This article originally appeared on VICE UK.
Poppie's day as a care giver in a residential dementia home starts at 8 AM and finishes at 8 PM.
Her first duty is receiving handover notes from care givers working the night shift, where anything from missed medication to emergency doctor callouts could have been recorded. She then makes tea for her section of the 67-resident home and assists those who are bedridden to shower and dress. At 12 PM, it's lunchtime. She feeds a puree dinner to residents with difficulty eating before serving lunch to the rest of the home. Following this, Poppie (who is 20) administers medication, which is usually paracetamol or Laxido but sometimes involves more complex pain-control drugs such as BuTrans patches.
By 3 PM, it's time for another round of tea and chat with residents—one of whom is convinced Poppie is a man. Dinner, including another puree option, is served at 5 PM and followed by afternoon medication. Poppie then assists residents into nightwear, makes her final hot chocolates, and fills in handover notes, ready for the night shift.
"During a 12-hour shift, we get an hour taken off, which is meant to be for breaks," she says. "But you're not always guaranteed one."
Like many care workers in Britain, Poppie's pay is just above national minimum wage. It's an amount that does little to reflect a physically demanding job relied on by some of the country's most vulnerable people. One former care giver I spoke to had to pay 30 cents each time she made a cup of tea in the staff room—such a basic, petty "up-yours" to an increasingly young workforce, it would be laughable if it wasn't so sad.
"On a bad day, the low wages honestly make you feel like you don't get paid to deal with everything that is thrown at you," says Poppie. "However, I personally try to provide the best quality of care I can, regardless of my wage."
While Poppie's case seems unfair, the situation for carers who travel to people's houses to provide care is worse. Ninety-three percent of councils in England and Wales don't make it a contractual agreement for home-care providers to pay their workers for the time spent traveling in between care appointments. Last year, two Reading home-care workers publicly resigned after receiving only a few paid hours for a full day's work.
The National Audit Office estimates that 220,000 care workers are being illegally paid in this way or employed on zero-hour contracts. After deducting the unpaid time spent traveling, as well as gas and even uniform costs, some home-care workers have reported earning as little as $5.30 an hour.
"It is not only unacceptable to pay less than the minimum wage, it is against the law," a spokesperson at the Department for Business, Innovation, and Skills told VICE. "We're working closely with the Department of Health, Communities, and Local Government and HM Revenue and Customs to improve compliance with the national minimum wage in the social care sector."
Despite these claims, few councils or private care providers have received penalties for underpaying their workers. In the government's recent "name and shame" list of 37 employers who fail to pay national minimum wage, there was only one adult care provider.
A new petition from public service union UNISON puts pressure on the government to conduct further investigation to the underpayment of care workers. Released last month, it has received more than 12,400 signatures, and 100 MPs have backed an early day motion supporting an HMRC program of "proactive investigations into the sector to help end non-compliance with the National Minimum Wage."
"Care workers are embroiled in one of the largest illegal wage scandals this country has ever seen," says Heather Wakefield, UNISON's head of local government. "As well as plunging workers into poverty, it directly impacts on the quality of care that people receive."
Representatives from UNISON will meet with Jo Swinson, minister for Employment Relations and Consumer Affairs, in February to discuss the issue, but there are fears that HMRC will not investigate breaches of employment unless the workers have registered complaints through the government's Pay and Work Rights Helpline. Due to the convoluted nature of care work pay slips and the fact that many carers are unaware the line even exists. Glen Turner, press officer at UNISON, told me that only 25 home-care underpayment complaints were received last year.
UNISON's Ethical Care Charter is an attempt to work with councils to combat this underpayment. Developed in 2012, the charter responds to a survey of 431 home-care employees that found "poor terms and conditions for workers" were causing lower standards of care.
Councils who sign up to the initiative must employ home-care workers on permanent contracts that pay at least the Living Wage of $11.60 an hour, or $13.30 in London. The Charter also states that workers are to be paid for time spent traveling between home visits, as well as "travel costs and other necessary expenses such as mobile phones."
"The principles set out in the Charter mean care workers are able to provide better care and support," says Councillor Dora Dixon Fyle at Southwark Council, one of the first local authorities to sign the charter. "People who need care support value continuity and quality in their routine, which increases the need to retain staff and create a secure working environment for them."
Having the reassurance of a solid wage is something many carers say would allow them to provide a higher standard of care. It may also mean the sector has to rely less on young people straight out of college. Many, like Poppie, went straight from college into the role because, as Turner points out, most care-worker jobs don't require formal qualifications. If a higher statutory wage were offered, it may widen the field.
"[A solid wage] would give care workers a boost," says Poppie. "It will make us feel like we do matter and that the abuse and unsociable hours are worth our time and effort and commitment. We'd feel like we really are appreciated."
With an aging population and further cuts to health-care services, the question of how the country takes care of its most vulnerable—and the people who look after them—is going nowhere.
Follow Phoebe on Twitter.