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Care home jobs: Overseas workers ‘exploited and trapped’ in UK care home

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Overseas workers ‘exploited and trapped’ in UK care home : care home jobs

Care home jobs: Staff at care homes have told the BBC that they feel exploited and trapped by the company that brought them to the UK to work.

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Prestwick Care employees told an undercover Panorama reporter that they believed their contracts prevented them from leaving.

Low staffing levels, according to health professionals, put vulnerable residents at risk, according to the BBC investigation.

Prestwick Care strongly denies any allegations of systematic wrongdoing or poor practice.

An undercover reporter for Panorama worked as a care assistant at Addison Court in Crawcrook, west of Gateshead, one of Prestwick Care’s 15 care homes in the north-east of England. He worked there from September to November of this year after hearing allegations about the home from local health professionals.

More than 50 old people live at Addison Court, where weekly fees average around £1,100. These are funded by the local government, the NHS, the residents, or their families.

Addison Court, like many care homes in the UK, relies heavily on foreign workers.

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140,000 visas were issued for overseas health and care workers to come to the UK in the fiscal year ending September 2023, more than doubling the previous year. 39,000 of these were issued to Indian citizens.

Nurses and care workers from other countries can apply for a skilled worker visa. This means they can work in the UK, but they must be sponsored by a company.

If they leave their job, they have 60 days to find another job, or they must return to their home country.

There have been concerns raised about the power this gives employers.

“If you are in a position of power as a boss, then you can exert coercive control over an individual,” says Andrew Wallis of the anti-exploitation charity Unseen.

Prestwick Care employs nearly 180 overseas workers on visas in the UK, accounting for nearly one-third of its workforce.

One Indian nurse there told the reporter that she was unhappy in her job but couldn’t leave because the company sponsored her visa, and she felt she had no choice.
“I can’t leave here.” I could at least resign if I were back at home. “But I can’t just walk away here,” she explained.

Prestwick does not make it easy for overseas nurses who have decided to leave the company.

Ahmed (not his real name) moved to the United Kingdom in 2018 from the southern Indian state of Kerala.

He was asked to sign a contract when he arrived. It stated that if he left the company within five years, he would be required to pay Prestwick Care more than £4,000, which included money paid to the Home Office and legal fees for his visa.

Staff should not be required to pay these costs, according to the Department of Health and Social Care (DHSC) Code of Conduct.

“If you don’t want to stay here on that contract,” Ahmed says, “you can go back to India.”

He claims Prestwick Care tried to keep him from leaving, but he resigned after being offered a more senior position at another company’s care home.

Prestwick Care then filed a lawsuit against Ahmed, claiming that he owed the company more than £5,000 in back pay.

Bunty Malhotra, CEO of the Malhotra Group, which owns Prestwick Care, was then contacted. He said to Ahmed, “What you have done is immoral, unethical, and terrible.”

Ahmed was also informed that a contract clause prohibited him from working for any competitor care home for six months.

Liana Wood is a lawyer. She claims that this clause would not be upheld by a court or a tribunal, and that it was only in place “to trap [nurses and senior care assistants] in their situation.”

Ahmed’s legal action was eventually settled by his new employer.

Unscrupulous bosses, according to Andrew Wallis of Unseen, use debt to control their employees.

Prestwick Care denies that its contracts are intended to intimidate its employees and claims that it is currently reviewing repayment clauses in all employee contracts.

Some Addison Court employees’ situations were exacerbated by the fact that they had paid between £6,000 and £10,000 for their visas through a recruitment agency called BGM Consulting.

If they had applied directly through the UK government website, a three-year visa would have cost only £551.

According to the DHSC, businesses should not work with recruitment agencies that charge job seekers a fee.

Sunil Thomas, the director of BGM, claims that the company has not taken any funds for the recruitment of care workers in the UK, and that any money paid would have gone to “sub-agents” acting without his knowledge in India.

Prestwick Care has announced the suspension of all new arrangements with BGM Consultancy.

The reporter also heard concerns about how Addison Court’s low staffing was affecting the quality of care.

There are no guidelines for how many employees a nursing home should have. According to Prestwick Care, one nurse can provide adequate care for 54 residents on night shifts (between 20:00 and 08:00), as they are supported by a team of carers, some of whom can administer medication.

However, an agency nurse who worked the night shift told the reporter that it was difficult to manage and that some residents did not always receive their medications on time.

Late drug administration can have serious consequences for some conditions, such as insulin injections for diabetics or Parkinson’s disease medications.
According to the agency nurse, he once attempted to raise concerns about staffing levels with Bunty Malhotra. Mr Malhotra, he claims, swore at him and was dismissive in his response, which Mr Malhotra denies.

Other Addison Court employees told the undercover reporter that concerns about a lack of staffing had been raised, but that management was uninterested.

Local health professionals have echoed the workers’ concerns.

A GP at Addison Court who requested anonymity said she noticed a pattern of certain patients not receiving their medication on time.
Staff recognized that care was not always adequate, but they felt it was pointless to bring their concerns to management because they would “either somehow make it their fault or just try and sweep it under the carpet,” she said.

The manager of Addison Court denies that she fails to investigate complaints and claims to have positive relationships with the home’s staff.

Until last year, NHS nurse Katy Maughan came to the home once a week. She claims that the nurses she spoke with were unhappy but couldn’t leave.

She assumed that employees were not raising concerns because they did not want to upset the company and be forced to leave the country.

Ms Maughan claims she was so concerned about some residents that she issued 33 safeguarding alerts to Gateshead Council over a two-year period.

One of those alerts was about a resident who died after being left for 72 hours with severe constipation, according to her. She believes the death could have been avoided.

“They [the staff] should be talking to the doctor and saying, ‘Look, we still haven’t had a bowel movement,’ and they should be getting medical advice.” It’s a result of neglect.”

Gateshead Council told Panorama that it was unable to share the outcomes of the safeguarding concerns due to the release of highly sensitive personal information. Each alert was responded to and “managed in the best interests of the residents… based on the evidence provided at the time,” according to the report.

Prestwick Care’s parent company, Malhotra Care Homes Limited, reported a profit of £9.3 million in the fiscal year 2021-22 in its most recent published accounts. According to Chartered Accountant Vivek Kotecha, this margin – around 40% – is extremely high for a care home. He believes that one reason for this could be that the company spends less on staff than its competitors.

“That’s kind of worrying,” he said, “because these kinds of patients need staff and care… otherwise they are at risk of falls or injuries.”
The Home Office suspended Prestwick Care’s license to sponsor overseas workers in December 2022. There is no explanation for the action.

Bunty Malhotra summoned Addison Court’s Indian staff to a meeting, where he attempted to persuade them to stay.

He seemed to imply that he was willing to overlook and cover up any errors they made.

“If you work for the NHS, one mistake [and you will be] reported to the NMC (Nursing and Midwifery Council) straight away,” he can be heard saying.
“We will always protect our staff, we’ll always say, ‘this mistake is a training issue’… this protection isn’t allowed outside.”

Katy Maughan, who witnessed the meeting, was astounded by how he appeared to be scaring staff into staying at the care home.

Prestwick Care’s license to sponsor overseas workers has now been “fully revoked” by the Home Office. Following the safety reports, including one from the BBC, the Care Quality Commission (CQC) suspended Addison Court’s “good” rating.

Prestwick Care claims that any suggestion of systematic wrongdoing or bad practice is unfair and inaccurate. It states that the safety and well-being of its employees is still of the utmost importance, and that it is “fully committed to thoroughly investigating all concerns raised and taking appropriate actions as necessary.”

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