Over the past decades the English adult social care system has seen a set of policy reforms combined with funding cuts and austerity measures. This chapter utilizes secondary and primary data sources to investigate the current state of the English social care workforce with a particular focus on the increasing role of migrants; persistent low wages and job related stress. The findings highlight the continued role of migrants in the sector with a clear shift in their profile that is consistent with the direction of the UK immigration policies. From 2013 migrants joining the care sector from Bulgaria and Romania alone have exceeded all other migrants entering the sector. The analysis indicates the persistent low wages in the sector, which are facilitated by a number of factors including austerity measures and the increasing role of the private sector and outsourcing of services. The nature of care work combined with difficult working conditions created various situations where individual workers felt a considerable level of stress. The latter is likely to impact not only on workers’ ability to complete their work to the highest quality but also has a potential negative impact on their own well-being and increases the likelihood of job quitting.