A spotlight on social care workers – the latest challenges facing the sector - Part 2

Published 17/04/2024   |   Reading Time minutes

This is the second article in a two-part series focused on social care workers. Our first article looked at recent visa restrictions for migrant workers, which is likely to put further pressure on a workforce already struggling to fill vacancies.

This article looks at what we know about the current state of the workforce and the pressure on the sector, which is contributing to rising concerns about modern slavery and exploitation in social care.

Workforce shortages

The social care workforce has reportedly been ‘in crisis’ for several years, with severe staffing shortages and recruitment difficulties. Our article sets out recent developments relating to the workforce.

There is widespread agreement that parity in pay and terms and conditions is needed with similar jobs in the NHS to improve the situation. The then Deputy Minister for Social Services told the Health and Social Care Committee in November 2023 that the difference between somebody who's working in social care as a care assistant and somebody working in the NHS as a care assistant is £3,000 in terms of pay, when “they’re doing very much the same job”. She said she wanted to see this addressed but due to financial pressures, she “can’t see when that could be done”.

The Association of Directors of Social Services Cymru and the Welsh Local Government Association say that workforce issues “topped the list of key concerns” for local authorities in recent research. They also highlight concerns about further imminent vacancies following the results of Social Care Wales’ social care workforce survey. The survey found:

  • Just over a quarter (26%) feel it’s ‘quite’ or ‘very’ likely that they’ll leave the social care sector in the next 12 months, and 44% feel at least ‘quite likely’ to leave in the next five years.
  • The most common reasons given for expecting to leave are pay (66%), feeling overworked (54%) and poor employment or working conditions (40%).

What we know about workforce numbers

It’s difficult to accurately assess and monitor the scale of the problem with care worker vacancies (and impact of the new visa restrictions), due to the lack of up-to-date, comprehensive data available publicly.

The Welsh Government and Social Care Wales do not routinely collect data on the number of migrant care workers. A Pilot Workforce Survey by Social Care Wales in May 2023 found that 15% of registered care workers (who responded to the survey, out of a total of 2,325) were born outside the UK.

In terms of workforce and vacancy numbers, the latest information available is in Social Care Wales’ workforce report 2022 (figures are provided for the whole workforce, not just care workers). In 2022, there were an estimated 84,134 people employed in the social care workforce. There were 5,323 vacancies recorded; which was 9% of the total workforce. The data showed an overall increase in vacancies compared to 2021, and domiciliary care roles account for the largest number of vacancies.

The Health and Social Care Committee has continued to question the Welsh Government about vacancy numbers, and progress in improving the sustainability of the workforce. In January 2024, the then Deputy Minister for Social Services told the Committee that the Welsh Government is “absolutely committed to addressing the recruitment and retention issues in the sector”, but the actions underway “are not quick fixes”, and “will take time to feel the impact within the workforce”.

The then Deputy Minister went on to say that local authorities are providing monthly workforce data to the Welsh Government and that “during 2024 the aim is for more data to be made available”.

Modern slavery and exploitation

The issue with care workers experiencing exploitation is that very vulnerable people are being employed to care for very vulnerable people

Unseen, Who Cares? report (2023)

As discussed in the previous article, pressure on the care sector across the UK led to the rapid introduction of a new visa to employ more overseas staff to reduce vacancies. However this development has contributed to a different, growing problem.

In December 2023, the Care Quality Commission (CQC) (the independent regulator of health and social care in England) told the UK Parliament’s Health and Social Care Select Committee that modern slavery is now “a trend and a feature” of the care sector market. The CQC explained the end of free movement of workers significantly increased the possibilities of exploitation, as workers are now dependent on a visa and a single employer. It said cases of modern slavery are on track to have increased tenfold in the last three years.

The Director of Labour Market Enforcement has identified adult social care as a sector with a high risk of labour exploitation, and emphasised the particular vulnerability of live-in and agency care workers. Research by Nottingham University also highlighted the specific vulnerability of migrant live-in care workers to modern slavery.

There have been numerous media articles highlighting the exploitation of overseas care staff and a recent investigation by Panorama uncovered exploitation in a care home in England.

Modern slavery cases identified in Wales

Unseen (operators of the UK’s Modern Slavery & Exploitation Helpline) reported a ”significant rise” in the number of cases indicating labour abuse and forced labour in the care sector in recent years and identified a small number of cases which had been reported to Welsh police forces. The charity found that nearly one in five potential modern-slavery victims identified in 2022 worked in the care sector.

Unseen found that some care workers are being charged thousands of pounds for travel to the UK and sponsorship certificates. The cost of sponsorship is a few hundred pounds which is met by most care companies, but a minority of employers and agents are charging care workers as much as £25,000, adding interest and deducting the debt from their wages.

According to UNISON, some social care employers demand migrants pay large fees of up to £15,000 upfront for finding them a job and housing in the UK. Many end up in cramped, sub-standard accommodation, then have rent deducted from their wages. The union goes on to say the exploitation and “shocking abuse” faced by skilled migrant workers can include huge charges to pay back ‘relocation costs’ if they wish to change jobs.

The Unseen report concludes "it becomes evident that workers are in a cycle where they will never be able to pay off the debt."

Citizen’s Advice say work visa design is driving the exploitation

In March 2024, Citizen’s Advice published a spotlight report after reviewing 150 cases of contacts from migrant care workers. The charity found “countless examples of poor treatment and serious exploitation, as well as violations of visa conditions”. Its findings include:

  • 1 in 4 had been charged an upfront recruitment fee - on average more than £10,000;
  • 1 in 3 were paid less than they should have been; and
  • 1 in 4 said they were scared to complain for fear of being dismissed.

The report adds that:

Half the migrant care workers we helped were experiencing financial hardship - they were struggling or unable to buy food, pay their bills, or afford their rent, with some at clear risk of homelessness. Lack of access to a financial safety net can make people even more reliant on their employer, and more likely to accept poor treatment at work.

Citizen’s Advice set out the steps needed to enable individuals to enforce their rights and leave exploitative jobs. Many of its recommendations lie with the UK Government, such as the call to “remove - or at the very least weaken - the link between a person’s employer and their visa”.

Although modern slavery is not devolved, the Welsh Government says it has put policies and practices in place to tackle this issue. The Welsh Government was the first country in the UK to create an anti-slavery coordinator role in 2011. In February 2024, the Welsh Government issued guidance on modern slavery and labour abuse in social care. It highlights the Code of Practice for the international recruitment of health and social care personnel which it says applies in England and Wales. However Citizen’s Advice warns that the Code “needs to be made enforceable with proper monitoring of compliance”.

It's clear that the exploitation of migrant staff is a rising problem in social care which needs sustained action across governments to address it.

Article by Amy Clifton and Claire Thomas, Senedd Research, Welsh Parliament