Experts' debate: will registering care workers reduce risk or restrict choice?

Karolina Gerlich and Clenton Farquharson
Photograph: Dean Mitchell/Getty Images

‘The role requires special skills’

Would you ask a stranger to give you root canal treatment? Or rewire your house? You wouldn’t, because these tasks should be conducted by trained, qualified and registered professionals. So why do we risk having untrained, unchecked people look after some of the most vulnerable people: our children, parents, friends and family?

Employers are increasingly adopting values-based recruitment, believing that not just anyone should work in care. The job requires a caring and nurturing personality, empathy and patience. As extremely rewarding as care work is, it can be highly stressful, emotionally demanding and physically draining. The skills required are special and not easily found in any one individual.

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There is a growing debate about whether registration should be compulsory for frontline adult social care staff. Registration of care workers would not, as some people using services fear, take away choice; the aim would be to make the choice safe. Together with an appropriate training framework, it could help create a pool of care professionals from which to choose the person that suits an individual’s needs best, while reducing the risks.

Care workers often need to be highly skilled in areas such as clinical tasks, medication administration, post-op recovery and specialist care (for example, of those with dementia). At the same time, many capable care workers earn the minimum wage, or even below, and are unrecognised for the work they do. They cannot demand fair pay because they are unable to distinguish themselves from those without skills or experience.

We at the National Association of Care & Support Workers would like to create a registration process that does not discourage caring, naturally-skilled people in society from entering the sector. We hope the process can help promote the proven practice of values-based recruitment and bring more wonderful people to care positions.

The truth is that more people are ageing without having any children. For some of them, the only human contact they have might be with their care worker; registration is an essential step to improve the likelihood of these people receiving great care and reduce the risk of things going wrong.

Care roles grow more demanding each year; registration and a robust training framework should provide professional development opportunities and much-improved training standards. If every care worker gets the support and training they need at the same level of quality across the country, we can move on from aiming for good care for everyone to expecting outstanding care for all.

Karolina Gerlich is chief executive of the National Association of Care & Support Workers

‘I am excited by qualities not qualifications’

As someone who needs support to live my life, there’s a lot going on that concerns me. For starters, I am seriously worried about the new immigration policy and its impact on people who receive social care. Given both the vacancy rate in the sector and the complexity of social care funding pressures, I can’t see how proposed rules will have anything other than a negative and damaging effect on people’s day to day lives.

Beyond the issues concerning workforce supply, on a wider level I’ve been following discussions about the way the social care sector should be structured and regulated with interest.

There is a school of thought that suggests what the sector needs to solve its very real problems is more regulation, more training and qualifications for workers and more money.

Years ago, I realised that using a traditional care agency, with its regulation and training, would not enable me to thrive. The care workers seemed to lose sight of me as a person in the quest to undertake the tasks they saw as their primary role. I heard about a different way to get the help I need and since then have used a direct payment to employ my own assistants; a decision I have never regretted.

Related: Living with disability: 'Personal assistants are my ears, hands and body'

Direct payments were introduced in 1997, giving people who use services a means of exercising choice and control over their own support by providing a budget to spend on their care. Since then, the number of personal assistants in the workforce has grown, and the arguments for and against registration of this group have become more vociferous. In the strictest sense, personal assistants are unregulated, in that they are not required to undergo formal registration. But checks and balances do exist, in that they have a duty of care for the people they work for, and could therefore be prosecuted under the law.

While training and regulation is important and necessary, especially where specialist support is needed, I am excited by qualities not qualifications; values not standards. Values-based recruitment is considered effective in finding people with the right qualities to offer person-centred support. It is about matching skills and interests, rather than focusing on qualifications and experience.

The relationship between someone who uses a direct payment and a personal assistant offers the opportunity for more successful “matching” than the traditional model of care. Tellingly, the turnover rate for personal assistants is as low as 18%, compared with around 40% in the independent care sector.

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If we can agree that the ultimate goal is to improve people’s lives and enhance their wellbeing, that becomes the lens through which regulation of the sector is evaluated. The social care partnership organisation Think Local Act Personal, which I chair, is going to do some work to explore and establish a definitive view to ensure that any changes resonate with the values, beliefs and understanding of people who use services – in other words, the experts.

Clenton Farquharson is chair of Think Local Act Personal, and a disabled person. He is a member of the NHS assembly, chair of Quality Matters, trustee of the Race Equality Foundation and ambassador for Disability Rights UK