Recruitment and retention in adult social care: a qualitative study (accessible)

Question 1

About Revealing Reality

Accepted Answer

Revealing Reality is an independent, multi-disciplinary research agency, working with regulators, government, charities and private sector organisations. We provide insight to inform decision-making, policy recommendations and service design and to help drive change. We conduct detailed qualitative and quantitative research into services and their users – observing how systems function and capturing a range of different perspectives to understand user experience and unmet need.

Our work also includes exploration of people’s behaviours and motivations, with an emphasis on understanding these within the context of people’s real lives.

https://www.revealingreality.co.uk/

Role of the MAC in producing this report

Members of the Migration Advisory Committee (MAC), the expert advisory group for the social care commission, and the MAC secretariat met and corresponded with the research team at Revealing Reality to develop and steer this research project. However, the robustness of the analysis is the responsibility of the authors, and the findings and views presented in this report do not necessarily reflect those of the MAC.

Anonymity within this report

Anonymity and confidentiality are important in the reporting of this work. Throughout the report we have taken a standardised approach to ensuring respondents are non-identifiable. No names are used in the report. In addition, we have provided minimal details on who each person is, limiting information to their role and/or sector of work. Where possible, specific respondent details have been removed or aggregated. In some instances, we have changed some small details to provide further anonymity, including aspects about the person such as their gender, age, role, and exact location.

Question 2

Executive Summary

Accepted Answer

Background to the study

The adult social care sector has experienced major challenges related to the recruitment and retention of staff for many years. These have been acutely felt in the last few years in the wake of events such as COVID-19 and Brexit, with vacancy rates in the sector reported to have risen sharply in the last year^{[footnote 1]}. These challenges put pressures on the sector, its workers, and users, with care providers increasingly having to rely on expensive agency staff and feeling forced to turn down new clients^{[footnote 2]}.

In July 2021, the Migration Advisory Committee (MAC) was commissioned by the Minister of Future Borders and Immigration to undertake an independent review of adult social care and how these challenges might be addressed^{[footnote 3]}. The specific objective of the commission was to understand the impact that the ending of Freedom of Movement between the UK and EEA in January 2021 has had on the sector, and particularly how it has impacted:

The adult social care workforce, such as skills shortages
Visa options for migrant care workers
Long-term consequences for workforce recruitment, training and employment terms and conditions

As part of this work, the MAC carried out an online Call for Evidence and commissioned Revealing Reality to conduct qualitative research to explore these issues from the perspective of migrant care workers and employers within the adult social care sector. Alongside this, the MAC also interviewed direct employers of personal assistants and employment/introductory agencies involved with the recruitment and supply of personal assistants.

This report outlines the findings of Revealing Reality’s qualitative research.

Study objectives

The primary objective of the qualitative research was to understand current practice, the experiences of both employers and employees within adult social care, and the impact that the ending of free movement has had on the sector. As the research progressed, a secondary focus was exploring the attitudes of employers to the introduction of a new visa route which would allow migrant care workers to come to the UK on a Skilled Worker visa.

Fieldwork adapted to changing migration policy

With the ending of Freedom of Movement and the introduction of the Skilled Worker route, EU and non-EU workers alike could not enter the UK with the specific purpose of working as a care worker, as the job role was not eligible. This changed in February 2022, as the care worker occupation was made eligible following an interim recommendation in the MAC’s annual report which was published in December 2021. Since 15th February 2022, care workers can be brought into the UK on the Skilled Worker visa provided that:

Employees receive a salary of at least £20,480 per year, based on a 39-hour week of £10.10 per hour. Care workers and senior care workers must work at least 39 hours per week at £10.10 per hour to meet the salary threshold. Employees who are paid more than £10.10 per hour can work less than 39 hours a week, provided that their annual salary meets a minimum of £20,480.
They have a B1 English language level or above.^{[footnote 4]}

Fieldwork for the project took place between November 2021 and March 2022, before and after the change in migration policy. Given that only a small portion of fieldwork came after the change in migration policy in February 15th 2022, which allowed care workers to be brought to the UK on the Skilled Worker route, the research team were unable to consult care workers who had come to the UK on this route. Researchers were able to interview migrant care workers who had previously moved to the UK via a range of routes, to understand current practices of working in care and the range of motivations for moving to the UK. Interviews with employers allowed the research team to explore both preconceptions of the Skilled Worker route as a hypothetical option prior to February 15th 2022, and initial opinions, practices and challenges for those who were considering using the route in early 2022.

The research team interviewed 27 employers and 14 migrant care workers across England, Scotland, Northern Ireland, and Wales as part of this work.^{[footnote 5]} This report outlines the findings of semi-structured interviews and focus groups with participants, who were diverse in terms of background and characteristics, but who also had some common experiences. The qualitative nature of the research allowed the research team to get beyond basic answers, bring out nuances in participants’ attitudes and understand detail in people’s experiences of recruiting and working within adult social care. As the report is based on a small sample, findings cannot be generalised to the whole of the adult social care sector, nor can any percentages or proportions be derived from them.

Most employers said they had been struggling with recruitment and retention for some time, and that this had been exacerbated by the ending of free movement

Most employers spoken to as part of the research said they had experienced challenges in recruiting, and in some cases retaining, care workers in their organisations.

For many spoken to, these challenges had existed for a few years. Whilst five to ten years ago these employers said that recruitment had felt relatively straightforward – in some cases they spoke of having ‘turned away’ prospective candidates – many said they had been struggling in the last three to five years.

Most of the employers interviewed said they believed that a key reason for this was increasing competition in recruitment with other sectors such as hospitality and retail. They felt that these sectors were often more appealing, as they were able to offer higher wages for less responsibility and physical strain. Some employers also spoke about being in competition with the NHS and feeling unable to compete with the higher salaries it was able to offer. Almost all the employees in the sample also felt that pay in social care was comparatively low, and a few were actively looking to move into competing sectors.

Many employers spoken to, particularly those in urban areas and those who had strong international connections pre-Brexit, described being reliant on a steady flow of workers from the European Union before the ending of Freedom of Movement in January 2021. They explained that many of their employees would work in the sector for a short period and then move on. In line with this, many of the migrant care workers interviewed as part of the research said that they did not expect to work in the adult social care sector in the long-term. Instead, they typically saw social care as a temporary way of making money and a ‘stepping stone’ to better paid and more qualified roles.

Some employers interviewed recognised that the ending of free movement was having an impact on their workforce, alongside the recruitment challenges that pre-dated Brexit. Since January 2021, many employers in the sample had received very few, if any, applications from EU nationals, and several told us that they had seen European employees returning to their home countries in the years leading up to Brexit. Some employers also suggested that Brexit might have had an indirect impact on their ability to attract UK nationals into care roles. They spoke of EU workers leaving and creating gaps in the workforce of other sectors which could be filled by UK nationals, increasing competition with other sectors, and reducing the potential adult social care recruitment pool further. Several also mentioned that they thought that COVID-19 had a negative impact on recruitment and retention prospects in the sector, with the pandemic creating a sense of “burn-out” and reducing potential candidates’ willingness to move into the sector.

Employers interviewed spoke of how this combination of internal factors and the ending of free movement had resulted in a backlog of vacancies that many were still struggling to fill at the point of interview.

Most employers interviewed were unfamiliar with the sponsorship process, or had not thought that it could help them before the addition of care workers to the Skilled Worker route

Most employers interviewed had not been considering migration and sponsoring employees as a way of tackling their recruitment challenges before fieldwork started in November 2021. Some employers spoken to were aware that they were not able to sponsor entry level care workers – the role that employers often said they needed to fill most – under the Skilled Worker Visa at that time, and so had not engaged with the process. Other employers interviewed were not familiar with the rules of sponsorship at all.

Sponsorship was considered an unknown and intimidating process to several employers in the sample, who spoke of being unsure whether they would be able to make use of it effectively as a means of recruiting new staff. Indeed, some of these employers reported having focussed their efforts on domestic recruitment instead. A small number of employers in the sample already had sponsor licences, predominantly for Tier 5 routes, but even they felt somewhat cautious about the sponsorship process. A small number of employers within the sample described how they had either lost sponsor licences or had them put on hold in the past. Whilst concerns around the management of sponsor licences were notable within the research, it is important to note that, given the research’s small sample size, it is impossible to assess the extent to which this has been an issue within the wider sector.

The new route for migrant care workers was positively received by most employers in the sample, though many worried about minimum wage requirements and how long the route would be open for

Despite often having been tentative about sponsorship in the past, many employers in the sample welcomed the changes in migration policy announced on December 24th 2021 and introduced in February 2022 which would allow organisations to bring care workers to the UK on the Skilled Worker route.

However, some barriers were identified that could limit full use of the new route. For example, some employers spoken to worried that their lack of familiarity with the sponsorship process might lead to mistakes and delays, meaning it might take longer than expected to get employees into the UK. Some employers in the sample also described how the sponsorship process felt ‘risky’. They were concerned about making a mistake and losing their investment, and therefore planned to use the route tentatively to start with, to ‘test’ it. If the route were to only last for a year, it follows that the number of migrant care workers that employers could bring over to the UK would be limited if it took them a long time to research and test the process.

However, a more noteworthy barrier was the wage requirements. Whilst most employers interviewed for this research said that the overall salary threshold of £20,480 would not, in theory, be an issue, many employers in the sample, some of whom were interested in sponsoring employees, were not paying staff the hourly threshold of £10.10 per hour. They said that they would only be able to reach the annual salary threshold if they were to employ people at a lower hourly rate for more than 39 hours a week, which would make employees ineligible for the visa. This was particularly the case for those we interviewed who were based outside of London and Scotland (which has a higher wage for care workers^{[footnote 6]}). Several of these employers said they were unlikely to be able to raise wages in the near future. As a result, they did not feel that they would be able to use the route straight away and might not be able to use it all should it only stay open for a year.

Question 3

Background and Methodology

Accepted Answer

Background and objectives

The adult social care sector has experienced major challenges related to the recruitment and retention of staff for several decades. These have been acutely felt in the last few years in the wake of events such as COVID-19 and Brexit, with vacancy rates in the sector reported to have risen sharply in the last year.^{[footnote 7]} These challenges put pressures on the sector, its workers, and users, with care providers increasingly having to rely on expensive agency staff and feeling forced to turn down new clients.^{[footnote 8]}

In July 2021, the Migration Advisory Committee was commissioned by the Minister of Future Borders and Immigration to undertake an independent review of adult social care. The aim of the commission was to understand the impact that the ending of Freedom of Movement in January 2021 has had on the sector, particularly on how it has impacted:

The adult social care workforce, such as skills shortages
Visa options for migrant care workers
Long-term consequences for workforce recruitment, training and employment terms and conditions

As part of this work, the MAC carried out an online Call for Evidence and interviewed direct employers of care workers, and employment/introduction agencies involved with the supply and recruitment of personal assistants. The MAC also commissioned Revealing Reality to conduct qualitative research to explore these issues from the perspective of migrant care workers and employers within the adult social care sector.

This report outlines the findings of Revealing Reality’s qualitative research.

Study objectives

The primary objective of the qualitative research was to understand current practice, the experiences of both employers and employees within adult social care, and the impact that the ending of free movement has had on the sector.

As fieldwork progressed, interviews were also used as a space to test thoughts around the MAC’s recommendation to add care workers to the Skilled Worker route, which the government accepted in December 2021 and which came into force on 15th February 2022. Researchers also gathered thoughts on a hypothetical unsponsored visa route which, similarly to a Youth Mobility Visa, would allow young workers to come to the UK for limited amount of time and take any job they wish (be that within or outside of adult social care).

Approach

27 employers and 14 migrant care workers across England, Scotland, Northern Ireland, and Wales participated in the research. The fieldwork consisted of:

Three online focus groups with 9 employers in social care
18 online semi-structured interviews with employers
Three online follow-up interviews with employers
14 online semi-structured interviews with migrant care workers

Participants were diverse in terms of background and characteristics but had some common experiences.

Further information on methodology and sample can be found in Annex 1.

Fieldwork adapted to changing migration policy

With the ending of Freedom of Movement and the introduction of the Skilled Worker route, EU and non-EU workers alike could not enter the UK with the specific purpose of working as a care worker, as the job role was not on the government’s eligible occupation list, though senior care workers were eligible. This changed in February 2022, as the care worker occupation was made eligible following an interim recommendation in the MAC’s annual report which was published in December 2021. Since 15th February 2022, care workers can be brought into the UK on the Skilled Worker visa provided that:

Employees receive a salary of at least £20,480 per year, based on a 39-hour week at £10.10 per hour. Care workers and senior care workers must work at least 39 hours per week at £10.10 per hour to meet the salary threshold. Employees who are paid more than £10.10 per hour can work less than 39 hours a week, provided that their annual salary meets a minimum of £20,480.
They have a B1 English language level or above^{[footnote 9]}

Fieldwork for the project took place between November 2021 and March 2022, before and after the change in migration policy. Given that only a small portion of fieldwork came after the change in migration policy in February 15th 2022 – which allowed care workers to be brought to the UK on the Skilled Worker route – the research team were unable to consult care workers who had come to the UK on this route. Researchers were able to interview migrant care workers who had previously moved to the UK via a range of routes, to understand current practices of working in care and the range of motivations for moving to the UK. Interviews with employers allowed the research team to explore challenges of recruiting within the adult social care sector, preconceptions of the Skilled Worker route as a hypothetical option prior to February 15th 2022, and initial opinions, practices and challenges for those who were considering using the route in early 2022.

About this report

This report outlines findings that came out of semi-structured interviews and focus groups with participants. The report is not intended as a summary of the sector and findings cannot be generalised to the whole of the adult social care sector. As the sample for the research was small, this research can evidence the presence of certain attitudes and behaviours within the sector but is unable give a sense of scale and the extent to which these attitudes and behaviours are prevalent across the sector.

Throughout the report we have taken a standardised approach to ensuring respondents are non-identifiable. No names are used in the report. In addition, we have provided minimal details on who each person is, limiting information to their role and/or sector of work. Where possible, specific respondent details have been removed or aggregated. In some instances, we have changed some small details to provide further anonymity, including aspects about the person such as their gender, age, role, and exact location.

Further detail on sample, methodology, consent and anonymity in this research can be found in Annex 1.

Question 4

Experiences of recruitment and retention within adult social care

Accepted Answer

At the time of interviews, almost all the employers in the sample were struggling to recruit and retain the full workforce they needed

Almost every employer that we spoke to described having gaps in their workforce that they were struggling to fill. Some employers interviewed, especially smaller providers, said they were seriously concerned about their future. Some said they had seen other similar care providers go out of business in their local area.

Challenges around recruitment and retention were not new to research participants and had been felt acutely in the few years prior to fieldwork. Wider research on these issues is detailed in the MAC’s Adult Social Care and Immigration: A report from the Migration Advisory Committee.^{[footnote 10]}

This section of this report sets out some of the challenges employers in the sample were facing in filling their vacancies – both with migrant care workers and domestic workers.

Employers interviewed reported that some care workers either do not want to or are unable to work additional hours

A key challenge raised amongst employers in the sample was that of finding enough workers within the domestic market to cover the shifts and hours for which they needed care staff. A few employers reported that existing domestic staff who were receiving benefits alongside their employment sometimes did not want, or felt unable, to work more hours because it would impact the amount of money they would receive from the Government:

“People don’t want to work more hours because it will tip them over and they won’t receive their benefits.” Employer, Northern Ireland focus group^{[footnote 11]}

Other employees were only able to work around other responsibilities such as childcare, and so even though some employers in the sample were offering existing staff more hours, employees were not taking them up:

“Our biggest challenge is getting staff to work early mornings and evenings – if staff have children, they don’t want to work those shifts.” Employer, England

Employers said that they were generally looking to attract entry-level workers

Many employers in the sample described having a greater number of entry level care workers in their workforce than more senior and qualified workers. This seemed to be mirrored in the type of vacancies that were being advertised within these organisations. Overall, employers in the sample reported that the gaps in their workforces tended to be for entry-level care workers, rather than for senior care workers or managers.

One director described how he was mostly looking for entry-level care workers. He did not feel that he could afford to employ any senior roles until the company took on more work overall. He estimated that they would need about 100 more hours of work per week to be able to afford to employ people in senior roles.

Another employer in Wales described a similar situation of needing entry-level workers, but struggling to find them:

“There’s an absolute outcry for [entry level care workers]… we don’t need more managers we need more care workers… I don’t necessarily want senior workers – I want care assistants, you know, people who don’t need any experience because I can train them up.” Employer, Wales

Some employers had decided to reduce their requirements of entry level workers

As they were receiving so few applications, some employers interviewed in the work had decided to reduce their requirements of potential employees. For example, some said that they no longer required potential employees to have any relevant experience or to provide cover letters.

