Nurses hired from abroad to work for one of Britain’s biggest social care chains have been left in debt and are in some cases suicidal after being stranded without pay for months.
They have also been paid lower wages than they were told they would receive and were in some cases given false promises about their accommodation and employment terms, an Observer investigation has found.
The affected workers were hired through agencies as part of a drive to fill 400 vacancies at Cambian children’s services – part of the CareTech group – and are mostly female nurses from India recruited for residential support worker roles.
They are understood to have spent as much as £18,000 each on relocation costs, “training” charges and other fees to take up jobs in homes that provide taxpayer-funded care for disabled and vulnerable children, including those with complex trauma and learning difficulties.
Before they left India, the nurses were promised by agents that they would receive financial support from their 11th day in the UK while inductions and background checks were completed. But after they landed earlier this year they were told this was not the case, and they would be paid only after starting shifts, according to evidence seen by the Observer.
Administrative delays and the temporary closure of several Cambian children’s homes – leaving fewer vacancies than expected – means some workers have been waiting for up to four months to start work, without any income. They are unable to find other work because their visas are tied to their employer.
Four whistleblowers at Cambian independently described to the Observer how their Indian colleagues were accruing debt by the day. Many of those affected borrowed money and sold property and belongings to come to the UK in the first place. One source, in a senior role at the company, said the workers had been given information while in India that did not match the reality. “They were sold a dream and it isn’t what they were promised,” they said.
The source added that the workers were afraid to speak out for fear of repercussions. “They’ve spent a lot of money on this and the last thing they want is to [lose their sponsorship] and be deported. They want to make it work here,” they said.
Another whistleblower described how Cambian’s recruitment drive had been blighted by “basic logistical failings”, including workers being placed in housing miles from the children’s homes where they work. “They brought these people here with no idea what was going to happen when they got here. Even the commonsense things for me, they [Cambian] haven’t looked at,” the source said.
The findings raise urgent questions about the treatment of international workers recruited by one of the UK’s biggest and most profitable social care chains.
Cambian children’s services is part of the CareTech group, which has contracts with more than 300 UK councils providing care for the country’s most vulnerable people. The company, owned by Haroon and Farouq Sheikh, took over Cambian in 2018 and recently took the group private in a deal valued at £830m. CareTech’s latest accounts show it made £79.5m profit in the year to September 2021, up 49% on the year before, with revenue from its children’s division accounting for about 55% of the total.
The problems are said to have left some of the workers suicidal. One long-term Cambian employee said she knew of colleagues who were “crying all the time” and had been forced to rely on food banks.
A nurse hired from India to work at a Cambian children’s home claimed she had been waiting for three months without pay at the same time as paying 20 times as much for rent as she was back in India. “Our family is dependent on us. We came here to work for them,” she said. Now the nurses were asking for help from those same relatives so they could “eat and pay the bills”, she said.
At a series of meetings with affected workers in late May, a senior Cambian executive appeared to acknowledge that the nurses had paid thousands of pounds to come to the UK.
According to multiple sources of evidence, he said he was aware the workers had “spent lots of money” to come here – up to £18,000, including what he described as a £4,000 “referral fee”.
He also said the company had “made mistakes” for which he apologised and acknowledged a decision had been taken not to pay workers until they had started shifts – despite them being told by agents they would receive money after 11 days.
The delays had led to “months of tears and hardship” that the workers “could have done without”, he said, adding that “in an ideal world” they would have had all their checks completed before leaving India.
In a statement to the Observer, Cambian distanced itself from the comments and said it and its executives “emphatically denied” any knowledge of money being paid by candidates to agents. It said it would investigate, but did not comment on whether it would reimburse workers if fees were found to have been paid.
The company denied suggestions that it was in any way responsible for “shortcomings” in the recruitment process and said many of the problems were issues for its agency partners.
“Expectations regarding working in the UK have been set by other agencies and not under the instruction of Cambian,” a spokesman representing the company said. He said Cambian had not stated in its offer letters that workers would be supported financially before starting shifts, and that suggestions the company had taken a decision to change its policy were wrong.
The UK-based recruitment agency Cambian contracted to source workers, Harley Medical Services Ltd, appeared to dispute Cambian’s position, saying all information it gave to candidates was provided to it by the employer. The company sources many of its workers through a third agency which did not respond to requests for comment.
Cambian’s spokesman also said delays to workers starting shifts and getting paid had been because “official checks took longer than expected”, some workers’ arrivals had been unplanned and the company had needed to “adapt” to changes in site requirements. He added that Cambian was “unaware of fee arrangements” between workers and agents.
