Work Orientations and Conditions of Care Workers

Project outline

The project, funded by the John Fell Fund, uses Albert Hirschman’s framework of exit, loyalty and voice to examine how workers in care homes manage discordance between the material, the psycho-social and the political, aspects of their work and life.

Focused on identifying the realities of their everyday lives especially in a context of COVID-19, it examines the role and limits of their loyalty, the extent to which they see exit and or voice (in terms of political engagement) as available to them, and where the tipping point is between staying or leaving.

Specifically, the project:

• Explores care workers’ attachment to their work, the working conditions and their perceptions of their choices and how they make decisions to stay or leave;
• Utilises this and other evidence to co-produce policy insights and practical guidelines with a host of stakeholders.

The project is led by Professor Mary Daly, with Research Associate Duncan Fisher, from the ESRC Centre for Care.

The projects has had two major publications. Information on the report in the Barnett Papers is below. For links to other articles, please refer to the 'Publications' tab.

Barnett Papers in Social Research: The Job and Work Orientations of Workers in English Care Homes, Mary Daly and Duncan U. Fisher. Working paper, 23-01. May 2023 

This research study examined the job- and work-related behaviour and agency of care home workers providing direct care in care homes. The research sought to reveal, analyse and theorise the diverse concerns, priorities and work experiences of care home assistants and to harness this information to both inform policy action and academic scholarship.  

This was done by pursuing three research objectives. 

The first was to explore the nature of paid care work by identifying practices, constraints and norms in how it is carried out in care homes from the perspective of the workers. A second objective was to research the attachments and ties the workers have to their work and the residents, and to see how these fit with workers’ employment and personal biographies. Thirdly, the research explored workers’ agency in trying to improve their jobs and explored – with workers and stakeholders – the priorities for change and routes to realising those. 

Key findings 

Key findings from the research included: 

• The care workers studied carried a very heavy work burden.  

• Feelings about and personal investment in work dominated respondents’ accounts of their jobs.  

• Workers created meaning by invoking the relationship between their personal characteristics and the job. There is evidence of both a perceived values match and of care as embedded in people’s biographies.  

• The workers perceived the work as complex and even highly-skilled.  

• The respondents placed high value on the job in the sense of the work involved and were convinced that only certain people could do the work (which also acted to elevate their sense of their own value as workers).  

• The narratives contained a mix of references to the job, both negative and positive. This co-existence of strongly positive and negative views leads to considerable ambivalence and mixed feelings.  

• Some respondents saw a values mismatch between themselves and the employing organisation.  

• The workers generally felt misunderstood and un(der)appreciated by the public.  

• The sense of individual(ised) workers came out strongly from the research; they have to decide for themselves what is acceptable practice.  

• COVID-19 emerges as a hugely significant and mainly negative factor in regard to the experience of care workers in care homes. There was a strong sense of the pandemic as a traumatic experience for the workers, residents and families.  

• The participants in the stakeholder workshop had a very strong sense of what would help the workers’ situation and improve the functioning and quality of care provision in England more broadly.  

• These discussions and the many suggestions of workers themselves can be taken forward through necessary reforms and measures that address and improve: recruitment processes; support entry to the job and sector; on-the-job support; pay and financial benefits and recompense; general employment conditions; training, development and progression; the level of public information on care. 

About the research 

This research was funded by the John Fell Fund of the University of Oxford. The empirical research, which was carried out between October 2021 and February 2022, had three components: (1) an online survey (of 86 respondents); (2) interviews with 29 care home workers and: (3) a co-production workshop with key stakeholders.