In this Futures of Work issue, we focus on continuity and change in caring relationships. In the NICE (National Institute for Health and Care Excellence) quality standard on people’s experience using adult social care services, quality statement 3 asserts: ‘People using adult social care services have continuity of care and support.’ Knowing a person, their preferences and needs, goes the rationale, allowing better care provision, with positive impacts for a person’s wellbeing and quality of life. Unfortunately, the articles in this issue show that this is more of an ambition than a reality. We include diverse perspectives on what it means to provide care, whether in the workplace or in the home. We explore relationships between care providers and care recipients, both in the context of adult social care service provision and beyond it.
A theme of continuity and change in care runs through all the pieces. In the opening article, Duncan U. Fisher uses Polly Morland’s book A Fortunate Woman as his jumping-off point. He considers Morland’s argument that continuity of care should once again be integral to shaping general practice services and work. This theme is reflected in Hannah Reseigh-Lincoln and Rachel Kelso’s piece, written from the perspective of domiciliary care workers. They outline how boundaries between care worker and cared for can become blurred and how this makes it all the more important to have continuity of care. They also describe, however, how the very nature of such care means that ‘many people live with a “revolving door”’ of different faces turning up at their home. This can have huge implications for those receiving care and their ability to engage with and trust their (changing) care workers. Julie Sansom describes this in her account of client Nancy S, who initially rejects her and then becomes a friend. The cycles of continuity and change continue after Nancy dies, as the care worker has to adapt to supporting a new person requiring care without much time to grieve. The role of the employer is key here, and this extends beyond employers in adult social care. Chandrima Roy and Katharine Venter discuss the role of employers of individuals who care outside their employment context, and query what such employers can and should do to support those caregivers. Some organisations work hard to (appear to be) ‘carer friendly’ and have good corporate social responsibility objectives, but the reasons that motivate employers to commit to supporting carers are still poorly understood. The final piece by Oci Stott also considers care beyond the health and social care sector. Examining the provision of climate change education in schools, this article emphasises the centrality of continuity but also highlights the dangers of such continuity being driven by individuals who might leave. An alternative approach is suggested to make sure that care for the environment turns into meaningful action that is aligned with self-care. In the process, Stott provides positive and practical suggestions on how caring could be undertaken differently.
Vanessa Beck is a Professor in Employment Studies at the University of Bristol. She is interested in individuals and groups at the margins of the labour market, including those who are unemployed or underemployed, and who experience multiple and complex barriers to (decent) employment. Her work centres on the interrelationship between individual experiences and social or structural contexts, with a particular focus on gender and age. She publishes in journals such as Work, Employment and Society, Human Resource Management Journal, Organization, Education + Training, and the Journal of Education and Work.
Duncan U. Fisher is a researcher at the ESRC Centre for Care at the University of Sheffield, UK. His research focuses on paid care work within adult social care, with his current project a study of organising, activism and trade union activity among paid care workers in England. He wrote this article about the depiction of paid care work in Ken Loach’s film Sorry We Missed You for a previous issue of Futures of Work.
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