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Hidden in plain sight

Sometimes we live with situations for so long that we don’t challenge or even think about why things they are the way they are...

Issues become problems, solutions become focused around specific aspects, and a narrative emerges which suggests its all too difficult to resolve. Blame and inertia creep in.

Some would say that social care has reached this point. Too hard to solve, too expensive, too lacking in humanity - the narrative is consistent. It overlooks the people receiving brilliant care, the great relationships at its heart, its essential kindnesses. Moreover, it consistently ignores one essential element - the voice of care workers - the people at the front line. The struggles of care workers have for so long been hidden in plain sight. As Karolina Gerlich, a care worker for 12 years and organiser of an emerging movement of care workers says:

'Helping people live their lives the best they can is one of the best things I can ever imagine doing. Yet for as many years as I have been doing it, I have been talked down to, disrespected, assumed to be stupid and ignored. My rage at the unfairness of these attitudes finally led to me giving all I have into professionalising care work and getting it the respect it needs.'

The care workers’ movement is part of Nesta’s Social Movements for Health programme which is exploring how social movements are driving change in UK health and care systems.

Injustice in the system

Care workers are professionals who offer support - perhaps to older people in residential care homes, adults with disabilities or children and young people who have been taken into local authority care. There are 1.5 million care workers in England. They are mostly women (82 per cent) and many are migrants.

They provide skilled support - much of which is too easily overlooked. Their skills may include a nuanced understanding of the many presentations of dementia; complex moving and handling expertise; a range of communication skills; and flexibility and agility to deal with a wide range of situations, often working in isolation from other professionals.They work long hours, often in split shifts, working nights and on call. Historically, care workers have been perceived as low-skilled, low-pay labour that filled in the gaps of nursing and housekeeping. They still care; even when it’s for people who may be dis-orientated or aggressive, ungrateful, angry, rude - and sometimes racist or sexist. Resilience is a key part of their skill set!

Many care workers do not receive the national living wage, there is little support in place in terms of unions or reflective supervision for workers. In recent research, over 60 per cent of Care Workers reported that their mental health was affected by their job. The care system has been creaking for some time as financial imperatives have driven a race to the bottom and increasing privatisation of services. When care contracts collapse, the voice of care workers is rarely included in the assessment of what has gone wrong.

Moreover, the dominant narrative about care workers is one of blame. When people and families are failed, the media and public are quick to brand all care workers as abusive or, worse, vindictive and cruel. This narrative is pervasive and powerful - leading to the acceptance that they are part of the problem - not a key to the solution.

Nurses are consistently voted the most trusted professionals in society. We need to reach a point where the narrative is re-framed so all health and care professionals receive the trust they deserve.

Professional Care Workers Day - Our chance to celebrate care workers

As well as being a care worker, Karolina is also CEO of the not for profit organisation, The National Association of Care Workers (NACAS), which Paul Featherstone founded in response to the poor treatment he received by employers as a Care Worker. NACAS is a campaigning organisation which wants greater recognition and respect for care workers. It is a membership body which wants to raise standards and campaigns for workers rights.

They host an annual ‘Professional Care Workers’ day (this year on 4th September) to bring care workers together and celebrate the amazing care work that is delivered everyday. This year the focus is on the wellbeing of care workers. Care workers are excellent at caring for other people but often not so good at looking after themselves.

Professional Care Workers’ Day is a special day to ensure that care workers are perceived as needing support and care. It is a day to remind people that we can only expect care workers to deliver great care with respect and dignity if they receive that themselves.

What can you do to show how you value care workers? All are welcome to join the movement and get involved by promoting it across social media, using the hashtag #ProfessionalCareWorkersDay


Karolina Gerlich

Karolina is a Care Worker and Chief Executive of the National Association of Care and Support Workers.

Sally Zlotowitz

Sally Zlotowitz

Sally Zlotowitz

Programme Manager, Social Health

Sally was a Programme Manager in the Social Health team of Nesta and worked on Social Movements in Health and Good Help.

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Damian Hebron

Damian Hebron

Damian Hebron

Programme Manager, Social Health

Damian worked on Social Movements in Health as well as Nesta's Arts and Health work.

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