Building our Industrial Strategy Consultation response from Carers UK About Carers UK Carers UK is a membership charity of carers we work to represent and support the 6.5 million people in the UK who provide unpaid care for ill, older or disabled family members or friends. Carers UK is a membership organisation of carers, run by carers, for carers. We have 35,000 members and a reach of many more. We provide information and advice about caring alongside practical and emotional support for carers. Carers UK also campaigns to make life better for carers and influences policy makers, employers and service providers, to help them improve carers' lives. Carers UK s advice and information services answer around 20,000 queries from carers and professionals every year. Our website is viewed by over 100,000 people every month, over 24,000 subscribe to our monthly email newsletters. Carers UK works across the UK with offices in England, Wales, Scotland and Northern Ireland. Carers UK and major businesses have set up Employers for Carers offering help to employers to retain the 1 in 9 employees who are caring for a family member. Employers for Carers is a forum of employers large and small currently chaired by British Gas and supported by the specialist knowledge of Carers UK. Our Employers for Carers network including over 115 employers covers well over 1,000,000 people juggling working and caring. Overview Without the contribution of the UK s growing number of unpaid carers, valued at 132 billion per year, our health and care systems would not be able to meet the health needs of our population. The different, often more complex needs of a society living longer with multiple long-term health conditions has meant that more than ever we rely 1
on families and friends often caring in conjunction with more formal services. Yet this is having a damaging impact on the health and wellbeing of those providing care, and lack of support and the difficulty of combining work and care threatens to leave many in long-term financial hardship. For those combining paid work and care, trying to juggle it all without the understanding and support of employers and without access to statutory leave means that many are using annual leave or sickness absence to manage caring and employers have identified caring as a factor in both absenteeism and presenteeism. Our ageing and shrinking workforce is driving a need to extend working lives and to make our workforce more productive. Employers, workplace rights and investment in skills all have a role to play in enabling people to combine work and care and to return to work after time out to provide care. But a lack of reliable quality care services is a growing barrier to achieving this. Failures in social care not only paralyse families, they stifle economic productivity. Over two million people have already given up work to care and a further 3 million have reduced their hours 1. Care services need to be recognised as a vital part of economic productivity, a condition for employment as essential to employers thinking of locating their business as good transport links and a decent housing supply. As well as addressing these barriers, stimulating a vibrant care market to meet this growing demand can turn the challenges of an ageing population and an ageing workforce into a driver for economic growth. Social care should be seen as an industry with potential for growth and for creation of better paid and higher status jobs. Current trends of high turnover, low pay, low skills and low status must be reversed and social care work recognised as an enabler of growth. Technology to support caring and more flexible working is both a means of supporting the wellbeing and employment prospects of carers and in itself is an area of economic growth that should be fostered and incentivised. Recommendations: Care services must be clearly recognised in the Government s Industrial Strategy as a pre-condition for work - part of the infrastructure needed for participation in the labour market. 1 Carers UK and YouGov (2013) as part of Caring & Family Finances Inquiry UK Report (2014) Carers UK 2
Increased funding for social care putting in place a sustainable funding settlement for social care and ring-fenced funding for carers breaks. The care market should be seen as an area of potential economic growth both enabling people to continue to do paid work alongside caring and an as an area of innovation and growth. A number of measures are needed to create workplaces which are carer friendly and remove the barriers that older workers, in particular, have to combining paid work and caring. These should include a statutory right to paid care leave. The Strategy s Pillar on Investment in science, research and innovation should specifically include the role of technology in supporting health and care. Government should work with local government to support the implementation of the Care Act duty on shaping the care market with reference to sufficiency of supply for carers and disabled people in work or seeking to return to work by: o Including support for working carers in planning guidance around health and work for Sustainability and Transformation Plans o Including the need to reflect the requirements of working carers in Joint Strategic Needs Assessment guidance. Encourage employers to promote health and care technologies that can support their staff to balance work and caring responsibilities. Government should support a vibrant, accessible health and care technologies market focused on consumers, which delivers attractive, affordable products and services which reflect how families live and work. A national cross-government housing strategy needs to be developed with the needs of an ageing population at its heart. The Government should invest in re-skilling and supporting carers who wish to return to work through: o Training and resources for Job Centres to skill up staff to identify and support carers and former carers to return to training or work including becoming selfemployed, or to keep in touch with the labour market. o Encouraging employers to offer apprenticeships for older workers and offer a National Insurance holiday for employers who employ a carer or former carer. 3
