Care work must be urgently reframed as essential, skilled labour and not a ‘natural’ extension of women’s roles if the recruitment crisis is to be tackled, new research has warned.
Following interviews with care workers, a Lancaster-led research team has shown how a combination of organisational structures, alongside social constructs, significantly impacts on recruitment and retention within the adult social care sector.
They say that, while improved access to qualifications and better training opportunities are essential for raising the status of care workers, a more systemic response is needed to address ‘entrenched structural and cultural barriers’.
The research, led by Dr Carolyn Downs from Lancaster University Management School (LUMS) and co-authored by Dr Mike Ryder (LUMS), along with Dr Tomasz Bartosz Kalinowski and Dr Ilona Świątek-Barylska from the University of Lodz in Poland, is published in the Journal of Aging Studies and calls for a systemic response to the ‘professionalisation crisis’ in the care sector.
Through interviews with care workers across five European countries, researchers found that ‘gendered perceptions’ not only reduce the status of the role, but actively discourage workers, and particularly men and young people, from entering or remaining in the sector.
They found care workers employed in fragmented, poorly regulated sectors are often subject to exploitative conditions, which both damage morale and prevent skill development.
Dr Downs said: “Our research adds to a significant body of well-founded research, following more than 20 major reviews of social care in the past 30 years. There is a huge amount of practitioner experience and broad agreement on what solutions are needed. The enormity of the task ahead should not be an excuse for leaving things as they are.”
The research calls for five changes:

• There is an urgent need to reframe care as essential, skilled labour rather than a ‘natural’ extension of women's roles. Governments and care providers should explicitly challenge the pervasive gendered assumptions underpinning the devaluation of care. Public campaigns and policy messaging should position care as a core component of national infrastructure, comparable to health or education.
• Governments must move rapidly to include the true economic value of care work in national accounting and policy planning. Developing fiscal tools to enable this form of accounting would bring care work into the centre of longterm workforce and productivity planning.
• There is a clear need for enforceable sectorwide employment standards extending beyond minimum wage guarantees. These should include protection from zero-hours contracts, consistent access to reflective supervision, and secure time for rest and recovery.
• Care workers must be empowered through institutional structures promoting voice, codesign, and democratic accountability. Worker advisory panels or co-production structures should be built into care commissioning, inspection frameworks, and organisational planning processes.
• Governments and funders should support longterm investment in care workforce research, particularly approaches which include the perspectives of care workers themselves.

Dr Downs said: “Raising the status of adult social care providers requires a sustained challenge to the economic, cultural, and institutional dynamics perpetuating stigma and suppressing professional identity. Only by attending to these interlocking structures can care work be recognised as the skilled, essential, and dignified labour it truly is.”
The findings and recommendations are detailed in the paper Care work and status subjugation: An exploration of the relationship between care work organisation and training, and the recruitment crisis in adult long-term care.