Modern Slavery Concern Reporting Form
This form allows you to anonymously report concerns about modern slavery, human trafficking, forced labor, and other forms of exploitation specifically within care settings (e.g., residential care, nursing homes, home care, supported living) or related to staffing agencies supplying workers to these settings.
Your identity will be protected, and no personal information will be collected unless you choose to provide it. We cannot provide updates on individual reports due to the anonymous nature of this form. If this is an emergency or someone is in immediate danger, please contact local law enforcement or your national modern slavery helpline immediately (0800 0121 700).
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Section 1: Nature of the Concern
What type of exploitation do you suspect in this care setting or staffing situation? (Please select all that apply or describe)
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Forced Labor (e.g., forced to work, unable to leave)
Debt Bondage (e.g., exorbitant recruitment fees, deductions for accommodation/food)
Human Trafficking (general)
Exploitation of vulnerable residents/clients (not necessarily staff)
Exploitation of vulnerable staff (e.g., illegal deductions, excessive hours, document retention)
Domestic Servitude (e.g., care workers forced to perform personal tasks outside of duties for perpetrator)
Other (Please describe below)
If you selected other please provide more information here:
Briefly describe your concern. Please provide as much detail as possible about what you have observed or know. (e.g., How did you become aware of this? What specific actions or conditions concern you regarding staff or residents?)
*
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Section 2: Location and Entities Involved
Where is the alleged modern slavery activity taking place? (Name of Care Setting/Facility/Agency (if known), Specific Address/Location (if known), City/Town, State/County/Region, Country, Postcode:
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What type of care setting or entity is it? (Please select all that apply)
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Residential Care Home (Elderly/Adults)
Nursing Home
Supported Living Accommodation
Home Care Agency (providing care in private homes)
Staffing/Recruitment Agency (supplying care workers)
Private Residence (where a care worker is exploited)
Day Care Centre
Hospital/Clinic
Other (Please describe):
If you selected other please provide more information here:
Are there any distinguishing features of the location or business that could help identify it? (e.g., "red brick building near the river," "specific logo on uniforms," "well-known agency name in the area")
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Section 3: Details about the Victim(s) of Exploitation (Staff or Residents)
Who do you believe are the victims of exploitation?
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Care Staff/Workers
Residents/Clients of the care setting
Both Staff and Residents/Clients
Unknown
How many potential victims do you believe are involved?
*
1
2-5
6-10
More than 10
Unknown
What is the approximate age range of the potential victims?
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Children (under 18 - e.g., young care workers, or exploited residents)
Teenagers (13-18)
Adults (18+)
Mixed ages
Unknown
What is the gender of the potential victims (if known)?
*
Female
Male
Mixed
Unknown
Do you know the nationality or ethnicity of the potential victims? (Optional - if known, please provide a general description, e.g., "primarily Eastern European," "migrant workers")
*
What signs of exploitation have you observed in the victims? (Staff) (Please select all that apply and provide details below)
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Working excessively long hours (e.g., 12+ hour shifts regularly, no days off)
Working without pay or very low pay
Wages deducted unfairly or without consent (e.g., for accommodation, transport, "fines")
Appears to be in debt to employer/recruiter
Lives at work premises or in poor, overcrowded accommodation arranged by employer
Passport/ID documents withheld
Restricted movement or communication outside of work
Fearful, anxious, or submissive demeanor
Visible injuries or signs of neglect/abuse
Appears isolated or lacks personal possessions
Threat of deportation or harm to family
Unable to leave their job despite wanting to
Other (Please describe below)
What signs of exploitation have you observed in the victims? (Residents/Clients) (Please select all that apply and provide details below)
*
Appears neglected or malnourished
Visible injuries or signs of abuse (physical, emotional, financial)
Appears fearful or withdrawn around certain staff members
Sudden change in financial situation or property ownership
Lack of personal possessions or access to their own money
Restricted access to visitors or outside world
Other (Please describe below)
Please provide more details on the observed signs:
*
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Section 4: Details about the Perpetrator(s)/Exploiter(s)
How many perpetrators/exploiters do you believe are involved?
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1
2-5
6-10
Unknown
What is their role/relationship to the care setting or victims (if known)?
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Care Home Owner/Manager
Staffing Agency Owner/Manager
Supervisor/Team Leader
Other Staff Member
Recruitment Agent
Family Member of a victim
Unknown
Other (Please describe):
If you selected other please provide more information here:
Do you have any identifying information about the perpetrator(s)? (Optional - e.g., name, nickname, physical description, vehicle details, contact information, specific role)
*
How do they control or exploit the victims?
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Physical violence or threats
Psychological manipulation/Coercion (e.g., threats of dismissal, reporting to authorities)
Debt (real or fabricated, often from recruitment fees or 'training costs')
Confiscation of documents (passport, ID, work permits)
Isolation from family/friends/outside world
Threats against family members
Exploiting immigration status or lack of language skills
Withholding or delaying wages
Other (Please describe below)
Please provide more details on how they control victims:
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Section 5: Timeframe and Additional Information
When did you first become aware of this concern? (Approximate month/date/year)
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-
Month
-
Day
Year
Date
How long do you believe this situation has been ongoing?
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Days
Weeks
Months
Years
Unknown
Are the activities you are reporting still ongoing?
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Yes
No
Unknown
Is there any other information, details, or context you think would be helpful for us to know? (e.g., typical work routines, specific shift patterns, details of recruitment process, specific resident needs being neglected, other staff who might have witnessed this, vehicles involved, known contacts, any documents or photos you could describe even if you can't submit them)
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