Cambian and Harley Medical denied charging or receiving any such fees, and there is no suggestion that they did. But labour rights groups said the claims raised questions about potential exploitation in the supply chain.
As well as the absence of financial support on arrival, many workers are alleged to have faced delays receiving wages for shifts they have worked. Others are being paid lower rates than what they had been offered in India, whistleblowers allege. Candidates were told they would be paid about £11.50 an hour but are actually getting £1 an hour less. More than 100 workers are understood to have asked for help with pay issues in recent weeks.
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Workers have in some cases been housed in shared accommodation that is dirty or lacks basic facilities such as a fridge after paying £550 a month up front, it’s alleged. Others are said to have been promised English lessons which they have not received.
Cambian said it was not responsible for arranging workers’ accommodation or English lessons and that this was the job of agencies. On the underpayment claims, it said staff were offered employment at “various rates” which were then reflected in their contracts “subject to relevant checks”. A spokesman said there had been “some errors in this regard” but that these had now been corrected.
Neill Wilkins, head of the migrant workers programme at the Institute for Human Rights and Business, described the allegations as “scandalous” and said the affected workers were in a “very vulnerable” position.
He said the whistleblower testimony suggested they were being “exploited in India during recruitment and then in the UK during employment”. “They are probably being promised all sorts of things and there is a form of exploitation in that they’re not being given what they were told they would receive,” he said.
He added that besides paying for accommodation, employers should cover all costs associated with hiring workers from abroad in line with International Labour Organisation standards. “Companies have a duty of care to their workforce,” he said.
The debts said to have been incurred by the workers also raise questions about Cambian’s approach to international recruitment.
Rather than hiring workers directly from India, the company is understood to have contracted Harley Medical, which in turn engaged another agency, Care2Nurse, to help it source many of the candidates.
Unlike traditional recruitment agencies – which charge fees to employers but not to workers – Care2Nurse describes itself as a “training organisation” which supplies international nurses to work in the UK as carers or support workers while they improve their English or prepare for the qualifications needed to practise as UK nurses.
According to Harley Medical, these “students” are charged fees for this process. Harley Medical said it “periodically audits” Care2Nurse’s invoices “to ensure their fees to students are in keeping with agreed parameters”. It did not say what these parameters were, but said the fees charged by its “direct suppliers” were not close to the £18,000 allegedly paid by some workers. When asked to comment on the arrangement, Cambian said it could not as this fell outside its “area of knowledge”. It is unclear why the decision was taken to hire workers in this way given that this training was not a requirement of working in the Cambian support worker jobs.
Had they been hired to work as NHS nurses directly, the costs of the exams and preparation needed to get their licence to practise in the UK would probably have been paid by the health service, which has been allocated £7,000 for each recruit.
Under UK law, charging recruitment fees – defined as any fee for “finding or trying to find you work” – is illegal. Agencies are permitted to charge for services such as training and CV writing, provided they do not force candidates to use them as a condition of finding them work. The Department of Health and Social Care also says employers hiring workers from abroad must ensure they are not charged fees.
Such fees can saddle workers with huge debts they have no realistic prospect of paying off, leaving them vulnerable to exploitation and in some cases pushing them into conditions akin to debt bondage.
As well as a ban on charging workers fees to find them jobs, the law prohibits agencies from charging for services such as training and CV writing which workers are given no true choice but to pay.
Care2Nurse did not respond to repeated requests for comment via email and phone. Harley Medical said: “We receive no fee from any candidate or any agency representing any candidate. Our only income comes as a nominal introduction fee from the employer for each candidate introduction.”
Cambian said any suggestion that shortcomings were its fault were misleading, and that it had gone beyond its contractual or official obligations to support international recruits, including offering interest-free loans for those facing financial hardship and hiring a transition officer.
It added that overseas staff had “successfully worked” in the organisation for “many years” and that they played a key role at Cambian and in the wider sector. “We acknowledge that we have had some challenges … However, we are working with staff directly on the issues identified and these are being addressed,” the company said.
Suresh Packiam, general secretary of the British Indian Nurses Association, said the case should be investigated thoroughly and that action was needed from the government to prevent “more people coming over in this way”.
He said he knew of multiple other cases where qualified nurses from India had been brought over to work as carers on the understanding they would progress to NHS roles. “They are desperate and they are promised they are going to make a lot of money. Then when they arrive, they feel cheated,” he said. “This is not just one company. There are many other companies doing the same thing.”