Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK
Abstract
:1. Introduction
2. Methodology
2.1. Survey Design
2.2. Recruitment and Data Collection
2.3. Measures
2.4. Analysis
3. Results
3.1. Survey Respondents
3.2. Self-Isolation, Working Hours and Pay
‘We had to work longer hours with less staff…’[Care worker, supported living/extra care housing]
‘Employers should have more staff to avoid increased workload…’[Care worker, older adults, domiciliary care]
‘I have found it such a struggle…to keep my head above water to pay bills and council tax as I only received about £93 for the 11 days I had off with COVID 19’.[Care worker, older adults, care home]
3.3. Experiences of Abuse and Violence during the COVID-19 Pandemic
3.3.1. Prevalence, Types and Perpetrators of Abuse
‘Being called names, being threatened, being followed’.[Care worker, adults with physical and/or sensory disability, supported living/extra care housing]
‘A huge amount of negative comments on social media, blaming carers for so many residents who died of COVID, and blaming care homes of keeping residents hostage, unwilling to allow visits’.[Care worker, older adults, care home]
‘Because we were on the front line and trying to implement guidelines we had been given, we got all the abuse thrown at us from residents and staff. No support given’.[Management, supported living/extra care housing]
‘Family’s don’t seem to understand that the company I work for don’t make the rules, or guidance given from PHA. They can be very frustrated and take that anger out on us’.[Care worker, older adults, care home]
‘Management threatened that we would have to complete our isolation period in work and live there for the duration if there was an outbreak amongst residents. Management ordered us to not use the track and trace app on our phones.’[Care worker, children and young people, care home]
‘I was threatened with a disciplinary from a regional manager due to me stating I was not going to let my team look after residents without full PPE despite having positive COVID results on my unit’.[Regulated professional, older adults, care home]
‘It’s not safe to get help.’[Care worker, adults with physical and/or sensory disability, supported living/extra care housing]
‘There was nothing I could do. It was reported to line management. I was trying to keep all within the government guidelines and to keep people safe and colleagues wanted and did work against the directives given placing all others at risk. When this was raised they bullied and used threating behaviour…’[Management, care home]
‘… It was reported to police and management, but they did nothing because “can’t do anything about it because of COVID restrictions and tenancy agreements”. So we had to take the abuse for almost a year…’[Care worker, adults with mental health needs, domiciliary care]
3.3.2. Abuse Differentials by Individual and Organisational Characteristics
‘Trying to keep staff motivated & committed was all the harder when they saw media reports of what NHS [National Health Services] staff were getting (freebies, discounts, etc)’.[Management, supported living/extra care housing]
‘A huge amount of negative comments on social media, blaming carers for so many residents who died of COVID, and blaming care homes of keeping residents hostage, unwilling to allow visits’.[Care worker, older adults, care home]
3.4. Implications of Abuse/Mistreatment on Individual Workers and the Organisation
‘It has been a hard year and fear to the job working all the way through the COVID 19 pandemic. Stress and depression on staff not knowing the outcome’.[Care worker, care home]
‘Have found working during pandemic very stressful’.[Care worker, older adults and adults with a learning disability, autism or mental health needs, domiciliary care]
‘The pandemic was extremely stressful. The information changed daily and we were struggling to enforce what was needed…’[Management, older adults, care home]
‘Unreasonable workloads and lack of support for shielding household. The stress involved led me to step down from position in order to protect them’.[Care worker, domiciliary care]
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Data Quality Checks and Exclusions
