Risk in caregiving labor is starting to be recorded. Situations that workers had previously handled individually in the field have now been organized into a standard document.
The Seoul Welfare Foundation is producing and distributing a safety and rights-protection guidebook for visiting social service workers to providers of Seoul’s daily care services and home-visit housekeeping and caregiving support services. It covers situations such as verbal abuse, violence, sexual harassment, infectious diseases, falls, and emotional labor through real cases and step-by-step response guidelines.
The guidebook is divided into four sections: a safe care environment covering crisis response and prevention; dignified care rights covering worker protection and support; respectful care relationships covering communication and ethics; and systematic care operations covering management and inspection manuals. It is designed for use by both agency managers and workers.
Yoon Hee Yoo, head of the Foundation’s Social Service Support Center, said that the quality of care services can improve when workers’ safety and rights are guaranteed. The guidebook will be used in training newly hired workers and as material for agencies’ own safety education.
The home-visit care workplace is the user’s home. The condition of working alone in a private space defines the nature of the risk.
There are no colleagues and no witnesses. Even if verbal abuse or physical contact occurs, there is often no evidence. Even when the scope of service is clearly defined in writing, boundaries become blurred inside a closed space. A policy report by the Gyeonggi Women and Family Foundation has also pointed to isolated labor and ambiguous work boundaries as defining features of home-visit caregiving work.
The numbers support this. In a survey conducted by the Public Transport Workers’ Union from March 26 to May 30 of this year of 435 care workers, 53.3% said they had experienced abuse of power, verbal abuse, violence, or sexual harassment by users or their families. Among only care helpers, the figure was 75.3%. In addition, 46.1% said they simply endured the abuse on their own.
This is not a gap created by the absence of law. The Industrial Safety and Health Act places on employers the duty to prevent health harm caused by customer verbal abuse and similar conduct. The Ministry of Employment and Labor interprets care helpers as included among customer-facing workers. The problem is that the measures required by law were designed with stores or offices in mind.
Requirements such as posting notices banning verbal abuse and having a response manual make sense when the workplace is a single fixed site. In home-visit services, however, the workplace changes every day, and the user is the manager of that space. The guidebook seeks to fill precisely this gap.
Some see the issuance of on-site guidelines as progress. Until now, there has been no standard for how to respond in crisis situations. Each institution handled matters differently, and new workers relied on senior workers’ experience. A written standard at least provides a basis for judgment.
More skeptical voices focus on the nature of the guidelines. If the cause of risk lies not in workers’ poor response skills but in the structure of being isolated one-on-one, then a response-orientated approach can shift responsibility onto the individual. It also leaves room to be used later as grounds for saying the manual was not followed.
Interpretations also differ over the scale of harm. Unlike the union’s 53.3% figure, a survey of home-visit care workers conducted by the Gyeonggi Women and Family Foundation found 17.7% for verbal violence and 6.3% for sexual harassment and sexual violence. The difference is understood as arising from differences in sample composition and question design. The very absence of official statistics is part of the problem.
There are also voices pointing to the lack of enforcement. The National Health Insurance Service has long advised that benefits can be suspended if sexually inappropriate conduct occurs, but critics have noted that no actual cases of benefit suspension have been confirmed.
The demand for care workers will continue to grow. Since entering a super-aged society, home-visit services have been expanding in the direction of replacing facility-based care.
Worker turnover is a variable. Complaints that experienced workers are leaving the field and new workers are not coming in have been repeated on the ground. Safety is part of working conditions, and working conditions are a condition for supply.
What happens after the guidelines are issued is even more important. If merely distributing them becomes the achievement, the document will remain in a cabinet. A process that checks what institutions actually did must be attached for the guidelines to function.
The guidebook is only a starting point. Knowing how to recognize risk and follow response procedures is one matter; not suffering a loss when those procedures are followed is another.
The first thing that needs fixing is the cost of stopping work. The Industrial Safety and Health Act stipulates that if verbal abuse or similar conduct occurs, work may be temporarily suspended or changed. In home-visit caregiving, that provision effectively means a loss of income. Because most workers are hourly paid and are compensated only for visit time, the structure is one in which enduring abuse brings earnings while responding means losing pay. In such a system, manuals will not be read.
If work is suspended, the wages for that time should be preserved and a mechanism should be added to give priority in assigning other users, alongside the guidelines. A practical approach would be to pilot this with Seoul city funds and measure the results.
Conflicts of interest in the reporting route also need to be addressed. At present, workers report to the agency, and the agency decides what to do. For agencies, user attrition means a drop in revenue. The structure contains an incentive to suppress reporting.
If a separate review office is established at the district or metropolitan level so that decisions on service suspension and user reassignment are made outside the agency, much of this problem can be resolved. With decision-making authority outside, agencies will also find it easier to persuade users.
Rules for users need to be moved into contract documents. Notices saying benefit suspension is possible have existed for a long time, but no actual cases of application have been confirmed.
It would be better to specify in the service contract, step by step, what procedures are followed after certain conduct is repeated a certain number of times and when service will be suspended, and to require the user and guardian to sign at the time of contracting. Pre-agreed standards create less friction than post hoc notices.
Physical safety measures can be handled through joint procurement. Devices with emergency call functions and location sharing are already commercially available for solo workers. It may be burdensome for individual agencies to buy them, but if districts pool procurement, unit prices will fall. It would also be worth considering a system in which accompanied visits are the rule for first visits and for households with a history of risk, and in which minimal information is shared so that users who move between agencies do not lose their risk history.
On the policy-design side, standards tailored to home-visit work are missing. The measures set out in the Enforcement Rules of the Industrial Safety and Health Act are centered on posting notices, preparing manuals, and providing training. They are a list premised on fixed workplaces.
A separate notice for home-visit services should follow, laying out standards specific to them, including advance risk assessment, conditions for limiting solo visits, and procedures for exercising the right to suspend work. Japan will implement a revised law on October 1 that makes measures to prevent customer harassment a legal obligation for all employers. South Korea already has the legal basis. What remains is to make it specific for home-visit services.
The final step is verification. Whether the institutions that received the guidebook actually conducted training, and how many 피해 reports were received and how they were handled, must be accumulated through anonymous reporting. Without statistics, survey results will differ from one study to another, and without consistent figures, there will be no basis for budget planning. If Seoul operates a semiannual anonymous reporting system for recipient institutions, it will create the first data to measure the effectiveness of the guidelines.
The quality of care is determined in the relationship between the person receiving it and the person providing it. A design that treats one side’s safety as a cost will ultimately come back as a problem in the service received by the other side.