Social care essential for an economy that is resilient and fit for the future Demand and potential for growth The UK s population has aged significantly. Since mid-2014 the average age has exceeded 40 and by 2040, nearly one in seven people will be aged over 75 years 2. For older people, healthy life expectancy is not keeping pace with growing life expectancy meaning that people over 65 are spending more time in ill health. Yet, today 25 per cent fewer older people are receiving social care support than five years ago 3. As a consequence of this demographic change and pressures on public spending, the gap between social care demand and spending has widened with family and friends increasingly filling this gap by providing more and more care unpaid. Between 2001 and 2015 the UK s population increased by 6.2% 4. The 16.5% rise in the number of people providing unpaid care outstrips the population increase and represents a large growth in caring, with a higher proportion of people providing care 5. The increase in people providing substantial amounts of care (20-49 hours per week) was very large (up almost 43%) and rose sharply (by almost 33%) among those caring intensively (for 50 or more hours per week) 6. This rapid increase has a number of effects: The overall health and well-being of the population because of the impact of caring - will decrease overall, whilst increasing health costs longer term. The ability of the workforce to juggle work and care will decrease, with the likelihood of early exit from the labour market or reduced working hours and income Although caring can be a rewarding experience that many would do again if they needed to, caring responsibilities that have a large impact can put pressure on 2 Government Office for Science, Future of an Ageing Population (2016) 3 Kings Fund and Nuffield Trust (2016), www.kingsfund.org.uk/blog/2016/07/taking-control-our-socialcare-system 4 Census 2011 5 Carers UK, University of Sheffield, University of Leeds (2015) Valuing Carers the rising value of carers support 6 Carers UK, University of Sheffield, University of Leeds (2015) Valuing Carers the rising value of carers support 4
family relationships with partners and children in particular, and lead to loss of social networks and isolation 7. The role of care services that are publicly funded are critical in this mix. Government needs to look, urgently, at improving the sustainability of publicly funded care services and the diversity of the care market. Instead of looking at the cost of care services as a pull on the public purse, care must be considered in economic terms and recognised as a key part of infrastructure and an area with potential for growth. Carers UK believes there should be a fresh new look at care services and their role in the economy. With a fragile residential and home care market, it is vital that these services are sustained in the longer term and that they provide the services that families depend on. The evidence from our work is that a weak, disappearing, unaffordable or poor quality care market locally results in carers giving up work to care and poorer health and well-being. Reliance on continued growth in unpaid caring is not sustainable. The Government Office for Science sums up the imperative for prioritising care, both paid and unpaid, in our future policy: Chronic conditions, multi-morbidities, and cognitive impairments will become more common. At the same time families will face increasing pressure to balance care with other responsibilities, particularly work. This is likely to mean that demand and supply of care will diverge as the UK has more people needing physical and financial support, at a time when there are fewer people able to fund public services and provide care. Continued reliance on families and friends to replace paid for care services is at a tipping point where the availability of unpaid care cannot meet demand. Firstly increased female participation in the labour market has dramatically increased and is now the norm. Secondly, smaller families and childlessness is increasing creating more vertical, so called bean pole families with fewer people available to care for those older than them. Finally, migration for work opportunities or for other reasons has increased, meaning people often live at significant distances from families. It is already clear that providing unpaid care brings with it a number of negative consequences for health, relationships and financial security, and these pressures are increasing. In order to secure current levels of unpaid care giving, a greater 7 Carers UK (2015), Alone and Caring 5
