1.  Marginalisation and pay differentials in the UK social care sector Dr Shereen Hussein King’s College London

2. What is social care?  Social care supports people of all ages  With needs arising from physical, cognitive or disabilities  Assist in carrying out personal care or domestic routines (activities of daily living).  Helps sustain paid or unpaid work, education, learning, leisure and other social support systems.  Supports people in building social relationships and participating fully in society. 27/06/2012shereen.hussein@kcl.ac.uk2

3. Why is social care so important?  Complex interactions of political, economical, sociological and demographic factors  Role of state, society and individuals  In the forefront of political debates  reforms, big society, mutuals, personalisation etc.  Value of emotional work  Duties and responsibilities  In the heart of demographic forces  Strong business case! 27/06/2012shereen.hussein@kcl.ac.uk3

4. Formal and informal spheres of care  Sociology of care  Norms and traditions  Individual, society and government responsibilities  Working with other forms of support (social security, health and housing)  Complement, intersect but do not substitute one another  Interaction with health care 27/06/2012shereen.hussein@kcl.ac.uk4

5. Marginalisation of the social care as a labour market sector  Dealing with a special kind of ‘commodity’  Value of ‘care’ work to the society  Gendered; emotional; for granted !  Responsibilities and duties of care  The role of the welfare state (means tested)  Assumed or planned  Pricing ‘emotional’ work 27/06/2012shereen.hussein@kcl.ac.uk5

6. The position of the care sector and labour dynamics  Changing structure; place; nature, interaction with health services  Domiciliary, residential  Individual budgets  Links to government funds  Interactions with other markets  Role of the private and voluntary sector  Secondary labour position  Migrants and BME workers contribution  Pay and working conditions  Possible other rewards  Flexibility  Satisfaction  Stepping stone  Only job!  Temporarily or continuous 27/06/2012shereen.hussein@kcl.ac.uk6

7. Characteristics of the care sector  Means tested, state-funded, less than 12% of users  Private sector major supplier of services (75% of services)  Different types of settings- with domiciliary care workers accounting for 48% of the workforce  Increase policy emphasis on personalisation and user choice  Wages are a major cost component  Growing demand- high vacancy and turnover rates- almost a recession proof sector  No signs of funding reforms! 27/06/2012shereen.hussein@kcl.ac.uk7

8. Workforce structure  Gender (80% women), age (mid 40s) and education (minimum skills required)  Migrants and immigration policies  International and local supply  Grey economy and domestic work  Lack/unclarity of career path  Marginalisation within a marginalised sector 27/06/2012shereen.hussein@kcl.ac.uk8

9. Pay structure 27/06/2012shereen.hussein@kcl.ac.uk9

10. Marginalisation in pay  One of the main low paying sectors (LPC)  Before and after the introduction of the NMW  Two tier pay levels; with direct care and ‘other’ workers paid on, below or just above the NMW  ‘Top’ tier includes professional workers (SW, OT ect.) and managers  Pay rates are significantly lower in the private sector and in domiciliary care settings  Ethnic pay-gaps also exist  BME workers paid lower than white workers after accounting for other factors  More people leave care work due to low pay from the private than statutory sector 27/06/2012shereen.hussein@kcl.ac.uk10

11. Sector effect: hourly pay rate statistics for different job groups working in different sectors, SCWP 6 27/06/2012shereen.hussein@kcl.ac.uk11

12. Setting effect: hourly pay rate statistics for different job groups working in different settings, SCWP 6 27/06/2012shereen.hussein@kcl.ac.uk12

13. Investigating pay differentials in the sector  Using mixed-effect models  Controlling for measured and unobserved factors and cluster effects at different levels of hierarchy  Separate models for different job role groups  Managers/supervisors  Ancillary  Direct care  Professional 27/06/2012shereen.hussein@kcl.ac.uk13

14. Direct care workers pay differentials  Significant and large in magnitude effect of individual providers (55% of variance)  Sector variations are large and significant  Large regional effects  Significant fixed effects:  Type of care setting/service type  Ethnicity  Interactions between age and setting  Interactions between gender and setting  Interactions between sector and setting 27/06/2012shereen.hussein@kcl.ac.uk14

15. Descriptive: Variations in hourly pay of adult direct care workers by some selected individual and employer-level characteristics, SCWP 7 27/06/2012shereen.hussein@kcl.ac.uk15

16. Results of final mixed-effect model of hourly pay of adult direct care workers, SCWP 7 27/06/2012shereen.hussein@kcl.ac.uk16

17. But.. Available data don’t represent accurate figures  Data provided by employers (NMDS-SC)  One figure for hourly rate (no indication of ‘enhanced’ rates etc.)  Sector is not very well defined (LFS)  Over represent higher wages and more stable workforce (ASHE)  Unrecorded ‘working’ time  Travel between clients  Extra work  On call – sleep in duties etc. 27/06/2012shereen.hussein@kcl.ac.uk17

18. Attempt to improve estimates of those paid under NMW  Combining different data sources  Adjusting for unpaid travel time  Adopt a methodology that maximises the benefit of prior knowledge  Focus only on direct care workers (majority of the workforce) 27/06/2012shereen.hussein@kcl.ac.uk18