This was the case for the HR Manager of a company with a few residential homes in the South of England. She described how she tried to reduce the number of details required and make the application process as easy as possible to attract as many applicants as she can:

“With care assistants we’ll take anyone through to interview … we completely stripped back our application process and all we ask them to do now is pretty much name, telephone number, email address and a very short sentence saying why they would want to work for us.” Employer, England

Some employers interviewed were trying out new domestic recruitment strategies, but were struggling to see any benefit from them

Several employers in the sample spoke of trying to adapt their recruitment strategies to tackle the drop in applications they had been experiencing. Despite this, most of these employers described still struggling with recruitment. There had been efforts by some employers to increase their advertising for positions or to try new advertising routes, but the employers in our sample had had little success. One employer from England expressed such difficulties:

“We did some magazine and leaflet drops. From 8,000 leaflets, we got nothing back. We’re considering paying for Facebook advertising.” Employer, England

Challenges in recruitment and retention meant that some employers in the sample were having to turn down new work and clients

A few employers in the sample described how recruitment challenges were affecting their capacity for growth and taking on new work. Several explained that they were having to turn down new clients because they did not have the staff to care for them.

For example, the registered manager at a small domiciliary care provider in Scotland explained that the company has lots of interest from new clients, but they are having to turn work down because they are struggling to recruit staff:

“We’re standing on the edge. Hoping it will get better. Three big care providers have just gone down. There’s a big risk for us. We have lots of demand from new clients but are having to turn clients down because we are struggling to recruit staff.” Employer, Scotland

Similarly, the director of a small domiciliary care provider in the North of England estimates that the company turns down an average of 500 hours of work from the council every week because they do not have enough staff:

“Our challenge for the next year is surviving. Our costs are going up every year and if we can’t recruit to bring in more income survival is an issue.” Employer, England

Some large organisations interviewed said they were used to having a high staff turnover and said there was poor retention especially when young people made up a large proportion of their workforce – as staff were often students who would move away after a certain period of time.

Challenges in recruitment had been experienced for several years – and with a number of contributing factors

Many employers that took part described how a decade ago they had comparatively very few issues with recruitment, and in some cases had been ‘turning people away’ but that in the last 3-5 years this had changed. Employers in the sample struggled to identify what had changed but felt that it was a combination of the ending of Freedom of Movement, COVID-19 and increased competition from other sectors.

“We’ve known about impending care staff shortages for years and nothing has been done. Falling numbers have been compounded by Brexit and Covid, by better opportunities in other sectors… We generally hadn’t relied on people from the EU in our care organisations – but ending of Freedom of Movement has meant that people have left from other sectors which have left spots available for care workers to move into. And in NI, there is a limited pool of people to draw from, so we’re running out of options.” Employer, Northern Ireland focus group

For many employers in the sample, the ending of Freedom of Movement seemed to have an impact on their ability to recruit and retain staff – either directly or indirectly

Some organisations interviewed had seen a reduction in the proportion of their workforce coming from the EU over the last few years. Some employees were reported to have left the UK between the Brexit referendum result and the date the UK left the EU. Against the backdrop of the existing difficulties in filling vacancies outlined above, employers were concerned both about employees leaving the UK, and about the removal of a source of new recruits.

“We had 4 EU people leave in the last year because of Brexit, and there are no new people coming into the country.” Employer, Scotland

Freedom of Movement was seen as particularly crucial for the care organisations interviewed who employed live-in care workers. These care workers often moved between the UK and their home country as frequently as their work patterns required. For example, one employer for an England-based live-in care company, explained that her organisation relied on EU workers to work in the UK for several weeks, after which they would go back to their families in Europe for a couple of weeks. Freedom of Movement was seen as vital to the organisation, who at the time of the interview were having to rely solely on UK citizens or on long-term EU employees who had already acquired settled status in the UK.

“50 percent of our carers were based in Europe for a long time, for the first ten years of our organisation…Then the pandemic hit and Brexit was masked behind all the other drama. So the deadline came and went quite quietly in terms of the news. For us, it was a really big deal. We spent years trying to support people to get that pre-settled status and settled status. We’ve probably still got about 30 to 40 percent overseas carers. But every time an overseas carer resigns, we know that we can’t replace them with somebody similar. So it is a significant impact on us and also an additional burden for some of our carers.” Employer, England

Other employers interviewed said that they had not lost any EU workers due to Freedom of Movement but were noticing that recruiting new workers was more difficult.

For example, one employer with care homes in various locations across England told us that he was having the most difficulty recruiting staff for sites in the East Midlands. He attributed this to the fact that many EU workers used to migrate to the East Midlands for work in agriculture and food production. He felt that some of these workers, or their dependants, would have transferred to social care in the past:

“I went down to Lincolnshire just before Brexit and sat at a pub… it was dominated by people from Eastern Europe because they worked on the farms around there… [at one of our homes] for a period of time the majority of people we recruited had come out of another industry.” Employer, England

Unsurprisingly, some employers interviewed saw a dramatic reduction in applications from staff from the EU after the ending of Freedom of Movement. This was described as hitting employers, who had been used to a steady flow of short-term workers, particularly hard.

One employer in Northern Ireland described how she had experienced a large decrease in applications since Brexit. The organisation had multiple sites, and whilst they had good retention in some of the smaller branches, she described how they had high turnover in the larger sites which have a younger population. She explained how employees would come in young friendship groups at school age/just out of school, and when one left the others would quickly leave too.

“We definitely don’t get as many EU applicants anymore… before we would have been offering probably two EU citizens a job every week, whereas now I haven’t seen any since November… we have 355 employees and 50 vacancies at the moment…” Employer, Northern Ireland

Several employers described getting very few applicants overall, and some mentioned that the applicants they did get were often students or people who did not want to work many hours:

“We have advertised on Indeed and Reed, but haven’t been having any luck. We had a couple of students apply but they have visa restrictions on how much they can work. And the company can’t be run on students.” Employer, Scotland

“We’ve just noticed in general that candidates are far less committed. They’ll try two months here, they’ll try two months there, whereas retention before was much easier. So the market itself is really challenging. There’s so much more competition with everything.” Employer, England

It was also suggested that the full effect of Brexit may not have been seen yet, and that the end of free movement will only be felt more fully further down the line:

“Brexit might be felt more in the long term, and what has been attributed to Brexit and Covid over the last couple of years, may just have been Covid.” Employer, Scotland

Employers interviewed felt that other sectors were more appealing to workers

We heard from both employers and employees that the loss of EU workers throughout the UK workforce has led to increased demand in other industries, too, some of which compete with adult social care in terms of pay and status. There were several factors which the employers interviewed felt made care work unappealing compared to these other occupations.

COVID-19 has put extra strain on care workers

A few employers that participated, particularly those who had been employing migrant care workers, thought that COVID-19 had had an impact on their ability to retain and recruit staff, which in some cases made it difficult to distinguish what was a result of Brexit and what was a result of COVID-19. Existing staff were said to be fatigued, because of having to deal with COVID-19 regulations and having to work longer hours to cover for colleagues who had been unwell. Some employers reported that employees did not want to work extra hours even though lots of work was available.

For example, one employer felt that the strain put on care workers during the pandemic had impacted peoples’ willingness to work in social care:

“I think the experience that people have gone through… I wouldn’t call it PTSD… but I think people have gone through a life-changing experience and working in social care in particular has been a massive challenge…” Employer, England

“Staff are fatigued. They just want to do their contracted hours and not any overtime.” Employer, Northern Ireland focus group

A few employers interviewed mentioned that political and public attitudes to care work during COVID-19 had only exacerbated the situation. NHS staff were perceived to have received greater positive attention than care workers.

“Covid did lead to a spike in applications for nursing, but not care… I know that some organisations were doing a lot of work to try and promote the stories of care and support workers… trying to get people to recognise that really they’re the unsung heroes of the show, to be honest.” Employer, Northern Ireland focus group

“But there’s lots of different things that have made it really challenging – the public perception that care is an unsafe place in terms of Covid, people just being exhausted and working through the whole pandemic and then feeling like they’ve just not been rewarded appropriately or haven’t had the respect that they should have, so it’s still the most challenging recruiting market we’ve ever worked in.” Employer, England

Some employers spoken to also mentioned concerns around enforcing a mandatory COVID-19 vaccination, when it was believed this was going to be introduced for social care workers. The policy introducing vaccination as a condition of deployment for all frontline and social care workers came into force on November 11th 2021, and was revoked on 15th March 2022.^{[footnote 12]}

“We are losing 3 out of 30 people because they don’t want the mandatory vaccination.” Employer, England

“And some more political statements have been a turn off for carers wanting to work in this sector; Javid’s [Sajid Javid, Secretary of State for Health and Social Care] comment that people are lazy if they don’t get the vaccine and not being treated in similar ways to the NHS; the whole mandatory vaccine thing has really put people off…” Employer, England

Care workers were seen as having high responsibility but lacking status

Employers interviewed said that care work was undervalued compared to other sectors, and that care workers often were just as skilled as workers in other sectors. Several employers said that they felt that the responsibility of working in social care was not matched by appropriate pay.

One employer in England, felt that care work was seen as low-status, and that the skills required were not sufficiently recognised and not adequately remunerated.

“Care is seen as low skilled, but it isn’t really. We do a nurse’s job, we do end of life care. We do things like colostomy changes, oxygen, insulin.” Employer, England

Many of those interviewed also highlighted that care workers have a lot of responsibility and can be investigated if something goes wrong – which can affect their ability to work and overall morale.

“If you do something wrong, you’re put under investigation, and sometimes not told what for. You can’t work for a while. Staff don’t want to come back after that.” Employer, Northern Ireland focus group

Other sectors or employers were described as offering better pay and benefits

Overall, employers spoken to reflected that other sectors such as retail and hospitality were more appealing for workers, as they required less responsibility and offered better pay. Employers interviewed said that their flexibility to offer higher pay was limited, but that they nevertheless felt under pressure to try and create a better job offer. Factors that were thought to improve staff retention included annual leave entitlement, sick-pay, progression, and good communication with employees. For example, one small employer reported that employees appreciated the ease with which they could resolve issues, such as being able to approach a manager directly if there is a problem with their rota. Another employer in England, who ran a small branch of a multi-site organisation, felt that the progression offered at her company contributed to their retention.

In general, however, employers described themselves as being too financially constrained to compete with other sectors:

“We have lots of good benefits, which we try to advertise, such as better pension, training, good holiday, gym membership reductions, vouchers, but we just can’t match the pay of private companies/other sectors. People prefer better paid jobs with fewer challenges elsewhere.” Employer, Scotland

Some organisations we spoke to explained they were using management consultants or trying to introduce bonuses to attract staff. Two Welsh employers we spoke to had tried alternative incentives to recruit people into care.

“We’ve tried to do a ‘refer a friend scheme’ where you get a £150 bonus.” Employer, Wales

“We’ve introduced life insurance… it’s not expensive, it’s £3000 a year. It’s still cheaper than trying to increase their wages, which is what we would have preferred to do… We had to pay a management consultant to look at [recruitment and retention] and at what we can afford.” Employer, Wales

Some felt they were in direct competition with the NHS, which was often seen as being able to pay more for similar roles.

We spoke to one domiciliary care employer who said that he had not noticed any trend of employees leaving to work for hospitality or retail. Instead, employees tended to leave to work for the NHS, in part because he was not able to pay them full wages for their travel time, whilst in the NHS they could stay in one place, and in part because he could not offer as high rates of pay:

“I can’t blame anyone for [leaving]. It’s better pay on the NHS.” Employer, England

Most organisations in the sample were relying more heavily on agency staff to fill gaps in their workforce

Many of the employers we spoke to were having to rely on agency staff, which had largely increased over the last few years. Across the sample, using agency staff was felt to be an unappealing option because of the high costs incurred, and the inconsistency of staff.

“Before, we were recruiting from the EU [and] we didn’t need to make much of an effort… people knew about us and [we] would be turning people down because more young folk from abroad wanted to come and work here, more than we had space for. Now we’ve got to go out and hunt for people and we use agencies… it can be really crippling and expensive. It could be anything between £20 and £40 [per hour] and is dependent on the nature of the shift.” Employer, Scotland

Another employer in Scotland was paying regular staff £10.20 an hour, but was paying £19 or £22 an hour for agency staff depending on the time of the week.

We also spoke to one employer who was the registered manager of a small site in Scotland. She had very rarely used agency workers in the past – they were only needed if, for example, multiple staff were on annual leave and someone called in sick. However, over the last 6 months her site had struggled to recruit four care worker roles. She described how they were trying to shift working schedules to cover vacancies within their workforce, but were now also having to rely more heavily on agency staff and were spending around £600 per month on agency fees. This was seen as a large cost for such a small organisation, and one which they would struggle to sustain.

Question 5

Experiences of applying to and working in adult social care

Accepted Answer

While a few of the employees we interviewed had moved to the UK with the intention of working in care, most explained that they were motivated by other reasons and had ended up working in care when looking for a job after they had arrived. For many of these employees, they were drawn to care as it was seen as an easy and flexible way of quickly earning money.

For example, quite a few of the employees we interviewed had come to the UK to study. Some of these employees described how they saw getting a job in care as a convenient and flexible way of acquiring an income and staying productive outside of their studies.

“I thought that it’s the ‘done thing’ for students to get a job while studying. Why am I sitting down doing nothing? I just tried to get started and get doing something.” Employee, England^{[footnote 13]}

Some of the employees in the sample who had moved to the UK for reasons other than study also said that they valued the flexibility of the adult social care sector.

“There’s so much flexibility with the hours, you can just pick and choose each week when you cannot work or ask for less work, or double time on Sunday, one and a half on Saturdays.” Employee, England

Some employees in the sample described having previous work experience related to social care, and so working in care felt like a logical and familiar option to them. Though these employees had different reasons for coming to the UK, they saw working in care as a natural choice for them based on their previous experience.

“Social care work was something I’d always volunteered for back home with my church. So it just made sense.” Employee, Scotland

“I did volunteer work back in Nigeria, trying to give back to the community, trying to take care of children with no parents in the orphanage, talk to them and try to motivate them to go to school.” Employee, England

“In my previous work, I was caring for people with severe autism and moderate to severe learning disabilities, so these people would be impaired their whole life.” Employee, Scotland

“I’d done some care work in Australia, so I thought I could do something similar here. When my friend said there was an opening at a care home, I went for it.” Employee, Northern Ireland

Familiarity was not the only reason for getting a job in care. Several employees said that they went into social care because they felt it was a sector where they would quickly be able to find a job and start earning money.

One employee in the sample explained that he appreciated the security of a job in social care. He was currently completing a degree and hoped to find a career that made use of these skills. However, he was aware of the high demand for workers in the social care sector and said he was confident that there would always be a job for him if he needed to return. He felt that working in social care alongside his degree meant he was acquiring two skillsets at once, which would make him more employable in the future.

“There is always going to be a job for you as a care practitioner, there’s no way social care is going to be automated in the next few years, so it’s something to fall back on.” Employee, Scotland

Another employee said that she had been looking to move to the UK with her husband for over 3 years. She described how they wanted to move away from her home country’s poor economy and seek a “better life”. The couple had considered several countries to migrate to but settled on the UK after the announcement in 2019 that students would be able to stay in the UK for an additional 2 years after their studies, as this seemed to provide a better opportunity for potential long-term settlement. She came to the UK as a dependant on her husband’s student visa and was looking to start a job immediately to support herself, her husband and young children financially. She described how she spoke to friends and relatives who had already moved to the UK and told her that social care would be the easiest job to move into quickly:

“Back home you ask questions of those who have actually moved…The advice was there is a shortage in the health industry…If you’re not a doctor or a nurse you can start in care work.” Employee, England

Many in the sample also cited flexibility as a key motivation for working in care

Employees also explained that jobs in social care provided them with the appropriate flexibility to fit their work around other commitments.

One employee said he wanted a job that could fit around his studies, and that could be adapted to changing deadlines.

“I can choose my hours and cancel, with some notice, if I discover that there is any clash with my schoolwork.” Employee, Scotland

Another employee had children to look after, and decided she needed a job that could work around her husband’s factory work during the day, so they could share childcare responsibilities.

“I didn’t really know what I was going to do for work when I arrived. I just knew it would have to fit around my husband’s work and looking after my kids… I knew you could do twilight shifts in care.” Employee, Northern Ireland

One employee was working two other jobs in a working week that was approximately 72 hours long. He said he needed flexibility in his two care jobs to ensure he could fit all his desired working hours in.

Another employee described how she chose social care work because the flexibility gave her time for her other religious commitments.

