By Dr Caroline Emberson
Over the past 18 months, I have been collaborating with other researchers to investigate the vulnerability of paid, migrant, live-in care workers in London to modern slavery.
Most live-in care workers in the UK are migrants, and a high proportion travel to and from their home countries between client placements.
Understanding the factors that exacerbate these workers’ vulnerability to exploitation is important because it enables the development of the most appropriate policy responses to minimise risk and harm.
Our research is timely, given the commitment made by the UK government to extend to public sector bodies, including local authorities, the organisational duty to report on the steps that they have taken to eradicate modern slavery from their supply chains.
Local authorities are major purchasers of many different types of home care, which are often delivered through a fragmented network of organisational partners and agencies.
With a new Modern Slavery Bill promised in this year’s Queens Speech, social workers and other local authority staff can have an important part to play in spotting the signs of exploitation and eradicating this form of abuse among the hidden workforce of live-in care workers.
Risk factors for live-in carers
Our findings show five factors that create the conditions for exploitation:
- Live-in care workers’ employment status and the business models of live-in care and the role of intermediaries.
- The information asymmetry that exists between live-in care workers and the agencies who match them to their clients.
- The pressures of live-in care work.
- Barriers to exercising rights at work.
- Factors related to individual risk and resilience.
Less experienced live-in care workers seem to be at particular risk of exploitation.
Agencies, including introductory agencies, have near-total control of matching care workers and clients, and can hold – or withhold – key information. Our participants described how companies took advantage of care workers perceived as less experienced – often migrant workers who had recently moved to the UK or had been specifically recruited to work as a live-in care worker.
It was common for live-in care workers to find themselves in difficult or even hazardous situations when starting a new placement.
Inherent risks of role
There are also particular features about the role of a live-in care worker that can lead to exploitation.
Participants identified various types of emotional pressure associated with being closely involved in the everyday lives of their clients and families.
Although to an extent these were seen as “part of the job”, they can become significant and have a long-term impact on care workers, contributing to burnout and mental health problems.
Inappropriate behaviours, including sexual harassment and racism/xenophobia, were also mentioned by many participants.”
Being asked to run errands
Sleep deprivation, especially, was noted to be a major challenge. Live-in care workers are required to be constantly present and available – apart from a short daily break.
A number of participants spoke about the difficulty of getting the break to which they were entitled, or their breaks being used to run errands for clients.
Being asked to carry out non-care related tasks was also a common experience and many live-in care workers felt, or were, pressured to go beyond supporting activities of daily living and to carry out a range of domestic tasks, often for the whole family, such as cleaning, cooking and gardening.
Health and safety risks
Inadequate working and living conditions were often mentioned by participants that amounted to health and safety risks. These could include unsanitary working conditions, lack of equipment for safe handling and moving, and inadequate food provision.
When clients are hospitalised or pass away suddenly – not uncommon considering the age and needs of this population – live-in carers do not tend to enjoy employment protections.
They are often asked to leave at short notice with no compensation for lost earnings, or are allowed to stay and wait for their flight with no pay, or must take up a new placement without having time to grieve or rest.
How to make things better
We make 11 specific recommendations for policy. These include:
- providing carers with greater freedom to change employer without risk to their immigration status;
- introducing a registration system for recruitment agencies;
- an expanded role for the Care Quality Commission in ensuring carers’ employment rights are respected;
- local authorities to carry out regular audits of live-in carers’ working conditions.
You can find the full recommendations in the report. Three of our recommendations were generated by peer researchers who were, or had been, live-in care workers themselves.
All of our participants expressed a sense of agency and an awareness of the risks and drivers of exploitation. Many had critically reflected on their personal situation and the broader, structural factors that are creating the conditions for widespread exploitation and labour abuse.
Raising awareness of the risks of exploitation in live-in care work among social care professionals will help in its eradication.
About the research
The vulnerability of paid live-in care workers in London to modern slavery was published in August 2022 by the Rights Lab at the University of Nottingham, and was funded by charitable foundation Trust for London. The authors are:
- Meri Ahlberg, Focus on Labour Exploitation (FLEX)
- Caroline Emberson, Rights Lab, University of Nottingham
- Lucila Granada, Focus on Labour Exploitation (FLEX)
- Shereen Hussein, London School of Tropical Hygiene and Medicine
- Agnes Turnpenny, Institute of Public Care, Oxford Brookes University