Social care: “To say we feel vulnerable is an understatement”

By a Scottish health and social care worker

Working in social care is generally intense. Hours are long, resources stretched, demands high. In nursing homes elderly frail people are gathered with different physical and mental health conditions.

Staffing is always an issue. There are over 120,000 vacancies across the service at a UK level, every single day. This has meant strain in the system is a permanent feature. Covid-19 puts those general features under the most extreme of pressure.

Where I work, a standard care facility with up to 60 residents in four clinical settings, from learning difficulties to elderly mental illness, the imminent arrival of coronavirus is anticipated with dread.

A number of residents already vulnerable face a fatal threat. The virus starts with familiar features before escalating into a critical lung infection. A chest infection is a threat to the elderly and frail, this virus maximises that risk.

The threat of infection has transformed working practice. New systems are in place, generally to reduce work to its absolute essentials.

We have been in lock down for over a fortnight, only essential visitors are allowed. That doesn’t include family who may provide an infection risk to their loved ones. 

Care team staff are also under life saving/threatening restrictions. It is accepted that staffing levels will plummet under the strain of an escalation in the outbreak, but we are already seeing staff coming into work under enormous strain now, as they weigh up the risk of infection against the loss of income due to pre-existing terms and conditions of no contractual sick pay.

Low pay

Social care does not remunerate those that work in it. The benefit system subsidises the low pay. The private provision of social care has seen the removal of protections public service workers can expect as a right.

Being a registered nurse, if off sick under coronavirus I can expected Statutory Sick Pay of £90 a week, but only for a fortnight. 

That means health decisions are influenced by financial pressures. These are universal to all social care workers, and illustrate how poor working conditions are for people now considered essential to prevent mass fatalities from Covid-19.

Trade union organisation is crucial in this sector to fight for workers’ rights, proper paid sick pay and health and safety, including adequate and full protective equipment. 

This is a service that is all but ignored by the Tories. There were no new provisions in the first budget of this government. In debating immigration restrictions recently parliament characterised social care as unskilled work, not needing support from migrant workers.

Underfunded, yet run for profit, a service that delivers close personal care to frail elderly people facing their own mortality at the best of times is now finding itself in the frontline against coronavirus.

To say we feel vulnerable is an understatement. It is not clear that residents will be tested for the virus, let alone ourselves as staff, until there is an outbreak within the home.

Even then, given conditions of palliative care, that is by no means certain. We are briefed on a daily basis now, sometimes twice, about management of the infection and it is clear this is the biggest threat to health that the many thousands of residents in nursing homes will face.

This crisis has revealed permanent damage has been inflicted on care services under successive governments. Austerity hastened further injuries to the beleaguered care sector.  

On the other side of this crisis transformational change needs to occur. As the wider public realise how poorly funded all care services have been there needs to be a demand for something that is fit for purpose.

• Employers must provide full personal protective equipment (PPE) for all workers at all times. Any worker not provided with adequate PPE to remove themselves from working in potentially dangerous situations on full pay and without disciplinary sanction
• Emergency investment in the NHS and social care
• Bring all major social care provision into public ownership
• A living minimum wage of at least £12 an hour and guaranteed sick pay based on full pay
• Nationalise the pharmaceutical and research companies under democratic workers’ control and management