Round table report: immigration and the care sector – time to recognise an unappreciated workforce

Recent government figures show a major shortfall in staffing in the adult social care sector, with some 165,000 posts remaining vacant as of the end of 2022.

The strategic workforce development and planning body for adult social care in England, Skills for Care, says this is due to recruitment and retention difficulties in the sector rather than a decrease in demand, with employers not being able to recruit and keep all the staff they need.

Several commentators have attributed staff shortages in health and social care to multiple factors. This includes: a lack of long-term workforce planning by the government and the NHS; Brexit leading to a loss of staff coming from the EU; concerns over pay; and job pressures due to increasing staff shortages.

At this exclusive round table event, we gathered together the major players in adult social care across the Midlands to discuss these points – and how the care sector can overcome them.

The discussion kicked off with a look at recruitment practices. We asked the panel how they ensure that all legal requirements are met when recruiting generally and especially from overseas.

Liz Jones from the National Care Forum said: “We help our members understand. There are a lot of organisations offering recruitment services – and there is certainly evidence of agency organisations offering agency workers who have not been recruited through ethical methods.

Thal Vashista of Paragon Law asked what Jones meant by “ethical recruitment”.

She replied: “We should be making decisions about what our recruitment practices are going to be. There needs to be processes in place for recruitment organisations to follow in a way that suits governance and accountability.”

Rena Christou of Halborns brought up the claw back clause, which requires sponsored employees to agree to repay the immigration fees associated with their application if their employment terminates.

Aaron Biddon of BMB Recruitment said: “If there is a claw back that implies that employers have paid up front to begin with. If you have a claw back for nurses it falls down after two years anyway.”

Chris Stacey of Rushcliffe Care said that her organisation did have a claw back clause in place with nurses.

The discussion turned to how panellists ensured that sponsored workers are meaningfully integrated into their wider teams.

For Ben Patrick of Apex Prime Care, shadowers were essential. He said: “Where we notice a big difference in culture, then the shadower took a larger role in training. However, an induction can take the pressure off a shadower.” –

Lynn Pyatt of Country Court said that staff sometimes take on larger roles than just line managers. She added “Many overseas workers come over with family in the area, specifying where they want to live. It’s often the task of our home managers to help them with accommodation.”

Preparation was key for Jill Forbes of the Tanglewood Healthcare Group. She said: “We aim to build up relationships with overseas workers before they start with us. And, yes, we help with accommodation too. We’ve had around 80 overseas staff and not had any problems. We’ve been extremely lucky – they all seem happy. We’ve had a few people where care wasn’t their chosen career, but it’s turned out to be. They’re integrating really well.

Jones bemoaned the lack of depth to the current national debate on overseas workers. She said: “In this political debate there doesn’t seem to be a recognition of the quality and skills that people come with.”

Biddon brought up an extra element of support that his company supplies. “We also work on the family reunification side of things; we aim to be the bridge that connects the family to employers. They’re pleased when they see their family member stabilised and working successfully in this country.

Patrick added: “We’ve also seen our managers take on a lot more responsibilities, adding that these have included becoming de facto letting agents and driving instructors. “But they’ve welcomed it,” he said.

Christou pointed out that there was a “massive” focus on getting overseas workers to the UK, and making them feel settled. But, she pointed out: “There are also other factors, such as them wanting to go on holiday, or be home for family events. The cost of this can be disproportionate to how much annual leave they have and so they can be away from their family for considerable amounts of time.”

For Stacey, overseas workers are an integral part of his company. “They’re integrated into the company – and feel part of it. They’re treated in the same way as everyone else. Covid taught us that we’re all the same,” he said.

The discussion then turned to how the panellists kept talented sponsored colleagues engaged, motivated and retained within the organisation.

Jones thought that the welcome “really matters”. She added: “The greeting and the first 100 days are crucial, as is helping overseas workers link to local organisations. You need a welcoming community at home and at work.”

Christou thought it was all about making people feel generally engaged. She said: “Some things are difficult to quantify; if you look at some of the documents new overseas workers have to fill in, most of them don’t offer a very warm, accessible welcome. Could we say the same things in a more positive way? These people might not necessarily be particularly academic, but they have reams and reams of forms to fill in.”

The conversation then turned to the requirements on managing Home Office expectations as sponsors of overseas workers. Vashishta said the Government has confirmed that sponsor compliance visits remain a priority in their strategy on preventing illegal working and that they will be increasing unannounced visits particularly in businesses that rely on migrant workers. We asked the panel whether their business has systems and processes in place if compliance officers were to attend your head office or one of their sites?

Kirin Abbas of Paragon Law thought that most businesses will have the systems in place, but added a caveat. She said: “What really varies is how aware they are – compliance might not be so high up on their list of priorities. Certain organisations will have invested a lot more in compliance – but that doesn’t necessarily mean they have more to offer. Size doesn’t matter in this case.”

To round up, we asked the panel: if they were to draft a letter to the Government putting forward their concerns about the sponsorship regime and immigration law more widely affecting the care sector, what would they want included?

Patrick said he would want the cost “sorting out”, while Biddon would ask for ethical recruitment practices to be regulated.

Patrick wanted simpler and easier access to information. “It would be really easy to get this all wrong,” he said.

Vashista pleaded with the Government to be honest with the electorate. “We are an ageing population and there’s a global war on talent,” he said, asking those in charge of immigration policy to accentuate the benefits of overseas workers and the UK’s reliance on overseas workers.

Forbes bemoaned lack of clarity. She said: “Every challenge that comes up politically, the Government adds small bits of legislation that adds up to create nothing. You wouldn’t believe the hoops we have to jump through, just because the Government believes this extra legislation sounds good.”

Abbas said that she wanted more from UK Visas and Immigration (UKVI). “It’s clear how unsupportive it can be. They don’t interact and everything is very much a tick box exercise. This needs to change.”