I was involved in regularly visiting friends and family in care homes for about 40 years, from mid 1970s to mid 20teens and the rise in the use of foreign carers in that time worried me and still does.
It has got nothing to do with the quality of the workers, or even their command of the English language, but their lack if any shared cultural background at a trivial level.
When people are old and frail they think and talk of the past. Shops they knew, radio and tv programmes they watched, actors and filmstars of the past. Remembered food and household products. There is a cultural shorthand of shared phrases, words and memories shared by carers and cared when they share a cultural background which contributes immeasurably to the mental health of care home residents.
No matter how kind and gentle a carer is, someone from the Philippines, Romania or India does not have that shared background so necessary for those with dementia and other memory problmes. Having some foreign workers is fine, but for a short while an aunt and uncle where in a care home where without exception all the care staff were Phillipinas. The physical care was superb but there was rarely ay conversation be tween cared and carer, that did not directly relate to care - and that bothered me.