“For me, work has always been a means to an end and the most important thing in my life is my relationship to God and the rest, you know, we work to support ourselves.” Employee, Northern Ireland

Whilst some employees valued flexibility in their work, it appeared to sometimes work to their detriment

In some cases, employee flexibility and choice seemed to be to the detriment of workers’ own wellbeing and the standard of care they were delivering. Some employees spoke of agency staff that they worked with choosing to work back-to-back shifts, which impacted their health and ability to provide good care. For example, one employee said that she had worked with agency workers who had worked two 12 hour shifts back-to-back in order to earn more money, but that this had left them tired and unable to provide the care required. The employee who reported that he was working a 72-hour week to set up a new life with his partner was also trying to provide for his two children and father. Due to the low wages in social care in England, especially compared to his previous wages back in his home country, he felt he needed to work a very high number of hours to make enough money.

Some of those we spoke to who were working in domiciliary care described having difficulty because they were not paid full wages for their travel, and if they were this was based on predicted travel time. Although it is not a legal requirement for care workers to be subsidised travel between their home and their place of work, some employees described how it could be difficult for domiciliary care workers on a minimum wage to pay for their own travel to all of their various clients:

“If you add up all the time you were out… sometimes you don’t even get the minimum wage per hour… the problem is the travelling time is set and sometimes it’s not realistic. It doesn’t take into time the traffic nor the weather conditions.” Employee, Northern Ireland

Whilst social care was viewed in many ways as being a convenient career for some, some employees also reported barriers. Some of these barriers were said to be felt by both domestic and migrant care workers across the sector, whilst some specific issues were more applicable to migrant care workers.

For example, particularly in domiciliary care or independent living, an inability or reluctance to drive in the UK was prohibitive. Even outside these parts of the care sector, this sometimes impacted employees’ work options. One employee in Northern Ireland could not drive, which affected the kinds of shifts that she was able to choose.

“I only pick shifts that are nearby and at decent times because I don’t drive and the public transport stops at a certain time of night.” Employee, Northern Ireland

Another employee said that he was able to drive in his home country but did not feel comfortable driving in the UK. The ability to drive was a requirement that affected care workers of different nationalities across the sector, but it seemed to be an issue that could particularly affect migrant care workers, seeing as their own experience of driving was not always as transferable as those who had driven in the UK. Luckily in this particular case, this employee’s company paid for his taxis on his night shifts when he needed to work outside of the city he lives in, but the ability to drive was an important requirement for many of the employees we spoke to.

“Driving in the UK is very different in the UK compared to Nigeria. I still don’t understand the way of driving here.” Employee, England

There were also some issues with employees having to provide the correct documentation to start a job in care, which led to delays for some applicants. For example, one employee who had moved to the UK could not work in care at first owing to delays in receiving her DBS^{[footnote 14]}, and consequently she had to get another job in a clothing factory whilst she waited. Similarly, another employee experienced delays in getting his DBS approved and also experienced difficulties in getting his references from his previous care employer back in Australia, which meant he was slightly delayed in starting his care jobs.

Many employees we spoke to thought that working in social care was undervalued by society in the UK. Some in the sample said that they therefore saw working in social care as a flexible and reliable temporary job or as a ‘stepping stone’ to other work in the UK job market, but not as a long-term career.

For example, one employee viewed his work in social care as a good job to have in the short-term, a flexible option to fit around his studies, and a useful supplementary salary to his wife’s higher wage. However, he explained that if his wife no longer brought in that salary, he might look for a better paid job elsewhere.

Another employee, who is soon to complete her Master’s degree, thought that someone with her qualifications should be capable of ‘more’ than entry level work in social care and wanted to progress to a more senior administrative role.

“It is a bit unfair for a Master’s degree student to be doing care door-to-door.” Employee, England

Finally, one employee described that working in social care acted as an opportunity to be active and meet people and understand the culture of the UK better, whilst also aligning with her Master’s degree topic. She explained that she did not want to remain in social care long-term, instead preferring to apply for jobs in public health or research when she graduates.

“There’s no career progression. I see some people who have been in the same role for 10 years. I’m applying for jobs in public health for when I graduate.” Employee, England

The strenuous and physical nature of care work was also a difficulty for many participants in the long term

The physical nature of the work was also commented on by various employees.

One employee described how she preferred to find work in supported living or in domiciliary care because she found residential care homes more demanding, as she was caring for people who were less mobile.

“You can literally see maybe 90% of them are not mobile, so you’ve got to do all the hoisting and move them around.” Employee, Northern Ireland

Another employee told us that he had gained more serious injuries from his work in care than his previous work in furniture removals, hurting his back and also tearing his meniscus.

“Reaching over, rolling people, helping people, I was actually getting more sore than I was working in removals, because you get used to picking up square objects and doing it with another person, and those objects don’t move whereas people move around and they’re awkward. I got two of my injuries, my back injury and my knee injury, from care rather than from removals.” Employee, England

Despite the physical nature of care work, a few employees felt that it was less strenuous or demanding than other work they had had.

One employee who had settled in Northern Ireland after moving from the EU, felt that care work was less strenuous than one of her previous jobs as a cleaner:

“The reason why I applied for the care sector is because I used to work as a cleaner. I was self-employed and I loved my job… But cleaning is demanding physically… I’m also trying to plan a bit for the future and I don’t want to do cleaning until I’m retired because I will not be able to physically.” Employee, Northern Ireland

Similarly, another employee said that it was a nice change from his previous job, where he ran his own business, and that he wanted a job that was less busy.

“To be honest, running a business is almost a 24-hour job, so my life back home was always busy. Coming here I decided that I didn’t want to do that again – I didn’t want to do something that would take me away from the house almost 24/7… I wanted a job that would not engage me as intensely.” Employee, Scotland

Despite finding care work physically strenuous, one employee explained that he was encouraging his father to work for the same care organisation because he felt that there were lots of jobs in care work for those with disabilities, such as being a driver, which he did not think were very physically demanding.

“You can do it until you’re old because there are so many different ways of doing it. I could just be scaling it back to just driving people around…there’s so much versatility…you really cannot push a chair, not lift a hoist, not touch a person in my sector. I’m even trying to encourage Dad to get into it. He’s 71 and has another 5, 10 years. The guy is walking 2 or 3 hours at a time – he can certainly do disability.” Employee, England

Staff shortages in organisations impacted some participants’ experience of their day-to-day work

Several employees in the sample mentioned that constant understaffing and the consequent pressure to cover more shifts was off-putting. One employee, for example, told us that the organisation she works for does not do enough to prevent staff shortages, even though they know in advance they will not have enough staff. She explained that she takes on extra shifts to fill the gaps due to their disorganisation.

“The rota-ing is rubbish. I rarely get two days off in a row. And it’s all so disorganised. They know they are going to be short-staffed but don’t organise agency staff quick enough.” Employee, Northern Ireland

Another employee cited similar staff shortages in residential care homes as another reason that she tries to avoid working shifts in residential care.

“Maybe it’s prevalent everywhere, but I realised that nursing homes are usually short staffed…I think in the long run it’s going to lead to poor services. People don’t show up, and maybe one or two people are left to manage first and second floor.” Employee, Northern Ireland

One employee had previously worked as a Deputy Manager and said that he found that he had had to cover a lot of shifts for those who might be sick or sometimes just did not turn up.

“There’s a lot of hustling, running around. If someone calls in ill, you have to cover it. There is also this expectation, which I think is generally true in care, that you will step in if needed if no one else is able to or willing to.” Employee, Scotland

He also found that local domestic workers were typically less able to cover shifts than live-in EU workers had been pre-Brexit, as EU workers had fewer ties and were consequently more flexible, whereas domestic workers (whatever their background) were not generally as able or as willing to cover weekends when they might have other commitments or wants.

“Young, live-in EU workers tend to be more flexible in terms of covering an odd hour that is uncovered because someone is off ill. This was much easier to arrange compared to having people living somewhere outside, having to drive because it’s very hard to get the bus here – there’s a bus stop two kilometres away. So because there are far fewer people who apply for those live-in positions, the whole organisation has had to reorganise itself and change how it is managed. So, there’s a bit of a struggle in that sense, because of the different demographics applying for the jobs and getting the jobs. These people live in the local area – perhaps they have families and many things to attend to so they are less flexible, they have some hours they can work and some they can’t work. For example, it’s very difficult to cover weekends in some of the houses because people don’t want to work weekends because they have children and so on.” Employee, Scotland

A few employees interviewed also cited poor treatment at the hands of their clients

Some employees in the sample spoke of occasions where employees received poor treatment at work. For example, one employee mentioned that she would sometimes receive abuse from those she cared for, getting threatened with calling the police and receiving insults from some of her clients with dementia.

“There’s nothing they don’t say. They tell you they will call the council, call the police to do this and you become threatened even at your own job, trying to save them.” Employee, England

Whilst such difficulty with some clients could be seen as a routine part of working in care, it was a part of the job that a small number of employees said that they had not been prepared for and found challenging.

Other employees mentioned mistreatment from other members of staff. Although she personally had not received abuse, one employee described noticing very poor attitudes towards her African colleagues from domestic workers who worked with her, saying that lots of the domestic staff unjustly viewed them as poorer workers and did not want to work with them. Whilst poor treatment from clients and colleagues might affect anyone working in the care sector, such anecdotes suggest that in some cases, poor treatment from colleagues might be more of a problem for migrant care workers than domestic workers.

Due to low pay, some employees in the sample were consequently moving out of care organisations or working multiple jobs to supplement their otherwise low wage

For some of those we spoke to, the fulfilling nature of working in social care could not sufficiently make up for the low pay. Low pay was cited as a factor in causing some employees to decide to leave the sector. Some employees in the sample were moving into agency care work or other industries on account of low pay, even where the nature of the work was less congenial.

“I love my job. I take so much satisfaction out of my job… (but) the salary doesn’t reflect the work that we do.” Employee, Scotland

“I wanted to leave my organisation. I read reviews of other care organisations and they all sounded terrible. I didn’t want to go out of the frying pan and into the fire… I ended up taking a job in a factory. It pays £11.50 an hour for the night shift. It’s boring, not fulfilling but it’s less stressful.” Employee, Northern Ireland

This was also the case for another employee who moved to the UK to complete her training in healthcare. She said she had chosen to work in care alongside her degree because it would give her an insight into UK culture – both generally and specifically within healthcare. She explained that she loved the care home where she worked and had great relationships with many of the residents, but that the strenuous work, lack of progression and low wages in particular were difficult and unappealing. She noted that they were always understaffed, and that she had to work extra hours, which was difficult because she was only meant to work 20 hours per week on her student visa. She was planning on leaving her job and getting work through one of the large agencies who pay more.

One employee who was planning on staying in care explained that he was working two care jobs and another teaching job to increase what would be an otherwise low annual wage. He also said that working in care in the UK was paid far less than it was back in Australia.

“Compared to working in care in Australia, it’s similar, but the wages are a fair bit lower.” Employee, England

Overall, these employees said that the fulfilment they got from working in social care could not sufficiently make up for the negative experiences, low pay, and perceived lack of status.

Question 6

Experiences of using sponsorship pre-Brexit

Accepted Answer

Most employers in the sample had not had experience of sponsoring employees before the introduction of the new route for migrant care workers

Most employers interviewed had not sponsored employees prior to the changes in legislation in February 2022 allowing care workers to come into the UK on the Skilled Worker route. In some cases, this seemed to be because employers were aware of sponsorship restrictions – they knew that they were not able to bring over entry level workers on the skilled worker route.

“You can’t bring care workers over on a visa. And I don’t want senior care workers because I can’t afford to pay more senior staff.” Employer, Scotland^{[footnote 15]}

However, in most cases employers in the sample had not used sponsorship because they were unfamiliar with the process. They described how they had assumed that the sponsorship process would be a hassle and therefore not worth their time, and so avoided thinking about it for as long as they felt they could. Sponsorship seemed to be considered as a last resort after all other domestic efforts had been exhausted.

“If you were setting up a whole new care home that would be fine…but for one or two new people, it might not be worth it.” Employer, Scotland focus group

“Two years ago, I would never have considered sponsoring employees… there’s a lot of red tape.” – Employer, Wales

Employers in the sample who felt they had exhausted domestic recruitment routes thought they might have to consider sponsorship in the future

Some employers described how they had focussed on domestic recruitment strategies before considering sponsorship, with varying success. Employers who had struggled to get enough applicants domestically said they felt they might have to try sponsorship. For example, one organisation said that they had been advertising on job websites but that they now felt they would have to turn to sponsorship.

“We don’t really have any other option [than to sponsor]. There are no staff available here.” Employer, Scotland

On the other hand, one English organisation in the sample said that they had also never considered international recruitment before the interview and described how they probably would not in the future. Unlike most organisations interviewed as part of the research, this employer said that the organisation had not seen a large increase in unfilled vacancies since Brexit, and therefore had not felt an immediate need to look overseas like some other employers. They had been investing in their domestic recruitment strategies to ensure that they were “up-to-date”, which was one of the reasons they believed that they were not struggling to recruit as much as other adult social care organisations.

“Our main way of recruitment now is Facebook… the world has changed you can’t just post on job board anymore… and Facebook has now got less users so we’re instinctively thinking about other recruitment strategies.” Employer, England

A small number of employers had sponsored employees in the past, but this was very rarely on a Skilled Worker visa

Most employers that we spoke to had never tried to sponsor employees from abroad prior to the changes to the visa system in February 2022 which now allows care workers to be brought to the UK on the Skilled Worker route. Instead, most employers in the sample described how they had been focussing on the domestic recruitment of UK nationals and foreign nationals with the right to work in the UK: they had recruited from those already in the local area, whatever their nationality.

However, a few employers in the sample had used the UK visa sponsorship system in the past to enable migrant care workers to work in their care organisations. These employers described using sponsorship to fill vacancies that they would struggle to sufficiently fill domestically.

The few employers in the sample who had used sponsorship in the past said they were generally looking to employ people into entry-level care work roles, and that they had therefore not used the Skilled Worker route before February 2022. These employers explained how they had used other routes which allowed them to bring over the entry level workers but on different terms to the Skilled Worker visa, such as the Tier 5 temporary work visa that allowed people to work in roles for a maximum of two years^{[footnote 16]}.

One employer interviewed in the research, whose organisation provides residential and day care to people with learning disabilities in several sites across the UK, had been using visas for the whole time she had been in the organisation. Recently they had only used the Tier 5 visa to fill some live-in care assistant vacancies.

“We’ve been using visas as an organisation forever…. We’ll tend to use sponsorship for the more niche roles, for example live-in care assistants, whereas for regular support worker roles, we’ll recruit them locally … We constantly advertise for the live-in roles because we’ve always got vacancies for them somewhere in the organisation… When the points-based migration system was set up in 2008, I was part of getting that settled, so I’ve been on the sponsorship licence since then in one capacity or another… over the last five years, we’ve basically been on the Tier 5 temporary charity worker route.^{[footnote 17]} That was the only one really that was open to us because we didn’t meet the skilled worker visa criteria… as a live-in volunteer role the Tier 5 was completely fine, but it didn’t do anything to meet the needs of our regular care and support worker vacancies” Employer, UK-wide

Similarly, a Northern Irish organisation had been using the Tier 5 visa for a few years, bringing over people from outside the EU to work as assistants to users living in their residential care provision, doing activities such as crafts and helping with meals. The employer described how this freed up care workers to focus on more care-related activities.

“We have been a Tier 5 sponsor for a few years now to bring across volunteers who help out with bits and pieces around our residential care home.” Employer, Northern Ireland

This employer explained that they had also been engaging volunteers from inside the EU via European Solidarity Core funding, but this had come to an end post-Brexit, which left them with far fewer volunteers.

Another employer that we spoke to had used the Skilled Worker visa to recruit nurses and senior care workers in the past. However, she was only sponsoring people who were already in the UK. She believed that sponsoring employees from abroad would involve additional work to recruit them and an increased amount of ongoing administration.

Some employers who had used the sponsorship system in the past had come into difficulties with their sponsorship licence

The employers who had used sponsorship in the past said that this was an important part of their recruitment strategies, allowing them to recruit employees who could fill vacancies that they would otherwise struggle to fill. However, some of these employers had also encountered difficulties in sponsoring employees in the past: with two employers having lost their licences in the past and one having had their licence put on hold. Whilst they said that they saw value in sponsoring employees, they nevertheless said they felt that the actual process of sponsorship had a high degree of friction and created additional work for the organisation, and that it was very easy to make mistakes.

The organisation that had had its licence put on hold had experienced these problems in 2018, when it was suspended while the company’s compliance was investigated. This led to a reshape of the organisation’s HR function and the way they managed sponsorship across the organisation. They felt they could not feasibly sponsor people and keep to the rules without having a centralised role that oversaw the processes, a resolution which would likely only be viable for the largest employers.

“In 2018 the organisation went through a lot of changes, including creating this job I’m in now, because we hadn’t kept to all of the compliance rules. There was an issue with our sponsorship licence which was suspended while UKVI (UK Visas and Immigration) had some questions. The best way to resolve that, we thought, was to just centralise it and really make it a specialised post in its own right.” Employer, UK-wide

We spoke to one employer who runs a domiciliary care agency in London. She also had difficulties with a sponsorship licence in the past, which she was using for volunteers. They lost their licence because they had failed to update their address when the company moved offices. She had also found the sponsor management system difficult to manage:

“One of my previous gripes when we lost our licence was around the whole ‘when you’re sponsoring you’re responsible for the worker’ … you can’t guarantee that somebody won’t abscond.” Employer, England

Another employer who runs a residential care company in England had previously lost his licence once, and nearly lost it a second time too.