Definition | |
---|---|
Verbal abuse | Behaviour that humiliates, degrades or otherwise indicates a lack of respect for the dignity and worth of an individual. |
Bullying | Repeated and over time offensive behaviour through vindictive, cruel, or malicious attempts to humiliate or undermine an individual or groups of workers. |
Threat | Promised use of physical force or power resulting in fear of harm or other negative consequences to the targeted individuals or groups. |
Physical violence (attack/assault) | The use of physical force against another person or group, that results in harm. |
Appendix B
n | % | |
---|---|---|
Required to self-isolate | 283 | 27.3 |
Were on sick leave due to COVID-19 | 182 | 17.6 |
Stopped working due to the fear of infection | 40 | 3.9 |
Reduced working hours/stopped working for personal reasons or caring responsibilities outside work | 126 | 12.2 |
Were furloughed | 57 | 5.5 |
Had workload increased without additional pay | 330 | 31.8 |
Increased paid working hours | 212 | 20.4 |
Been redeployed to a different role or workplace other than usual role or workplace | 137 | 13.2 |
Stopped or been stopped by employer from working in as many different places to reduce spread of COVID-19 | 135 | 13.0 |
Worked from home | 116 | 11.2 |
Were on sick leave—not due to COVID-19 | 16 | 1.5 |
Made redundant/were suspended/resigned | 7 | 0.7 |
Thinking of the past few weeks how much of the time has your job made you feel | n | % |
---|---|---|
Tense, uneasy or worried | ||
All/most of the time | 404 | 39.0 |
Some of the time | 335 | 32.3 |
Occasionally/never | 298 | 28.7 |
Calm, contended or relaxed | ||
All/most of the time | 335 | 32.3 |
Some of the time | 302 | 29.1 |
Occasionally/never | 400 | 38.6 |
Depressed, gloomy or miserable | ||
All/most of the time | 249 | 24.0 |
Some of the time | 331 | 31.9 |
Occasionally/never | 457 | 44.1 |
Cheerful, enthusiastic or optimistic | ||
All/most of the time | 412 | 39.7 |
Some of the time | 317 | 30.6 |
Occasionally/never | 308 | 29.7 |
Overall, how satisfied or dissatisfied are you with | n | % |
Work-life balance | ||
Very satisfied/satisfied | 529 | 51.0 |
Neither satisfied nor dissatisfied | 222 | 21.4 |
Dissatisfied/very dissatisfied | 286 | 27.6 |
Wellbeing: Proxy (Feelings at Work) | Wellbeing: Work-Life Balance | |||||
---|---|---|---|---|---|---|
β | β | β | β | β | β | |
Characteristic | (1) | (2) | (3) | (4) | (5) | (6) |
Gender | ||||||
Male | 0.017 (0.028) | 0.022 (0.028) | 0.021 (0.028) | −0.042 (0.074) | −0.029 (0.074) | −0.026 (0.074) |
Ethnicity and nationality | ||||||
White Non-British | −0.072 * (0.042) | −0.064 (0.042) | −0.058 (0.043) | −0.092 (0.119) | −0.069 (0.119) | −0.060 (0.119) |
BAME | 0.028 (0.032) | 0.025 (0.032) | 0.029 (0.031) | 0.033 (0.080) | 0.027 (0.078) | 0.044 (0.078) |
Age | ||||||
Under 25 | −0.070 (0.052) | −0.067 (0.051) | −0.068 (0.051) | −0.177 (0.139) | −0.170 (0.138) | −0.170 (0.140) |
25–34 | −0.012 (0.030) | −0.008 (0.030) | −0.016 (0.030) | 0.016 (0.081) | 0.028 (0.080) | 0.019 (0.081) |
35–44 | −0.023 (0.028) | −0.021 (0.028) | −0.019 (0.028) | 0.031 (0.074) | 0.037 (0.073) | 0.043 (0.074) |
55+ | −0.019 (0.026) | −0.019 (0.026) | −0.018 (0.026) | 0.006 (0.071) | 0.008 (0.071) | 0.008 (0.071) |
Regional COVID | ||||||
Cases | 0.000 (0.000) | 0.000 (0.000) | 0.000 (0.000) | 0.000 (0.000) | 0.000 (0.000) | 0.000 (0.000) |
Deaths | −0.008 (0.012) | −0.009 (0.012) | −0.009 (0.012) | 0.004 (0.033) | −0.001 (0.033) | 0.003 (0.033) |
Sector | ||||||
Public sector | 0.051 * (0.027) | 0.050 * (0.027) | 0.050 * (0.026) | 0.178 ** (0.069) | 0.174 ** (0.068) | 0.173 ** (0.068) |
Charity | −0.020 (0.033) | −0.019 (0.033) | −0.018 (0.033) | −0.065 (0.090) | −0.060 (0.089) | −0.062 (0.089) |
Other | −0.011 (0.027) | −0.012 (0.027) | −0.013 (0.028) | 0.086 (0.073) | 0.084 (0.072) | 0.082 (0.072) |
Setting | ||||||
Care home w/wo nursing | −0.067 *** (0.022) | −0.063 *** (0.022) | −0.062 *** (0.022) | −0.029 (0.060) | −0.018 (0.059) | −0.021 (0.060) |
Service user | ||||||
Older adults | −0.005 (0.022) | −0.012 (0.022) | −0.014 (0.022) | 0.111* (0.060) | 0.093 (0.060) | 0.091 (0.060) |
