Who Cares? Researching and Meeting the Needs of Migrant Care Workers June 2007 – September 2009


This study, conducted in collaboration with the charity Kalayaan, investigated the role of migrant domestic workers employed to care for the elderly in private households. It explores the living and working conditions of migrant care workers (MCW) caring for the elderly, and covers broad areas such as employment relations, care regulation, race and racialised labour, integration and skills.

Combining a robust scientific and user orientated methodology, a policy focus and an interest in theory development, it examines the importance of migrants in the provision of elder care in private households; whether MCWs share common characteristics (i.e. Immigration status, nationality, age, gender, etc.); the living and working conditions of MCWs; the means by which MCWs negotiate their employment and social relationships with care users and their relatives; and the ways in which race and racism impact on the employment of MCWs.

Findings arising from the study are of policy relevance in the fields of both care and immigration, particularly in the context of the European Commission’s Green Paper (December 2008) on the future of Europe’s healthcare workforce.

Principal Investigator

Bridget Anderson


Mumtaz Lalani (Kalayaan, London), Lourdes Gordolan (Kalayaan, London)


The Big Lottery Fund (BLF)

Professionals' Advisory Group





CareCivil SocietyDiscriminationGender




Analysing capitalism not simply as an economic system, but as an institutionalized social order, helps illuminate the contradictions that emerge between the capitalist economic system and its conditions of possibility. Fraser characterises these conditions as being the conditions of social reproduction, of nature and of political power. Capitalism’s conditions of possibility have their own social and normative ontologies. This project took care work as a key contribution to one of its conditions of possibility, i.e. social reproduction, and considered the personal and social relations generated by migration, commodification, care and domestic labour.


The project combined qualitative and quantitative methods, and integrated support and workshops with research work. It also developed previous academic work on the eldercare sector more generally. The research process provided an opportunity for care workers (often isolated) to meet and share experiences and provide information and workshops on practical problems. Key methods included a statistical analysis of Kalayaan’s client database, tracking which migrants work in eldercare and the characteristics they share; participant observation in Kalayaan; in-depth semi-structured interviews with migrant elder care workers; focus group discussions with migrants; and interviews with employers, agencies and stake holders. The research was supported and advised by an advisory committee including 4 migrant workers, and an ethical sub-committee has played an important role in ensuring that the research was conducted with a view to the British Sociological Association’s ethical guidelines.


Restrictions and grey areas in policy affect migrant workers’ living and working conditions. First, government restrictions on access to NVQ training for migrant care workers places MCWs in a position where they are often forced to provide care services without any official training. Second, employers in private households are not subject to regulatory checks performed by the Care Quality Commission (CQC). Third, although the Health and Safety Commission provides guidelines for the safety of migrant workers, care workers in institutional settings, and health workers in general, it falls silent when it comes to specific provisions protecting paid care workers working in private households not hired by agencies. These three factors help create conditions which place migrant care workers in a particularly vulnerable position, subject to exploitation by care users, and isolated both socially and legally as a sector.

The contractual and social relations elements of the employment relationship between migrant care workers and their employers are extremely complex. Contractually, the main distinction, as expressed by MCWs, was whether they worked through agencies, or were directly employed, either by the care user or by a member of his or her family. The social relations element of the employment relationship complicated the picture further. The imbalance in power relations between the two parties resulted in employers frequently oscillating between a more contractualised relationship, and one that was more familial. This study shows that employers have greater expectations of the care worker when they are paying directly for their own care. It also demonstrates that as greater numbers of individuals take up personal budgets and choose to employ personal assistants, this can lead to the formation of quasi ‘employment agencies’ registering a number of self-employed personal assistants on their books.

In private households, racial discrimination is particularly difficult to deal with. Both care users and agencies indicated preferences for employing particular nationalities and/or races. Agencies concealed racist remarks through referring to ‘national characteristics’. In other cases, the reasons given for employing or not employing people were related to issues to do with their ‘culture’. The kinds of stereotypical ‘national characteristics’ mentioned above as facilitating entry into eldercare in general, and as segmenting the labour market with different groups considered more or less desirable, also affect working conditions and wages which can vary by nationality.








Who Cares? How best to protect UK care workers employed through agencies and gangmaster from exploitation, Oxfam Briefing Paper, 2 December 2009 (citation of COMPAS/Kalayaan research, saved to S: Drive)