Relationships matter: addressing worker conditions in care homes

When we think about the experience of care for children, we often don’t think about the adults in charge of them as needing to be cared for themselves.  Instead, we often locate the source of problems in the care system in the inability of those adults to properly care for children. In my research about staff working in residential facilities for young people in America, I began to understand that we make a grave mistake when we fail to see the workers in these systems as agents who are acting maliciously towards children without understanding the broader social structure that shapes their actions.

This does not mean that we ignore grave and serious violations of children’s physical and human rights at the hands of staff, but it requires us to address the broader conditions in which these staff work and act. As the economist Susan Himmelweit has argued, neoliberal economic conditions have resulted in the lowering of the quality of care and worker conditions and pay. Workers who are hired to work in care homes are less and less qualified, more and more vulnerable, and work for lower  pay. This has become particularly true in the context of austerity measures.

I have observed this erosion of care work in New York, where I conducted research. As the state shifted to cost-cutting approaches to the care of young people in the child welfare and juvenile justice system, they increasingly contracted out the provision of care for young people in trouble with the law and in the child welfare system, with agencies that hired staff to work long hours at extremely low wages. Turnover rates are high, and staff members often experience high rates of injuries and work-related stress. Care homes and residential facilities provide staff with little training and little support, and the only tools they gave them to manage young people were restraints.

As paid care work grows, however, we cannot ignore the consequences for the recipients of that care. As Himmelweit powerfully argues in her work on transforming care work, “relationships cannot be mass produced.” We must attend to the ways that poor standards of care, training, support (both emotional and financial) for the workers who support young people has dire consequences for young people’s experience of care.

Workers are often treated as expendable

One of the distinguishing features of care work today is that it is one of the most rapidly expanding sources of work in the new global economy, and one of the forms of work that is least likely to be extinguished in the era of machine learning. Yet these workers are often treated as expendable. Instead, it is arguable that we should pay all the more attention to this kind of work in the context of that work becoming all the more critical.

Care work can be transformed in important ways. As a start, this comes from recognizing that workers themselves are vulnerable; they import their own needs, anxieties, and relationships to care with them into the context in which they work. They deal with issues of projection and introjection, boundary setting and attachment. Without attending to these needs and these histories in the work through a strong system of clinical supervision, which allows the workers to reflect on and change their approaches to young people, we put the young people in care at greater risk. We can also improve the working conditions of the carers, providing them with adequate time off, a living wage and sufficient benefits.

We can also recognize that the workplaces themselves promote the well-being and flourishing of both staff and children. We should provide the opportunities for staff working in the care system to grow and flourish in the way that they aspire to, whether it be to provide support for further education training, childcare, or to grow their earning potential at the same time that we focus on developing young people’s capacity to flourish in the way that they expect to.

Residential care homes are complex organisms where relationships matter. In my research, I learned that we cannot sufficiently address the problems of criminalization and punishment that exist in care, especially the use of restraints and physical force, by arresting and penalizing staff members. We must instead recognize that at the heart of any institution are the relationships that take place inside of them, and an investment must be made in both the human capital and the social capital inside of them. We must recognize that staff members often draw upon the tools of arrest and restraint for several complex reasons.

Staff working in the care system should be able to grow and flourish

While we cannot ignore the forces of individual racism and bigotry, personal animus and inclinations towards violence that staff possess, we also must understand that staff members often call the police or resort to physical force for reasons that are shaped by the complex interaction between negative assumptions about children’s criminality and a failure of the broader care management system to value care itself. Put simply, if the management of the care homes themselves fail to value the work of care, by sufficiently providing for the carers themselves, then the carers may arguably be more likely to call the police than initiate a difficult conversation with a child, particularly one that may eat into their shift or make them feel ‘unsafe.’ If carers feel under-protected and exploited, in other words, they may then take those feelings out on children.

It is critical to recognize the individual experiences of physical, emotional and sexual abuse that children experience in care homes, as well as the practices of criminalization that occur as a result of individual staff members’ choices, but I would argue that we must also attend to the broader structures of care that matter deeply for the relationships that develop inside of care homes. These relationships matter deeply, and it is the workers themselves who are at the heart of those relationships.

Dr Alexandra Cox is based at the University of Essex

Comments