Adults with physical/sensory disability | 0.073 *** (0.028) | 0.073 *** (0.028) | 0.069** (0.028) | −0.015 (0.079) | −0.016 (0.078) | −0.018 (0.079) |
Adults with mental health needs | −0.009 (0.033) | −0.011 (0.033) | −0.011 (0.033) | 0.105 (0.086) | 0.099 (0.085) | 0.101 (0.084) |
Other | 0.004 (0.036) | 0.006 (0.036) | 0.009 (0.036) | −0.076 (0.096) | −0.068 (0.095) | −0.067 (0.096) |
Role | ||||||
Non- direct care | −0.044 * (0.025) | −0.045 * (0.025) | −0.047 * (0.025) | −0.283 *** (0.068) | −0.284 *** (0.067) | −0.287 *** (0.067) |
Tenure | ||||||
<2 years | 0.043 (0.033) | 0.043 (0.033) | 0.045 (0.033) | 0.015 (0.084) | 0.016 (0.083) | 0.024 (0.083) |
2–5 years | 0.021 (0.028) | 0.020 (0.028) | 0.021 (0.028) | −0.147 ** (0.074) | −0.148 ** (0.073) | −0.148 ** (0.074) |
6–10 years | 0.008 (0.027) | 0.007 (0.027) | 0.008 (0.027) | −0.094 (0.076) | −0.097 (0.076) | −0.094 (0.076) |
Contract type | ||||||
Non-permanent | 0.055 ** (0.024) | 0.059 ** (0.024) | 0.062 ** (0.024) | 0.133 ** (0.064) | 0.145 ** (0.063) | 0.151 ** (0.063) |
Union member | ||||||
Yes | −0.083 *** (0.022) | −0.083 *** (0.022) | −0.082 *** (0.022) | −0.082 (0.059) | −0.080 (0.058) | −0.073 (0.058) |
Abuse (any) | ||||||
Yes | −0.185 *** (0.023) | - | - | −0.312 *** (0.064) | - | - |
Abuse (severity) | ||||||
Single | - | −0.128 *** (0.028) | - | - | −0.143 * (0.081) | - |
Multiple | - | −0.254 *** (0.030) | - | - | −0.519 *** (0.082) | - |
Abuse (type) | ||||||
Verbal abuse | - | - | −0.093 *** (0.027) | - | - | −0.182 ** (0.077) |
Bullying | - | - | −0.145 *** (0.035) | - | - | −0.222 ** (0.096) |
Threat | - | - | −0.033 ns (0.046) | - | - | −0.015 ns (0.123) |
Physical violence | - | - | −0.107 ** (0.050) | - | - | −0.381 *** (0.138) |
N | 1037 | 1037 | 1037 | 1037 | 1037 | 1037 |
R-squared | 0.168 | 0.177 | 0.176 | 0.099 | 0.111 | 0.112 |
Characteristic | n | % |
---|---|---|
Current employer voluntarily | ||
Very/quite likely | 449 | 43.3 |
Not very/at all likely | 588 | 56.7 |
Social care altogether | ||
Very/quite likely | 300 | 28.9 |
Not very/at all likely | 737 | 71.1 |
Intention to Leave in the Next 12 Months: Sector | Intention to Leave in the Next 12 Months: Current Employer | |||||
---|---|---|---|---|---|---|
ME | ME | ME | ME | ME | ME | |
Characteristic | (1) | (2) | (3) | (4) | (5) | (6) |
Gender | ||||||
Male | 0.076 * (1.75) | 0.076 * (1.76) | 0.082 * (1.86) | 0.082 * (1.69) | 0.082 * (1.68) | 0.090 * (1.83) |
Ethnicity and nationality | ||||||
White Non-British | 0.120 (1.60) | 0.122 (1.62) | 0.115 (1.55) | 0.174 ** (2.30) | 0.173 ** (2.29) | 0.169 ** (2.23) |
BAME | 0.101 * (1.94) | 0.101 * (1.94) | 0.113 ** (2.14) | 0.169 *** (3.03) | 0.169 *** (3.03) | 0.178 *** (3.17) |
Age | ||||||
Under 25 | 0.032 (0.37) | 0.033 (0.38) | 0.028 (0.32) | 0.077 (0.86) | 0.076 (0.85) | 0.070 (0.79) |
25–34 | −0.115 *** (−2.81) | −0.114 *** (−2.78) | −0.108 *** (−2.62) | −0.103 ** (−2.03) | −0.103 ** (−2.04) | −0.095 * (−1.89) |
35–44 | −0.047 (−1.11) | −0.046 (−1.10) | −0.046 (−1.10) | −0.053 (−1.08) | −0.054 (−1.09) | −0.053 (−1.08) |
55+ | 0.036 (0.86) | 0.036 (0.87) | 0.032 (0.78) | −0.066 (−1.40) | −0.066 (−1.41) | −0.068 (−1.46) |
Regional COVID | ||||||
Cases | 0.000 (0.02) | 0.000 (0.04) | −0.000 (−0.08) | 0.000 (0.94) | 0.000 (0.93) | 0.000 (0.80) |
Deaths | −0.004 (−0.20) | −0.004 (−0.22) | −0.002 (−0.08) | −0.015 (−0.68) | −0.014 (−0.67) | −0.012 (−0.55) |
Sector | ||||||
Public sector | −0.029 (−0.71) | −0.028 (−0.71) | −0.033 (−0.82) | −0.073 (−1.58) | −0.073 (−1.59) | −0.074 (−1.62) |
Charity | −0.071 (−1.60) | −0.071 (−1.60) | −0.073 * (−1.66) | −0.024 (−0.43) | −0.025 (−0.44) | −0.028 (−0.49) |
Other | −0.028 (−0.66) | −0.028 (−0.66) | −0.028 (−0.66) | −0.009 (−0.18) | −0.009 (−0.18) | −0.009 (−0.17) |
Setting | ||||||
Care home w/wo nursing | −0.008 (−0.24) | −0.008 (−0.23) | −0.008 (−0.23) | −0.024 (−0.61) | −0.024 (−0.62) | −0.026 (−0.64) |
Service user | ||||||
Older adults | −0.065 * (−1.96) | −0.066 ** (−1.98) | −0.058 * (−1.74) | −0.009 (−0.22) | −0.008 (−0.20) | −0.001 (−0.04) |
Adults with physical/sensory disability | 0.025 (0.59) | 0.025 (0.59) | 0.034 (0.81) | 0.021 (0.42) | 0.021 (0.42) | 0.032 (0.64) |
