Crisis in care homes as new staffing rules loom
From Times Online
March 31, 2010
Beneath the sash window of a care home in Wimbledon, lit by a shaft of spring sunlight, Lady Cicely Mayhew sits in the leather chair she occupies most days. Now 86, she reminisces about her adventures as the first female British diplomat, and her childhood growing up in Kenya, Tanzania and South Africa. Its a trip down memory lane made all the more enjoyable by the attentive acknowledgement of Johannesburg-born nurse Irene Mahasela.
I dont think one wants to be in a care home anyway, says Lady Mayhew. But they do a pretty good job.
Queens Court Care Home is one of thousands of residential care facilities that rely on migrant workers. Out of 41 workers, 38 were born outside the EU in the Philippines, India, Nepal and South Africa. But manager Shaaron Caratella says that under new rules she will not be able to renew their visas when they expire this year.
More than a million extra workers will be needed to support the UKs ageing population by 2025. In 2007 one in three care workers was recruited from outside the UK, and an estimated 60 per cent of London care workers are non-EU migrants.
Not all managers are as scrupulous as Ms Caratella. Experts have warned that recent immigration clampdowns are threatening the future of the care industry, and driving its non-EU workers into a trafficking scenario.
With a lack of government funding for the sector, pressure is being put on the workers willing to be cheap. According to the Centre on Migration, Policy and Society (COMPAS) at the University of Oxford, as many as one in five migrant care workers is paid less than the minimum wage.
Theres no pressure on the Government to put any more money into social care, Bridget Anderson, senior researcher at COMPAS, said. In fact, its going to become more squeezed, so its going to end up with migrants in it, either through legal or illegal processes.
Recent changes to the points-based system do not permit non-senior care workers to enter the country from outside the EU. In order to renew visas for senior migrant care workers they must now be paid more than 7.02 an hour, which most care homes cannot afford. Dr Sondra Cuban, lecturer in Education Studies at the University of Lancaster, says that strict rules drive migrants into illegality, where they are constantly at the mercy of their managers.
The points-based system traps them in modern slavery work, she said. It almost looks like some kind of trafficking scenario.
The union Unison says that many workers sleep several to a room and are forced to work overtime with the threat of the removal of their visas. Others are in debt-bondage, sending most of their earnings to the unscrupulous agencies that charge them up to 5,000 before they have even left home for visas, paperwork and accommodation that never materialises. Even at the minimum of 5.80 an hour before tax and living, it becomes a long-term project to pay back the debt. Most cannot return home until they have done so.
Greg Thomson, development manager for migrant and vulnerable workers at Unison, says that workers come to him for advice, but fear action.
People inevitably say, Dont do anything because we dont want to lose our job, he said.
The process of changing the rules seems to us to be a fairly minor thing because we have the right to regulate our own borders. But it impacts very harshly on the people who come here are are looking after the most vulnerable members of our society.
Care agencies unwilling to go underground say that they face a serious manpower crisis. Lesley Flory, director of recruitment for Barchester Health Care, who run Queens Court, says that the future looks bleak without the migrants who make up 40 per cent of her work force nationally.
Personal care needs people, she said. You dont deliver it on skeleton staff.
She says that recruiting in the UK and within the EU will not solve the problem. Initially the Government pushed us heavily towards recruiting in the EU but the economic reality doesnt make it attractive for them to come to England any more.
Mr Thomson says that despite the fact that UK unemployment stands at 3 million, the Jobcentre alone will never be an adequate source of work.
The trouble is, its not straightforward. If someone loses their job in the building industry that doesnt make them a perfect choice to become a care worker.
If you are a British person in a local Jobcentre and you have this job with antisocial hours, minimum wage and low-status, and youre looking for a long-term engagement in the labour market, why would you do that? Ms Anderson asked. Unless they do something about pay and conditions and the status of the job, and unless they treat it with some respect, theyre not going to get British people into it.
At Queens Court, Marian Heal, 82, appreciates the presence of the foreign staff who share the building she has called home for 3 years.
I hear about them and their homes. Ive got a vast atlas in my room and I look up where they are going and it provides a lot of interest and stimulation, she says. Theyre much needed, because British people arent prepared to do the job and to work as hard, which care workers from abroad do.
Mrs Mahasela is willing to concede that its not always easy. She had to leave behind her three young children and her husband who works in a soft drinks warehouse when she left South Africa five years ago. She returns to visit every six months.
First and foremost I learn patience in whatever sphere, she says, taking a deep breath.
Next door in her armchair, Lady Mayhew is similarly realistic. Generally speaking, staff could do with a little polishing, she says, her accent clipped. But they put themselves in the place of patients and theyre very good at it, She smiles.
They probably think were trouble, too.
It happened on a night shift. But before Evelyn Bolano reported bruises on the body of an elderly patient at the Canterbury care home in which she worked, she wavered for a moment. She knew that her working visa and the job that supported her teenaged children in the Philippines was in the hands of her manager.
Little did she know that the blame would be pinned on her and three other Filipino co-workers.
Because you are on a work permit these things can happen, she said. You are quite afraid.
Mrs Bolano was being paid the minimum wage, which at the time was 5.52 an hour. It was a pound an hour less than her British colleagues at the same level. She says that other migrant care workers had been overworked, underpaid and threatened with legal work permits being overturned or illegal status being reported in the event of disobedience.
Mrs Bolanos status is legal, but her situation is still precarious. She came to the UK on a work permit five years ago. Having worked as a qualified nurse in the Philippines for 23 years, including a position at Unicef, she moved to Britain as a care worker. Despite taking a job for which she was overqualified, she would be able to send more money home to her husband and two teenage children.
She paid 5,000 to a travel agent, who promised her transport, papers and accommodation. Its a debt that she and her family have still to pay back.
You have to pay back the debt, she said, and living here is very expensive. In addition, the promised accommodation never materialised, and she slept on floor space provided by a generous colleague. She was too ashamed to admit this to her family.
Though she saw fellow workers abuse their positions with long breaks, her fellow migrant workers were constantly afraid of their manager who threatened to pull their placements and with it their visas.
When you are a migrant worker you abide by policy because you are afraid to break it. There is always a panic and no stability. When we were suspended I thought, Oh my God. I prayed a lot.
Following an investigation by police and social services, Mrs Bolano and her colleagues were cleared, and the home was shut for six months while new management was sought.
I love the clients, and they love to be cared for, she says. They can be angry sometimes, but thats how people are. I have parents in their eighties, and I do understand them. Old people cannot speak for themselves. You have to speak for them youre fighting.