19. Recent estimates and analysis  Approach  Sector specific data (provided by employers; NMDS-SC) adjusted by other sources (provided by workers; LoCS survey)  Accounting for previously published estimated by the LPC and small surveys (Bayesian approach)  Assumptions  Very small adjustments (average of 22.7 minutes of unpaid work and 4.8 min of travel time per week)  Findings  From (9.2% to 12.9%) or 156,673 to 219,241 ‘direct care’ workers in the UK are paid under the NMW 27/06/2012shereen.hussein@kcl.ac.uk19

20. Pay distribution of direct care workers Source: Hussein (2011); SCWP Issue 16 27/06/2012shereen.hussein@kcl.ac.uk20

21. Posterior distributions of being paid under the NMW 27/06/2012shereen.hussein@kcl.ac.uk21

22. Risks- what to be aware of  Pay distributions are borderline with NMW in most cases  Any unpaid time likely to cause hourly pay rates to move under the NMW  Any changes in the NMW rates will have a large impact  Larger numbers of workers are likely to be affected if  we include ‘other’ workers- 14% of the total workforce  we include unreported work; especially through direct payment/personalisation schemes  Main risk areas for underpaying includes travel time/cost and night shifts  Innovative ways to cut costs:  reducing number of staff in shifts; increasing duties of lower paid ranks (care workers to give injections instead of nurses); shorter shifts (forcing some to work extra unpaid time); ‘real time’ shifts by the minutes etc. 27/06/2012shereen.hussein@kcl.ac.uk22

23. Marginalision Migrant workers 27/06/2012shereen.hussein@kcl.ac.uk23

24. Migrant workers  Continue to constitute a considerable part of the workforce  Majority non-EEA migrants (usually with nursing qualifications)  Large regional variations  Concentrated in certain jobs  No large variations in pay levels  Linked to immigration status- minimum wage> NMW  Usually given ‘harder’ shifts which may pay more, e.g. night/weekend  Discrimination  Immigration policies:  Differences between EU and non-EU migrants  Attachment to employer  Qualifications  Choice and mobility  Language 27/06/2012shereen.hussein@kcl.ac.uk24

25. Experience of racism  Many experience racism and or discrimination  Then I noticed some of my colleagues started to, you know, I don’t know kind of my colleagues then so I think I noticed that, you know, people really sometimes they bully especially if you’re a different colour (Site 06, Migrant worker, Asian man 607).  Most are fine, but some clients can be rude and swear at you they can use racist comments: colour plays a big part. The excuse is often their mental health (Site 01, Migrant worker, black African woman 137).  Differential experiences of different ethnic groups  Visible social markers  Being ‘foreign’  The ‘time’ factor Source: Stevens, Hussein and Manthorpe (2012) 27/06/2012shereen.hussein@kcl.ac.uk25

26. Top nationalities of migrant workers Source: Hussein (2011); SCWP Issue 11 27/06/2012shereen.hussein@kcl.ac.uk26

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28. Trends of number of migrant workers (in the care sector) entering the social care sector from 1995-2010 by nationality groups Source: Hussein (2011); SCWP 12 27/06/2012shereen.hussein@kcl.ac.uk28

29. Migrants and pay 27/06/2012shereen.hussein@kcl.ac.uk29

30. 27/06/2012shereen.hussein@kcl.ac.uk30

31. Another Advantage of many migrants “...are less likely to quibble and will accept worse conditions than established citizens; getting on with the job and not complaining too much.” (Refugee organisation director) Source: Hussein, Stevens and Manthorpe 2010 27/06/2012shereen.hussein@kcl.ac.uk31

32. Next steps  Examine the profile of those likely to be paid under the NMW  Using sector specific data complemented by other national data  Sector differences  Type of settings  Providers/employers characteristics associated with very low pay  Investigate pay and conditions among workers employed directly by users (personal budgets)  Partnership/collaborative approach  Policy, research and practical knowledge  Understand, educate, regulate and penalise 27/06/2012shereen.hussein@kcl.ac.uk32

33. References  Hussein, S., Manthorpe. J. and Stevens, M. (2011) The Experiences of Migrant Social Work and Social Care Practitioners in the UK: Findings from an Online Survey. European Journal of Social Work, 14(4): 479-496.  Hussein, S. (2011) ‘Estimating probabilities and numbers of direct care workers paid under the National Minimum Wage in the UK: A Bayesian approach. Social Care Workforce Periodical, Issue 16: December 2011’.  Hussein S. (2011) The contributions of migrants to the English care sector. Social Care Workforce Periodical, Issue 11- February 2011.  Hussein S. (2011) Migrant workers in long term care: evidence from England on trends, pay and profile. Social Care Workforce Periodical, Issue 12- March 2011.  Hussein S., Stevens M. and Manthorpe J. (2010) International Social Care Workers in England: Profile, Motivations, experiences and Future Expectations, February 2010. Final Report.  Stevens, M., Hussein, S. & Manthorpe, J., (2012), 'Experiences of racism and discrimination among migrant care workers in England: findings from a mixed-methods research project', Ethnicity and Racial Studies. 35(2): 259-280. 27/06/2012shereen.hussein@kcl.ac.uk33

34. 27/06/2012shereen.hussein@kcl.ac.uk34 Thank You For Listening Now Your Turn!