24/7 Care
The risk of severe labour exploitation and modern-day slavery for live-in carers

By OISC accredited adviser Natalia Byer
Wednesday 4 May 2022

The report ‘State of Ageing 2022‘ by Ageing Better shows that 11 million people in the UK (in other words, 19% of the population) are older than 65 years old. The report concludes that in 10 years the number will increase to 13 million. Inevitably, the demand for 24/7 care will need to be met. Most people in the UK are familiar with some forms of care like residential, nursing or home care. I focus on the least known or understood type of care – live-in care. 

A live-in carer is a person who lives and works in the same place without having an external in-country address. It’s like an au-pair, but instead of caring for children, a person cares for an elderly, terminally ill, or a person with a profound disability. Unfortunately, it is not easy to find statistical data showing the actual number of live-in carers. The Skills for Care project which covers around 45% of the whole care sector, estimates that there may be about 25 000 live-in carers in the UK, but it counts them together with domiciliary carers. These workers are likely to be non-British and women. Live-in care services are costly, explaining why they are so unpopular. This lack of popularity is also reflected in legislation that looks like Swiss cheese at best. The main concerns about the treatment of workers are about employment law, especially Working Time Regulations, breaks entitlement, sleep-ins and health and safety, specifically manual handling procedures and violence at work issues.

On top of that, live-in carers struggle with everyday access to basic things like opening a bank account or registering with a GP. The reason is that as they live and work under the same address as their client, in many cases, they are being forbidden to use that address for what their employer or patient’s family calls ‘private purposes’. This has far-reaching implications if they are an EU citizen who had to apply to the EU Settlement Scheme and if they have to change from pre-settled to settled status. In cases like this, the choice of documents that can be used to evidence a residency is limited. Carers I spoke to choose to travel back home after their contracts ended, risking the continuity of their residency in the UK, which can result in a refusal on a settled status application. This makes live-in carers a vulnerable group of workers that are even more exposed to the unfair and discriminatory hostile environment. Not only are they victims of Theresa May’s infamous policy, they are also at additional risk of severe labour exploitation and modern-day slavery.

For years, trade unions have tried to push the government to resolve issues like no wages for sleep-in shifts. This is an artificial concept simply because this type of work requires reactiveness 24/7. My conversations with the live-in carers also show that the recruitment agencies expect them to work either as self-employed or sign dubious contracts that claim 5 hours a day shifts. These are typical ways in which agencies avoid adhering to basic statutory terms.

The organisation overseeing the care sector called Care Quality Commission has a long history of failing both workers and the patients due to not enough in-depth inspections, turning a blind eye, and often responding to a concern raised with them too late or not at all. It means that the least visible group of workers is left on their own without any systemic support. The live-in care sector is expected to be the fastest growing one because residential settings will struggle to meet the demand for 24/7 care. The latest increase in National Insurance contributions will not cover the financial needs of the care sector. What is urgently needed is addressing legislative shortcomings, tighter regulations of the employers, more targeted organising work by trade unions and a widespread campaign to stop the live-in carers from being an invisible group both for the government and in the public eye.

Natalia Byer is an OISC (Level 1 – EU Settlement Scheme) accredited adviser working with Polish and Romanian residents. Since 2014 she is an activist for Unison and their former organiser. Natalia has expertise in the care sector and its social context. 

She also runs a programme of Direct Services including an advice and support referral network for Polish Migrants Organise for Change (POMOC).