Innovation: Network of Care and Employment Services (ROSA)

Italy

AAI Domains:

• Independent, healthy and secure living (care to older adults, lifelong learning, financial security)

• Employment (extending working lives)

All European societies face ageing populations and Italy is a country that is experiencing a particularly difficult set of challenges. Italy has a growing number of older people in need of social care and this in the context of a welfare system and society that is less able to provide informal care due to the pressures on women to be in paid employment. There is still a familial orientation towards care for older people – the expectation that older people should be cared for by family members – and a cash orientated system of care benefits.

As a result of these factors there has been a significant growth in the number of migrant care workers who have come to Italy to meet this ‘care gap’ from eastern Europe, east Asia, south America and north Africa. In 1991 there were estimated to be approximately 35,000 care workers with foreign nationality making up approximately 16% of all home care workers but by 2007 this number had increased to an estimated 700,000 people and 90% of all home care workers. This trend is likely to have continued in the years after this as push factors in foreign countries increased and the demand for care in Italy has continued to increase.

Many home care workers provide care on a ‘live-in’ 24 hours a day 7 days per week basis without a regular contract of employment and remit a significant proportion of their earnings to their families at home. There are many potential issues for migrant care workers involved in such arrangements including cases of severe exploitation due to lack of employment rights and the risk of deportation. Clearly there is a need for a socially innovative solution to address this increasingly important issue for the mutual benefit of older people in need of care, their families and migrant care workers.

The Network for Employment and Care Services (ROSA) was established in the region of Puglia in southern Italy in 2008 and was a partnership of the six provinces in the region, the National Association of Italian Municipalities and the three main national trade unions with the Equal Opportunities and Rights Department of the Italian government. It aimed to establish a system of supporting people who need or provide care by matching supply with demand through a network of stakeholders.

It was socially innovative by attempting to meet the need for qualified Italian and migrant care workers among families with older relatives by acknowledging and encouraging the use of regular employment contracts. By doing so it also aimed to improve knowledge about undeclared home care work in order to combat it and the sometimes extreme examples of exploitation that this can involve.

A register of all care workers offering care in households was established by the province and financial incentives have been designed to encourage families to employ migrant care workers on regular employment contracts. Migrant care workers need to complete a specialist training course to be enrolled on the register for care workers. Families who then hire registered migrant care workers are eligible for a means-tested one-off care voucher of up to €2,500 with the costs financed by the Equal Opportunities and Rights Department of the Italy government. However, only a relatively small number of families had taken up the offer of the care voucher indicating a reluctance for many people to engage with this provision.

There were also information and support services for formal employment contracts in localities across the region administered by trade unions to make the process of regularising employment easier. There have been mixed results from the evaluation of ROSA, which ran up until 2012, with a growth in the number of registered home care workers, increasing numbers of formal contracts of employment and improvements in the quality of home care for older people. However, there are also numerous weaknesses as shown by the small number of families who have taken up to care voucher offer, a lack of municipality capacity to support home care services and the reluctance of many people to go through a bureaucratic process.

In relation to active ageing, ROSA probably improved the quality of care for older adults and increased the employment rate for home care workers and women in families with caring responsibilities for older adults. It should have also contributed to financial security for home care workers by regularising their employment status in what is still a precarious and highly demanding occupation.

Information about ROSA on the Interlinks website