Adults with mental health needs | −0.025 (−0.52) | −0.025 (−0.53) | −0.022 (−0.47) | 0.040 (0.74) | 0.041 (0.75) | 0.041 (0.75) |
Other | −0.038 (−0.72) | −0.037 (−0.72) | −0.047 (−0.89) | −0.038 (−0.60) | −0.038 (−0.60) | −0.046 (−0.72) |
Role | ||||||
Non-direct care | −0.028 (−0.75) | −0.028 (−0.75) | −0.027 (−0.72) | −0.113 ** (−2.54) | −0.113 ** (−2.55) | −0.113 ** (−2.56) |
Tenure | ||||||
<2 years | −0.030 (−0.65) | −0.030 (−0.58) | −0.024 (−0.51) | −0.011 (−0.21) | −0.011 (−0.21) | −0.005 (−0.10) |
2–5 years | −0.024 (−0.57) | −0.024 (−0.58) | −0.025 (−0.60) | 0.026 (0.53) | 0.026 (0.53) | 0.026 (0.54) |
6–10 years | −0.012 (−0.29) | −0.012 (−0.29) | −0.016 (−0.39) | −0.057 (−1.18) | −0.056 (−1.18) | −0.057 (−1.20) |
Contract type | ||||||
Non-permanent | 0.062 * (1.67) | 0.063 * (1.69) | 0.061 (1.61) | 0.073 * (1.68) | 0.073 * (1.67) | 0.071 (1.62) |
Union member | ||||||
Yes | 0.078 ** (2.29) | 0.077 ** (2.29) | 0.086 ** (2.52) | 0.108 *** (2.77) | 0.108 *** (2.77) | 0.114 *** (2.93) |
Satisfaction with workload | ||||||
Neither satisfied nor dissatisfied | 0.043 (1.29) | 0.044 (1.30) | 0.043 (1.28) | 0.137 *** (3.44) | 0.136 *** (3.42) | 0.132 *** (3.33) |
Dissatisfied/very dissatisfied | 0.241 *** (6.20) | 0.242 *** (6.21) | 0.243 *** (6.17) | 0.429 *** (10.99) | 0.428 *** (10.92) | 0.432 *** (11.04) |
Satisfaction with pay | ||||||
Very satisfied/satisfied | −0.101 *** (−2.72) | −0.102 *** (−2.73) | −0.100 *** (−2.70) | −0.131 *** (−3.07) | −0.131 *** (−3.05) | −0.127 *** (−2.98) |
Neither satisfied nor dissatisfied | −0.057 (−1.41) | −0.057 (−1.42) | −0.063 (−1.57) | −0.078 * (−1.70) | −0.078 * (−1.70) | −0.080 * (−1.75) |
Abuse (any) | ||||||
Yes | 0.233 *** (5.71) | - | - | 0.260 *** (7.04) | - | - |
Abuse (severity) | ||||||
Single | - | 0.225 *** (4.48) | - | - | 0.223 *** (4.72) | - |
Multiple | - | 0.243 *** (4.17) | - | - | 0.200 *** (3.67) | - |
Abuse (type) | ||||||
Verbal abuse | - | - | 0.135 *** (2.86) | - | - | 0.115 *** (2.92) |
Bullying | - | - | 0.103 *** (1.55) | - | - | 0.057 ns (1.05) |
Threat | - | - | 0.128 * (1.61) | - | - | 0.072 ns (1.06) |
Physical violence | - | - | −0.067 ns (−0.64) | - | - | 0.020 ns (0.24) |
N | 1037 | 1037 | 1037 | 1037 | 1037 | 1037 |
References
- Beresford, P. What are we clapping for? Sending people to die in social care: Why the NHS did this and what needs to happen next? In COVID-19 and Co-Production in Health and Social Care Research, Policy, and Practice; Bristol University Press: Bristol, UK, 2021; pp. 89–99. [Google Scholar]
- Reed, A.C.; Murmann, M.; Hsu, A.; Turnpenny, A.; Van Houtven, C.; Laberge, M.; Low, L.-F.; Hussein, S.; Allin, S. Risk recognition policies for the long-term care workforce during the first year of the COVID-19 pandemic: A multi-country study. J. Long-Term Care 2022, 2022, 22–39. [Google Scholar] [CrossRef]
- House of Commons Public Accounts Committee. Readying the NHS and Social Care for the COVID-19 Peak. HC 405. House of Commons, London. Available online: https://committees.parliament.uk/publications/2179/documents/20139/default/ (accessed on 14 March 2022).
- Office for National Statistics Deaths Involving COVID-19 in the Care Sector, England and Wales: Deaths Registered between Week Ending 20 March 2020 and Week Ending 2 April 2021. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsinvolvingcovid19inthecaresectorenglandandwales/deathsregisteredbetweenweekending20march2020andweekending2april2021 (accessed on 4 April 2022).
- Daly, M. COVID-19 and care homes in England: What happened and why? Soc. Policy Adm. 2020, 54, 985–998. [Google Scholar] [CrossRef] [PubMed]
- Towers, A.-M.; Killett, A.; Handley, M.; Almack, K.; Backhouse, T.; Bunn, D.; Bunn, F.; Dickinson, A.; Mathie, E.; Mayrhofer, A.; et al. Producing ‘Top Tips’ for Care Home Staff During the COVID-19 Pandemic in England: Rapid Reviews Inform Evidence-Based Practice but Reveal Major Gaps. J. Long-Term Care 2020, 151–166. Available online: http://doi.org/10.31389/jltc.43 (accessed on 14 March 2022). [CrossRef]
- Care Quality Commission. Delegating Medicines Administration. Available online: https://www.cqc.org.uk/guidance-providers/adult-social-care/delegating-medicines-administration (accessed on 14 March 2022).