investment is needed in supportive paid for services and in technology that supports caring. Role of Housing in supporting older people and carers The approach Carers UK has taken is that housing is an integral part of ageing and disability and correspondingly has an impact on carers too their ability to care well, safely and be free from hardship, homelessness and poverty. Future housing should, and must, incorporate carers needs if caring is to remain sustainable alongside a shrinking working age population relative to people living in the community with care needs. Carers and their families need greater choice and flexibility of housing. Local authorities must ensure that a range of housing products are developed and built in their area, including sufficient provision of specialist homes. Care and support planning and housing planning needs to be done locally in an integrated way. Planning obligations should be better utilised, to help ensure that more accessible and suitable homes are built which are flexible across the life course and enable family caring with the vast majority of new homes built to be adaptable. Recommendations: Care services must be clearly recognised in the Government s Industrial Strategy as a pre-condition for work - part of the infrastructure needed for participation in the labour market. Increased funding for social care putting in place a sustainable funding settlement for social care and ring-fenced funding for carers breaks. Government should work with local government to support the implementation of the Care Act duty on shaping the care market with reference to sufficiency of supply for carers and disabled people in work or seeking to return to work by: o Including support for working carers in planning guidance around health and work for Sustainability and Transformation Plans o Including the need to reflect requirements of working carers in Joint Strategic Needs Assessment guidance. A national cross-government housing strategy needs to be developed with the needs of an ageing population at its heart. Social care a pre-condition for work 6
Support in the workplace through a stronger statutory rights base and greater awareness of caring and informal support from employers themselves have a huge contribution to make to supporting people to manage caring alongside paid work and creating a more productive workforce. But without access to flexible, affordable, reliable and high quality care services people will increasingly take the difficult decision to give up work. 46% of carers responding to our research who have left work to care cited problems with care services as a contributing factor 8. The combination of childcare and care for others, particularly distance caring supporting older parents or disabled derivatives at the other end of a motorway is significantly adding to workplace stress and absence at a cost to individuals, business and the economy. A study by the London School of Economics has estimated the public expenditure cost in England of people leaving their jobs to care as 1.3 billion a year in carers benefits and lost tax revenues. If you add to that the impact of lost income and pensions for individuals and families and the figure given in a report by Age UK is a staggering 5.3 billion UK-wide. Add to that again losses to employers in terms of recruitment and retention and lost productivity and the figure would be higher still 9. The work that Carers UK has done with employers shows that the loss to the company of an employee is roughly equivalent to a year s salary, if not more. Centrica (which chairs the Employers for Carers forum) estimates potential costs savings of 2.5 million through increased staff retention and 4.5 million through reduced unplanned absenteeism 10. Whilst there is good evidence that Employers for Carers members are moving towards ever better practice, and flexible working as an issue across all employers is improving, the evidence from carers shows that the issue still remains largely hidden in the workplace. For example, implementation of rights could be improved, and businesses are not aware that they need to maximise the potential of their employees, because they are not aware of the impact of caring. Carers who have given up or reduced hours to care were asked to name the top three things they felt would have helped them stay in work. More support from care workers coming to the home of the person they care for was the top choice of most carers (28%) and 54% of carers put it in their top three. 45% of carers put support with household chores such as help with shopping as a top three priority and one third (34%) put support for managing or coordinating care in their top three 11. This underlines that it 8 Carers UK (2014) Quality of Care and Carers 9 Age UK (2012) Care crisis wipes over 5.3 billion from the economy 10 Centrica Best for Carers and Eldercare, Top Employers for Working Families Special Awards 2015 11 Carers UK (2016), State of Caring 2016 Report 7
isn t only those providing personal care that are seeing an impact on their ability to stay in work but also those arranging and organising care for loved ones. This is a particular issue for women s participation in the labour market. 1 in 4 women aged 50-64 have caring responsibilities, compared to 1 in 6 men 12. Women have a 50:50 chance of providing care by the time they are 59; compared with men who have the same chance by the time they are 75 years old 13. Women are more likely to be sandwich carers (combining eldercare and childcare) are also more likely to give up work in order to care. Provision of childcare has long been recognised as a condition for women and men to participate in the labour market with Government and legislative interventions that seek to ensure parents have sufficient access to affordable and reliable childcare services. Investment in childcare in the 1990s through the tax system, through childcare vouchers, through business incentives enabled new players to come into the childcare market, and increased the supply of childcare to families. We want the same strategy for care, providing the right leadership and the right opportunity for growth. Similarly, maternity, paternity and shared