Vici Richardson, our Community Care and Personalisation Manager, attended the Future of the Social Care Workforce Parliamentary reception. This was organised by the All Party Parliamentary group for Adult Social Care at the Houses of Parliament. Because Vici works with Personal Assistants and Direct Payments every day, both professionally and personally, this was an extremely important discussion for her to contribute to. She has written this blog about her experiences.
There has been much in the media recently about the shortage of staff in the social care sector. I have seen the very real consequence of this. Recently, my son’s agency pulled out at only 48 hours’ notice, as they could not provide the staff.
The ‘People are at the heart of care’ Adult Social Care Reform White Paper sets out a 10-year plan. An important part of this is a strategy for the Social Care workforce. On Monday, I had the privilege of attending the Future of the Social Care Workforce Parliamentary reception. It was organised by the All Party Parliamentary group for Adult Social Care (you can read the report here). I stood in Dining Room A in the House of Commons on a very hot day in London. I was listening to some very well-connected and well-informed professionals. However, when they started talking about the workforce and the aspirations of professionalisation, I began to panic. I know I wasn’t alone.
Isaac Samuels gave a very clear message. He wants to bring the focus back to the people who are being supported. He gave examples of how his life has been transformed through self-directed support.
When it came time for questions, I couldn’t help but raise my hand. Where do the 70,000 individual employers fit into the strategy? Where do the thousands of Personal Assistants (PAs) stand?
I asked a question of Gillian Keegan Minister for Care and Mental Health. I also gave some examples of how the PA workforce have supported my son. I was able to tell her that- as well as using a fantastic care agency- I employ a team of 4 PAs to support my son Zak. We also use one self-employed PA. They all bring different skills and opportunities to him. They don’t have care qualifications and they’ve got no formal training. But what they do have is a passion for what they do, a love of the job and a respect for my son. They have the right values. Not only do they work towards ensuring he is able to live life in the way he chooses, but they know when to step back and when to support. They ‘get him’, they learn what his support needs are, they listen to and take direction from him.
The PAs were all chosen for what they could bring to the role and bring to Zak. It wasn’t focused around qualifications: it was around connections. As a result, Zak now has a vibrant social life. He is well known in his local area and he has a fantastic role in a local community hub Cafe.
As parents, we aim to give Zak and our other children the best life we can. But the PAs truly give him his independence. In this last year, through their support, he has really been connected to the place he lives. He actually now has less reliance on ‘services’.
I’m not sure the PAs would have learned how to do that through a Care Certificate. I don’t think you can write it into a skills framework. If they had to have completed mandatory training, it could have been a barrier to them working with him.
Yes, there are some specific things they need to know to support Zak effectively. There are some things around helping him to move. In addition, they need to know what to look out for if he were unwell and what the emergency procedures would be. This is true for many PA roles. But the difference is the individual decides on the training and often directs it.
The PAs I employ would gain nothing by doing a qualification. They all have other jobs, some unrelated to social care. There are many situations where this is the case. Pushing the professionalisation agenda onto PAs could be to the detriment of their employers. There are many others who share this concern with me.
I am not suggesting that there is no discussion around professionalisation. There needs to be work done in raising the profile of this undervalued workforce and work done around pay, terms and conditions. The role of a PA can also be used as a spring board into something like nursing or social work for example: this is something we need to recognise and promote. There are certainly some benefits in labelling it as a career. I can also see how a Skills Framework and portable certification would be beneficial. For example:
- It makes sense for staff transferring between work places to have portable qualifications.
- A registered manager and the responsibility involved should be recognised as a professional.
- A care worker should have the opportunity to further training and progressing through the social care route.
- Those supporting children and young people in formal settings need some very specific training. A framework would ensure that guidance is met.
- Clinical Health tasks need the appropriate training.
- It would allow an individual employer to choose for their PA to have had the mandatory training.
BUT we must recognise that the work, qualities and skills of PAs can not always be recorded on a certificate.
I am an individual employer. I have worked as a Direct Payment Advisor for Disability North, and I am currently managing their Personalisation Team. I have worked with hundreds of disabled people and their families in the past 12 years, to self-direct their support and employ their own PAs. Over the years the two most common things I have been asked to put in a job description are:
- ‘you must be willing to work under my direction’
- ‘no formal experience is needed as training on the job will be given.’
In addition, I’m often told “we are often looking for people who don’t yet know they want to be PAs”. Many employers want to be able to train their PAs in the way they want their support to be delivered. It is self-directed. Many will actively look for people who aren’t qualified. There are some employers that look for specific qualifications. But because their care is personalised, it should be about choice.
