Care providers tell us that up to 50% of care workers quit within their first three months on the job. Nearly half a million quit every year, leading to a national care crisis. For five years, Ana has been working in a care home for people with disabilities. She enjoys the work and cares for her patients, but a combination of anxiety and poor working conditions have made her, too, think about quitting.
To protect her identity, we are using a pseudonym. Ana is not her real name.
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Could you tell us about what you do?
I've been in the UK for about six years, working in care for about five. I studied to be a social worker back in Eastern Europe. I'm a support worker at a supported living home. We help people to be as independent as possible. We always encourage everyone to live the life they want as much as they can, as much as it is safe for them to do.
What is it like? In the home and the people who live there?
It's a small house, with only five people between 20 to 60 years of age. They have learning disabilities, epilepsy, ADHD, anxiety, depression, etc. They have been assessed that they cannot be left on their own due to their disabilities. We take a person-centered approach. Everyone is treated like an individual and their options are respected. If we see there is potentially a health issue, we take note, call the GP and do all sorts of things in case something goes wrong.
How does a typical day look like for you and your team?
We start at 7:30 in the morning and discuss with staff if anything happened overnight and if we need to be aware of anything in particular. An example could be someone isn't feeling well or is feeling anxious, so we know how to approach the situation. We help them with personal care and breakfast, and make plans for the day. They cannot be on their own outside, so we support them with shopping, cleaning, laundry, medication, booking and appointments... Pretty much anything that you would typically be able to do alone, they can't. Some of them have bad social anxiety so we have to encourage them to speak, or we have to ask for something on their behalf, if that's what they want. We don't follow them around the house but we do check in on them. We knock on their door and see if everything is fine.
Everyone who has been in the house has been here for years. Most of them have improved and shown progress. When families are happy, that's when you know you've done a good job.
Does that mean you have to be in the home around the clock?
We are 11 to 12 people over the week working in shifts. We always have someone working in the home, 24 hours around the clock. We need night shifts because it's not safe for people to be alone. They have learning disabilities and need help any and all hours of the day. For example, if there is a fire they might not know what to do.
Late shifts and weekends are difficult, because most of the workers are moms and they work in the morning when kids are at school. There isn't any incentive to work late or on weekends. The pay is the same whether you do morning, evening, night or weekend shifts, so people aren't interested.
What do you like best about the job?
The best part about it is seeing positive changes. We had someone who moved in a couple years ago and had such severe anxiety that even closed doors was a huge trigger. After much support and encouragement, that person is now unrecognisable. That person is now able to have fun, socialise and have proper conversations.
It's a great achievement to see someone's life change for the better because of the things you've done. It's really rewarding to look back and see that we did something so well that their family tells us that someone is coherent and able to have conversations again.
Everyone who has been in the house has been here for years. Most of them have shown progress. When families are happy, that's when you know you've done a good job.
Does the work ever affect you personally?
It can be difficult and I have had episodes of feeling unwell. In two instances, I had to be off sick with anxiety. We have had people in our care who weren't suitable for the house. It's very challenging when we can see that someone isn't a good influence on the other residents. Our house is quiet; it's not a physical and aggressive kind of house. We had a case when someone was brought in who didn't seem suitable – and did turn out to be unsuitable. One of my colleagues was hit in the head. When you don't put people in the right homes, you can have consequences like this.
I'm very sorry to hear it. What happened then?
When my colleague was hit by one of the residents, she tried to contact the employee assistance program for help and nobody answered. Nobody treated us like a priority. She was very distressed and got medication from the doctor, but she still wasn't treated like a priority. She got paid time off because she was physically hit. She wasn't gone for very long, but I know she struggled quite some time after because I could tell she wasn't really herself.
I myself was sick with anxiety and was given off from the doctor for three weeks. But when I spoke with my manager, I found out I had to choose between being able to pay my bills and making it work, as I would only receive SSP (Statutory Sick Pay: £116.75 a week for up to 28 weeks). I was told: "Well, you weren't injured at work." The stress inflicted at work brought me to a breaking point, but because it wasn't a physical injury I only qualified for SSP.
I had to pretend. I had to do my job. At the end of the day I was absolutely exhausted because I couldn't show how I felt and be myself. It took even more energy and time for my recovery. But who's going to pay my bills otherwise?
My contract states that my job comes with a degree of stress and it's up to me to manage it. I ended up forcing myself to say I'm fine and came back to work after five days. It's difficult when you're not fit and have to return to work. You have to make it seem like you're alright, because my manager wouldn't have let me back to work if I had said I wasn't. I had to pretend. At the end of the day I was absolutely exhausted because I couldn't show how I felt and be myself. It took even more energy and time for my recovery. But who's going to pay my bills otherwise?
