In October 2020 the government promised the House of Lords that an independent report into the ending of free movement and the social care workforce would be completed within 6 months ie. by the end of May 2021.

This has only just been commissioned and will not be completed until April 2022.

Since the closing of the EU Settlement Scheme to most social care workers at the end of June coupled with the impact of the pandemic both individual disabled people who employ PAs and care workers directly as well as care agencies are finding it significantly more difficult to recruit and retain staff. This is leaving many disabled and older people at risk and severely limits the choice that disabled people have over the quality of workers they employ.

It is unlikely that domestic workers can instantly fill this gap leaving potentially disastrous consequences for the lives of Disabled People especially those who need 24 hour live- in support.

None of the current Immigration routes for non-UK staff. who require Home Office permission to work, are available for disabled people to use if they are individual employers whose social care and support for independent living is funded through Local Authority Direct Payments or Continuing Health Care (CHC) funding when they need to recruit new, or replacement staff. Declaring social care a shortage occupation alone would not be enough to allow this group of disabled people to employ non-UK residents.

It is already apparent that an ability for individual disabled people and Care Agencies providing live-in care workers to recruit non-UK social care workers, often called Personal Assistants (PAs), is crucial to prevent a devastating shortage of skilled, qualified social care workers.

This inability to recruit live in social care staff could not only literally put disabled people’s lives at risk but would also increase both pressure and avoidable expense on our NHS and Adult Social Care services. The very real danger to disabled people cannot be over emphasised but can be avoided if prompt action is taken.

Social care and support for independent living is needed by working age disabled people as well as our older disabled citizens. This support allows many disabled people with high support needs to work as well as taking part in society.

As the government claim to be committed to having more than 1 million disabled people in work by 2027 and have boosted the number of Disability Employment Advisors “help disabled people to secure and stay in work” through the ‘Plan for Jobs scheme.’ ¹This however will be doomed to failure if at the same time they remove access to a suitably qualified workforce to support disabled people to live independently in the community and by doing so deny them the possibility of working.

While the government has made exceptions for corporations to employ agricultural workers from abroad absolutely nothing is in place to help direct payment recipients who are individual employers to continue to be able to employ the most suitable live-in staff in the future. Supporting Disabled People to live independently in the community and take a full part in society is not only morally essential but also comparatively much more cost effective for the tax payer. The cost of an Adult Treatment Unit placement ² can be around £12,000 per week, a care home placement for those with a Learning Disability at e.g. Winterboure View an average £4,500 a week³ and a hospital bed £2,500 a week.⁴

Disabled People who use Direct Payments or CHC funding to pay for their 24 hour, live-in social care is a small and a very specific part of the much larger social care sector. It is a unique employment situation which is not found in any other employment sector.

While the government state that they want social care workers to be paid more individual disabled employers pay PAs all of the budget they receive form LAs or from CHC funding regardless of their nationality. However as the funding for Adult Social Care has been cut by at least £7.7 billions between 2010 and 2019 ⁵it is impossible for disabled employers to follow the government’s empty call for higher pay without funding from Government for Adult Social Care being increased also. Live-in social care workers salaries do not include the value of free accommodation whilst working unlike the Inter- company transfer visa which does. In London a room in a shared house could easily cost around £185 a week or £9,600 per annum.

The need to have 24 hour live-in care is a necessity without which Disabled People risk dying or at best being hospitalised. It is not a choice and normal Supply and Demand rules are not applicable.

The huge degree of responsibility is involved in providing live-in social care support for independent living, the lack of any peer supervision and the importance of a personal relationship make this a role not suitable for those without some degree of confidence and maturity and definitely not for all. While social care is provided in individual service users’ homes all those who need 24 hour live-in care have high support needs many of them medical in nature. Tasks include eg. being hoisted in and out of bed, assisted with personal care needs, sometimes involving manual bowel evacuation and assistance with bladder functioning, managing diabetes, having medication, drinks and food provided, supporting the use of Bipap and Cpap machines for breathing, as well as being supported to work and take part in society.

The provision of quality care is important to the mental and physical wellbeing of a vast swathe of the UK’s disabled and older people – who are often denied rights and opportunities many non-disabled people take for granted. We are deeply concerned about a dramatic worsening of their quality of life, and loss of freedom leading to many becoming imprisoned in their own homes without the support needed to live independently.

The complex intersection of various aspects of being disabled are often difficult for people without lived experience to navigate which is why we believe input from disabled people and our DDPOs is so crucial to the development of any long term strategies that will impact on our lives.

With regard to the lack of any useable immigration route for individual disabled employers of social care staff we agree entirely with Association of Directors of Adult Social Care that a sector specific route is needed which must be a non-sponsored route that can be used by individual employers.

Although the available statistics are limited we estimate that there are as few as 100,000 to 135,000 disabled people who need live-in social care so as such these numbers would not make any real change to migration levels nor would it allow unfettered freedom of movement. Simply we are asking for a non-sponsored route similar to the Frontier Worker scheme which does not allow any right to settle in the UK as most PA/ live-in social care workers simply want to come and work here for a limited period of time then return home.

Of equal concern looking at the social care sector as a whole GMB union estimate that care home and domicilliary care will face a shortfall of 430,000 workers. We know that United Kingdom Home Care Association (UKHCA) have also written to you to emphasise the current difficulties their members are facing with recruitment and retention of staff. Disabled employers of PAs and social care workers often rely on being able to use care agencies in emergencies when without staff so this too is of enormous concern as it means that no back up is available.

The Prime Minister has stated that only 5% of the social care workforce are not UK residents yet for live-in social care agencies that figure is in fact much higher. Last year Independent Living Alternatives said that 60% of their live-in workforce were not from the UK and similarly PA Pool had 50-60% of their live-in workforce from outside of the UK, mainly from EU countries. Since January PA Pools recruitment has plummeted from 280 new available PAs down to only 84 in June 2021.

We believe urgent action must be taken by the government now to ensure the safety of disabled and older people who need social care and support.

Urgent and immediate policy changes needed

1. Revise migration policy urgency by introducing a non-sponsored sector specific route allowing PAs and social care workers to be recruited by individual disabled employers from countries outside of the UK.

2. to avoid a staffing crisis in other related social care sectors such as live-in care agencies, domicialliary agencies and care homes adding social care workers in these sub sectors to the shortage occupation list.

3. Reducing the salary threshold for immigration in social care sectors and also allowing the value of free accommodation to be included for live-in staff.

4. Allow exemption from quarantine for live-in careworkers arriving in the UK from outside the Common Travel Area, provided they are double-vaccinated, PCR-tested, and without symptoms of COVID-19. It is important to balance the risk of infection with that to the safety and well-being older or disabled people with high support needs being left without social care. There is already a very lengthy list of occupations which are exempt.

5. Recognise legitimate vaccination certificates of careworkers from outside the UK, in addition to those supplied by the NHS.

6. Currently once working here live in social care workers get free PCR tests twice weekly but have to book and pay for tests on day 2 and 8 before travelling here. These initial test should also be made free.

7. Increase funding for social care so that disabled employers can afford to pay their staff a real living wage. Over £8 billion has been cut from Local Authority budgets since 2010 and in many parts of the country people can earn more working in hospitality or as cleaners than they can earn working in social care.