“2016 was when we lost our licence. So we lost all our migrant workers. We literally lost a quarter of our workforce…2016 there was a mindset change in the Home Office that they wanted to reduce migration…and it wasn’t just with us, it was with hundreds of providers up and down the country. This is the biggest fear that I have: that they’re opening this route up because they have to, but when they want to tighten up, they can throw the smallest thing at you – ‘Yeah, you haven’t put a full stop on this, you haven’t crossed this T, you haven’t dotted this I’ – and literally just cancel your licence.” Employer, England focus group

This employer also told us that the types of mistakes that are penalised are sometimes not ones that the employer can avoid. He described the sponsorship management system as very rigid, and not allowing for any leeway that might occur because of cultural differences in naming or other similar issues.

“On passports, I’ve got people that don’t have a surname, and if you don’t put the surname in, it comes up with that red asterisk, so what do you do? You have to put in an underscore or something – people [employers attempting to use the system] won’t know that. And culturally, we all have a first name and a family name, but not everybody has that. Some cultures their first name is their family name, and their family name is their first name – you get that wrong, and the system is very unforgiving.” Employer, England focus group

He described how, in these situations, employers do not only lose their licence or certificate of sponsorship, but also the money they have invested in the certificate of sponsorship. He described how other providers he had worked with had made similar administrative slip-ups and had lost their money, their certificates of sponsorship, and had to go back and reapply if they wanted to try to sponsor any more employees successfully.

“The system is totally unforgiving for people who make mistakes. I deal with providers crying that they’ve spent a thousand pounds issuing a certain number of certificates, and they’ve got each and every one of them wrong – minor mistakes – and they can’t go back and correct them because once you’ve hit that button, they’ve paid their money, it’s gone. And they’ve used all five of their certificates of sponsorship and now they have to go back and apply for another five, which takes two weeks, four weeks, eight weeks, depending on how busy somebody is in the Home Office.” Employer, England focus group

Question 7

Attitudes toward sponsorship and migration in recruiting for adult social care (post-Brexit)

Accepted Answer

The research with employers aimed not only to establish current challenges in recruitment and retention, but also to test potential visa routes that might support the sector in tackling these challenges. This involved understanding employers’ attitudes towards the addition of care workers to the Skilled Worker route and a hypothetical unsponsored route which would allow young workers to come to the UK for a limited amount of time and take any job they wish (be that within or outside of adult social care).

It is worth noting that interviews with employers took place between late November 2021 and early March 2022. A small number took place before the MAC published their annual report (15th December 2021) and the announcement of care workers’ inclusion into the Skilled Worker visa (24th December 2021), which came into force in February 2022. The research team were able to go back to some of these employers and interview them again after February 2022, to see whether there were any shifts in their understanding of, attitudes towards and practice around the changes in policy.

Whilst awareness of changes in migration policy seemed to be limited amongst employers at the start of fieldwork, it seemed to generally increase as fieldwork progressed

In this changing landscape, many employers were unfamiliar with the details of the changes in policy and some employers were even unaware that any changes in regulation had taken place, after they had come into force in mid-February. However, as fieldwork progressed, awareness of the changes in policy increased. Several employers had attended online webinars led by the Home Office, social care workforce bodies or law firms and had already been thinking about what the Skilled Worker requirements would mean for them as an organisation.

Given the many difficulties that employers described experiencing in recruiting the full workforce they needed into their organisations, many said they welcomed the changes that would allow for more care workers to enter the workforce. Whilst most employers had never engaged with sponsorship in the past – be that due to having been able to better fill vacancies under Freedom of Movement in the past, restrictions of visa routes, or wariness around the logistics of the process, – several employers were now considering sponsorship or had already started the process. These employers felt that they had exhausted all other options and that the new route was therefore “worth a try”.

One organisation, for example, had been a tier 5 sponsor for a few years, and described how in June 2021 they had started the process to be able to sponsor on the Skilled Worker route too because they were struggling to find staff. Similarly, another employer in England told us that he was only now considering sponsorship as a last resort, due to the challenges of recruiting domestically.

“To be crystal clear, I’d rather not do it [sponsorship]. I’d much rather recruit people locally. But I can’t, because I can’t find any domestic workers, so we’ve now started the process.” Employer, England^{[footnote 18]}

However, lack of familiarity with the process meant that some employers were delaying getting started and not taking full advantage of the new route

Some employers described being tentative about sponsoring employees on the Skilled Worker visa for fear of getting things wrong

Despite increasing awareness as fieldwork progressed, many employers told us that they were still unclear on some of the logistical details of how they would go about sponsoring people. This meant that some employers, especially those in the sample who had not sponsored before, had concerns about getting things wrong.

There were also some employers who said they were tentative because they had faced difficulties in the past with sponsorship, as outlined earlier in this report. One employer in Northern Ireland had previously sponsored employees who were already in the UK on another visa. They said they had not previously sponsored employees directly from abroad because of the perceived risk and complexity of the process. They had however started considering sponsoring employees from abroad, as they felt that they were running out of other options, and they had 50 vacancies open at the time of the interview. Despite this need for alternative recruitment solutions, they said they still had concerns as the process seemed overwhelming:

“We haven’t employed anyone from outside the UK, we need to do that, but it’s just not happened to date… It hasn’t happened literally because I’m not sure what to do, because I’ve heard so many reports of there being so many tests, you need vaccines and you need all sorts of stuff… And it just seems like a complete minefield.” Employer, Northern Ireland

Other employers we spoke to shared this employer’s concern and also felt tentative about starting the sponsorship process. Some felt that the best way to mitigate this concern was to start slowly and ‘test’ the sponsorship process. These employers spoke about only bringing over a limited number of employees in the first year, and if the process felt feasible, would then potentially bring over more people in the following years.

Some employers in the sample described how they had made mistakes in the sponsorship process, or feared making mistakes, leading to further delays

A lack of familiarity with the sponsorship process also seemed to be leading to some employers making mistakes when trying to apply for either a sponsorship licence or a certificate of sponsorship. Some found it took time to complete the various stages involved. In many cases this was leading to delays, with employers having to redo parts of the process.

One employer had recently been trying to set her organisation up as a sponsor to bring workers over on the Skilled Worker visa for 6 months. She described how mistakes and technical issues in the process meant that in January 2022 she had not managed to start the sponsorship process for any employee:

“We applied for a licence in June 2021 and had huge problems logging in and seeing if we had done our application form correctly. We heard in September that we had done it wrong and then had to engage a solicitor to help us.” Employer, Northern Ireland

Others were also finding that the application process to become a sponsor was taking a lot of time. Some felt that very minor errors could set back the application process considerably.

“We applied back in October and are still going through the meat grinder of the Home Office application process – it’s painful.” Employer, England focus group

Some employers said that they were very worried about making similar mistakes and were particularly worried about the financial cost that this might incur, as mentioned previously. These employers were wary about investing money into the process of sponsorship and not getting this money back if their recruit was not granted the visa.

“And the fact that it could cost us a good few thousand if we get it wrong. We will still have to pay for the certificate of sponsorship. It’s very easy to make a mistake, and it’s very easy to make a costly mistake.” Employer, Northern Ireland

“This puts all the risk and the costs on us. If Government is serious, they should waive some fees or subsidise it somehow.” Employer, Scotland focus group

Based on employers’ current experiences with the Skilled Worker route, navigating both unfamiliarity with the system and delays in the process, it is likely that the 12-month time window could potentially have major implications on the utility of the route. Whilst the duration of care workers’ visas can be up to 5 years under this route, care worker applications are only eligible for the Health and Care Worker (H&CW) visa for 12 months from February 15, 2022 (although this could potentially be extended and the MAC have recommended it is). If this window for applications were only to be open for 12 months, it is likely that the adult social care sector would not see the full benefit of it, based on the current capability shown by employers in navigating the process. Currently, some employers in the sample said that they had either not yet received their sponsorship licences, or they were not confident in sponsoring large numbers of employees due to their lack of familiarity with the process. As a result, it is likely that employers will not make the most of this option within the current 12-month window.

Some employers were particularly concerned about having to monitor employees

On top of a lack of familiarity and awareness of what is involved in the sponsorship process, interviews with employers identified additional barriers to some employers using the new route for migrant care workers. One of these barriers was around the logistics of monitoring employees via the Sponsor Management System (SMS). In relation to social care work, employers are required to report changes of circumstances of their sponsored employees, such as change of address, salary, or withdrawal of sponsorship. Several said that they were worried that this would add a large logistical burden to their workload and might necessitate the hiring of additional members of staff to manage the administration. It is worth noting that this barrier to using the Skilled Worker route may to some extent be more of a perceived barrier, as the workload related to monitoring employees appears to be minimal in the guidance.

Nevertheless, some employers told us that this was a barrier for them and was making them wary about making use of the route. One employer, who was interviewed in December 2021, said that she was keen to use the new route for care workers but had not decided whether to use it yet. She had one last unanswered ‘question’ in her mind, which was around monitoring employees:

“The main difficulty that we find is that you have to closely monitor people each week. That takes a lot of work from our side… the monitoring is an extra cost… on top of the administration costs and taxes and fees of getting the visa you would probably have to employ someone in the office to do the monitoring.” Employer, England

When interviewed again in March 2022, her fears around monitoring employees had subsided enough for the organisation to choose to go ahead with sponsorship. This was partly because they had installed a new system to help track employee behaviour. However, she said that she was still wary of the administration that might be involved if they were to sponsor people in higher numbers in the future.

“I’m not so worried about it now…It’s still going to be a lot of work though because you have to monitor their hours. If it’s only for one or two people obviously that’s not major work but let’s say if we hire 50 people at once that would be a task on its own. But now we’ve got a different system which lets you flag certain things and would make it easier for us to monitor things. We’re trying to adapt ourselves.” Employer, England

This employer was not alone in her concerns around monitoring employees via the SMS, with other employers worried about the potential administrative burden and the ‘unknown’ aspect of the SMS system. Employers were under the impression that their administrative duties would be onerous:

“The principal concern is around all your existing paperwork and the inspection process because we’ve not done it before. So it’s whether we keep our records or have the appropriate wording in contracts and documents and stuff like that. That’s the bit where you need proper advice, which we need to get ourselves.” Employer, England

“There’s a lot we have to do. I read it in the guidance from the Home Office. We have to report the hours, if they stop working, if they leave before 2 years…it’s feasible but it would take a lot, on top of all the paperwork we have to do anyway.” Employer, Scotland

For the employers we spoke to, there were misinterpretations and doubts about the salary threshold required to make care workers eligible for the Skilled Worker visa

Some employers said they would not be able to meet the required salary threshold for care workers on the Skilled Worker route

One of the most significant barriers to using the new route for migrant care workers was pay. To meet the salary requirements of the route, employees need to receive a salary of at least £20,480 per year, based on a 39-hour week at £10.10 per hour. Care workers and senior care workers must work at least 39 hours per week at £10.10 per hour to meet the salary threshold. Employees who are paid more than £10.10 per hour can work less than 39 hours a week, provided that their annual salary meets a minimum of £20,480.

Some employers we spoke to said they believed they could not meet the salary threshold. These employers were paying less than £10.10 per hour for entry level roles – the roles for which they had most vacancies. Most of the employers we spoke to who were not meeting the £10.10 hourly rate said that they would struggle to make use of the Skilled Worker route for entry level care workers, at least in the short term. One organisation from the Northern Ireland focus group described how they had only just been able to give their employees a pay rise to £9.50 an hour.

Employers were often restricted in their flexibility to change wages due to tight funding budgets, and some said that they would not be able to increase the wages of their migrant care workers without having to increase the wages of their entire work force, which would not currently be possible for them.

“We couldn’t do that, no. We couldn’t do that without raising the wages for everyone.” Employer, England

“We pay workers £9.50 per hour…on a 40 hour week we would be £200 below the threshold…it’s not a million miles away. £200 across the year is going to be negligible… It’s probably possible [to increase the pay]… but we would have to change the pay of everybody so it’s unlikely to be of any help now. We review our pay every April, so potentially in April.” Employer, Northern Ireland

Other employers misunderstood the exact requirements of the salary threshold, and therefore incorrectly believed they could meet the threshold

Whilst some employers thought the annual salary threshold of £20,480 was just about achievable, in a lot of cases there was confusion about how employees were required to meet the salary threshold. Some employers incorrectly believed that they might be able to meet the salary requirement through increasing the number of hours employees work each week, whilst paying them less than £10.10 per hour: the pay floor for the visa. This meant that some employers who were considering sponsorship through this route would not in fact be able to do so.

“If staff did a 40-hour week, at £10.02, they would just about get over the salary threshold.” Employer, Scotland focus group

“This is what I’m not sure about… if we were to offer say 44 hours but pay the same amount, is that allowed?” Employer, Northern Ireland

Some employers told us that they would be able to meet the salary threshold

There were some cases in the sample where organisations had received an uplift in funding from their local authority which would enable them to pay £10.10. A few others told us that they were already offering higher wages to try and differentiate themselves from competitors. For example, an employer from Scotland was already offering his staff £10.50 an hour, and therefore the salary threshold was not a concern for him. Another Scottish employer, though holding a previously mistaken belief about the number of hours required, upon being informed of the correct requirements, thought they would be able to meet the threshold.

“I thought that they would have to earn £18k per year, not £20,480…But we pay £10.20 an hour and we would want them to work around 38 hours a week, so that wouldn’t be an issue for us.” Employer, Scotland

However, even those who said they were able to meet the threshold still had some concerns and misunderstanding regarding the requirements

For one employer with 10 sites across the UK, the salary requirements, and variation in what they pay staff based on location and local funding, meant that they felt they would only be able to sponsor people who would work in London or Scotland, which she saw as a limitation.

“From April we’ll be a real living wage employer. I don’t know care workers who get £10.10 per hour. The only exception we’ve got is London because the salaries are high there and Scotland because we’re being mandated to pay at a higher rate. So we’re only going to be able to get migrant care workers for London, Edinburgh and Inverness.” Employer, UK-wide

One employer had looked into sponsorship and had the perception that, based on a 38-hour week, they would have to pay £10.36 an hour to meet the threshold. The salary threshold they would actually have to meet for a 38 hour week is £10.37, and whilst this employer likely would have been able to meet this slight increase, it is another example of an employer being somewhat confused over the salary threshold.

“Now there’s been an uplift in funding we will just about be able to meet that £10.36.” Employer, Northern Ireland

Another employer expressed misgivings about the validity of the care worker inclusion, given that it meant that care workers and senior care workers would now be paid the same wage. They therefore felt that this undermined the utility of the route.

“They have the same salary threshold at £10.10 an hour for carers as well as senior carers. So why would we not recruit more senior people instead of junior people if the pay is the same?” Employer, England focus group

Some employers had concerns around the cost of sponsorship

Many employers indicated that the sponsorship fees felt expensive, but this appeared generally to be less of a barrier than the salary requirement. Some employers indicated that this was because, whilst possibly still considered to be expensive, sponsorship seemed to feel ‘worth it’ compared to the costs of agency staff they were using to fill staffing gaps:

“£536 [for a licence] is peanuts in the scheme of things compared to what we spend on agency staff. It’s not prohibitive.” Employer, Scotland focus group

“We pay agency staff £19/hr on weekdays and £22/hr on weekends. Getting staff from abroad would be cheaper in the long run. And also it’s about consistency of service and care. Even if it cost us, we would go this route.” Employer, Scotland

However, a small number of employers that we spoke to mentioned that costs might in some cases become prohibitive to their use of the visa route. One employer, for example, mentioned that they would have to cap the number of people they were bringing into the organisation via the Skilled Worker route for it to be viable for the company.

“The costs would become prohibitive if we were using it in big numbers… I’ve decided to start small and have requested 5 undefined certificates of sponsorship… I think we’ll probably finish under the 20 threshold.” Employer, UK-wide

Some employers were also wary of the additional ‘hidden’ costs in the sponsorship process, particularly those necessary to help set up an employee in the UK. These included the costs of accommodation, travel and the time spent helping migrant care workers adapt to life in the UK.

“That pastoral care is unquantifiable, and it is expensive.” Employer, England focus group

“We’re anticipating having to provide a car and accommodation for the first six months to get them on their feet.” Employer, England focus group

“Aren’t there additional costs like the health surcharge and TB screening that we would need to cover [outside of the licence, certificate of sponsorship and immigration skills charge]?” Employer, Northern Ireland focus group

“There are also the hidden costs, like inducting them, cultural difference training, accommodation.” Employer, Scotland focus group

Finally, there was some concern around how to recruit in other countries. Most employers had no experience of having done this and said that they were unsure of the costs involved, or how long this process would take. Some expressed fears that they risked spending money on international recruitment agencies and then would not be able to bring people over to the UK within the year deadline.

