On this page we discuss current issues around staffing levels and workload in care work. From here, you can navigate to tables in which we identify relevant laws in England, Scotland and Wales.
Regulations which require sufficient staffing of care services, do so in order to protect the safety of people who use care and support services or are resident in care homes. However, regulations about staffing levels also have the potential to profoundly impact on the quality of care workers’ jobs. As our population ages, our society needs more care workers. The sector struggles with longstanding issues of high vacancy rates and rapid turnover of staff, with Skills for Care estimating there to be approximately 122,000 vacancies at any time. The situation has been described as ‘a dangerous shortfall’. By some estimates, the shortfall is set to rise to 1.1 million by 2037. Chronic underfunding of social care services by successive governments has contributed both to the care sector’s low levels of pay and problems of understaffing (to read more about recruitment issues in social care work, click here). Care workers now have higher, and more complex, workloads.
Recent years have witnessed a shift towards the personalisation of care and this has impacted on workloads and staffing levels too. In an effort to promote the dignity and wellbeing of people who require care, a more person-centred approach, which takes into account individual preferences, has been adopted in both policy and associated care practises. The aim is to respect individuals’ rights to autonomy, privacy, care and support. It represents an important step towards promoting and protecting the human rights of disabled and older people. Personalisation means that care work is increasingly complex, as it requires workers to take into account individuals’ specific needs and preferences rather than following blanket procedures provided by their employers. This includes issues relating to food and drink; privacy and dignity; and issues relating to communication and working relationships. This mode of care requires more time and effort, yet research demonstrates that this is not reflected in the working conditions of care workers. Significantly, the shift towards a person-centred approach has not been accompanied by the increases in funding that would be necessary to make individual choices meaningful. Understaffing leads to a deterioration in the quality of care, as care workers face pressure to cut corners to fit in all their work during the allotted time. Some researchers have observed the ways that rule breaking becomes ‘routine’ under increased time pressures, with care workers combining official and unofficial routines to enable them to complete as much of their workload as possible in the time allowed (Lopez 2007; Baines and Daly 2019).
Another issue to take into account is the increasing prevalence of dementia in our ageing population. In the UK, there are approximately 850,000 people with dementia, a figure projected to rise to 1.6 million by 2040. Dementia care is complex, requiring a broad range of skills and sensibilities. Skills for Care have published an 8-principle plan for caring for people with dementia, including “Promote independence and encourage activity” and “Recognise the signs of distress resulting from confusion and respond by diffusing a person’s anxiety and supporting their understanding of the events they experience”. From these examples it is clear that good quality dementia care takes time. Adequate staffing levels create the basic conditions through which good quality care becomes possible.
Lopez, S. H. (2007). Efficiency and the fix revisited: Informal relations and mock routinization in a nonprofit nursing home. Qualitative Sociology 30 (3): 225–47.
Baines, D. and Daly, T. (2019) Borrowed Time and Solidarity: The Multi-Scalar Politics of Time and Gendered Care Work. Social Politics: International Studies in Gender, State and Society.
If you use any material from these web pages, we suggest this is cited as follows:
Hayes, L., Tarrant, A. and Walters, H. (2020) Social Care Regulation at Work: Staffing Levels & Workload. University of Kent. [Viewed date]. Available at: <https://research.kent.ac.uk/social-care-regulation-at-work/staffing-levels-workload/>
