Scotland’s care sector needs a cultural overhaul to improve the quality of work and care, according to interviews with front-line workers compiled in a new report from UWS researchers.

Decent Work in Scotland’s Care Homes, funded by the British Academy’s Covid-19 Special Research Grant, reveals what care workers think about job quality in social care and what needs to be done to improve it in the wake of the Covid-19 pandemic.

Researchers Dr Hartwig Pautz, Dr Stephen Gibb and Joan Riddell spent the summer interviewing care staff, predominantly from care homes, to find out more about their working lives. They were asked 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.

“The interviews conducted over the summer offer a raw and uncut view of job quality and ‘decent work’ in the care sector. The workers highlighted that pre-existing issues and deficits in the sector were amplified during the pandemic.”
Dr Hartwig Pautz, Senior Lecturer, School of Education and Social Sciences

During the first wave of the Covid-19 pandemic in Scotland, 46% of those who died of the virus (a total of 4,482 people) died in care homes. Alongside these, at least 14 care home workers also died of Covid-19.

In the researchers’ interviews, many care workers noted that they felt blamed for care home deaths and that they had been, during the crisis, an ‘afterthought’ to health care workers like doctors and nurses, despite undertaking stressful and high-pressure work.

Out of the seven job quality factors, workers felt that five areas had worsened following the outbreak of Covid-19. 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.

In the view of care workers, the pandemic confirmed long-held beliefs that existing attitudes towards older people – attitudes characterised by ageism – translated directly into a lack of recognition for those who care for them.

The one area which improved was that of purpose and meaning, with the majority of workers saying that a sense of purpose and making a difference is what keeps them in the job.

“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."
Dr Stephen Gibb, Reader, School of Business and Creative Industries

Dr Gibb continued: “Our research with social care front line 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.”

Dr Pautz added: “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.”

The full report, including the views and stories of Scottish care workers, can be accessed online.

Last updated: 14/07/2023