“We would have to contract an agency in West Africa to help recruit too so that’s also extra money. I’m not sure how much it would be.” Employer, Scotland

Some in the sample were concerned about whether sponsorship would pay off if staff left the organisation soon after arriving in the UK

Some employers were concerned about the possibility that other organisations might ‘poach’ the staff that they had sponsored (by sponsoring them on another licence) which would mean losing all the time, effort, and money that they had put into the sponsorship process. Some said that other organisations who were able to raise their wages would do so because of similar staff shortages, and that there was therefore a risk that sponsored employees might be incentivised to move to those organisations as a result.

“I go through all this rigour, and then the NHS can pay more. It’s the elephant against the mouse. We can’t change that.” Employer, Scotland

“If the employee can find another employer who is willing to take on their sponsorship then they could move. And I have no doubt the Trusts would do that because…they’re in the same situation as us, critically understaffed.” Employer, Northern Ireland

“If the possibility is that they can go to another sponsor, and you don’t get that money back, then obviously that is a massive risk.” Employer, England focus group

One employer in England had already had experience of losing a migrant care worker to another organisation, which made them wary about investing time and money again.

“We’ve lost one migrant worker to another sponsor already within three months.” Employer, England focus group

There were some questions around care workers only being eligible to come over on the Skilled Worker route for a year

Some employers did not understand why the route would only be open for one year. Generally, those who were considering sponsorship were not completely put off by this, but some expressed fears that the time limit could greatly impede progress with recruitment. As seen above, employers were tentative around using the route and were likely to use the first year as a ‘trial’ and not sponsor as many people – if the route were to close after a year, they indicated that they did not think they would have made full use of it.

“I worry about the permanence. How long is this going to last? Are they likely to change their minds at the last minute and suddenly extend it or stop it? If I’m going to be investing in it and relying on that, will the government pull the rug out from under my feet?” Employer, England

Some employers we spoke to said that they were unsure whether the costs of sponsorship would pay off if they did not have enough time to recruit multiple workers. For example, some employers had started applying for their licence but had already been waiting long periods of time to receive the licence. It was also argued that the actual act of recruitment and creating networks takes time and might not be fully formed within the space of a year. Consequently, there were concerns around how many employees they would feasibly be able to recruit in the space of a year.

“It can take 3 months to recruit someone even in the UK, so it would take even longer to recruit from abroad.” Employer, Scotland focus group

Similarly, a couple of employers mentioned that before the ending of Freedom of Movement they had established channels of recruitment via word of mouth and organisational links, but that Brexit had disrupted this. These employers explained how these networks had generally taken time to build up and that it would take a while for them to rebuild them.

For example, before Brexit, one organisation had established connections with schools in Germany and Denmark and had a steady stream of people connected to the schools who would come into the organisation. Whilst connections with these schools still existed at the time of the interview, the employer we spoke to said that he was aware that it would take a while to re-establish them as recruitment channels.

“A lot of our recruitment is by word of mouth… For example, you get a lot of people from Denmark working here, and next thing you know their siblings had applied or their cousin had applied or someone from their school in the year below had applied… People tell their friends about their experience and then we get other applications. The chain of formal communication has now been broken…. We’re going to have to work to pick it back up… It might take a year to build up again, by which time the scheme [care worker eligibility for the Skilled Worker route] will have closed.” Employer, Scotland

Employers in the sample generally reacted positively to the hypothetical proposition of an unsponsored route

As part of the interviews, we tested a hypothetical un-sponsored route similar to the Youth Mobility Scheme. We set several hypothetical conditions around age, nationality, and duration as part of this in order to stimulate discussion and response, and to tease out the factors of greatest importance to those interviewed. The main feature of the hypothetical scheme was that it was unsponsored: employers would not have to sponsor workers, but the workers would apply for this themselves. They would be allowed to come into the UK for a limited period of two years, and work in whichever sector they liked. The other criteria of this hypothetical scheme were that it was restricted to those aged between 18 and 30 years old, and to people from a certain number of countries, principally from the EU.

Several of the employers we spoke to said that the idea of not having to sponsor employees, avoiding the administration and fees that come with this, was particularly attractive.

One employer, for example, liked the idea of having a route without the administrative friction that she had experienced using sponsored visa routes:

“I imagine there wouldn’t be the same level of admin required of us. For the Tier 5 route, there’s quite a lot of administrative work involved and hoops to jump through.” Employer, Northern Ireland

The route was especially well received by employers whose recruitment had been made particularly difficult by the ending of free movement. This was especially the case for employers who had relied on EU volunteers to help take some of the work burden off their paid care staff and had less flexibility in their budget to sponsor volunteers.

There were a range of responses to the hypothetical visa’s age restriction of 18 to 30 years old. Some employers said that they did not understand why there should be a restriction in age. Whilst some employers were keen to recruit a younger cohort of workers as they felt that their UK workforce was aging, others described how older people were preferable as they felt they could be more ‘caring’ or have more respect for clients.

“I would have questions about the under 30 restriction…it’s a generalisation, but in general older employees have more respect and care.” Employer, Northern Ireland

One employer said they were worried that younger, more transient workers might only stay in the sector for a couple of months, and so the visa route would not effectively solve the issue of recruitment and retention.

“I can’t understand the age range 18 to 30 – why 18 to 30? 18 to 30 year olds tend to be a bit more fluid in where they work, what they do, where they go.” Employer, England focus group

Another employer of a small site in Scotland which had high retention, thought that the two-year limit was not sufficient and would not suit her organisation’s business model.

“It takes a year to train people up properly in the first place and build their confidence… our workers tend to stay for at least 4 years, so it would be a restriction for us.” Employer, Scotland

Some employers that we spoke to also raised the concern that, whilst the hypothetical route would add people to the ‘recruitment pool’ in the UK, there would be nothing stopping those employees either coming to work in sectors other than social care or leaving to work in another sector once in the UK. It was therefore seen as an option that would not necessarily tackle the current recruitment issues in adult social care head-on. Nevertheless, the option was generally still welcomed and seen as ‘better than nothing’.

“I think probably it would be a helpful addition. But I think it’s probably going to be marginal because I don’t know how many people would actually want to come and work in care for two years. It feels like people would more likely do hospitality, that sort of thing.” Employer, Scotland

Question 8

Conclusion

Accepted Answer

Most employers spoken to reported having struggled with recruitment

A primary aim of this report was to understand the impact of the ending of Freedom of Movement on the adult social care sector. Unsurprisingly, almost all employers consulted as part of this work had been struggling in recent years to recruit the full workforce they needed. Many described having experienced these challenges for a few years, even before Brexit, with growing competition within the workforce against other better paid and less demanding sectors.

Many employers in the sample believed, however, that the ending of Freedom of Movement in January 2021 had exacerbated challenges in recruitment, with the sharp reduction in the pool of potential candidates in the UK having had both direct and indirect impacts on the sector. Not only had most organisations in the sample reported a significant drop in applications from EU citizens (often described as a vital workforce stream), some employers believed that the reduction in the potential UK workforce had also created significant demand in other sectors. These other sectors appeared to have more flexibility to adjust salaries and attract candidates away from adult social care. Indeed, several migrant care workers in the sample described the draw of other sectors, such as hospitality and healthcare.

Many of the migrant care workers interviewed had been attracted to the sector as they perceived it as being easy to move into, given the high demand for workers and a lack of requirements for specialised qualifications. Employees described the draw of the flexibility that the sector could provide, the offer of zero-hour contracts, and the ability to choose shifts.

There was some anecdotal evidence that this appetite to work in adult social care in some cases existed before migrant care workers had moved to the UK. Some in the sample spoke of being informed of the high demand for work in the British adult social care sector before moving to the UK, and that it would be a good job to have if they wanted to start work immediately. Until recently however, it had been impossible for any of these employees to come over on Skilled Worker route. They had come over via other means, such as dependant and student visas.

However, most employees did not see themselves working in the sector long-term. For those we spoke to, care work was seen as a ‘stepping stone’ for a period of their lives when they were in particular need of flexible work, or whilst they were building skills that would allow them to move into higher paid work. Many employees in the sample, particularly those who were younger, did not imagine that they would stay in the sector for more than a couple of years, suggesting that the impact of the ending of Freedom of Movement has not yet been fully felt. Whilst some employees in the last cohort of migrants that came over before the ending of Freedom of Movement might still be in the sector now, this may not necessarily be the case in two years’ time.

Some employers in the sample thought that the addition of care workers to the Skilled Worker route might help them in their recruitment efforts, but the hourly salary appeared to present a challenge for some

There is a clear need to increase the pool of potential candidates who might work in the UK adult social care sector. An additional objective of this research was to probe around this challenge and gather thoughts about potential future visa options for migrant care workers.

During fieldwork for this project the UK government attempted to aid the process of widening the potential social care workforce in the UK via changes to migration policy. In February 2022, it took the significant step of making it possible for care workers to come to the UK on a Skilled Worker visa.

This attempt to support the sector via migration policy was supported by many employers in the sample. Several were considering engaging in sponsorship and some said they had actually started the process of applying for a licence at the time of interview. However, several other employers interviewed said they were not going to be able to make use of the route, at least in the short term. They saw the biggest barrier as being the salary requirement – whilst the annual threshold felt just about achievable for some employers, many were paying less than the minimum hourly rate of £10.10. With tight funding from local authorities, some employers in the sample felt they would not have the flexibility to improve wages in the short to medium term.

A lack of flexibility in funding meant that the direct and indirect costs attached with sponsorship were also seen as a barrier by some employers in the sample. Whilst some employers said that the sponsorship costs would be smaller than those they were currently paying in order to hire agency staff, for others the sponsorship costs seemed prohibitive, and would restrict the number of people they could sponsor.

Some employers said they found the option of a hypothetical route, similar to a youth mobility scheme, attractive, as it would remove the barriers of cost and salary requirements posed by the Skilled Worker route. However, this hypothetical option was not necessarily seen as a better option than the Skilled Worker route by everyone, as many felt it would not directly tackle adult social care’s specific recruitment issues - it would simply widen the general pool of workers in the UK, with employers still having to compete against other sectors.

It is likely that the full benefit of the new route for migrant care workers will not be felt if it is only available for a year

A common theme across the interviews conducted with employers who were considering the new visa route for migrant care workers was concern about delays. Some employers who had pre-established overseas recruitment routes before Brexit said they thought it would take time to re-establish them, as they had often been built on a chain of word of mouth. Those employers who had never directly recruited overseas were often unsure of how to do so and explained they would need time to research the options to them.

Some employers who had started the process of sponsorship described having experienced additional delays in the process itself. Some of the employers who were unfamiliar with the process described having made mistakes or needing time to understand the mechanics of the process. No employers that we spoke to had managed to bring over care workers on the route yet, despite having started the process, though this is likely to be due to the timing of fieldwork.

Several employers who were thinking about engaging with sponsorship said they were delaying their full use of the route on purpose. For these employers, sponsorship was a new process and needed to be ‘tested’. Fears of getting things wrong and not being sure whether sponsorship would financially pay off meant that many employers were choosing to only bring a small number of employees over on the route in the first year. They explained that they might bring over more people in the future if it felt worth it.

The full benefits of the addition of care workers to the Skilled Worker route are likely to only be felt if the route is available for several years. Many of the employers in this sample felt they would need at least a year to master and trust the process.

Question 9

Annex 1: Sample, methodology and consent

Accepted Answer

Methodology

The research used a qualitative approach to explore nuance in experiences and attitudes

The approach taken for this project was qualitative. Semi-structured interviews and focus groups were used to support and develop other research carried out by the MAC for the commission, such as their online Call for Evidence.

The qualitative approach to the research allowed the research team to get beyond basic answers, bring out nuances in participants’ attitudes towards the state of adult social care and analyse the prospect of using sponsorship to overcome recruitment challenges in the sector.

As fieldwork progressed, interviews were also used as a space to test thoughts around the MAC’s recommendation to add care workers to the Skilled Worker route, which the government accepted in December 2021 and which came into force on 15th February 2022.

Researchers also gathered thoughts on a hypothetical unsponsored visa route which, similarly to a Youth Mobility Visa^{[footnote 19]}, would allow young workers to come to the UK for a limited amount of time and take any job they wish (be that within or outside of adult social care)^{[footnote 20]}.

The research team consulted employers and migrant care workers through remote focus groups and one-to-one semi-structured interviews over video call

27 employers^{[footnote 21]} and 14 migrant care workers^{[footnote 22]} participated in this research. Fieldwork comprised:

Three online focus groups with employers in social care – Each group comprised two to four participants from the same nation. Focus groups covered the three nations of Scotland, England and Northern Ireland. Welsh participants were consulted via one-to one interviews only, as participants’ schedules could not be aligned for a focus group. Focus groups were led by a researcher who directed the topics of conversation using a semi-structured topic guide (see Annex 2). The groups enabled participants to highlight challenges specific to their nation and gave researchers the opportunity to draw out comparisons in experience between participants.
18 online semi-structured interviews with employers – Remote, one-to-one, semi-structured interviews were conducted with employers from UK-based adult social care organisations, spread across England, Scotland, Northern Ireland, and Wales (see ‘Sample’ below for full break down). Researchers used a semi-structured interview guide (see Annex 3) to gain an in-depth understanding of the employers’ organisations and their recent experiences of recruitment and retention. Semi-structured interviews were also used to test and explore employers’ attitudes to the addition of care workers to the Skilled Worker route, introduced in February 2022, and a hypothetical unsponsored route similar to the youth mobility scheme.
Three online follow-up interviews with employers – Follow-up interviews were conducted with three employers. These interviews were used to capture changes in behaviour and attitude towards the use of sponsorship in recruiting migrant care workers and were particularly useful as visa options changed over the course of fieldwork, with the new route for migrant care workers being introduced in February 2022. Follow-up interviews allowed the research team to go back to some of the initial participants and assess the extent to which changes in policy had or would affect their recruitment strategies.
14 online semi-structured interviews with migrant care workers – semi-structured, one-to-one interviews were conducted with migrant care workers spread across England, Scotland, Northern Ireland, and Wales (see ‘Sample’ below for full break down). Researchers aimed to find out more about recent experiences of moving to the UK, and understand the experience of applying for jobs in social care and working in the sector. The research team also used these interviews to assess the potential future value and viability of a new visa route for care workers from the perspective of employees.

In normal circumstances fieldwork for the research would have been conducted face-to-face. However, due to restrictions around COVID-19, interviews and focus groups were conducted remotely using video conference platforms (such as Zoom and MS Teams). Whilst online interviews have some limitations, for example in terms of rapport-building, in this instance they allowed the research team to cover a wider geographical spread more easily.

Focus groups lasted 60 to 90 minutes and semi-structured interviews lasted 45 to 60 minutes, depending on participants’ availability.

Focus groups and interviews followed a discussion guide (see Annex 2, 3 and 4), developed collaboratively between Revealing Reality and the MAC. These were used flexibly by researchers, who probed areas of interest, but also responded to relevant issues raised by the participants and were to some extent led by these issues.

Employer interviews and focus groups covered topics such as:

Background and needs of the organisation, particularly in relation to workforce makeup
Recent experiences and challenges in the recruitment and retention of staff
Specific challenges faced since the ending of Freedom of Movement
Attitudes towards the addition of care workers to the Skilled Worker route and towards a hypothetical unsponsored route, and the feasibility of using each option

Migrant care worker interviews covered topics such as:

Motivations for moving to the UK and experiences of migration
Motivations for moving into the adult social care sector
Attitudes toward working in the adult social care sector
Future intentions, including whether they plan to stay in adult social care and whether they plan to stay in the UK

The full discussion guides can be seen at Annex 2, 3 and 4.

Where possible, the research team mitigated against the impact of the ‘researcher effect’

Researchers did not always share the same background or personal characteristics as the participants they interviewed. The team were aware that these differences could impact what participants shared and how the information was analysed. The team sought to mitigate against the impact this could have on findings by being aware of these limitations and how they might affect the interview discourse and making every effort to remain objective in analysis.

Recruitment and Sample

Several methods were used to recruit participants for the research.

The MAC first liaised with social care workforce bodies across the UK^{[footnote 23]}. The social care workforce bodies sent out an introductory email to a selection of its members, which was filtered on population data. The email explained the nature of the project and the MAC’s objectives and directed interested parties to directly contact Revealing Reality at a dedicated email inbox.

Revealing Reality consulted some people within the project who had already taken part in the MAC’s Call for Evidence, and who had given permission to be recontacted for further research by the MAC or its research contractors. The MAC transferred these contact details to Revealing Reality using an encrypted connection on secure, password-protected spreadsheets with time-limited deletion dates. Revealing Reality directly contacted those in the spreadsheet who matched the sample, outlining the research process and interview topics that would be covered.

