Following Jef Smith’s recent article (CT, April 2010) based on his interview with me, and the follow-up correspondence from Lesley Bell and Pauline McCoy, I feel compelled to respond. I do so as a long-time supporter of people who deliver hands-on (‘person to person’) care ans as one who has continued to argue that the role and status of such staff is inappropriately overshadowed by discussions on social work and commissioning.

Jef Smith’s original article often quoted me out of context and I am not entirely surprised therefore at the responses from Lesley and Pauline. However, I shall try to put the record straight. My main points were responses to questions about the recruitment of care staff, and also issues of training and quality.

Firstly, I stated that encouraging more young people into paid caring roles should not solely focus on stressing career prospects. Many younger people may be interested in short involvement in such work and provided we have got the right sort of people, this should be encouraged. The industry has for many years been reliant on a significant proportion of staff working for short periods in hands-on roles, and given the difficult nature of the work, and the ridiculously poor pay, this is to a certain extent to be expected. We must encourage younger people to think about spending time directly caring for others, even for limited periods, and indeed this is the way that I myself, and many others, came into the sector, and stayed there.

For too many good people ‘careers’ has often meant moving on into other roles outside of hands-on care, e.g. social worker and policy positions, which is the only way that their pay and status could be enhanced. This certainly needs addressing, but I am not convinced that over-stressing training and qualifications is the route to do this, rather than the political or ‘market’ one.

On training itself, what I stressed is the need to balance this with the greater importance of the right sort of person, and the right management. The point I made to Jef was two-fold in this regard. Firstly that all things being equal the character and empathy of an individual was more important than the training they receive, and secondly that notwithstanding the importance of a baseline generic training for most, and sometimes specialist training for some, an over-emphasis on training can lead to the care worker believing they know best as to the way care and support should be delivered, rather than being directed by the ‘cared-for’ person or their carer.

So, ‘professionalisation’ and training can create a view that things must be done in certain ways irrespective of the view of the individual being supported. I believe that, despite rhetoric to the contrary, this is already a problem within the social work profession. And I say this both from my personal experience as an informal carer and social worker, and also based on the experience and feedback from many recipients of care and support services over the years.

Like Lesley Bell, I have been in this business for 35 years, the great majority of them involving management of homecare services on an in-house basis or, more latterly, commissioning such services. many people who know me well, both in my role as an informal carer (to my sister who died from multiple sclerosis in 2000 after 10 years of fairly intensive domiciliary, health and social care support) and also as a manager of homecare services, will know that I’m a long-time supporter of the importance and value of paid person-to-person support. I believe these hands-on roles are both underpaid and undervalued, but I am not convinced that ‘professionalisation’ built around training will resolve this problem. More to the point however my own experience and that of others suggests that, while a certain amount of basic training is important, it needs to be ‘married’ with a caring person who has an approach that is responsive to the cared for person’s wishes and prepared to negotiate that against their training and experience.

When looking for support for my sister, I looked primarily for experience, attitude and character; training was secondary. In fact over-training/entrenched professional approaches were a problem. I accept this cannot of course be an across-the-board position, as many people are not in a position to direct what they want/need, and certainly the position is different where staff are changing all the time and continuity is poor. There, good management is absolutely crucial, allied with generalised and sometimes specialised training. The point overall though is one of balance.