Have you ever thought about leaving?
Yes, I did a couple of times. I thought about an office job, but it sounds very depressing sitting down all day not even having a window. The good thing about our jobs is that there is something different every day. Your mind never gets bored. You always find new ways of thinking, being creative, helping people to do interesting things. It's more interesting and exciting than just sitting in an office. It's a nice job, but we need more support and understanding.
Many colleagues do leave. One is moving because things have gotten too expensive. Another is moving because he has three kids and it's not affordable anymore. Financially the job is not good enough to cover our expenses.
If care workers keep leaving, do you have to recruit all the time? How does that go?
Recruitment is really difficult. My service is recruiting again as some of the guys are leaving, but no one is interested because of the pay. If you paid decently you'd have more staff, and if you had more staff, you'd have an easier and less stressful environment. It would help if care workers didn't have to do as many hours as some of us do. It all comes down to money.
Because companies cannot afford to be too picky, you end up with unsuitable candidates in care. But this is not the kind of job that you should let just anyone do. It's complicated and you need a lot of awareness and understanding to be able to provide good support. It's not just about being there, it's also about helping people overcome things. You can't dismiss their anxieties and fears just because you don't think it's a big deal. You have to empathise, and see things from their perspective.
It would be nice if we would be treated the way we treat the people we look after. With dignity and decent pay, the chance of being off sick if you're mentally or physically unwell.
You've been working for five years in this industry. What needs to change?
Luckily, we are not a violent service. There are really, really rough services where people have challenging needs. When I hear we're being paid minimum wage while our mental and physical health are struggling, it's an absolute insult and quite degrading. It would be nice if we would be treated the way we treat the people we look after. With dignity and decent pay, the chance of being off sick if you're mentally or physically unwell.
When I first spoke to Liz, I was very happy to see what she's trying to do. Because honestly it doesn't feel like…I find it ironic that we are trained and we have to do all these things for vulnerable people but our own wellbeing is completely overlooked. It's not a priority. Now I see my company is running employee surveys, but it doesn't feel genuine. It just feels like another box to tick.
How did you get to know Tresacare?
Liz contacted a colleague of mine and he told me about it as he knew I was going through a difficult time. He said Tresacare offered wellbeing support for carers. I had a talk with Liz and we've been in contact since. She ran a Wellbeing Gym for a while. Unfortunately it was almost always during the workday so I wasn't always able to attend. I did in the beginning and it was really nice. It was refreshing to hear people talking about similar struggles, because sometimes you feel like a terrible person for being exhausted from the job.
What do you mean by "feeling like a terrible person"?
You might be aware that people have disabilities, but you still struggle with the repetitiveness of answering the same question hundreds of times. Even if you don't want to, you simply cannot help it. Thanks to the Wellbeing Gym, I'm with people who are struggling and experiencing similar feelings of exhaustion. It felt validating to hear people go through the same things.
That's a lot of emotions to process. How does the Wellbeing Gym help?
The good thing is we always shared experiences about what was difficult or challenging. Liz always tried to end the day on a positive note. Even after talking about things that were quite bad, the session always ended in a good way. Every time was different. We did meditation a few times, exercises to write down what you are thinking, drawing and painting activities. They were all relaxing activities that helped to restore calm. It was really nice. I really appreciate what she's trying to do. It can't be easy. Fighting with the system that has been like this for such a long time. She's still finding a way to challenge all that.
Why do you suppose these activities are effective?
It's a way to forget your day-to-day stress. Having a social life helps you break from your daily work environment. It's easy to mistake what is happening at work for what is happening everywhere. That's not necessarily true. Work doesn't reflect how life can be.
Many people working in the UK are immigrants and it gets difficult to make new friends after a certain age. If you're working all the time and not meeting people, it's not good for mental health and not ideal to just have a work-home routine. You have to go home after a shift to rest, but on days off you might need to socialise. You need lifestyle breaks. Lots of places are so short-staffed that even though you might not want so many hours, you still end up doing them.
The more of us there are, the louder our voice gets. At the moment there is a shortage of over 100,000 care workers. If you have those positions filled with people who understand that things need to change, then maybe someone at some point will listen.
Any words for people thinking of joining care?
It's a good job that helps you discover yourself. To assess your knowledge and see how much you know, since there is so much you have to know. I think it would be good if more people joined care work, because many of us would like to see change. The more of us there are, the louder our voice gets. At the moment there is a shortage of over 100,000 care workers. If you have those positions filled with people who understand that things need to change, then maybe someone at some point will listen.
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