To find participants for some of the harder-to-reach parts of the sample, Revealing Reality contracted paid free-find recruitment agencies, who used a variety of methods, for example using market research agency databases. Agencies introduced the project to participants and securely transferred their contact details to Revealing Reality.

Revealing Reality conducted pre-interview screening calls with everyone who registered interest and was relevant for the project and interviewed the participants who best fitted the sample criteria, as outlined below.

A diverse range of employers and migrant care workers were consulted for the research

The sample aimed to capture a diversity of background and experiences. The research team spoke to employers and employees from a range of different adult social care organisations, which varied in terms of size, type of care provided, and location.

The care workers who were interviewed represented a spread of country of origin, location of residence in the UK, type of organisation worked in, and visa route into the UK. Most care workers interviewed had been in the UK for a short amount of time (most for less than 3 years). Recent experience of coming to the UK and moving into the sector allowed the team to understand experience of employees who were less settled in the UK, and for whom recent events such as COVID-19 and the ending of Freedom of Movement were likely to have a larger bearing on their future plans.

The research team aimed to interview a spread of employers and migrant care workers across the four nations

The original sampling criteria for the research looked for employers and migrant care workers from a range of backgrounds and a spread of locations across the UK.

Some challenges were experienced during recruitment. These included low response rates, participants being unable to give up time to take part in the research, and inability to align busy schedules of employers. Revealing Reality worked around these as far as possible, for example by conducting semi-structured interviews rather than focus groups. A full breakdown of the final sample can be found below.

Final sample break down

Employer focus groups:

Category	Sample specification (15-18 participants)	Sample achieved (9 participants)
Location	5-6 x Scotland 5-6 x England 2-3 x Northern Ireland 2-3 x Wales	2 x Scotland 3 x England 4 x Northern Ireland
Size of org	Aim for spread	Scotland (2 medium) England (3 medium) Northern Ireland (1 small, 2 medium, 1 large) ^{[footnote 24]}
Type of care provided	Aim for spread	Scotland (1 residential, 1 domiciliary) England (2 residential, 1 domiciliary) Northern Ireland (2 residential, 1 domiciliary, 1 both)

Employer interviews:

Category	Sample specification (16 participants)	Sample achieved (18 participants)
Location	4-5 x Scotland 4-5 x England 2-3 x Northern Ireland 2-3 x Wales	4 x Scotland 11 x England 1 x Northern Ireland 2 x Wales
Size of org	Aim for spread	Scotland (1 small, 1 medium, 1 large, 1 N/A)^{[footnote 25]} England (1 small, 3 medium, 7 large) Northern Ireland (1 large) Wales (1 small, 1 medium)
Type of care provided	Aim for spread	Scotland (1 residential, 2 domiciliary, 1 mixed) England (3 residential, 6 domiciliary, 1 mixed) Northern Ireland (1 residential) Wales (2 domiciliary)

Employee interviews:

Category	Sample specification (25 participants)	Sample achieved (14 participants)
Location in UK	Scotland x 5 England x 10 Northern Ireland x 5 Wales x 5	Scotland x 3 England x 5 Northern Ireland x 5 Wales x 1
Country of origin	EU x 15 Non-EEA x 10	EU x 4 Non-EEA x 10 (spread of nationalities including Nigeria, Australia, France, India, Poland, and others)
Job role	Care worker x 15-20 Senior care worker x 5-10	Care worker x 13 Senior care worker x 1
Ethnicity	Aim for spread	Black African x 7 Asian Indian x 1 White x 6
Gender	Aim for spread	9 Female 5 Male
Age	Aim for spread	20-29 x 3 30-39 x 7 40-49 x 3 50-59 x 1
Visa Route into UK	Aim for spread	Student x 5 EU x 4 Dependant x 3 Ancestral x 1 Right of abode x 1
Type of care	Aim for spread	Residential x 7 Domiciliary x 5 Both x 1 Agency x 1

Revealing Reality explained the nature of the research and the consent and anonymity processes with all participants at the pre-interview screening call. Respondents were given the opportunity to ask questions and outline any concerns they may have. This information was repeated at the outset of each interview, where ongoing consent was gained to proceed. Following the interview, Revealing Reality sent each respondent a consent form and information sheet about the project outlining the data protection processes, which respondents returned electronically.

Anonymity and confidentiality are important in the reporting of this work. Throughout the report we have taken a standardised approach to ensuring respondents are non-identifiable. No names are used in the report. In addition, we have provided minimal details on who each person is, limiting information to their role and/or sector of work. Where possible, specific respondent details have been removed or aggregated. In some instances, we have changed some small details to provide further anonymity, including aspects about the person such as their gender, age, role, and exact location.

Question 10

Annex 2: Employer Group Discussion Guide

Accepted Answer

MAC Social Care

Aims & objectives

To understand current practice and issues with recruitment and retainment of staff in adult social care
To understand employers’ perspectives on how current practice and experience of recruitment and retainment has been impacted by the end of Freedom of Movement
To understand employers’ perspectives on the importance of international recruitment to adult social care

Overview/Interview Flow

Section	Objective
Introductions (15 mins)	Build rapport Briefly establish the context, role, and responsibilities of each participant
Awareness of factors affecting social care (20 mins)	Understand awareness of recent changes to immigration rules/ ending of Freedom of Movement, amongst other factors which have impacted social care in the last few years
Attraction and recruitment (20 mins)	Understand who have they looked to recruit in the past vs now Understand how they have tried to attract employees to apply, including what the key challenges have been in the process and how they’ve changed over time Understand what is involved in recruiting employees (international vs UK national) and how this has changed over time
Retention (20 mins)	Understand strategies for retention, and how these have changed over time Understand challenges to retention and how these have changed over time
Looking ahead (10 mins)	Understand who are they intending on trying to recruit/retain in the future? Understand what challenges will exist beyond COVID-19, and immigration’s place within this. Understand what strategies they will have to put in place to recruit UK national vs International workers

Introductions (15 mins)

Build rapport; Briefly establish the context, role, and responsibilities of each participant

Introduction:

Hello everyone. Thank you so much for taking the time to speak to us. Before we all introduce ourselves to each other, we’ll quickly run through the aims and the format of the session.

I’m X and I work as a researcher at Revealing Reality. We’ve been commissioned by the MAC for this project to explore employer and employee experiences of working and recruiting in the adult social care sector, in particular understanding how the recent end of Freedom of Movement has affected the social care sector. Findings from the interviews will be used to help the MAC evaluate areas for possible change.
This session is an opportunity for us to get an overview of your perspectives as employers in the sector. We’ll be asking you draw on your experiences and discuss the priorities and challenges faced by the sector.
It’s important to remember that there are no right or wrong answers. We’re aware that people may have different responsibilities and levels of understanding of some of the things we’ll be talking about in the group – this is not a test, and all answers/opinions are valid!
You don’t have to answer anything you don’t want to. Whilst understanding personal experiences related to your specific organisations might be helpful, we’re aware that some may not want to go into detail about their own organisation, which is absolutely fine. Feel free to make broader reflections about the broader social care sector as you’ve experienced it. That said, we hope to create a trusting, honest atmosphere where we see each other as collaborators, not competitors. The aim of this session is to gather reflections and workshop idea that can benefit the sector as a whole.
The session will last 1.5 hours.
We want the session to be conversational and for everyone to have their say. If there is something being said that you don’t agree with, please chip in and challenge
Everything you say during this session will be anonymised. None of the information you give us will affect your dealings with either the Home Office or your organisation.
The session is going to be recorded. This is in order to make an anonymised transcript, which with your consent will be passed onto the MAC.
At the end of the session we will be sending you a consent form and an information sheet.
Any questions?

1. Tell us a bit about yourself and your work.

Probe: Name, location, role, length of time in the adult social care sector
Tell us a bit about your organisation
Probe: Type of organisation, size of organisation, care provided

Understand awareness of recent changes to immigration rules/ ending of Freedom of Movement, amongst other factors which have impacted social care in the last few years.

2. What do you think are the biggest factors which have affected your organisation in the last couple of years? Let’s take two minutes to each have a think.

Get respondents to list factors and input into stimulus flashcards (Slide 2)

Why do you say this?
How have they affected your organisation?

Show additional pre-made flash cards (Slide 2)

What do you know about these factors?
Probe for flash cards on immigration: How important is international labour for your workforce?
How would you rank these factors in terms of the largest impact on your organisation and workforce? (Get respondents to order cards on stimulus scale- Slide 3)
Why did you put them in this order?
To what extent do you think this is the same for the wider social care sector in your region? (Get respondents to reorder cards - Slide 4)
Why did you put them in this order?
How do you think each of these factors have affected other sectors in comparison?

We’re particularly interested in the role of immigration and the ending of Freedom of Movement in relation to the sector. Of course, as we have seen, there are several factors which have affected the sector in the last year. Let’s try to unpick these factor where we can for the rest of the interview.

Attraction and recruitment (20 mins)

Understand who have they looked to recruit in the past vs now
Understand how they have tried to attract employees to apply, including what the key challenges have been in the process and how they’ve changed over time
Understand what is involved in recruiting employees (international vs UK national) and how this has changed over time

3. How easy or difficult is it to get the right workforce at the moment?

How does this compare to a year/two years ago?

4. How easy/difficult is it to attract workers into the sector now?

Who are you trying to attract? Probe: qualifications, experiences, skill set
What proportion of your workforce have qualifications above/below the minimum requirements?
How do you try to attract them?
What do you need to offer?
[Probe] pay and progression
To what extent does the offer differ depending on international/UK national employees?
To what extent can you vary the terms of your offer based on the applicant?
[Probe] experience, qualifications
How does what you do to attract employees compare to a year/two years ago?
To what extent do you attract the right people for the job?
What are the challenges in attracting the right employees?
To what extent are you competing with other sectors?
What is the impact of these challenges on your organisation?

5. To what extent has the ending of Freedom of Movement impacted your ability to attract the right people?

6. What is the recruitment process once people have expressed interest in working in your organisation?

How does this compare for UK national vs international applicants?
What are the main routes that you use for international workers?
How does the process change depending on the route?
Do you sponsor workers? What does this process involve?
To what extent has the process of getting employees into the organisation changed over the last one/two years?
What are the key challenges in getting people into the organisation?
How has this changed over time?

Retention (20 mins)

Understand strategies for retention, and how these have changed over time; Understand challenges to retention and how these have changed over time

7. What are they main challenges in retaining staff in your organisation? Let’s take two minutes to have a think of ideas

Get respondent to list out challenges on stimulus – slide 6

Why do you say this?
How long do employees tend to stay in your organisation?
To what extent does vary between roles?
Why do you think this is?
How has the scale of turnover in your organisation changed over time? [Probe: Compare 1/2/5 years ago]
How do these challenges compare to the challenges you faced one/ two years ago?
To what extent are you competing with other sectors?
Which sectors?
How does this compare to a year/ two years ago?

8. What do you think might encourage employees to stay longer?

Probe: pay, training and opportunities, hours
Have you made any changes to your retention strategy in response to recent changes?
Probe: COVID-19, new immigration system, [any other challenges they have mentioned]
What do you think could eb done to make retention easier?

Looking ahead (15 mins)

Understand who they are intending on trying to recruit/retain in the future?; Understand what challenges will exist beyond COVID-19, and immigration’s place within this; Understand what strategies will they have to put in place to recruit UK national vs International workers

9. What are your recruitment and retention plans for the future?

Do you see there being any changes in who you recruit?
Probe: UK/ international; different roles
Do you see there being any changes in how you recruit British/international workers?

10. Do you envision your recruitment challenges changing in the future (for better or worse)?

Probe: shortages? Recruitment? Retainment? International versus domestic labour
Are you taking/planning to take any actions that might mitigate against current and expected future challenges?
- Probe: Changes to job offer, redesigning jobs
To what extent do you expect the future increase in the national minimum wage will impact you organisation?
- Probe: Expected implications on recruitment, retention, the wider organisation
- How easy or difficult will it be for your organisation to meet this new minimum?

New visa route

1. Changes have recently been made to allow care workers to come to the UK on a Skilled Worker visa.

To what extent would you make use of this visa?
To what extent do you think you could support workers to settle in the UK after 5 years of being on the Skilled Worker Visa?
- Probe: Feasibility around necessary pay progression over the 5 years.

2. Have you considered sponsoring employee’s visas?

Probe on which of the sponsorship requirements would be most/ least likely to put them off the route.

3. What is your understanding of your requirements as an employer to be able to sponsor employees?

Do you know if there are any requirements that the candidate must fulfil?

Employee requirements

B1 English language requirement

How would you feel about having to find potential workers who fulfil this requirement?

What English level do you think it’s necessary for potential employees to have, if any?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

Employee must have a salary of at least £20,480 per year (equates to approx. £10.10 per hour).

This means it’s likely the job would need to be full time.

How would you feel about having to pay potential workers this amount?

How feasible is this for you? Why / why not?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What salary level would be feasible for you to pay?

How would you feel about having to employee new migrant care workers full time?

How feasible is this for you?

Employer requirements

The application process takes approx. 8 weeks.

Note to researcher -You’re usually a small sponsor if at least 2 of the following apply:

Your annual turnover is £10.2 million or less

Your total assets are worth £5.1 million or less

You have 50 employees or fewer

How would you feel about having to pay this amount?

How feasible is this for your organisation? Why / why not?

How would you feel about the sponsor application process taking 8 weeks?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee/ time period would be feasible for your organisation?

Potentially pay £199 per worker for a Certificate of Sponsorship.

Which countries would you be looking to recruit workers from?

How would you feel about having to pay for a Certificate of Sponsorship?

How feasible is this for you? Why / why not?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee would be feasible for your organisation? What if it was £100? What if it was £300?

Immigration Skills Charge per worker:

Small sponsors - £364 for first year, £182 for each subsequent 6 months;

Large sponsors - £1000 first year, £500 each subsequent 6 months

The cost of the COS and Immigration Skills Charge for each workers who stay in the UK for 5 years would equate to roughly £5,000 for medium/large employers and £2,000 for small ones.

How would you feel about having to pay for a Certificate of Sponsorship?

How feasible is this for you? Why / why not?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee would be feasible for your organisation? What if it was £XX?

Compliance checks may be carried out by the Home Office.

How would you feel about having to track and record employee’s attendance?

How feasible is this for you? How much time do you think it would take?

How do you feel about being subject to compliance checks?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

Other considerations

The new visa route for care workers (as opposed to only senior care workers) is only due to be open for 12 months, but workers who come to the UK during this time can stay as long as they want and settle.

Does the fact that the government has said the route will be open for 12 months affect your thinking about how/whether to use the route?

How effectively would this help you to recruit new workers?

What about if the route was open for 18 months? 3 years? Indefinitely? Would this change how/whether you use this route?

4. Thinking about all these considerations, how would you feel about using this visa route?

Which would be the biggest barriers for you?
What would enable you to use this route?

5. Another hypothetical option would be for there to be an unsponsored visa route, i.e. you would not have to sponsor a worker to come to the UK and workers would be able to take any job, in or outside of the care sector. This might work similarly to a Youth Mobility Visa.

[show stimulus with potential requirements]

How do you feel about this idea?
What do you think about these requirements?
- How do you feel about the age criteria (18-30)? How suitable would these people be for the roles you would want to fill?
- How do you feel about the 2-year duration?
- How do you feel about it only being open to people from certain, mainly EU countries?
  - Which countries would you be looking to recruit people from?

6. Is there any other type of immigration system / visa route that you think would be beneficial for your organisation?

7. If you were able to recruit whoever you wanted, what difference do you think this would make to your organisation?

8. Is there anything else you would like to mention?

Thank you.

Question 11

Annex 3: Discussion Guide – Employers

Accepted Answer

MAC Social Care

Aims & objectives

To understand current practice and issues with recruitment and retainment of staff in adult social care
To understand employers’ perspectives on how current practice and experience of recruitment and retainment has been impacted by the end of Freedom of Movement
To understand employers’ perspectives on the importance of international recruitment to adult social care

Purpose of this document

This is a semi-structured guide for the topics that the researcher will cover in the interview. The researcher will use the guide flexibly - they may not ask questions in the order they are presented here, but in the order which makes most sense for the interviewee - the researcher may probe beyond the questions if topics of interest to the wider goals of the project arise.

