Care workers' voices matter: Co-producing with the experts on the frontline

Following the creation of a new co-production guide to enable businesses to better collaborate and drive decisions alongside care workers, we spoke with Olivia Firth from The Care Workers’ Charity alongside care workers Oma and Happiness who serve on The Care Worker Advisory Board, to discuss the importance of the initiative and  how the guide came about. 

This informal chat explored why meaningful engagement with care workers is vital for the future of adult social care; what some of the barriers are preventing care workers from speaking up, and the incredible results of true co-production. 

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The birth of the co-production guide 

Birdie: What inspired the creation of a guide on co-producing with care workers? 

Olivia: At The Care Workers’ Charity, we're dedicated to advancing the financial, professional, and mental well-being of care workers across the UK. A core aspect of our work is advocacy and campaigning, with care worker consultation and co-production at the  heart of it. Care workers are often disregarded, with discussions about their futures happening without them even in the room. There's a real lack of value placed on their perspectives. We believe that the voice of care workers should be central to any conversation about the future of adult social care. That served as the inspiration for creating this guide. We want to see engagement, consultation, and co-production with care workers implemented across every level, with care workers' voices at the front and centre to outline ways organisations can ensure they are valued in these discussions. 

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"Care workers are often disregarded, with discussions about their futures happening without them even in the room. There's a real lack of value placed on their perspectives. We believe that the voice of care workers should be central to any conversation about the future of adult social care."

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When Care Workers' voices are ignored 

Oma: From my perspective, there have been specific issues surrounding rota planning, flexible working arrangements, and fulfilling job descriptions. There's a clause in most job descriptions that say you can perform any other job assigned to you, and employers latch  onto this to add more responsibilities that are out of tune with what care workers ought to do. For example, care workers have been made to work in the kitchen washing dishes while leaving vulnerable residents unattended. If something happens to the residents, that same  care worker will be held responsible. The impacts include demoralisation of care workers and effects on the quality of care. It also leads to migration of care workers from the sector. People who would want to stay longer reconsider because of this treatment. 

Happiness: We often get told, “This is a new policy, these are the new rules,” and we just  have to go along with it even if the policy is openly damaging to our wellbeing or livelihood.  We were never consulted on anything. If you're not happy with it, then that's it—you leave. There is typically nothing in between, no say, no choice. 

Olivia: The care workforce currently sits at around 1.73 million people, and there's a  consistent overlooking of care workers. They're treated as tools in the system, with a real  lack of humanity. One example is the Fair Pay Agreement. At our first in-person event, some participants had  no idea what this was or how it would impact their futures. For something designed to  standardise wage structures for care workers, if you aren't even talking to them, you're  missing a perspective that is incredibly valuable to the conversation. 

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The Care Worker Advisory Board 

Olivia: The Advisory Board and Champions Project is groundbreaking, aiming to embed  Care Workers voices into mainstream policy, research and practice discussions and  decision-making. This project is designed to raise the voices of Care Workers and address  critical policy issues affecting the Adult Social Care Sector. Funded by The Rayne Foundation, The Care Workers’ Charity is leading the project, having recruited a diverse national network of 30 frontline Care Workers from across the UK.  This network of frontline Care Workers will be a platform for Care Workers to share regional  insights, foster collaboration and learning through enhancing their skills and visibility. They will also share their experiences to ensure the future success and prosperity of the Adult  Social Care Sector.  We launched it officially last September, and within a month we had 75 applicants, which  highlights that care workers want to be involved in these discussions. Those involved range  in age, gender, sexuality, ethnicity, nationality, and care setting. We wanted to ensure the  group was as reflective as possible of the wider adult social care workforce. At our in-person meeting, there was a significant conversation about the exploitation of  migrant care workers. One person said, “I had no idea that was happening—I didn't realise  my experience isn't the singular experience of care workers.” This highlights why diverse  perspectives are so important. 

Oma: Before my first contact with The Care Workers’ Charity, my colleagues and I were  trying to figure out how to channel our grievances without fear of retaliation. The Care  Workers’ Charity provided that platform. As Olivia mentioned, I was someone who hadn't heard about the Fair Pay Agreement before our meeting. That was a key moment for me,  and I felt that I want to be the voice for those who cannot speak up.

Happiness: We're often scared to complain as care workers because we might lose our jobs. Even when we are brave enough to say something, nothing gets done. But this  platform allows us to be heard, which I think is the best thing done so far for care workers. 

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"With tokenism, you can tell straight away. We have meetings where we discuss things but nothing gets implemented. When employers genuinely want to listen, they take notes and plan with us how to move forward."

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Meaningful engagement vs. tokenism 

Oma: Meaningful engagement is where the employer and care worker work side by side to  achieve the common good. Care workers' inputs are taken into account in policy formulation  and working procedures. This gives care workers a sense of ownership—that their views are valued, and they're seen  as partners rather than tools. In contrast, tokenistic engagement is where employers use a top-down approach, making decisions without considering any care workers' views. 

