A “total cultural shift” is needed in the care home sector to make it a more decent place to work, according to a new report.
The University of the West of Scotland research examined the impact of Covid-19 on the job quality of frontline workers and what needs to be done to improve it in the wake of the pandemic.
Speaking about the first weeks of the pandemic, one care worker told researchers: “Those who passed away died a terrible death.”
During the first wave of the Covid-19 pandemic in Scotland, 46% of deaths were in care homes while at least 14 care home workers died, the report said.
Researchers interviewed care staff about the seven job quality factors which make work “decent” under the International Labour Organisation’s definition – supportive managers, terms and conditions, a safe work environment, decent pay, job security, social recognition, and purpose and meaning.
Many care workers noted they felt blamed for care home deaths and that they had been an “afterthought” to health care workers like doctors and nurses during the crisis, despite undertaking stressful and high-pressure work.
A safe work environment was a major cause for concern among those interviewed, with many reporting a lack of access to appropriate personal protective equipment (PPE) at the height of the first wave of the pandemic.
One frontline worker commented: “When people died, they were taken away by guys in private ambulances who turned up in full PPE – they had full hazmat suits, they were completely kitted out for the private ambulances; and they were looking at us wearing bin bags.”
In the view of care workers, the pandemic confirmed long-held beliefs that existing attitudes towards older people, characterised by ageism, translated directly into a lack of recognition for those who care for them.
Dr Hartwig Pautz, one of the researchers, said: “The issues identified in this report are not a product of the pandemic – they are long-standing and require a total cultural shift in order for them to be fully addressed.
“The country’s care workers were under intense pressure throughout the pandemic, putting their own health and safety at risk to care for the most vulnerable in society, and this was largely under-recognised.
“We hope that our work can be used to influence much-needed change across public, private and third-sector care organisations.”
Out of the seven job quality factors, workers felt that five areas had worsened following the outbreak of Covid-19, those relating to supportive managers, terms and conditions, a safe work environment, decent pay and job security.
The report said that a whole sector approach to cultural change is needed.
Dr Stephen Gibb, another of the researchers, said: “2021 will be a tipping point for both decent work and quality of care in social care in Scotland.
“We can move forward to more decent work and care quality instead or risk sliding back to less decent work and care quality, as if we had not learned and appreciated some hard lessons from the pandemic.
“Our research with social care frontline workers provides evidence of where the tipping points may be, and what can make a positive difference. Among those, the biggest tipping point and greatest difference lies in creating a ‘culture of care’.
“Scotland lacks a ‘culture of care’ which values older people specifically, but also other people needing social care. By addressing this, we can see a real change across the sector.”
The study, titled Decent Work in Scotland’s Care Homes, was funded by the British Academy’s Covid-19 Special Research Grant.
A Scottish Government spokeswoman said: “The pandemic has highlighted issues of fairness in employment practice and opportunity for care workers which clearly need to be addressed.
“This is why the Fair Work in Social Care Group are urgently developing proposals to embed the fair work principles which will lead to better terms and conditions, as well as more rewarding roles, for the care workforce whose hard work and dedication we are immensely grateful for.
“It is also a key reason why we’ve established an independent review to consider the idea of a national care service chaired by Derek Feeley, former director general of Health and Social Care in the Scottish Government.”