Overview/Interview Flow

Topic	Objective
Introduction and background (5 minutes)	Build rapport with the respondent Understand their role/ responsibilities
Description of the organisation (5 minutes)	Understand where the respondent’s organisation fits into the care sector Get a sense of their key business needs
Intro into the impact of the end of Freedom of Movement (5-10 minutes)	Get a sense of what the respondent knows about the recent changes to the immigration system Learn whether the respondent feels the end of Freedom of Movement has impacted their organisation
Pre- end of Freedom of Movement (15 minutes)	Learn about the makeup of the respondent’s workforce before the end of Freedom of Movement Learn about the respondent’s recruitment and retainment of international and UK workers before the end of Freedom of Movement
Post- end of Freedom of Movement (20 minutes)	Gain a deeper understanding of how the end of Freedom of Movement has impacted the respondent’s organisation Learn about whether/ how the makeup of the respondent’s workforce has changed since the end of Freedom of Movement Learn about the respondent’s recruitment and retainment of international and UK workers since the end of Freedom of Movement Identify which visa routes the respondent uses for international recruitment
Looking to the future (15 minutes)	Gain an understanding of what the respondent expects the future to look like in terms of recruitment, retainment and workforce makeup Gain and understanding of what the respondent would like the future to look like in terms of recruitment, retainment and workforce makeup
Reflections (5 minutes)	Gather over all reflections

Introduction and background

Objectives: Build rapport with the respondent + understand their role/responsibilities

Thank you so much for taking the time to speak to us. We’ve been commissioned by the MAC for this project to explore employer and employee experiences of working and recruiting in the adult social care sector, in particular understanding how the recent end of Freedom of Movement has affected the social care sector. We’ll be speaking to both employers and employees about their experiences. Findings from the interviews will be used to help the MAC evaluate areas for possible change.

Interview process:

The interview will last about 1 hour
It’ll be recorded/transcribed, but it will be anonymised.
You have the right to withdraw at any stage.
Explain consent form and say we’ll send it after the session.
Nothing will be shared with your organisation or the home office: there is no way that anything you say can be used to affect any of your dealings with the Home Office, either now or in the future.
Do you have any questions?
Check if the participant is happy to continue and be recorded.

9. Can you tell me a bit about your role?

What are your key responsibilities?
Prompt: recruiting, management responsibilities
How long have you been working at [organisation]?
How long have you been working in the adult social care sector?

Description of the organisation

Objectives: Understand where the respondent’s organisation fits into the care sector; Get a sense of their key business needs.

10. Could you tell me a bit more about [organisation]?

What sort of care do you offer?
Prompt: adults with SEND, elderly patient
Prompt: domiciliary, residential
How many people do you take care of?
Where is your organisation based?
[If multi-site]:
Where is your own office located?
Where is the head office located?
Do you have any international presence?
How do the different sites work together?
Where are you based? (If single site)

11. What have been the biggest challenges for your organisation over the last year or so?

What are the main factors that have been causing these challenges?
How do you think the way you’ve been impacted compares to other adult social care organisations?
To what extent do you think the way you’ve been impacted compares to other sectors outside of adult social care?
To what extent has this affected the quality of care that you can offer?
To what extent has this affected your workforce?

Introducing the impact of the end of Freedom of Movement

Objectives: Get a sense of what the respondent knows about the recent changes to the immigration system + Learn whether the respondent feels the end of Freedom of Movement has impacted their organisation

12. How important is international labour for your workforce?

Probe with EU/ non-EU
What are the benefits to your organisation in recruiting internationally?

13. As you may know, from January 2021, the UK stopped being a part of EU Freedom of Movement and the new points-based immigration system came into force. This means that EU citizens now require visas to come and work in the UK. How much do you know about the new immigration system?

For researcher: some information about the new system to probe with/ test against:

Single, global, points-based immigration system
Need 70 points to get any visa
Immigrants need: job offer and sponsorship letter
Routes for care workers: skilled worker, health and care worker visa
Only senior care workers can come in (SOC 6146)
The shortage list = lower salary requirement + lower application fee
Senior care workers are currently on the shortage list
‘Going rate’ for each profession differs and can supersede general salary requirements
Immigrants need evidence of personal savings to support themselves
Skilled worker + HSC visa lasts for up to 5 years before you need to extend it – you can extend as many times as you like – after 5 years you may be able to settle permanently
Can only recruit senior care workers under the new system, not standard care workers)

14. Have you noticed any ways in which the new immigration system has impacted your organisation?

Are these anticipated impacts, or are they already taking place?
What has changed?
Prompt: recruitment retainment, staff shortages
To what extent has this affected your workforce?
Prompt: Makeup – job titles, nationality, contract type
Prompt: personal difficulties, strain, sickness
To what extent has this affected the quality of care that you offer?
To what extent has this affected your business?
How do you think the way you’ve been impacted compares to other adult social care organisations?
To what extent do you think the way you’ve been impacted compares to other sectors outside of adult social care?

Pre- end of Freedom of Movement

Objectives: Learn about the makeup of the respondent’s workforce before the end of Freedom of Movement + Learn about the respondent’s recruitment and retainment of international and UK workers before the end of Freedom of Movement

15. Could you describe your workforce before the end of Freedom of Movement?

What sort of roles did you employ? (Probe around job titles)
What sort of hours did your staff tend to work? (Probe around contract types)
Could you estimate the proportion of British/ EU/ non-EU staff?

16. Who did you want to recruit for your workforce?

Probe around nationality, job titles, contract types
Were there any job roles that were harder/easier to fill than others?
Were there any significant gaps in your workforce? Who did you need to fill them?
How important was international labour for your organisation?

17. What do you think attracted staff to work for your organisation?

What did your organisation offer in terms of progression, training and opportunities?
Was there anything you included in the job offer in order to make it more appealing?
- Probe: UK/EU/international
- Probe: pay or other benefits
- Was there any flexibility with what you could offer to different recruits?
Why do you think international workers wanted to come and work in UK social care?
Do you think workers saw social care as a long-term career?

18. Practically, what was involved with trying to recruit these people?

What channels would you use to reach people?
Probe: UK/EU/international
Did you conduct your own recruitment or outsource to recruiters?
Probe: UK/EU/international
What sort of qualifications, if any, did workers need to have? Were these qualifications recognised internationally?
Probe: UK/EU/international
What sort of qualifications did workers tend to have in practice?
- What proportion of your workforce had qualifications above/below the minimum requirements?
What did your organisation offer in terms of training, if anything?
Probe: UK/EU/international
Does this include any qualifications?
Was it easier to recruit workers from any countries more than others?
Probe: UK/EU/international
Do you know which visa routes overseas workers tended to use? Did you have any responsibilities regarding their visas?
For those sponsoring employees:
What is the process of sponsoring employees?
How easy or difficult is it to apply for a COS (certificate of sponsorship) for employees?
Were there any particular costs associated with recruiting staff
Probe: UK/EU/International
Probe: sponsorship costs
Did you offer any additional support to new migrant workers?
Were there any differences in how you recruited for different roles?
Probe: UK/EU/international
Were there any particular challenges involved in recruitment?
Probe: UK/EU/international
What might have made recruitment easier, if anything?
Probe: UK/EU/international

19. How long did employees tend to stay at your organisation?

Did you have a sense of employees professional ambitions when starting at your organisation?
Do you know whether employees tended to see social care as a long term career?
When people did leave, what reasons did they tend to cite?
Were there any particular professions that employees moved to?
Can you think of anything that might have encouraged people to stay longer?

Going deeper into the workforce post- end of Freedom of Movement

Objectives Gain a deeper understanding of how the end of Freedom of Movement has impacted the respondent’s organisation; Learn about whether/ how the makeup of the respondent’s workforce has changed since the end of Freedom of Movement; Learn about the respondent’s recruitment and retainment of international and UK workers since the end of Freedom of Movement;

20. Could you describe what your workforce looks like now?

What sort of roles do you employ now? Are there any changes here? (Probe around job titles)
What sort of hours do your staff tend to work now? (Probe around contract types)
Are there any changes to the proportion of British/ EU/ non-EU staff?
What has been the proportion of turnover in your workforce in the last 6 months?
How typical is this?
How has the scale of turnover in your organisation changed over time? [Probe: Compare 1/2/5 years ago]

21. Who do you most want to recruit for your workforce now?

Probe around nationality, job titles, contract types
Are there any gaps in your workforce? (Probe around whether gaps are because of lack of recruitment or lack of retainment) Who do you need to fill those gaps?
Are there any job roles that were harder to recruit for/ fill than others?
How important is international labour for your organisation?

22. What do you think attracts staff to work for your organisation?

Do you think there have been any changes in how attractive a career in adult social care is since January?
What does your organisation offer in terms of progression, training and opportunities?
Is there anything you include in the job offer in order to make it more appealing?
Probe: UK/EU/international
Probe: pay or other benefits
Is there any flexibility with what you can offer to different recruits?
Why do you think international workers want to come and work in UK social care?
Do you think workers see social care as a long term career?

23. Practically, what is involved with trying to recruit these people?

Has your recruitment strategy changed in any ways since the end of Freedom of Movement?
Probe: UK/EU/international
What channels do you use to reach people?
Probe: UK/EU/international
Do you conduct your own recruitment or outsource to recruiters?
Probe: UK/EU/international
What sort of qualifications do workers need to have? Are these qualifications recognised internationally?
Probe: UK/EU/international
What sort of qualifications do your workers tend to have in practice?
- What proportion of your workforce have qualifications above/below the minimum requirements?
What does your organisation offer in terms of training, if anything?
Probe: UK/EU/international
Is it easier to recruit workers from any countries more than others?
Probe: UK/EU/international
Do you know which visa routes overseas workers tended to use? Do you have any responsibilities regarding their visas?
Prompt with options:
- Skilled worker (NB. only works for senior care workers (SCWs) when on shortage list)
- Health and care worker (what did they think of this being introduced? NB. It being introduced gave a route for SCWs)
- Family visa
- Youth Mobility scheme
- Temporary work visa
- Student visa
- Are there any particular costs associated with recruiting staff
- Probe: UK/EU/International
- Probe: sponsorship costs
- Do you offer any additional support to new migrant workers?
- Are there any differences in how you recruited for different roles?
- Probe: UK/EU/international
- Are there any particular challenges involved in recruitment?
- Probe: UK/EU/international
- What might make recruitment easier, if anything?
- Probe: UK/EU/international

24. How long do employees tend to stay at your organisation?

Do you have a sense of employees professional ambitions when starting at your organisation?
When people leave, what reasons do they tend to cite?
Are there any particular professions that employees move to?
Do you have any current strategies for improving retention?
Can you think of anything that might encourage people to stay longer in the future?

25. To what extent are you able to support employees who are currently looking to gain settled status in the UK?

To what extent do you have to do anything beyond your current responsibilities as an employer to support these employees?

Looking to the future

26. Do you see your workforce changing in the near future?

Do you see it changing for better or for worse?
Probe: proportion of senior care workers/ care workers?; full-time/ part-time/ self-employed; British/ EU/ non-EU?
Probe: COVID-19 easing?

27. Do you anticipate any particular challenges in the next year or so?

Probe: shortages? Recruitment? Retainment? International versus domestic labour
Are you taking/planning to take any actions that might mitigate against current and expected future challenges?
Probe: Changes to job offer, redesigning jobs
To what extent do you expect the future increase in the national minimum wage will impact you organisation?
Probe: Expected implications on recruitment, retention, the wider organisation
How easy or difficult will it be for your organisation to meet this new minimum?

28. Do you have a sense of your recruitment strategy going forward?

For international workers?
For British workers?

29. Changes have recently been made to allow care workers to come to the UK on a Skilled Worker visa.

To what extent would you make use of this visa?
To what extent do you think you could support workers to settle in the UK after 5 years of being on the Skilled Worker Visa?
- Probe: Feasibility around necessary pay progression over the 5 years.

30. Have you considered sponsoring employee’s visas?

Probe on which of the sponsorship requirements would be most/ least likely to put them off the route.

31. What is your understanding of your requirements as an employer to be able to sponsor employees?

Do you know if there are any requirements that the candidate must fulfil?

Employee requirements

B1 English language requirement

How would you feel about having to find potential workers who fulfil this requirement?

What English level do you think it’s necessary for potential employees to have, if any?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

Employee must have a salary of at least £20,480 per year (equates to £10.10 per hour).

Employees must receive a salary of at least £20,480 per year, based on a 39-hour week at £10.10 per hour. Care workers and senior care workers must work at least 39 hours per week at £10.10 per hour to meet the salary threshold. Employees who are paid more than £10.10 per hour can work less than 39 hours a week, provided that their annual salary meets a minimum of £20,480.

How would you feel about having to pay potential workers this amount?

How feasible is this for you? Why / why not?

What impact if any do you think this would have on contracts/salaries for domestic workers?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What salary level would be feasible for you to pay?

How would you feel about having to employee new migrant care workers full time?

Employer requirements

The application process takes approx. 8 weeks.

Note to researcher -You’re usually a small sponsor if at least 2 of the following apply:

Your annual turnover is £10.2 million or less

Your total assets are worth £5.1 million or less

You have 50 employees or fewer

How would you feel about having to pay this amount?

How feasible is this for your organisation? Why / why not?

How would you feel about the sponsor application process taking 8 weeks?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee/ time period would be feasible for your organisation?

Do the costs involved in sponsoring employees feel worth it for your organisation?

Probe: How do they compare to the costs spent on agency staff if used?

Do you imagine there would be any other costs you would have to incur when sponsoring employees?

Probe: Travel etc

Potentially pay £199 per worker for a Certificate of Sponsorship.

Which countries would you be looking to recruit workers from?

How would you feel about having to pay for a Certificate of Sponsorship?

How feasible is this for you? Why / why not?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee would be feasible for your organisation? What if it was £100? What if it was £300?

Immigration Skills Charge per worker:

Small sponsors - £364 for first year, £182 for each subsequent 6 months;

Large sponsors - £1000 first year, £500 each subsequent 6 months

The cost of the COS and Immigration Skills Charge for each workers who stay in the UK for 5 years would equate to roughly £5,000 for medium/large employers and £2,000 for small ones.

How would you feel about having to pay for a Certificate of Sponsorship?

How feasible is this for you? Why / why not?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

What fee would be feasible for your organisation? What if it was £XX?

Compliance checks may be carried out by the Home Office.

How would you feel about having to track and record employee’s attendance?

How feasible is this for you? How much time do you think it would take?

How do you feel about being subject to compliance checks?

How big a barrier would this requirement be for your organisation? How might you overcome it, if at all?

Other considerations

The new visa route for care workers (as opposed to only senior care workers) is only due to be open for 12 months, but workers who come to the UK during this time can stay as long as they want and settle.

Does the fact that the government has said the route will be open for 12 months affect your thinking about how/whether to use the route?

How effectively would this help you to recruit new workers?

What about if the route was open for 18 months? 3 years? Indefinitely? Would this change how/whether you use this route?

32. Thinking about all these considerations, how would you feel about using this visa route?

Which would be the biggest barriers for you?
What would enable you to use this route?
To what extent do you think using this recruitment route would tackle challenges you’re facing as an organisation?

33. Another hypothetical option would be for there to be an unsponsored visa route, i.e. you would not have to sponsor a worker to come to the UK and workers would be able to take any job, in or outside of the care sector. This might work similarly to a Youth Mobility Visa.

[show stimulus with potential requirements]

How do you feel about this idea?
What do you think about these requirements?
- How do you feel about the age criteria (18-30)? How suitable would these people be for the roles you would want to fill?
- How do you feel about the 2-year duration?
- How do you feel about it only being open to people from certain, mainly EU countries?
  - Which countries would you be looking to recruit people from?

34. Is there any other type of immigration system / visa route that you think would be beneficial for your organisation?

35. If you were able to recruit whoever you wanted, what difference do you think this would make to your organisation?

36. Is there anything else you would like to mention?

Thank you.

Question 12

Annex 4: Discussion Guide – Employees

Accepted Answer

MAC Social Care

Aims & objectives

To understand current practice and issues with recruitment and retainment of staff in adult social care
To understand employee’s perspectives on the push/ pull factors to work in adult social care in the UK
To understand employees’ perspectives on how the sector has been impacted by the end of Freedom of Movement

Purpose of this document

This is a semi-structured guide for the topics that the researcher will cover in the interview. The researcher will use the guide flexibly - they may not ask questions in the order they are presented here, but in the order which makes most sense for the interviewee - the researcher may probe beyond the questions if topics of interest to the wider goals of the project come up.

Topic	Objective
Introduction and background (5 minutes)	Build rapport with the respondent Understand their role/ responsibilities
Route to UK social care (20 minutes)	Understand the respondent’s experience of migrating to the UK, including visa route Identify pull factors to UK and social care sector
Working in UK social care (10 minutes)	Gain deeper understanding of the respondent’s current role: job satisfaction and working conditions Identify how far the respondent understands the recent changes to the immigration system and whether they feel this has impacted their job
Future plans (15 minutes)	Learn about the respondent’s longer-term goals/ ambitions Identify push/ pull factors in their organisation/ the wider sector
Wrap up (5 minutes)	Encourage reflection and wrap up the interview

Overview/ Interview flow

Introduction and background (10 minutes)

Build rapport with the respondent; Understand their role/ responsibilities

Thank you so much for taking the time to speak to us. We’ve been commissioned by the MAC for this project to explore employer and employee experiences of working and recruiting in the adult social care sector, in particular understanding how the recent end of Freedom of Movement has affected the social care sector. We’ll be speaking to both employers and employees about their experiences. Findings from the interviews will be used to help the MAC evaluate areas for possible change.

