Experience of migrant homecare workers
Many of our members have come to the UK via the Health & Care Worker Visa scheme. For reasons explored below, we find that many of our migrant colleagues are subjected to exploitative working conditions and, in the worst of cases, modern slavery.
Through no fault of their own, migrant homecare workers are suffering exploitation in every corner of the country as they go about providing essential support for people in their homes.
What's going on?
In 2020, the Health & Care Worker Visa was introduced, inviting people from overseas to plug gaps in the UK's adult social care workforce.
It was left to employers to identify prospective overseas workers, despite thousands of care-providing businesses having no such links. This gave rise to a side-industry of middle-men recruiters who charge illegal fees of thousands of pounds to the worker in question. By the time many of our colleagues arrived from abroad, they were already in debt or had effectively sold off their lives back home.
In the worst cases, people find themselves victims of modern slavery, employed by unscrupulous companies who house workers in substandard accommodation and monitor their every move.
Many individuals taking up roles in domiciliary care were unaware they would be required to purchase their own car for work once they arrived in the UK, adding additional unexpected costs before work could even begin. After 12 months, individuals must pass the UK’s theory and practical driving tests in order to legally continue driving, putting their ability to work in further jeopardy.
Unlike their domestic colleagues, there is no financial safety net in the form of in-work benefits to help migrant homecare workers through this situation and the current cost-of-living crisis. This is because migrant workers have No Recourse to Public Funds (NRPF) which prevents them from accessing publicly funded schemes like Universal Credit, social housing and homelessness services. NRPF status consigns many of our migrant colleagues and their dependents to a life below the poverty line, all the while they are providing essential support to individuals in our communities.
Arguably most shocking- and not yet widely reported - is the systemic exploitation of migrant domiciliary care workers (aka homecare workers). This stems from an apparent lack of understanding at the highest level about employment conditions in homecare:
To meet the terms of the Health & Care Worker Visa, the worker must earn enough to meet a minimum salary threshold set by the Home Office. In a low-paid role, this translates to full-time work. There is no issue here when a person has a set place of work, like a care home.
In domiciliary care, it is common for workers to only be paid for their direct contact time with clients and not for the time it takes to travel from one house to the next, or for other gaps between visits. To clock up 40 hours’ pay in homecare, an individual must often be out ‘on the road’ for far longer. To meet the minimum salary threshold, migrant homecare workers often start work at 7am and don’t return home until 10pm, 6 or 7 days a week.
Even when working these long hours, it can still be difficult to meet the minimum salary threshold. It is also very difficult to predict whether you will meet the threshold, as our working hours are so changeable from one week to the next. If the Home Office finds out that a worker is not meeting the minimum salary threshold, this breach of their visa conditions may very well result in their deportation. The threat of deportation to individuals who - through no fault of their own - are not being given the work they were promised, prevents them from feeling able to raise the alarm about their situation.
Under the current work sponsorship system, it is very difficult for Health & Care Worker Visa holders to change employers. This is because the visa is dependent on their being ‘sponsored’ by one specific employer. To change employers involves re-engaging with the visa application system and applying for a new Certificate of Sponsorship. To do so comes at a cost to the new employer, and this has unfortunately resulted in additional illegal fees being charged to individual workers. The process also takes time. Ultimately, many migrant homecare workers find it almost impossible to switch employers, some applying for work with literally hundreds of employers. In many cases this sense of being ‘trapped’ in combination with all of the other pressures described can be detrimental to an individual's mental health.
To address these difficulties in relation switching employers, Unison has recently progressed calls for a Certificate of Common Sponsorship. This would allow individuals to apply for work with any CQC-registered care provider. Such a change could be pivotal for victims of modern slavery by allowing them a route to safety. That said, a Certificate of Common Sponsorship would not make it any easier to accrue sufficient working hours in domiciliary care. The effect might logically be for migrant homecare workers to apply en-masse for roles in residential care settings, where there are only so many positions available, undermining the visa scheme’s purpose to support all parts of the care workforce.
Therefore, we focus on the need to end unpaid working time in domiciliary care. Such a change would significantly uplift employment conditions for domestic and migrant homecare workers alike.
What are we doing to support migrant homecare workers?
Homecare Voices has become a trusted source of informal peer-led support for migrant homecare workers. Via our community, migrant homecare workers often get to know others in similar positions. This can do the world of good for an individual’s mental wellbeing whilst we do what we can to influence change from a more practical point of view.
Through our community spaces, we exchange information relevant to migrant homecare workers on a day-to-day basis. We regularly sign-post individuals to appropriate sources of formal advice and support, such as the Work Rights Centre, Unison, Acas, Project 17, and - all too sadly - the UK Modern Slavery Helpline We recently published the first publicly-available list of all the International Recruitment Hubs that are being set up around the country to support migrant care workers.
We further connect migrant homecare workers with opportunities to contribute their voice to relevant discussions wherever possible. In December 2024, a number of Homecare Workers’ Group members attended focus groups alongside officials from the Home Office and the Department of Health & Social Care who sought to understand more about the challenges facing migrant care workers.
Many of our members have participated in various research studies that are producing new knowledge about the experiences of Health & Care Worker visa holders, with a view to affecting positive change.
Two members of our internal Advisory Board are migrant homecare workers, ensuring people with lived experience of the Health & Care Worker visa inform our approach to supporting others in this position.