Introduction

This is the first report by the Fair Work Convention (FWC) since the Fair Work Framework was published. As Co-chairs of the FWC Social Care Inquiry, it has been a great privilege to lead this work on the Convention’s behalf.

In January 2017 the FWC established our inquiry because of concerns raised over the social care workforce during the consultation on the Fair Work Framework. The Convention chose to prioritise social care and to set up an inquiry to explore whether fair work is being delivered in the sector.

To support the inquiry, we established an expert Social Care Working Group. Group members provided expert advice on the current landscape and social care policy initiatives, and helped consider the insights received from many stakeholders consulted during the eighteen months of the project. We are very grateful to the individuals and organisations who engaged with us and to the FWC Secretariat for their organisation and facilitation.

We commissioned research from the University of Strathclyde on how frontline workers and their managers feel about their day to day work. We also commissioned research on Personal Assistants working for employers using Self Directed Support. Scottish Care and CCPS helpfully agreed to include focus group sessions within their existing engagement events and they and other organisations shared relevant research with us.

Evidence and stakeholder views underpin our conclusions and recommendations, though we emphasise that the Review conclusions and recommendations are those of the FWC alone.

Our overarching finding is that fair work is not being consistently delivered in the social care sector. Despite some good practice and efforts by individual employers, the wider funding and commissioning system makes it almost impossible for providers to offer fair work. We found that this mainly female workforce has limited meaningful collective voice. Effective voice is highlighted in the Fair Work Framework as vital to delivering fair work, providing the mechanism for workers to pursue other dimensions of fair work, such as security, fulfilment and respect. Without an effective voice mechanism, workers are less able to convey their concerns effectively, challenge employers on poor practice or make the reality of their situation visible to policy makers.

That is why the first recommendation of this Inquiry is that a new sector-level body be established in Scotland with representation from across key sector stakeholders to 1) establish standard minimum fair work terms and conditions for the social care workforce and 2) provide the opportunity for ongoing dialogue and agreement on workforce matters. The first task of this body should be to develop Fair Work First criteria for inclusion in commissioning.

Several positive policy initiatives in recent years have aimed to improve the situation in the sector for this committed and dedicated workforce, notably the Living Wage initiative. However, we conclude that low pay is a symptom of wider structural problems arising from the commissioning system for social care itself. Furthermore, protections for workers in the sector are simply not strong enough to counteract a system that frames and constrains what employers in the sector can offer to their workforces.

The current method of competitive tendering based on non-committal framework agreements has created a model of employment that transfers the burden of risk of unpredictable social care demand and cost almost entirely onto the workforce. We have deliberated carefully over the nature of the contractual frameworks, and it is our belief that this method of procurement creates a situation that is untenable. We found that the significant use of zero–hours, low–hours and sessional contracts in the social care sector is largely an outcome of the way care is purchased. Too often care provider organisations do not know how many support hours are required on a day to day basis. This type of commissioning in turn impacts on the type of contracts offered to staff, with flexibility benefitting the employer and burdening the social care worker with unpredictable working hours and unstable earnings. Commissioning agencies under budget constraints are only willing to pay for the actual amount of time that direct care services are delivered (rather than paying for a sufficient number of people to be engaged to deliver the service). Employers then pass this risk on to staff by placing them on contracts that maximise employer flexibility. This can mean workers having their shifts cancelled where demand falls, or being asked to do extra hours at a moment’s notice where demand increases, leading to feelings of being always ’on-call’. Workers struggle to manage their lives around frequently changing and/or unpredictable work schedules, while many managers report spending most of their time managing rotas, covering gaps and meeting new requests, rather than supporting and developing their teams.

Ultimately this commissioning process results in poor employment practices that are not consistent with fair work. We found many people wanting to work fewer hours, alongside others needing additional hours or juggling multiple jobs to ensure a decent income. For many, contracted and actual working hours were not well aligned. This impacts negatively on personal and family life and ultimately on their wellbeing.

Many care providers also reported increasing difficulties in recruiting and retaining staff and being unable to compete for staff with employers in sectors offering better pay and more stable working arrangements. We also heard from front line staff that the requirements to obtain qualifications while working – and the lack of support for obtaining these qualifications - are creating an additional barrier to joining the sector and to retaining staff in the sector.

Therefore, we recommend treating the problem at source. We recommend that the current commissioning practice of hourly rate based non-committal competitive tenders and framework agreements should end. Social care providers should be commissioned based on their level of skill, expertise, understanding and application of the Fair Work Framework, and on costs based on the right numbers of staffing required and a satisfactory and fair income level for each member of staff. Commissioners should be responsible for assessing and predicting the level of demand and commissioning the right levels of staff from the provider organisation, with no expectation that the provider or worker carry the risk for working time not being required.

We also considered the impact of Self-Directed Support (SDS) policy on fair work practices within the sector. Drawing on research evidence, we extend our recommendations to all social care workers, including Personal Assistants, and to include the commissioning of social care services through SDS. Those commissioning SDS services will need to be funded and supported to deliver fair work and to deliver on our recommendations as relevant to them.

To ensure cost effectiveness whilst delivering fair work, commissioners and providers should jointly address working arrangements, work organisation and working practices that can better align demand and supply. We have looked at all of the evidence and found that unlike other community health and social work employees, the majority of the social care workforce have no or limited autonomy to organise their own work schedules and decide on the support they provide to users at the front-line. This too is driven largely by commissioning processes. Their work is timetabled, and task-focused and they are not able to use their judgement to improve or adapt the support they provide. Yet this is a skilled and highly regulated workforce, expected in other ways to act in a professional manner in undertaking what is undeniably a highly responsible role.

The lack of status and chronic undervaluing of social care is not unconnected to perceptions of care as ‘women’s work’. Failure to address the gendered dynamics of the care sector and to challenge its significant voice deficit, low pay and one sided-flexibility contributes significantly to women’s poorer quality of work and to Scotland’s gender pay gap.

There is no simple way of tackling structural gender and other inequalities in society other than tackling them head-on where we find them. Given the nature of the social care sector, with over 1,000 employers and multiple methods of commissioning services, the challenges facing social care workers are not easy to address in a coherent and consistent way. This stands in sharp contrast to how other health care services are delivered, yet health and social care integration in Scotland recognises the inextricable connection between the two. There is an urgent need for the explicit and direct interventions as recommended in this report to improve the quality of work and employment in social care in Scotland. Enhancing fair work for social care workers is crucial to ensuring a workforce for the future and to delivering high quality social care services to some of our most vulnerable citizens.

Henry Simmons and Lilian Macer

Chairs of the Fair Work Convention Social Care Inquiry
Members of the Fair Work Convention