- Shore, C.; Maben, J.; Mold, F.; Winkley, K.; Cook, A.; Stenner, K. Delegation of medication administration from registered nurses to non-registered support workers in community care settings: A systematic review with critical interpretive synthesis. Int. J. Nurs. Stud. 2022, 126, 104121. [Google Scholar] [CrossRef] [PubMed]
- Skills for Care. The State of the Adult Social Care Sector and Workforce in England; Skills for Care: Leeds, UK, 2021. [Google Scholar]
- National Audit Office. The Adult Social Care Workforce in England. HC 714. National Audit Office, London. Available online: https://www.nao.org.uk/wp-content/uploads/2018/02/The-adult-social-care-workforce-in-England.pdf (accessed on 7 April 2022).
- The Care Workers’ Charity. ‘Just Part of the Job’—Violence, Aggression and Burnout in the Care Industry. Available online: https://www.thecareworkerscharity.org.uk/social-care-voices/just-part-of-the-job/ (accessed on 14 March 2022).
- Hussein, S.; Saloniki, E.; Turnpenny, A.; Collins, G.; Vadean, F.; Bryson, A.; Forth, J.; Allan, S.; Towers, A.; Gou, K.; et al. COVID-19 and the Wellbeing of the Adult Social Care Workforce: Evidence from the UK; Personal Social Services Research Unit: Kent, UK, 2020. [Google Scholar]
- Edmunds, C. Carer finds note on car branding her a ‘killer’ after treating patient and NHS worker is abused for confronting joggers flouting lockdown rules in more attacks on frontline staff during coronavirus pandemic. Mail Online, 6 April 2020. Available online: https://www.dailymail.co.uk/news/article-8191863/Carer-treating-vulnerable-patient-coronavirus-crisis-finds-killer-note-car.html (accessed on 6 April 2022).
- International Labor Organization. Framework Guidelines for Addressing Workplace Violence in the Health Sector; ILO: Geneva, Switzerland, 2002. [Google Scholar]
- Gerberich, S. Verbal abuse against home care aides: Another shot across the bow in violence against health care and other workers. Occup. Environ. Med. 2019, 76, 593–594. [Google Scholar] [CrossRef]
- Karlsson, N.D.; Markkanen, P.K.; Kriebel, D.; Gore, R.J.; Galligan, C.J.; Sama, S.R.; Quinn, M.M. Home care aides’ experiences of verbal abuse: A survey of characteristics and risk factors. Occup. Environ. Med. 2019, 76, 448–454. [Google Scholar] [CrossRef]
- House of Commons Health and Social Care Committee. Workforce Burnout and Resilience in the NHS and Social Care. Second Report of Session 2021-22. HC 22. House of Commons, London. Available online: https://committees.parliament.uk/publications/6158/documents/68766/default/ (accessed on 14 March 2022).
- Colton, M.; Roberts, S. Factors that contribute to high turnover among residential child care staff. Child Fam. Soc. Work 2007, 12, 133–142. [Google Scholar] [CrossRef]
- Harris, B.; Leather, P. Levels and consequences of exposure to service user violence: Evidence from a sample of UK social care staff. Br. J. Soc. Work 2012, 42, 851–869. [Google Scholar] [CrossRef]
- Lovell, A.; Skellern, J. Tolerating violence: A qualitative study into the experience of professionals working with one UK learning disability service. J. Clin. Nurs. 2013, 22, 2264–2272. [Google Scholar] [CrossRef]
- Skills for Care. Supporting Social Care Employers to Prevent and Manage Abuse and Violence Toward Staff; Skills for Care: Leeds, UK, 2014. [Google Scholar]
- Schnelli, A.; Karrer, M.; Mayer, H.; Zeller, A. Aggressive behaviour of persons with dementia towards professional caregivers in the home care setting—A scoping review. J. Clin. Nurs. 2020, 1–18. [Google Scholar] [CrossRef]
- Braedley, S.; Owusu, P.; Przednowek, A.; Armstrong, P. We’re told, ‘Suck it up’: Long-term care workers’ psychological health and safety. Ageing Int. 2018, 43, 91–109. [Google Scholar] [CrossRef]
- Funk, L.; Spencer, D.; Herron, R. Making sense of violence and victimization in health care work: The emotional labour of ‘not taking it personally’. Int. Rev. Vict. 2021, 27, 94–110. [Google Scholar] [CrossRef]
- Bamonti, P.; Conti, E.; Cavanagh, C.; Gerolimatos, L.; Gregg, J.; Goulet, C.; Pifer, M.; Edelstein, B. Coping, cognitive emotion regulation, and burnout in long-term care nursing staff: A preliminary study. J. Appl. Gerontol. 2019, 38, 92–111. [Google Scholar] [CrossRef] [PubMed]
- Shi, C.R.; Ma, H.Q.; Huang, C.; Zhang, M.H.; Ren, Z.H. Cognitive emotion regulation strategies and depressive symptoms among nurses exposed to workplace violence: A person-centered approach. J. Ment. Health 2021, 30, 541–548. [Google Scholar] [CrossRef] [PubMed]
- Office for National Statistics. Vacancies and Jobs in the UK: March 2021. Available online: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/jobsandvacanciesintheuk/march2021 (accessed on 8 April 2022).