Happiness: With tokenism, you can tell straight away. We have meetings where we discuss things but nothing gets implemented. When employers genuinely want to listen, they take notes and plan with us how to move forward. We're often treated like numbers, not people. Whichever way, we can read our employers. If  they're really serious, we can tell by their approach and the outcome of the consultation. 

Olivia: Meaningful engagement involves care workers from the beginning, with a two-way  dialogue where they can ask questions and challenge ideas. It's broad and inclusive, taking  their input visibly into account. In contrast, tokenistic consultation happens after decisions have already been made. It's just  ticking a box to say, “We've had one conversation with care workers.” That small level of involvement isn't enough. 

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Barriers to Speaking Up 

Happiness: Some people get punished indirectly for speaking out. I've seen colleagues  given shifts they're not comfortable with as punishment, or suddenly not booked for shifts at  all. 

Oma: Another barrier involves sponsorship visas. I have a colleague whose manager told  her she's not entitled to proper maternity pay and leave. Because she's on a sponsorship  visa, there's a limit to how much she can push for her rights, as the employer can withdraw  the sponsorship. 

Olivia: Another major barrier is the societal misunderstanding of care work. There's a perpetuation of the idea that care work is low-skilled and therefore care workers aren't valuable to these conversations. But it's an incredibly skilled and responsible job. Care workers are on the front line, experiencing issues day in and day out, offering perspectives that otherwise wouldn't be considered. We need to break the narrative of what  care work is. Care workers often perform delegated health tasks that would typically be done by nurses or  doctors, like catheter care and stoma care. There are so many responsibilities care workers  take on. 

Oma: Yes, we take vital signs, provide emotional support and counselling, collect medical  samples, and administer complex medications. We're not always trained for these tasks, but  we perform them regularly. However, when people perceive care work, it is still as unskilled  and low-quality.

There's a perpetuation of the idea that care work is low-skilled and therefore care workers aren't valuable to these conversations. But it's an incredibly skilled and responsible job. Care workers are on the front line, experiencing issues day in and day out, offering  perspectives that otherwise wouldn't be considered.

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Practical steps for meaningful engagement 

Oma: First, know your workers as humans with potential and values. Come on shifts, do  rounds with them to appreciate the level of work being done. Second, engage with them, and third, follow up on their tasks. Get feedback from both care  workers and residents. Don't close your mind to feedback, whether negative or positive. If  you can't address specific feedback, don't make promises you can't keep, as this breaks trust. Create an environment with an open-door policy. We're all working together for the  residents. 

Happiness: Visit your establishment regularly to see how staff are doing. Have one-on-ones  with them, see things for yourself, and provide feedback on previous discussions. When you see problems firsthand, you can take action, and carers will be happy that they have a  manager who cares. 

Olivia: Establish a culture of trust and openness where care workers feel valued without fear  of repercussions. Make engagement formats accessible—if some people want to remain anonymous, allow that. Communicate clearly about what you're looking for, how their input  will be used, and how you'll show it has been used. 

Oma: Managers should encourage care workers' professional development. If you don't  empower your care workers to advance their careers, you're just seeing them as tools rather  than partners. 

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A vision for the future 

Olivia: One thing discussed in the guide is payment for care workers' time during  consultations. At The Care Workers’ Charity, we follow NIHR guidelines suggesting £25 an  hour or £200 a day. I'd love to see long-term engagement with care workers become part of  company policy. 

Happiness: I'd like to see a standardised pay structure across the board with progression  like the NHS band system. Certifications should be valid wherever you go. And regarding  benefits, there should be one rule for everybody, whether on a sponsored visa or not. We  should have consistency and fairness. I'd also like to see timeframes for implementing changes. Without clear deadlines, nothing  gets done. 

Oma: I'm expecting an overall change in perception toward care workers. Currently, care  work is seen as unskilled labour that doesn't require qualifications. A change in perception  would especially help those tied to sponsorship visas. I want to see care workers recognised and valued, with equal treatment for everyone  regardless of background. I also want domiciliary care workers to be paid from the moment  they leave their house, not just when they clock in at a client's home, and proper mileage  reimbursement. 

Olivia: I'd love to see care worker engagement become a leadership priority, with visible  examples of action taken based on care worker feedback, protected paid time for  engagement, and continuous consultation. 

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Care workers bring valuable expertise to the table. By engaging them from the beginning, treating them with respect, and implementing their feedback, organisations can create better  working conditions, improve care quality, and at the same time address systemic issues in  the adult social care sector. 

As Olivia noted, “If you're missing 1.73 million people's perspectives, of course things will go  wrong.” The new guide from The Care Workers’ Charity in partnership with The Care  Workers Advisory Board represents an important step toward recognising care workers as the professionals and experts they truly are.

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