The Workforce Crisis in Home Care: Recruitment Challenges and Visa Restrictions

Overview of the staffing problem

The success of domiciliary care services hinges on the availability of skilled, compassionate carers. Yet in 2025 the sector faces a staffing crisis. A Department of Health and Social Care (DHSC) survey conducted in April 2025 revealed that 71 % of provider locations found recruitment challenging, and 58.5 % of domiciliary care settings reported retention problems. The main reason providers cited for difficulties was better pay outside the sector, meaning that people can earn more working in supermarkets or hospitality. Low morale was also a major issue; 46.1 % of domiciliary care providers reported staff morale problems, compared with 36.9 % of residential settings.

Recruitment from overseas and the visa ban

To ease shortages, many home‑care agencies have relied on overseas recruitment in recent years. The number of foreign care workers recruited under the Health and Care Worker Visa scheme increased from 20 000 in 2021‑22 to 105 000 in 2023‑24. International staff provided essential support, particularly in areas with high vacancy rates. However, on 22 July 2025 the UK government enacted a ban on new sponsorships for care workers and senior care workers under the skilled worker visa route. Care providers can no longer recruit new overseas workers to these roles; those already in the UK can continue working until their visas expire (many until July 2028). The government argued that the health and care visa had been abused, with many migrants brought into low‑paid roles by unscrupulous recruiters. It hopes that restricting overseas recruitment will encourage employers to improve pay and conditions to attract domestic workers.

The sector, however, warns that the visa ban exacerbates existing shortages. In March 2025 the vacancy rate for care worker roles was 8.2 %. Home‑care providers argue that they cannot fill these vacancies domestically because pay remains low and the work is demanding. Many organisations rely heavily on international recruitment to meet demand; removing this pipeline risks leaving older and disabled people without adequate support.

Low pay and poor working conditions

Another factor driving the recruitment crisis is the perception that home care is low‑status, poorly paid and physically demanding. Carers often have zero‑hour contracts, travel between clients without pay for travel time, and work unsociable hours. Wages are sometimes only marginally above the minimum wage. While care work is deeply rewarding for many, the lack of financial recognition deters people from entering or staying in the profession. The DHSC survey found that pay outside the sector was the top reason for both recruitment and retention difficulties.

Proposed solutions and fair pay agreements

To address staffing shortages, sector leaders call for a Fair Pay Agreement for social care, similar to those in the NHS, which would set minimum pay and conditions nationally. The government has indicated that it will explore such an agreement under the Employment Rights Bill, but no firm timeline or funding has been announced. The Homecare Association and other organisations advocate for parity with NHS band 3 healthcare assistants, which would require higher hourly rates and a fully funded national contract. Providers also call for professional registration, career pathways and training opportunities to enhance the status of care work.

Retention strategies

In the meantime, individual providers are adopting measures to improve recruitment and retention. Many now offer paid travel time and mileage, guaranteed hours contracts and opportunities for progression into supervisory or nursing roles. Others provide mental‑health support, flexible rotas and recognition schemes to boost morale. Some agencies invest in digital tools that reduce paperwork, freeing carers to spend more time caring and less on admin. Raising awareness of these improvements may attract people who had not previously considered a career in domiciliary care.

What families and clients need to know

From a client perspective, workforce shortages can result in missed visits, inconsistent carers and waiting lists for care packages. When researching agencies, families should ask about staff turnover, training, pay rates and how the company supports its workforce. Agencies that prioritise staff wellbeing and career development are more likely to deliver consistent, high‑quality care. Understanding the wider recruitment landscape also fosters empathy for the pressures that carers face.