- Hussein, S. “We don’t do it for the money” The scale and reasons of poverty-pay among frontline long-term care workers in England. Health Soc. Care Community 2017, 25, 1817–1826. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hussein, S. Employment inequalities among British minority ethnic workers in health and social care at the time of COVID-19: A rapid review of the literature. Soc. Policy Soc. 2022, 21, 316–330. [Google Scholar] [CrossRef]
- National Audit Office. The Adult social care Market in England. HC 1244. National Audit Office, London. Available online: https://www.nao.org.uk/wp-content/uploads/2021/03/The-adult-social-care-market-in-England.pdf (accessed on 8 April 2022).
- Office for National Statistics. Care Homes and Estimating the Self-Funding Population, England: 2019 to 2020. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/socialcare/articles/carehomesandestimatingtheselffundingpopulationengland/2019to2020#self-funding-population-of-care-home-residents (accessed on 14 March 2022).
- Brockmann, M.; Butt, J.; Fisher, M. The experiences of racism: Black staff in social services. Res. Policy Plan. 2001, 19, 1–10. [Google Scholar]
- Brockmann, M. New perspectives on violence in social care. J. Soc. Work 2022, 2, 29–44. [Google Scholar] [CrossRef]
- Denney, D. Violence and social care staff: Positive and negative approaches to risk. Br. J. Soc. Work 2010, 40, 1297–1313. [Google Scholar] [CrossRef]
- Skills for Care. Violence Against Social Care and Support Staff: Summary of Research; Skills for Care: Leeds, UK, 2013. [Google Scholar]
- Giebel, C.; Hanna, K.; Marlow, P.; Cannon, J.; Tetlow, H.; Shenton, J.; Faulkner, T.; Rajagopal, M.; Mason, S.; Gabbay, M. Guilt, tears, and burnout—Impact of UK care home restrictions on the mental well-being of staff, families, and residents. J. Adv. Nurs. 2022, 78, 2191–2202. [Google Scholar] [CrossRef]
- Towers, A.-M.; Collins, G. The Impact of COVID-19 on the Social Care Workforce: Interviews with Stakeholders. PSSRU Blog. Available online: https://www.pssru.ac.uk/blog/the-impact-of-covid-19-on-the-social-care-workforce-interviews-with-stakeholders/ (accessed on 15 December 2021).
- Koritsas, S.; Coles, J.; Boyle, M. Workplace violence towards social workers: The Australian experience. Br. J. Soc. Work 2010, 40, 257–271. [Google Scholar] [CrossRef]
- Littlechild, B. The nature and effects of violence against child-protection social workers: Providing effective support. Br. J. Soc. Work 2005, 35, 387–401. [Google Scholar] [CrossRef]
- Newhill, C.; Wexler, S. Client violence toward children and youth services social workers. Child. Youth Serv. Rev. 1997, 19, 195–212. [Google Scholar] [CrossRef]
- Norris, D.; Kedward, C. Violence Against Social Workers; Jessica Kingsley: London, UK, 1990. [Google Scholar]
- Schat, A.; Kelloway, E. Workplace aggression. In Handbook of Work Stress; Barling, J., Kelloway, K., Frone, M., Eds.; Sage Publications: Thousand Oaks, CA, USA, 2005; pp. 189–218. [Google Scholar]
- Small, T. Verbal abuse in home care. Home Healthc. Now 2021, 39, 53. [Google Scholar] [CrossRef] [PubMed]
- Keogh, P.; Byrne, C. Crisis, Concern and Complacency: A Study on the Extent, Impact and Management of Workplace Violence and Assault on Social Care Workers; Social Care Ireland: Dublin, Ireland, 2016. [Google Scholar]
- Leather, P.; Beale, D.; Lawrence, C.; Dickson, R. Effects of exposure to occupational violence and the mediating impact of fear. Work Stress 1997, 11, 329–340. [Google Scholar] [CrossRef]
- Maffett, A.J.; Paull, D.N.; Skeel, R.L.; Kraysovic, J.N.; Hatch, B.; O’Mahony, S.; Gerhart, J.I. Emotion Dysregulation and Workplace Satisfaction in Direct Care Worker Burnout and Abuse Risk. J. Am. Med. Dir. Assoc. 2022, 23, 1257–1261. [Google Scholar] [CrossRef] [PubMed]
- Maleki, M.; Mardani, A.; Vaismoradi, M. Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making. Int. J. Environ. Res. Public Health 2021, 18, 12548. [Google Scholar] [CrossRef]
- QSR International Pty Ltd. NVivo (Version 12). Available online: https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home (accessed on 22 January 2022).