Interview process:

The interview will last about 1 hour
It’ll be recorded/transcribed, but it will be anonymised.
You have the right to withdraw at any stage.
Explain consent form and say we’ll send it after the session.
Explain incentive form and say we’ll send it after the session; then they will receive a £50 Love2Shop voucher
Nothing will be shared with your organisation or the home office: there is no way that anything you say can be used to affect any of your dealings with the Home Office, either now or in the future.
Do you have any questions?
Check if the participant is happy to continue and be recorded.

Can you tell me a bit about yourself?

What country were you born in?
What is your nationality?
How old are you?
Where you do you live? Who do you live with?

Can you tell me a bit about the organisation you work at?

Where do you work?
How long have you been working at [organisation]?
What sort of care does [organisation] offer?
Prompt: adults with SEND, elderly patient
Prompt: domiciliary, residential
How many people does your organisation take care of?
How many people does your organisation employ?
Probe: roles
Can you roughly estimate how many of those people who might have migrated to the UK from overseas?
Probe: EU/ non-EU
Are there any roles that your organisation is struggling to hire?
Are there enough staff in your organisation?

Can you tell me a bit about your role?

What is your title?
What are some of your key responsibilities?
What are your hours like?
Is this the same every week?
What is your salary?
How much do you take home each month?
What is the case for the discrepancy between these two figures?
- Are there any costs that you have to cover yourself? (Probe: PPE)
Are there any parts of your role that you’re not paid for?
- Probe: travel time, hours not covered by wage if live-in carer
How has your salary changed over time?
- How does your salary now compare to when you were first employed?
- Do you have a sense of what your salary might be in 1/2/5 years’ time?
How long have you been in this role?

Identify pull factors to UK and social care sector; Understand the respondent’s experience of migrating to the UK, including visa route

When did you start working in social care?

[If in home country]
Why did you start working in social care?
What attracted you to the sector?
- Probe: pay, hours, progression, passion
What qualifications did you have when you started working social care?
- When did you receive these qualifications?
- Where did you receive these qualifications?
- To what extent did the qualifications that you had at the time impact your decision to go into the social care sector?
Did you consider the possibility of moving abroad when you started working in social care?
How was your experience of working in social care in [home country]?
[If in UK]
What work were you doing before, in your home country?
Did you know you were going to work in social care when you migrated to the UK?
Why did you start working in social care?
What attracted you to the sector?
- Probe: pay, hours, progression, passion
What qualifications did you have when you started working social care?
- When did you receive these qualifications?
- Where did you receive these qualifications?
[If in neither home country nor UK]
What were you doing before working in social care?
- In this country?
- In your home country?
- In other countries?
Why did you start working in social care?
What attracted you to the sector?
- Probe: pay, hours, progression, passion
What qualifications did you have when you started working social care?
- When did you receive these qualifications?
- Where did you receive these qualifications?
- To what extent did the qualifications that you had at the time impact your decision to go into the social care sector
Did you consider the possibility of moving to another country when you started working in social care?
How was your experience of working in social care in [this country]?

Why did you decide to come to the UK?

Did you have any family or friends in the UK? What were they doing?
- Who? Where? What were they doing? How long had they been there?
Did you have any doubts about coming to the UK?
[If they started social care work in home country] Did you know anyone else who had migrated to work in social care?
What other countries did you consider migrating to, if any?
How long did you expect to stay?
Are there any particular career advantages to working in UK social care?

Could you tell me a bit about your journey to the UK?

Ask respondent to walk you through their journey to the UK and map on the timeline

[If they migrated with the job]

How/ when did you first hear about the job opportunity? (MAP)
- Probe: was it through an agency/ a recruiter/ an independent employer
- What did you like about the job opportunity?
- Was there anything you didn’t like about it?
What was the job application process like?
- How long did it take? When did you start/ finish? (MAP)
- What documents/ references/ qualifications were required?
- How easy or difficult was it to have your qualifications recognised in the UK?
When did you start preparing to come to the UK? (MAP)
What route did you use to come over?
[If visa (non-EU/Post-Brexit)]
- What was the visa route you used?
- Why did you use that route?
- Which others did you consider, if any?
- Did you receive any advice on which visa route to use [from employer]?
- What did you have to provide for the application process?
- Did you receive any support for the application process [from employer]?
- How long did the application process take? (MAP)
When did you arrive in the UK? (MAP)
How was your experience of finding accommodation?
- How long did it take? (MAP)
- Did you receive any support with finding accommodation?
How long was it until you started work? (MAP)

[If they migrated without job]

When did you start thinking about coming to the UK? (MAP)
- When did you start preparing to come to the UK? (MAP)
When did you arrive in the UK? (MAP)
What route did you use to come over?
- Why did you use that route?
- Which others did you consider, if any?
How was your experience of finding accommodation?
- How long did it take? (MAP)
- Did you receive any support with finding accommodation?
What sort of work were you hoping to do to begin with?
How did you go about looking for work?
Did you receive any support finding work?
Why did you start working in social care?
How/ when did you first hear about the job opportunity? (MAP)
- Probe: was it through an agency/ a recruiter/ an independent employer
- What did you like about the job opportunity?
- Was there anything you didn’t like about it?
What was the job application process like?
- How long did it take? When did you start/ finish? (MAP)
- What documents/ references/ qualifications were required?
- How easy or difficult was it to have your qualifications recognised in the UK?

Gain deeper understanding of the respondent’s current role: job satisfaction and working conditions
Identify how far the respondent understands the recent changes to the immigration system and whether they feel this has impacted their job

How does working in UK social care compare to your expectations?

Probe: refer back to reasons stated for getting into the sector and ask whether these still apply
Probe: if they worked in social care in home country before migrating, ask how social care in the UK compares

To what extent are you satisfied with your current job?

What do you like/ dislike about it?
How do you feel about the hours that you work?
How do you feel about the pay that you receive?
To what extent does your current role offer opportunities for progression?
To what extent does your current role offer training opportunities?
How does your experience compare to other employees at your organisation?
How have the conditions of your work changed over time?
How does the nature and conditions of your role now compare to when you first started?

As you might be aware, in January this year, EU Freedom of Movement ended, and a new immigration system came into place in the UK. To what extent do you feel this has affected your work?

To what extent has it affected your immigration status?
To what extent has it affected the workforce at your organisation?
Do you have a sense of the extent has it affected the social care sector more broadly?

Future plans (10 minutes)

Learn about the respondent’s longer-term goals/ ambitions; Identify push/ pull factors in their organisation/ the wider sector

How long do you expect to stay at [organisation]?

[if indefinite]
Have you ever thought about leaving?
Why?
Can you imagine any future scenarios that would make you want to leave [organisation]?
Can you imagine any future scenarios that would make you want to leave the care sector
[if they have plans to leave]
Why?
What do you plan to do when you leave? Why?
Can you think of anything that would need to change for you to want to stay in the organisation?
Do you plan to stay in the care sector?
How do your plans compare to other employees at [organisation]?

How long do you expect to stay in the sector?

[if indefinite]
Have you ever thought about leaving?
Why?
Can you imagine any future scenarios that would make you want to leave?
Are there any other sectors that you could imagine working in?
- Why?
Are there any other sectors that are attractive to you?
- Why? And why aren’t they attractive enough to want to leave…?
[if they have plans to leave]
Why?
What do you plan to do when you leave? Why?
Can you think of anything that would need to change for you to want to stay in the sector?
How do your plans compare to other employees at [organisation]?

Wrap up (5 minutes)

Encourage reflection and wrap up the interview

Is there anything else you feel is worth mentioning?

https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/publications/Topics/COVID-19/Staffing-and-occupancy-monthly-tracking.aspx ↩
https://www.nationalcareforum.org.uk/ncf-press-releases/just-grim-difficult-and-relentless/ ↩
https://www.gov.uk/government/publications/commissioning-letter-to-the-mac-for-the-review-of-adult-social-care ↩
B1 in the Common European framework of Reference for Languages refers to an ‘intermediate’ language level, where users can independently communicate with native speakers. https://www.commoneuropeanframework.org/](https://www.commoneuropeanframework.org/) ↩
By employers, individuals in a managerial or HR capacity within UK-based adult social care organisations, with oversight of recruitment processes in their adult social care organisations. Examples of roles of participants include CEO, manager, registered service manager, HR manager, co-owner. By migrant care workers, we mean people without UK residency who have moved to the UK and work as senior care workers and care workers. ↩
https://www.gov.scot/news/record-gbp-18-billion-for-health-and-social-care/ ↩
https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/publications/Topics/COVID-19/Staffing-and-occupancy-monthly-tracking.aspx ↩
https://www.nationalcareforum.org.uk/ncf-press-releases/just-grim-difficult-and-relentless/ ↩
B1 in the Common European framework of Reference for Languages refers to an ‘intermediate’ language level, where users can independently communicate with native speakers. https://www.commoneuropeanframework.org/ ↩
Adult Social Care and Immigration: A Report from the Migration Advisory Committee (PDF, 6.1 MB) ↩
All participants described in this report have been anonymised. In some instances, certain details have been changed to provide further anonymity ↩
https://www.gov.uk/government/news/government-to-introduce-covid-19-vaccination-as-a-condition-of-deployment-for-all-frontline-health-and-social-care-workers; https://www.gov.uk/government/publications/vaccination-of-workers-in-social-care-settings-other-than-care-homes-operational-guidance/coronavirus-covid-19-vaccination-as-a-condition-of-deployment-for-the-delivery-of-cqc-regulated-activities-in-wider-adult-social-care-settings ↩
All participants described in this report have been anonymised. In some instances, certain details have been changed to provide further anonymity. ↩
Disclosure and Barring Service check ↩
All participants described in this report have been anonymised. In some instances, certain details have been changed to provide further anonymity ↩
https://www.gov.uk/government-authorised-exchange ↩
You can apply for a Temporary Work - Charity Worker visa if you want to do unpaid voluntary work for a charity and you meet the other eligibility requirements. You can stay for up to 12 months. ↩
All participants described in this report have been anonymised. In some instances, certain details have been changed to provide further anonymity ↩
The Youth Mobility Scheme allows individuals between 18 and 30 years old, who have certain types of British nationality or are from certain countries or territories, to live and work in most jobs in the UK for up to 2 years ↩
This route is a hypothetical route. It is not currently in force within the UK, nor is there an intention for it being introduced. For details on the propositions, please see details in the annexed employer topic guide ↩
By employers, individuals in a managerial or HR capacity within UK-based adult social care organisations, with oversight of recruitment processes in their adult social care organisations. Examples of roles of participants include CEO, manager, registered service manager, HR manager, co-owner ↩
By migrant care workers, we mean people without UK residency who have moved to the UK and work as senior care workers and care workers ↩
This included Skills for Care in England, Northern Ireland Social Care Council, Scottish Social Services Council, Social Care Wales ↩
We have evaluated the size of the organisations based on the number of employees they have, in line with the SME Definition (Small and Medium-sized enterprises) by the European Commission, as set out in the link. These are predominantly estimations from employers, and do not represent exact figures. https://ec.europa.eu/growth/smes/sme-definition_en ↩
Although this organisation was not strictly a social care organisation, they recruit care workers as part of the HR Team for the local council, and they provided lots of interesting insights about care recruitment in relation to COVID-19 and Brexit. ↩

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About Revealing Reality

Role of the MAC in producing this report

Anonymity within this report

Executive Summary

Background to the study

Study objectives

Fieldwork adapted to changing migration policy

Most employers said they had been struggling with recruitment and retention for some time, and that this had been exacerbated by the ending of free movement

Most employers interviewed were unfamiliar with the sponsorship process, or had not thought that it could help them before the addition of care workers to the Skilled Worker route

The new route for migrant care workers was positively received by most employers in the sample, though many worried about minimum wage requirements and how long the route would be open for

Background and Methodology

Background and objectives

Study objectives

Approach

Fieldwork adapted to changing migration policy

About this report

Experiences of recruitment and retention within adult social care

Employers interviewed reported that some care workers either do not want to or are unable to work additional hours

Employers said that they were generally looking to attract entry-level workers

Some employers had decided to reduce their requirements of entry level workers

Some employers interviewed were trying out new domestic recruitment strategies, but were struggling to see any benefit from them

Challenges in recruitment and retention meant that some employers in the sample were having to turn down new work and clients

Challenges in recruitment had been experienced for several years – and with a number of contributing factors

For many employers in the sample, the ending of Freedom of Movement seemed to have an impact on their ability to recruit and retain staff – either directly or indirectly

Employers interviewed felt that other sectors were more appealing to workers

COVID-19 has put extra strain on care workers

Care workers were seen as having high responsibility but lacking status

Other sectors or employers were described as offering better pay and benefits

Most organisations in the sample were relying more heavily on agency staff to fill gaps in their workforce

Experiences of applying to and working in adult social care

Most migrant care workers in the sample saw social care as an easy sector to move into – and as a job that would provide flexibility

Some migrant care workers spoken to had relevant previous experience, and a job in social care seemed the most familiar option

Some employees said that they chose social care because they felt that the sector always had vacancies

Many in the sample also cited flexibility as a key motivation for working in care

Whilst some employees valued flexibility in their work, it appeared to sometimes work to their detriment

However, employees cited several barriers to working in social care

Some employees noted technical barriers to working in social care

Many employees spoken to felt that social care work is undervalued in the UK, and that career progression is difficult

The strenuous and physical nature of care work was also a difficulty for many participants in the long term

Whilst most workers in the sample said they found the job difficult, some also chose social care as a change of pace from their previous careers

Staff shortages in organisations impacted some participants’ experience of their day-to-day work

A few employees interviewed also cited poor treatment at the hands of their clients

Due to low pay, some employees in the sample were consequently moving out of care organisations or working multiple jobs to supplement their otherwise low wage

Experiences of using sponsorship pre-Brexit

Most employers in the sample had not had experience of sponsoring employees before the introduction of the new route for migrant care workers

Employers in the sample who felt they had exhausted domestic recruitment routes thought they might have to consider sponsorship in the future

A small number of employers had sponsored employees in the past, but this was very rarely on a Skilled Worker visa

Some employers who had used the sponsorship system in the past had come into difficulties with their sponsorship licence

Attitudes toward sponsorship and migration in recruiting for adult social care (post-Brexit)

Whilst awareness of changes in migration policy seemed to be limited amongst employers at the start of fieldwork, it seemed to generally increase as fieldwork progressed

Most employers welcomed changes in the migration system and the new opportunity to sponsor care workers from abroad

However, lack of familiarity with the process meant that some employers were delaying getting started and not taking full advantage of the new route

Some employers described being tentative about sponsoring employees on the Skilled Worker visa for fear of getting things wrong

Some employers in the sample described how they had made mistakes in the sponsorship process, or feared making mistakes, leading to further delays

Some employers were particularly concerned about having to monitor employees

For the employers we spoke to, there were misinterpretations and doubts about the salary threshold required to make care workers eligible for the Skilled Worker visa

Some employers said they would not be able to meet the required salary threshold for care workers on the Skilled Worker route

Other employers misunderstood the exact requirements of the salary threshold, and therefore incorrectly believed they could meet the threshold

Some employers told us that they would be able to meet the salary threshold

However, even those who said they were able to meet the threshold still had some concerns and misunderstanding regarding the requirements

Some employers had concerns around the cost of sponsorship

Some in the sample were concerned about whether sponsorship would pay off if staff left the organisation soon after arriving in the UK

There were some questions around care workers only being eligible to come over on the Skilled Worker route for a year

Employers in the sample generally reacted positively to the hypothetical proposition of an unsponsored route

Conclusion

Most employers spoken to reported having struggled with recruitment

Whilst many migrant care workers in the sample found the idea of working in adult social care attractive, they generally saw it as a short-term career option

Some employers in the sample thought that the addition of care workers to the Skilled Worker route might help them in their recruitment efforts, but the hourly salary appeared to present a challenge for some

It is likely that the full benefit of the new route for migrant care workers will not be felt if it is only available for a year

Annex 1: Sample, methodology and consent

Methodology

The research used a qualitative approach to explore nuance in experiences and attitudes

The research team consulted employers and migrant care workers through remote focus groups and one-to-one semi-structured interviews over video call

Interviews covered current experiences of working and recruiting in adult social care and attitudes to potential new visa routes

Where possible, the research team mitigated against the impact of the ‘researcher effect’

Recruitment and Sample

Participants were recruited via different methods, primarily through email send-outs from social care workforce bodies

A diverse range of employers and migrant care workers were consulted for the research

The research team aimed to interview a spread of employers and migrant care workers across the four nations