WIHSC study shines a light on one of Wales’ hidden workforces

A study undertaken by the Welsh Institute of Health and Social Care (WIHSC), University of South Wales, in partnership with Data Cymru, has been published. Commissioned by Welsh Government, the study, ‘Research on the employment of PAs in Social Care in Wales’ is part of the work programme of the Social Care Fair Work Forum.

Individuals who need care and support have the option to employ Personal Assistants (PAs) directly to assist them, thereby becoming employers in their own right. The study explored the role of PAs in the social care sector, gathered Wales level data on the workforce, identified key issues facing the workforce, and examples of good practice.

Findings show what is working well, and the key areas affecting PAs and their employers.

Many of the features working well for PAs were linked to the intrinsic close relationships built with their employers, based on trust and mutual respect. PAs derived distinct job satisfaction from providing person centred care, continuity of care, and enabling choice and control, and supporting their employer(s) to achieve their outcomes. These characteristics were of equal importance to employers who also referred to their need for a good quality of life, independence, and having time for other commitments, for example, family and employment.

The majority of PAs and employers confirmed permanent contracts were in place but that consistency around pay, terms and conditions were seen as requiring improvement. The evidence highlighted that often pay is not reflective of the level of complexity and skills required and that there can be a lack of shared understanding about PAs’ employment terms and conditions, for example entitlements such as holiday, overtime, and sick pay.  The Report also highlighted that some PAs don’t meet thresholds for National Insurance contributions, Statutory Sick Pay, and other benefits because they only work a small number of hours.

A shortage of training and development opportunities for PAs was highlighted as was the absence of specialist training. For employers, challenges referred to payment of expenses for PAs, and finding cover for absences.  However, the majority of PAs agreed they feel equipped to perform their role whilst employers also emphasised the importance of personal qualities, including compatibility, alongside training and formal qualifications.

Recruitment difficulties for employers ranged from being unable to recruit a suitable PA for specific hours, to being able to find cover when their PAs were absent. Retention enablers referred to being a supportive employer, mutual respect, and providing clear information regarding job descriptions, person specifications, entitlements, and pay rates.  Over 50% of employers reported PAs had been in post for over 12 months.

The report highlighted the importance of employers receiving and having access to information, guidance, and support to fulfil their role to fully support their PA(s) and uphold their employment responsibilities.

Dr Sarah Wallace, Senior Research Fellow, said: “We were pleased to have been able to undertake this study and add to the knowledge about this important workforce. The very personal nature of caring for people in a one-to-one setting means that it is critical that PAs and their employers can express their views and concerns about how their relationship works in practice.

“The study has helped to provide up-to date evidence for Welsh Government and local authorities and will support them in their efforts to achieve the continuous improvement in the quality of care that everyone is seeking.”

Julie Morgan MS, the Deputy Minister for Social Services said:

“The evidence WIHSC have provided is comprehensive and invaluable in bringing the voices and experiences of Personal Assistants directly into our national discussions about social care in Wales. 

“Personal Assistants are an integral part of the social care workforce family and play a critical role in enabling voice and control.  Direct payments empower and support people to continue to live independently and to be able to make choices about their care and support.  These principles will continue to be crucial in our vision for the future of social care. 

“We are already addressing low pay by ensuring the Real Living Wage extends to Personal Assistants as part of our wider workforce recognition arrangements.  These important findings will help inform our continuing actions to recognise and support the social care workforce across Wales including through the Social Care Fair Work Forum.”