- StataCorp. Stata Statistical Software: Release 15; StataCorp LLC: College Station, TX, USA, 2017. [Google Scholar]
- Tabachnick, B.; Fidell, L. Using Multivariate Statistics, 6th ed.; Pearson Education, Inc.: Boston, MA, USA, 2014. [Google Scholar]
- Shields, M.; Price, S. The determinants of racial harassment at the workplace: Evidence from the British nursing profession. Br. J. Ind. Relat. 2002, 40, 1–21. [Google Scholar] [CrossRef]
- Sims, S.; Harris, R.; Hussein, S.; Rafferty, A.M.; Desai, A.; Palmer, S.; Brearley, S.; Adams, R.; Rees, L.; Fitzpatrick, J.M. Social distancing and isolation strategies to prevent and control the transmission of COVID-19 and other infectious diseases in care homes for older people: An international review. Int. J. Environ. Res. Public Health 2022, 19, 3450. [Google Scholar] [CrossRef]
- Skills for Care. Research on Abuse and Violence against the Social Care Workforce: Focus on Personal Assistants; Skills for Care: Leeds, UK, 2014. [Google Scholar]
- Simmons, C.; Rodrigues, R.; Szebehely, M. Working conditions in the long-term care sector: A comparative study of migrant and native workers in Austria and Sweden. Health Soc. Care Community 2021, 1–12. [Google Scholar] [CrossRef]
- Schubert, M.; Ludwig, J.; Freiberg, A.; Hahne, T.M.; Romero Starke, K.; Girbig, M.; Faller, G.; Apfelbacher, C.; von dem Knesebeck, O.; Seidler, A. Stigmatization from Work-Related COVID-19 Exposure: A Systematic Review with Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 6183. [Google Scholar] [CrossRef] [PubMed]
- Hussein, S. Job demand, control and unresolved stress within the emotional work of long-term care in England. Int. J. Care Caring 2018, 2, 89–107. [Google Scholar] [CrossRef] [Green Version]
- Samuel, M. Most Social Workers Happy in Role Despite Unpaid Overtime, Cuts and COVID Mental Health Toll; Community Care: London, UK, 2022; Available online: https://www.communitycare.co.uk/2022/03/09/most-social-workers-happy-in-role-despite-unpaid-overtime-cuts-and-covid-mental-health-toll/ (accessed on 1 April 2022).
- House of Commons, Health and Social Care Committee. Expert Panel: Evaluation of Government’s Commitments in the Area of the Health and Social Care Workforce in England. Parliamentary Copyright House of Commons 2022. Available online: https://committees.parliament.uk/publications/23245/documents/169703/default/ (accessed on 20 June 2022).
Characteristic | n | % |
---|---|---|
Gender | ||
Male | 167 | 16.1 |
Female | 852 | 82.2 |
Other/Prefer not to say | 18 | 1.7 |
Age | ||
Under 25 years | 48 | 4.6 |
25–34 years | 222 | 21.4 |
35–44 years | 206 | 19.9 |
45–54 years | 301 | 29.0 |
55–64 years | 260 | 25.1 |
Nationality and Ethnicity | ||
White British | 866 | 83.5 |
White Non-British | 56 | 5.4 |
BAME | 115 | 11.1 |
Time working in social care | ||
Less than 6 months | 25 | 2.4 |
6–11 months | 62 | 6.0 |
12–23 months | 113 | 10.9 |
2–5 years | 225 | 21.7 |
6–10 years | 194 | 18.7 |
More than 10 years | 418 | 40.3 |
Employment type | ||
Guaranteed hours (temporary/permanent) | 726 | 70.0 |
Zero-hours | 280 | 27.0 |
Self-employed | 11 | 1.1 |
Other | 20 | 1.9 |
Main employer | ||
Public sector | 183 | 17.7 |
Private (i.e., for profit) | 557 | 53.7 |
Temporary staffing agency | 29 | 2.8 |
Charity | 133 | 12.8 |
Individual employer | 30 | 2.9 |
Self-employed | 11 | 1.1 |
Other | 94 | 9.1 |
Trade union or staff association | ||
Yes | 464 | 44.7 |
No, but have been in the past | 136 | 13.1 |
No, have never been a member | 437 | 42.1 |
Main job role | ||
Direct care | 763 | 73.6 |
Management | 193 | 18.6 |
Regulated professional | 49 | 4.7 |
Other (incl. ancillary) | 32 | 3.1 |
Client groups | ||
Older adults (incl. those with dementia) | 606 | 58.4 |
Adults with physical and/or sensory disability | 170 | 16.4 |
Adults with mental health needs | 144 | 13.9 |
Adults with learning disability or autism | 82 | 7.9 |
Children and young people | 27 | 2.6 |
Setting mainly carrying out work | ||
Residential care (with/without nursing) | 375 | 36.2 |
Domiciliary care | 397 | 38.3 |
Day centre/service or community | 48 | 4.6 |
Supported living/extra care housing | 202 | 19.5 |
Other | 15 | 1.5 |
Main area of work | ||
North | 292 | 28.2 |
