Soaring abuse in UK care jobs shatters migrants' dreams

Emma Batha
Published: March 11, 2024|Thomson Reuters Foundation

Emma Batha
March 11, 2024

What’s the context?

Probes into care companies double as reports of debt bondage and exploitation engulf migrant care workers lured by new visa scheme

When Indian office manager Maya heard of an opportunity to work as a carer in Britain she jumped at the chance to gain overseas experience and send money home, but she is now heavily in debt and says she and colleagues were "treated like slaves".

The mother-of-two is among tens of thousands of overseas carers who have arrived in Britain under an initiative launched in 2022 to plug massive staff shortages in the country's creaking social care system.

But reports of exploitation have sky-rocketed since the scheme's introduction, with one migration expert describing the care sector as "a complete wild west".

Maya and other care workers told Context they ended up working long days for little money after paying thousands of pounds to an agent in India to secure jobs with a care company in the north of England.

They said a climate of fear left staff terrified of speaking up in case they were sacked, which would put them at risk of deportation because their visa was tied to their employment.

"We've thought about going back to India but how would we survive with so much debt? We're trapped," said Maya, who asked to use a pseudonym for fear of repercussions.

"I pledged my home to the bank to get the loan to come here. We've also let our house so we don't have anywhere to go back to. And all our relatives lent us money to come here."

Jane Townson, chief executive of the Homecare Association which represents domiciliary care providers, said the sector was very concerned about unethical operators, adding there were "shameful and outrageous" stories of people being scammed for huge sums or housed in overcrowded "cockroach infested hovels".

In some cases, people were promised jobs in Britain only to discover there was no work when they arrived. Others were laid off after their employer went bust or lost contracts.

"They are having to rely on foodbanks and charities," Townson added. "A lot are in debt bondage. They have sold everything to come here."

Modern slavery care cases soar

In response to a freedom of information request, the Gangmasters & Labour Abuse Authority - a public body that investigates worker exploitation - said it had carried out 44 investigations into care businesses last year, double the number in 2022 and up from just one in 2020.

Almost all were cases of modern slavery.

Figures being finalised by the anti-slavery charity Unseen, which runs Britain's modern slavery hotline, paint an even grimmer picture.

It estimates that modern slavery cases in the care sector reported to the helpline last year potentially involved at least 800 victims, up from just 63 in 2021, before the visa route was introduced.

But public service union UNISON said the figures represented the tip of the iceberg as many carers do not report abuses for fear of deportation, or do not know where to seek help.

"A lot of these employers are chancing their arm," said UNISON's social care expert Gavin Edwards.

"The power relationship is just so skewed and that's why some of the unscrupulous ones can get away with this."

He said acute underfunding of Britain's care sector and the prevalence of organisations whose prime motivation was making a profit rather than providing quality care had created "a race to the bottom".

Britain opened up a new visa route for overseas workers in early 2022 to help fill some 165,000 vacancies in the care sector following the COVID-19 pandemic and Britain's departure from the European Union.

About 140,000 carers have since been granted visas, according to official data, with large numbers coming from India, Zimbabwe and Nigeria.

Concerns over the scheme prompted Britain's independent immigration inspector to launch an investigation last year into its effectiveness and whether job sponsorship rules protect carers from exploitation.

The report and the government's response are likely to be published in April.

Excessive fees

Maya's story began in April 2022 when she enlisted an Indian agent called Rishin Stanley in the southern city of Kochi to help sort out a job sponsor.

She said she was asked for payments totalling more than 10,000 pounds ($12,850).

Former colleagues told similar stories. Some paid even more.

When one of them queried the steep sums, the agent replied that sponsorship was expensive.    

But when the women arrived in Britain they were shocked to discover that it is the employer who covers sponsorship charges.

An illustration showing a tray of food being carried by a carer, with similar trays in the background holding bags labelled 'debt'.

Carers struggle to speak out on abuse as their visas are linked to their employment. Thomson Reuters Foundation/Karif Wat

Carers struggle to speak out on abuse as their visas are linked to their employment. Thomson Reuters Foundation/Karif Wat

Companies hiring foreign staff have to pay for a licence, a certificate of sponsorship for each worker and other charges of up to 5,000 pounds per worker. These fees cannot be passed on to employees.

The carers said they paid some of the money to the agent, but were asked to transfer up to 5,000 pounds to a British bank account they said belonged to Ease Healthcare, the company sponsoring them.

Deepa, another carer who also asked to use a pseudonym, was told the payment was for accommodation and administration fees, but received no breakdown and was only given housing for a few weeks.

Context was shown correspondence between Stanley and Ease Healthcare, which is based in the city of Sheffield. The sign-off stated he worked for a company called IMTP.

But when Context contacted Stanley on the number in the sign-off he said he had never helped anyone get a job in Britain and it was "wrong information".