My fear is that introducing frameworks and mandatory training could lead to direct links with pay and terms and conditions. This will have a potential negative impact on PA rates (some Local Authorities are still set as minimum wage). I worry that support for the wellbeing of the workforce will only be delivered to those who work for companies. They may not be support for individual employers. Ultimately, we may see a greater divide between those who work for providers and those who work for individuals.
Any conversations around raising awareness, pay, terms and conditions, support for wellbeing need to apply to the PA workforce too. Individual budgets will need to include funding to support PAs wellbeing.
We must ensure that there is flexibility, choice and control. Any training and framework should not made mandatory for the PA workforce. It should be an option that Individual Employers and their PAs can access if they choose. By making it mandatory, we potentially restrict the pool of PAs. PAs can be family members, friends, or people doing it as a second job. I shared these concerns with the Minister as did other individual employers there. She assured us that this would not be the plan. In response to my question she said they would not throw the baby out with the bath water. But what concerns me is that there is still a conversation to be had around the PA workforce. We need to support them as well as supporting the individuals employing them.
From some meetings I have attended over the last two years, I have realised that there is not a great understanding within Local Government and policy makers about the role of the PA. They need to recognise the variety of the skills they need and the jobs they do. There is also little understanding and recognition of what is involved in being an individual employer using a direct payment.
Employing PAs is not always the easy option and it comes with its own challenges. It is important to recognise that it is not always an informal arrangement with a friend or family member. Some individual employers are managing large teams, dealing with budgets running into hundreds of thousands of pounds. Often this isn’t recognised by Local Authorities. I believe this is evident in the lack of funding for training and support for individual employers as well as poor management and the low bar that is set with some direct payment support contracts.
The event at the Houses of Parliament tied in nicely with the TLAP report ‘The Forgotten Workforce’. It was released the following day. I was part of a working group who coproduced the survey and the report. It is a must read. You can read it here, but don’t assume all of the problems relate to pay. They don’t.
The report also shines a light on the lack of support individual employers receive. We need to ensure that individual employers who have chosen a direct payment are supported throughout the process, with good quality advice and support. I am not saying this from a biased point of view but a from an informed view point. I have seen the difference that good quality support and advice can make. More recently, I have seen what can happen with the lack of good advice and support.
There is so much to gain from a good support service who is on hand to support with good quality recruitment, advice on paperwork, and to answer queries and support with issues that arise. In the white paper, I would have liked to see a mention of access to peer support. User-led training in the workforce strategy would have been appreciated too.
Many Disabled Peoples User Led Organisations are now delivering their own PA training packages. These are very much based on the values needed. They cover the history behind the independent living movement and the importance of self-directed support. Working in a truly person-centred way and seeing life through the persons eyes and not your own. At Disability North we have just coproduced our own PA training course. We are also working with employers and PAs to deliver the training.
Conversations need to take place with Disabled Peoples User-Led Organisations. Many have had their funding stripped back over the years. They have lost support contracts to nationalised profit making companies. There needs to be useful conversations and funding to support them to deliver quality user-led training and support. Support which is accessible and place-based.
These organisations would also benefit from funding, so that they could run individual employer peer support groups. This would provide spaces where individual employers could get together to support each other. Where up to date training around employment matters could be discussed.
Funding for PA networks and effective PA registers would be another thing on my wish list. It would be great to have a local bank of PAs who can be called upon to step in in the event of sickness. This is something we have frequently been asked for over the years. And although we hold a register of contacts, it is not always effective for emergency cover as we don’t have the funding needed to put into it.
We need to ensure that the PA workforce are not forgotten. PAs are mentioned in the strategy. But the finer details relate to the roles within agencies or residential care homes. Furthermore, there is a very small section dedicated to Direct Payments. Any references to Direct Payments seem to suggest they are used for paying family members or more informal type support. This is not always the case.
Going forward we need to ensure that individual employers are given a seat at the table during discussions on workforce. They need to be fully involved in what the workforce reform would look like. There needs to be an equal voice, not an after thought as it was at the beginning of the Pandemic.
Coming back to my son… whoever supports him in life, whether they are employed directly by me or by the agency we use. What matters to us most is the values they have and what they bring to him. It is about the life he wants to lead and that is the starting block. The staff he has from the agency need to involve him as much in his support as the PAs. They need to take direction from him and keep him at the centre. Any framework must include some good person-centred planning training.
Maybe the conversation we need to be having isn’t about professionalisation. It’s about value.
It is about everyone being able to lead an equal life.