leave arrangements have been placed on a statutory footing to enable women to return to work after childbirth and to address the gender pay penalty that time away from work to care can have. Care services for children and adults with disabilities, long term mental or physical health conditions or needs that result from being older must urgently be recognised as pre-conditions for work both for people with disabilities themselves as well as for families and friends providing support to them. Re-skilling former carers for fuller working lives In his recent report the State Pension Age Reviewer, John Cridland, singled out carers as a group that need particular focus and support. In particular he raised the current difficulties of reconciling working longer with caring responsibilities and highlighted that those with caring responsibilities or other significant barriers to employment will have to live longer in poverty if the State Pension age increases As well as measures to support people to remain in work, the Strategy must have a focus on reskilling those who have taken time out of the labour market. Having given up work, many carers wish to return. This may be after a short period of time, or may be after many years. Skills audits with carers show that they feel disempowered, disconnected, outdated and a long way from the labour market. Work that Carers UK 12 Census 2011 13 Census 2011 8
did as part of a European Social Fund funded piece of work Action for Carers and Employment showed that pre-vocational training for carers was vital. A skills based programme for carers could range from pre-vocational training, to skills accreditation whilst caring, to amendments in the benefits system to allow vocational training whilst caring. A system of returnships could be developed with employers that fit older workers, disability returners and carers alike with NI holidays for employers who develop this approach. Encouraging, and incentivising employers to provide workplace apprenticeship programmes for older workers and carers, as well as for younger people, would also help. Training and resources should also be made available to job centres to skill up staff to identify and support carers (and former carers) to return to training or employment or to keep in touch with the labour market. Recommendations: A number of measures are needed to create workplaces which are carer friendly and remove the barriers that older workers, in particular, have to combining paid work and caring. These should include a statutory right to paid care leave. The Government should invest in re-skilling and supporting carers who wish to return to work through: o Training and resources for Job Centres to skill up staff to identify and support carers and former carers to return to training or work including becoming self-employed, or to keep in touch with the labour market. o Encouraging employers to offer apprenticeships for older workers and offer a National Insurance holiday for employers who employ a carer or former carer. Care as a growth industry Care has the potential to be a good news story of economic growth. If the need for more care is inevitable, then guaranteeing the supply of that care is an opportunity for growth in the care business. Other countries such as Belgium, France and Denmark have looked at using care services to boost the employment market for those providing services, as well as helping families to stay in work. There is increasing demand for better and more flexible services from families willing and able to buy care, from service-users with personal budgets, and from employers who want services that enable their employees to work without stress. Most people who use care services - and that includes the low level preventive services often paid cash 9
in hand such as cleaning, gardening or shopping - are self-funders, paying for it themselves. These care services could come from a range of providers; from social enterprises, the voluntary sector, micro businesses, big businesses. Services need to be affordable, so that families can use them as much as they need to, creating a virtuous circle of demand and supply. They must be flexible and reliable, so they meet real needs. Recommendations: The care market should be seen as an area of potential economic growth both enabling people to continue to do paid work alongside caring and an as an area of innovation and growth. Skilling up social care The care sector is already a significant part of our economy. Around 1.5 million people work in social care in England alone, and demand for care workers is increasing all the time as our population ages. The value of the UK care home market is estimated at 15.9 billion 14 and Skills for Care calculated that the adult social care sector in England is worth 40.4 billion to the economy in direct, indirect and induced effects 15. It is clearly an industry with problems, many relating to the under-funding of care by successive governments. Uncertainty over future migration rules following Britain s exit from the European Union could also have an impact on the availability of care work staff. In the first part of 2016 alone, over 80% of all migrant care workers who moved to England to take on a social care role were from Europe 16. Driving up the availability and quality of care that is needed cannot be achieved without a plan to improve the skills, status and pay of the care workforce. The current social care staff turnover rate of 27% - nearly twice the average for other professions in the UK is not sustainable and must be reversed. Without reliable back up from care professionals, families and society will continue to see a negative impact on their ability to care without negative effects on their health, well-being and livelihoods. Given the growing levels of multi-morbidities, more complex care requirements and the shift away from secondary care to the community, health and care workers need to have more training and to be able to work in inter-disciplinary teams that are likely to be funded from pooled health and care budgets. 14 Laing Buisson, Care of Older People UK Market Report, 27th edition, September 2015 15 Skills for Care, The state of the adult social care sector and workforce in England 2016 16 Independent Age (2016), Brexit and the future of migrants in the social care workforce 10
