or career development unless they moved into nurse training, social work or occupational health. Making this move was seen as impossible by most care workers, citing the need for an income, a lack of qualifications to undertake such training or personal circumstances as what prevented them from making such a move.

Many carers were keen to develop their skills within care, but found that opportunities were limited, stating that even if they undertook training this did not result in increased recognition, either through pay or promotion.

These negative perceptions within the care workforce indicate some of the many underlying reasons for the worryingly high turnover. As a result, we have developed a series of recommendations, to address this, including that training needs to be formalised, with national or EU-wide validation of qualifications and a suite of qualifications from level 1 (entry level) to level 6 (degree level), that all professional care givers should be registered as an absolute minimum (similar to registered child minder status in the UK).

There should be training for specialist care practitioners (stroke, dementia, etc), with a pay premium for specialist care practitioners to enable progression for care workers from entry to specialist level, to help raise the status of care workers to that of other health care workers such as Health Care Assistants in hospitals.

The project is now working on developing model career pathways for care workers, as well as mapping a potential curriculum for care work, moving from Level 1 (entry level) to Level 6 (first degree level), to set out pathways for improving the recruitment, training, development and retention of care workers.

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