He said he had not heard of Ease Healthcare or IMTP, even though he is listed as a regional representative on the company's website and IMTP appears on his LinkedIn page.   

IMTP's managing director Sasidharan Nambiar said the company did not organise jobs for carers, but that Stanley did this as a sideline.

'Unpaid work'

The women were hired by Ease Healthcare to work as domiciliary carers, helping elderly, disabled and sick people in their homes.

The company supplies staff to local authorities and works with prominent national charities, according to its website.

A job offer letter - seen by Context - promised an annual salary of 20,480 pounds for a 39-hour week, the minimum pay allowed for overseas carers in 2022 under government rules.

The letter from Ease Healthcare provided Stanley's email for queries.

The carers said their days started at 7 a.m. and ended late at night, leaving little time to eat and sleep.

Although they were not constantly working, they said they had to remain on call, waiting in cars for the next job.

An illustration showing an elderly person from the back, with a side-on view of a carer who is holding the patient under the arm and helping them to walk.

Some carers said they had paid thousands towards visa sponsorship, despite laws saying employers must carry the cost. Thomson Reuters Foundation/Karif Wat

Some carers said they had paid thousands towards visa sponsorship, despite laws saying employers must carry the cost. Thomson Reuters Foundation/Karif Wat

They said they were only paid for appointments - which is normal in home care - but these fell short of 39 hours a week.

The carers said they were not always given enough travel time between appointments, but if they arrived late they were not paid even though they did the work.

They had to log their hours via an app, but said these were often changed.

The carers said rotas were also sometimes altered late at night, meaning they could not make plans for days off.

"We're all educated and wanted to move for a better life," said Deepa. "In India we thought there was no exploitation or slavery in Britain. We thought Britain was safe because it had rules and regulations."

Ease Healthcare's director Essie Manomano denied the carers' allegations and said no one was underpaid, treated badly or threatened with the sack.

She said the company used an external accountant and a standard software system for rotas and appointments.

Manomano said the nature of the job meant hours were unpredictable, but staff were not kept on call between appointments or pressured to work on days off.

"Most of the information is not truthful," she added.

"People are free to leave. We don't hold anyone's passport. We give pastoral support."

Manomano said she did not know the Indian agent. She did not respond to emailed follow-up questions related to sponsorship arrangements.

Scared to whistleblow

Context first spoke to Maya, Deepa and three other carers in mid-2023.

Most came from professional backgrounds in the southern Indian state of Kerala.

They provided documents related to their employment with Ease Healthcare and dealings with the agent, but asked Context not to publish their stories until they had found new sponsors - a lengthy process.

Care industry experts said overseas carers' dependency on their sponsors for their visas and employment - and for references if they want to change jobs - made it difficult for anyone to whistleblow.

Homecare's Townson said some of the problems in the sector were due to wider systemic and funding issues.

"Local councils are so cash-strapped that they are driving rates for home care right down, and I think that is enabling labour abuse," she said.

In the past, local authorities gave care companies block contracts making it easier to plan, but now they pay by appointments which can change at short notice and fluctuate day to day.

"If you have security of income you can give security of employment, but at the moment nobody wants to pay for care," Townson said.

In some cases, care companies have gone bust, leaving workers jobless and sometimes destitute.

Scores of carers – many from the Philippines – were left at risk of deportation last year when their employer in Cambridgeshire in the east of England went out of business.

Overseas carers cannot access the welfare system and only get 60 days to find a new sponsor before they have to leave the country.

Deepa, who now works in a care home in southern England, said it had been incredibly hard to find a new sponsor.

"Everyone asks for money. They consider it as a business. They take advantage of people's helplessness," she said.

Britain's Home Office said it would take action against anyone abusing the immigration system and investigate cases where carers had been asked for large sums.

"We are committed to stamping out exploitation of those working in the care sector including people being brought over where jobs do not exist or being paid significantly less than required, leaving workers at risk of becoming destitute," a spokesperson said.

The government is introducing a new rule this week meaning care providers can only sponsor migrant workers if regulated by the Care Quality Commission (CQC), an independent watchdog.

But UNISON said this would not eliminate the problems as the CQC was "massively overstretched".

Maya has now found employment with a care home in another city, but is working up to 72-hours a week to repay her debts of 26,000 pounds.

"I thought I'd have a nice life here with good opportunities, but I've had to borrow again and again just to survive," she said.

"I would never have come if I had known I'd face so many problems."

($1 = 0.7808 pounds)

Reporting: Emma Batha

Illustrations: Karif Wat

Graphics: Diana Baptista and Emma Batha

Editing: Helen Popper and Amruta Byatnal

Production: Sonia Elks and Amber Milne


  • Wealth inequality
  • Race and inequality
  • Poverty
  • Migration
  • Workers' rights
  • Economic inclusion
  • Corporate responsibility