Care requires a mix of interpersonal and professional skills and a growing range of care services offers opportunities for a diverse and multi skilled workforce. Rather than the low status, poorly remunerated and disaffected workforce in which new research suggest 900 adult social care workers a day quit their jobs 17 a strategy to stimulate the care market could support the growth of a different kind of workforce. A vibrant care economy could grow a new kind of care workforce, technologically skilled and recognised for the contribution it makes to the maintenance of family, community and a productive and efficient economy. Recommendations: A workforce development strategy that looks to improve pay and conditions and provide adequate training for people working in the health and care sector is essential, as these are key drivers of quality. Improving conditions of work for health and care professionals will help to make care a career of choice, while more carer-focused training will allow providers and professionals to benefit from carers valuable knowledge and improve the experiences of families and carers, who will be better informed and supported The health and social care workforce should be trained to be more carer aware able to identify support that carers need as well as to recognise the importance of partnership between professionals and carers. It should also be technologically skilled to take advantage of new models of care provision. Investment in innovation to support caring and flexible working Investment in science, research and innovation is one of the ten pillars already set out in the consultation. Innovation and technology have a significant role to play in supporting families to care protecting their health and wellbeing, reducing stress and addressing the social isolation that is often associated with caring. Technology has huge potential to support people to combine work and care by enabling them to work flexibly and to help with caring. A range of technologies have the potential to change care in the home and community, reducing physical time and the psychological worry of providing care. Assistive technology can give both carers and the people they care for greater independence and reassurance. Carers UK research in 2013 showed that almost three quarters (72%) of 17 www.bbc.co.uk/news/uk-england-39507859 11
carers using technology said that it had given them greater peace of mind 18. Over 10% said that using health and care technologies had either helped them to get a job or stay in work alongside caring. Despite this, we are only now starting to realise the opportunities for practical and online technology to help families to co-ordinate a better work-life-care balance, access peer-to-peer support and save time. Connectivity and the ability to work remotely can enable people to combine their job with providing unpaid care, and technology enabled support networks can provide important peer to peer emotional support at work. Employers can also help by promoting health and care technologies that can support their staff with caring such as: smartphone apps which tell staff that a care worker has arrived on time, co-ordination tools for them to organise care between them and their families, or alarms and monitors at home which give carers peace of mind at work. They too have huge potential for growth, as part of a new and thriving care economy. ICTs will support a modern workforce and help people work smarter, and assistive technologies will deliver new services in new ways, responding to the needs of modern families and reshaping traditional models of health and care. Recommendations: The Strategy s Pillar on Investment in science, research and innovation should specifically include the role of technology in supporting health and care. Encourage employers to promote health and care technologies that can support their staff to balance work and caring responsibilities. Government should support a vibrant, accessible health and care technologies market focused on consumers, which delivers attractive, affordable products and services which reflect how families live and work. Contact To find out more, please contact: Chloe Wright, Policy and Public Affairs Manager T: 0207 378 4942 E: chloe.wright@carersuk.org Keep up to date with our campaigns and research: Web: carersuk.org Facebook: facebook.com/carersuk Twitter: twitter.com/carersuk 18 Carers UK (2013), State of Caring Report 2013 12
Carers UK is a charity led by carers, for carers our mission is to make life better for carers. We give expert advice, information and support We connect carers so no-one has to care alone We campaign together for lasting change We innovate to find new ways to reach and support carers 20 Great Dover Street, London, SE1 4LX T: 0207 378 4999 E: info@carersuk.org Carers UK is a charity registered in England and Wales (246329) and in Scotland (SC039307) and a company limited by guarantee registered in England and Wales (864097). Registered office 20 Great Dover Street, London, SE1 4LX. 13