Midlands | 251 | 24.2 |
London | 98 | 9.5 |
South | 242 | 23.3 |
Scotland | 92 | 8.9 |
Wales | 38 | 3.7 |
Northern Ireland | 24 | 2.3 |
General health | ||
Excellent/very good | 454 | 43.8 |
Good | 346 | 33.4 |
Fair/poor | 237 | 22.9 |
All | Abuse Type | ||||
---|---|---|---|---|---|
Verbal Abuse | Bullying | Threat | Physical Violence | ||
Abuse (any) | |||||
Yes | 265 (25.6%) | 205 (19.8%) | 118 (11.4%) | 83 (8.0%) | 53 (5.1%) |
No | 772 (74.5%) | 832 (80.2%) | 919 (88.6%) | 954 (92.0%) | 984 (94.9%) |
Abuse (severity) | |||||
Single | 143 (13.8%) | - | - | - | - |
Multiple | 122 (11.8%) | - | - | - | - |
Perpetrator (if Abuse Type = ‘Yes’) | |||||
Manager/supervisor | - | 38 (18.5%) | 34 (28.8%) | 21 (25.3%) | 2 (3.8%) |
Colleague/staff member | - | 49 (23.9%) | 37 (31.4%) | 13 (15.7%) | 6 (11.3%) |
Service user/client | - | 88 (42.9%) | 28 (23.7%) | 23 (27.7%) | 27 (50.9%) |
Service user’s/client’s family | - | 65 (31.7%) | 19 (16.1%) | 18 (21.7%) | 9 (17.0%) |
General public | - | 49 (23.9%) | 12 (10.2%) | 12 (14.5%) | 7 (13.2%) |
Action taken (if Abuse Type = ‘Yes’) | |||||
Took no action | - | 54 (26.3%) | 13 (11.0%) | 11 (13.3%) | 8 (15.1%) |
Reported it to a manager/supervisor | - | 96 (46.8%) | 35 (29.7%) | 31 (37.4%) | 19 (35.9%) |
Told a colleague/staff member | - | 39 (19.0%) | 32 (27.1%) | 14 (16.9%) | 7 (13.2%) |
Sought help from a union | - | 20 (9.8%) | 18 (15.3%) | 14 (16.9%) | 12 (22.6%) |
Nationality and Ethnicity | Care Setting | ||||
---|---|---|---|---|---|
White British (1) | White Non-British (2) | BAME (3) | Residential Care (4) | Domiciliary Care and Other (5) | |
Abuse (any) | |||||
Mean (SD) | 0.234 (0.424) | 0.286 (0.456) | 0.400 (0.492) | 0.315 (0.465) | 0.222 (0.416) |
N | 866 | 56 | 115 | 375 | 662 |
(1)–(2) | (2)–(3) | (1)–(3) | (4)–(5) | ||
Diff. (SE) | −0.051 ns (0.059) | −0.114 ns (0.078) | −0.166 *** (0.043) | 0.093 *** (0.028) | - |
Wellbeing: Proxy (Feelings at Work) | Wellbeing: Work-Life Balance | |||||
---|---|---|---|---|---|---|
Characteristic | (1) | (2) | (3) | (4) | (5) | (6) |
β | β | β | β | β | β | |
Abuse (any) | ||||||
Yes | −0.185 *** (0.023) | - | - | −0.312 *** (0.064) | - | - |
Abuse (severity) | ||||||
Single | - | −0.128 *** (0.028) | - | - | −0.143 * (0.081) | - |
Multiple | - | −0.254 *** (0.030) | - | - | −0.519 *** (0.082) | - |
Abuse (type) | ||||||
Verbal abuse | - | - | −0.093 *** (0.027) | - | - | −0.182 ** (0.077) |
Bullying | - | - | −0.145 *** (0.035) | - | - | −0.222 ** (0.096) |
Threat | - | - | −0.033 ns (0.046) | - | - | −0.015 ns (0.123) |
Physical violence | - | - | −0.107 ** (0.050) | - | - | −0.381 *** (0.138) |
N | 1037 | 1037 | 1037 | 1037 | 1037 | 1037 |
Intention to Leave in the Next 12 Months: Sector | Intention to Leave in the Next 12 Months: Current Employer | |||||
---|---|---|---|---|---|---|
Characteristic | (1) | (2) | (3) | (4) | (5) | (6) |
ME | ME | ME | ME | ME | ME | |
Abuse (any) | ||||||
Yes | 0.233 *** (5.71) | - | - | 0.260 *** (7.04) | - | - |
Abuse (severity) | ||||||
Single | - | 0.225 *** (4.48) | - | - | 0.223 *** (4.72) | - |
Multiple | - | 0.243 *** (4.17) | - | - | 0.200 *** (3.67) | - |
Abuse (type) | ||||||
Verbal abuse | - | - | 0.135 *** (2.86) | - | - | 0.115 *** (2.92) |
Bullying | - | - | 0.103 *** (1.55) | - | - | 0.057 ns (1.05) |
Threat | - | - | 0.128 * (1.61) | - | - | 0.072 ns (1.06) |
Physical violence | - | - | −0.067 ns (−0.64) | - | - | 0.020 ns (0.24) |
N | 1037 | 1037 | 1037 | 1037 | 1037 | 1037 |
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Saloniki, E.-C.; Turnpenny, A.; Collins, G.; Marchand, C.; Towers, A.-M.; Hussein, S. Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK. Sustainability 2022, 14, 9620. https://doi.org/10.3390/su14159620
Saloniki E-C, Turnpenny A, Collins G, Marchand C, Towers A-M, Hussein S. Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK. Sustainability. 2022; 14(15):9620. https://doi.org/10.3390/su14159620
Chicago/Turabian StyleSaloniki, Eirini-Christina, Agnes Turnpenny, Grace Collins, Catherine Marchand, Ann-Marie Towers, and Shereen Hussein. 2022. "Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK" Sustainability 14, no. 15: 9620. https://doi.org/10.3390/su14159620