International care workers in England: Practices and identities

Dr Shereen HusseinProf Jill ManthorpeDr Martin Stevens

Introduction• Migrant workers in social

care in the UK• The study• Theoretical frameworks• Findings• Conclusions

Taken from Guardian website – 26-03-2008

Evidence on international recruitment

• Migrant or migrant care worker make up 16% of the UK care workforce

• Increased demand for care workers– population ageing, – high levels of female employment– greater survival of people with long-term health conditions and

disabilities• Rapid rises in labour migration, often related to shortages of

labour in health and social care sectors (Misra, 2003, Elrick and Lewandowska, 2008, Doyle and Timonen, 2009)

• Migration and increasingly important political and social issue – changing migration regulations

11th November 200911th November 2009

The study

Funded by the Social Care Workforce Research Initiative of the English Department of Health

1. Review of literature, interviews with recruitment agencies & key stakeholders (35 interviews)

2. Analysis of national statistical data (international social workers - 7K; and recent migrants working in the care sector NMDS-SC - 5K)

3. In-depth 6 study sites interviewing migrant care workers, their colleagues/managers and service users/carers (196)

4. Interviews with a national sample of asylum seekers, refugees and people working with them (23)

4

Migrant care workers participating in the study

Country of birth• Commonwealth (32)• EU14 (excluding UK) (8)• EU A8 (13)• EU A2 (1)• Other EEA (1)• Zimbabwe (5)• Philippines (21)• US (1)• Nigeria (4)• Other countries (10)

Reason for coming to the UK• Recruited from my country for a

specific job (32)• Offered a work permit to work

in a specific job (6)• Accompanying a family member

(24)• An overseas student (14)• An asylum seeker/refugee (2)• Holiday/short visit (12)• Looking for work (moving from

EU) (6)

Models of migration motivations

• Standard economic maximization models

• Economic motives within household decision making

• Search theoretic models • Social mobility/social

status migration motives

Motivations of migrant care workers• Gendered nature of care work – therefore female perspective

important - under theorised• Women’s motivations incorporate more than individual

factors – eg family norms and gender roles (De Yong, 2000)• Macro and micro economic factors important and interact eg

Filipino migrant care workers (often nurses)sending money home (Menjivar et al. 1998

• Personal and professional factors are also important (eg for nurses: Ryan and Coughlan 2009)

• Importance of inter country dynamics– Similarity of social work/ social care work context (Valios 2008)– Differences in terms of workloads (Sale 2002)

• Care work as means of coping and stepping stone to other work (MacGregor, 2007)

Theoretical framework – individual perspective

Motivations to come to the UK• Positive views of the UK

– it’s my dream to come here to England’ (Nurse, Commonwealth - 412)• Build on previous skills

– I decided [to come to England] because before in my country, I’m working in the hospital and I’ve experience in home for the aged as well (Nurse, Commonwealth - 412).

• Financial motives– It [main motive] was more about money, I would think, in the

beginning. I thought I wouldn’t stay here longer in care (Senior care worker, A8 - 518).

• Following spouse/family• Other motives

– Broaden horizons – Return to former profession– Passion for English language– Bringing spouse/family

Motivations by country of originCommonwealth Philippines EEA Other countries

Positive views of UK Financial Passion for English language

Build on previous work

Builds on previous work

Builds on previous work

Following spouse Following spouse

Broaden horizon Positive views of UK Financial Positive views of UK

Stepping stone Bringing family Passion for English language

Financial Stepping stone Gain qualifications Gain qualifications

Following spouse Broaden horizon Positive views of UK Bringing family

Following spouse Broaden horizon

Bringing family Keen to work in social care

Build on previous work

Broaden horizon

Gain qualifications Gain qualifications Stepping stone

Main motivations to work in social care• Altruism (wanting to help others in difficult situations);

– It’s that, whenever I see vulnerable people or old aged people, it’s that it really touches my heart. (Senior care worker, Commonwealth - 508)

• Better than previous UK jobs (mainly factory jobs);– I took one other job in an agency and I didn’t enjoy it, so one of my

friends told me you can try caring, so I thought it would be good and I gave it a try and it really work so I choose that one. (Care assistant, other countries- 430)

• Social care sector is easy to get into;– I started to work as a care worker. It was the first job I could get. The

first available one. (Nurse, A8- 244)• Social care is a good career.

– Working in one sector will make you ready to work in another sector. You don’t need other training to work in one place. With your experience you can work in other places. (Social worker, Nigeria - 615)

• In most cases, multiple interacting motivation

Intermediary factors• Level of skills/qualifications

– Language skills– Skills and prior experience

• Historical and current links between home country and England– Variations in organisation of care services - So that’s the

difference, [here] we are more dependent. Here you cannot take your decision, you can, but in terms of how much is less decided. (Social worker, Commonwealth - 310)

• Personal factors– Non work stress (over half) (eg sending money home or

separation from family)– Time in the UK

Common experiences of working in UK social care

• Valuing the Caring Role – That particular woman said to me, she said, she said, you are the only one

I remember who stood there and spoke to me and she smiled at me. I thought, you couldn’t have seen me. She said she could....She said you were the only one who treated me like a human. That means such a lot. I’ve never forgotten it. I’ve never forgotten it. (Care worker, Commonwealth - 248)

• Demands and stress– Workload - We don’t have octopus hands (Care assistant, Philppines 228). – Emotional demands - My main calls are really because they are alone and

that hurts me. It does, terribly (Care assistant Commonwealth - 248)– Working with challenging service users - It can be, because your residents

can be challenging and upset and other days, it can be all calm and serene and nice. From one day to another, you don’t know what you are going to get. (UK care assistant – 111 )

• Administrative work• Low pay and status

Working relationships• Supportive employers

– Well, actually the management here are very equal. Everybody gets support from them. They give all the trainees all the hours if you want, you know. There’s no limitation. Of course there’s always limitations, but what I mean is they are always giving us equal opportunities. I’m happy that I am working with them in this place. (Senior care worker, Philippines - 316)

• Less supportive employers– I should think she was more of authoritative in a way, whatever

she says because this is how she feels and that’s it. (Social worker, Commonwealth 310)‐

• Colleagues – When I first came over to the UK and certainly like in any post as

a foreign worker I think it takes you longer to kind of get good working friendships. (OT, Commonwealth 516)‐

Working with people from different cultures• Complex web of culture interchange within social care services.• Breaking cultural rules

– Even though if a White girl goes out to assess a British older woman, she doesn’t see anything wrong with the woman staying by herself, but for me I tend to feel concerned, there should be somebody around. So it’s going to be a kind of a training or a kind of lecture about that.(Social worker, Nigeria - 615)

• Language and skin colour may be used as markers to classify, and negatively evaluate, others’ cultures (Johnstone and Kanitsaki 2008).

• Mutual respect (positive and negative)• Interpersonal relationships overcome cultural differences?• Time overcomes cultural differences• Local context

Experiences of racism

• Over two thirds of the migrant workers in the research sites (68/96)gave accounts of racist behaviour of:– employers, – colleagues – service users

• Differential experiences of different ethnic groups – Visible social markers– Being ‘foreign’

• Accounts of mistreatment on the grounds of language were fairly evenly spread

• Time reduces racism

Conclusion• Multiple motives reflect different models– economic and mobility – general and for status– macro and micro economic

• Interactions between motives to migrate and to work in social work and social care

• Interactions between motives, experiences and ‘intermediary factors?’

• Identity, ethnicity, gender and country/region of origin all important

• Time in host country