Link to this article: http://journals.cambridge.org/abstract_S0144686X11001309How to cite this article: KIERAN WALSH and ISABEL SHUTES (2013). Care relationships, quality of care and migrant workers caring for older people. ABSTRACTMigrant care workers make a substantial contribution to older adult care in Ireland and the United Kingdom (UK). However, little is known about the relational aspects of care involving migrant care workers and older people. Given that the care relationship is closely linked to quality of care, and that the Irish and UK sectors are increasingly restricted by economic austerity measures, this lack of information is a concern for care practice and policy. Our paper explores the relationship between migrant care workers and older people in Ireland and the UK and draws on data collected in both countries, including focus groups with older people (N = ), interviews with migrant care workers (N = ) and data from a survey of and interviews with employers. The findings illustrate the complexity of the migrant care workerolder person relationship; the prevalence of need orientated, friendship and familial-like, reciprocal, and discriminatory interlinking themes; and the role of individual, structural and temporal factors in shaping these relationships.KEY WORDSolder people, migrant care workers, care relationship, quality of care.

In recent decades, rapid population ageing has dramatically increased the need for older adult care provision in the UK. A prominent role in meeting the care needs of the older population has been played by migrant workers. The aim of this paper is to explore the characteristics of the UK social care system that shape demand for migrant labour, the conditions under which migrant care workers are employed, and older people's and migrant care workers' experiences of the quality of care. Our analysis draws on the findings of a survey of providers of social care for older people, in-depth interviews with migrant care workers, and focus groups with older people. The findings show that the underfunding of social care and interrelated workforce shortages are largely responsible for the extensive reliance on migrant workers among social care providers, and raise concerns for workforce inequalities and for the quality of care.

This article contributes to an understanding of how different institutional contexts produce similar outcomes as regards the employment of migrant workers in care work. It examines how the employment of migrant care workers in both the familial provision of care and the formal provision of care services for older people is shaped, first, by the marketisation of care and, second, by immigration controls. The analysis draws on data on the employment of migrant care workers by families in Italy and by providers of residential and home care services in the UK. It is argued that marketisation processes and immigration controls have contributed to the employment of migrant workers across so-called informal/formal types of care provision, and irregular/regular types of care work and migration. While the institutional contexts in which migrant care labour is located may differ, converging outcomes are evident regarding the structural positioning of migrant workers within the provision of care for older people.

The employment of migrant workers in long-term care is increasingly evident across western welfare states. This article examines the ways in which immigration controls shape the exercising of choice and control by migrant care workers over their labour. It draws on the findings of in-depth interviews with migrant care workers employed by residential and home care providers and by older people and their families in the UK. It is argued that the differential rights accorded to migrants on the basis of citizenship and immigration status shape, first, entry into particular types of care work, second, powers of ‘exit’ within work, and, third, ‘voice’ regarding the conditions under which care labour is provided.