Written evidence submitted by Anchor Hanover (WBR0029)

 

  1. Anchor Hanover

 

1.1 Anchor Hanover is England’s largest not-for-profit provider of care and housing for people in later life, with more than 60,000 residents in 54,000 homes across almost 1,700 locations, supported by more than 10,000 colleagues. Anchor Hanover provides retirement housing to rent and to buy, retirement villages and residential care homes, including specialist dementia care, operating in more than 85% of local councils in England.

 

1.2 Of the 114 care homes we operate in England, nine were rated Outstanding and a further 97 Good at their most recent CQC inspections. This makes Anchor Hanover the most compliant of large providers in England.

 

  1. How resilient was the NHS and social care workforce under pre-Covid-19 operating conditions, and how might that resilience be strengthened in the future?

 

2.1 Going into the current pandemic, there were 126,000[i] vacancies in social care and warnings that the sector is facing a shortfall of 1.1 million care workers by 2037[ii] expose the lack of resilience even prior to Covid-19. Delivery of care services is also being made increasingly difficult due to a lack of diversity in the workforce as care work continues to be viewed as an undesirable career path.

 

2.2 To strengthen this resilience, we are calling for the launch of a National Positive Ageing Strategy with an initiative to recruit more people into the care sector at its heart. The government’s Care for others. Make a difference. campaign is a positive step forward. However, we need a wider-reaching strategy, across both the public and private sectors, which promotes the UK as a society for all ages and encourages great intergenerational cohesion. This should be supported by a funding framework which enables the skilled and critical work undertaken by this workforce to be recognised.

 

2.3 There are signs that the care sector is beginning to be seen in a more positive light. The weekly #ClapforCarers at the height of the pandemic was dedicated to both the health and care workers and Anchor Hanover research, undertaken during the pandemic, has highlighted a welcome and significant improvement in attitudes towards the sector since the start of the pandemic:

 

-          62% of the public had a higher opinion of social care than at the start of the pandemic.

-          84% of the public are demanding the sector be given parity of esteem with the NHS.

-          54% of the public would like to see the government prioritise social care reform.

 

2.4 It is vital that this boost to esteem in which care work is held is now harnessed to help drive recruitment in the sector. We are keen to work with the government on this, having responded to the Department of Health and Social Care call to recruit 20,000 more care workers by putting our vacancies onto the DWP website. 

 

  1. What has the impact of the Covid-19 pandemic been on resilience, levels of workforce stress, and burnout across the NHS and social care sectors?

 

3.1 Throughout the Covid-19 pandemic, the dedication and commitment of our colleagues in care has been exemplary. Despite the extremely difficult circumstances of the pandemic, our colleagues have continued to deliver excellent care to our residents. This has been reflected in the CQC’s Emergency Support Framework inspections which have found that, of 46 homes inspected, 45 were “Managing” - the highest rating.

 

3.2 There have, however, been many challenges throughout the crisis which have exposed the lack of resilience in the sector and stretched existing resources. At the beginning of the pandemic, around 1,200 of our 10,000 colleagues were self-isolating in accordance with Government requirements demonstrating the serious problems caused by staff absences during the Covid-19 peak.

 

3.3 To ensure that we did not suffer significant shortages in the workforce, Anchor Hanover launched a targeted recruitment drive in March. This has been extremely successful with 2,177 applications received and 111 new staff onboarding or started between March and August. New recruits from this campaign helped us to continue delivering our services, despite the large number of self-isolating colleagues, though it is a stark reminder of the lack of depth which continues to exist in the care workforce.   

 

  1. What is the current scale of burnout across the NHS and social care? How does it manifest, how is it assessed, and what are its causes and contributing factors? To what extent are NHS and care staff able to balance their working and personal lives?

 

4.1 Anchor Hanover has worked exceptionally hard to safeguard the wellbeing of our service users. We have found that effective communications, engagement and facilities to support colleagues are extremely important to reducing the risk of burnout.

 

4.2 Our quarterly Employee Engagement Survey, undertaken in June 2020, showed overall engagement had increased from 77% in February to 85% in June with 74% of Anchor Hanover colleagues agreeing with the statement “Anchor Hanover cares about my health and wellbeing” in May, up from 61% in February. These are outstanding results in view of the circumstances of the pandemic and demonstrate the value of effective engagement and support.

 

4.3 Between April and June 2020, mental health related absences increased from around 15% of total absences to around 22%. Around 40% of all mental health absences during this period were due to anxiety. We recognise that, in addition to the particular circumstances faced by those working in the sector, many colleagues were also affected by circumstances in their home and family lives.

 

4.4 In response to this, our BeingWell programme, aimed at improving colleagues’ health and wellbeing and at demonstrating the benefits of working for Anchor Hanover, has been enhanced to meet the challenges of the pandemic. BeingWell is now offering advice on tackling loneliness as a result of social distancing and other restrictions. This advice includes maintaining contact with friends and loved ones where possible e.g. using social media, video platforms or in writing, information on exercise routines, activities for relaxation and online learning resources.

 

  1. What are the impacts of burnout on service delivery, staff, patients and service users across the NHS and social care sectors?

 

5.1 Anchor Hanover has taken a number of significant steps to mitigate against the impact of burnout on our staff and service users. As mentioned, we have undertaken a recruitment campaign to offset absence due to self-isolating and sickness and to bolster our workforce at a time of increased pressure.

 

5.2 As a not-for-profit organisation, with no shareholders, we are able to invest our surpluses into the organisation. This enabled us to offer our staff Discretionary Enhanced Sick Pay of 75% of earnings should they need to take time off due to illness at this time.

 

5.3 Our Hardship Fund, established at the beginning of the pandemic, provides interest-free loans to assist colleagues who may be experiencing financial difficulty as a result of measures taken to tackle Coronavirus. This has helped to reduce financial stress amongst colleagues. Between April and August, 177 colleagues applied for support through the Hardship Fund; all of these were applications were approved with a total of £142,000 of assistance paid out. 

 

5.4 Throughout the pandemic, our colleagues have demonstrated a tremendous dedication to their work and our service users. Many have been reluctant to take time off for minor illness in order to support their colleagues.

 

  1. What long term projections for the future health and social care workforce are available, and how many more staff are required so that burnout and pressure on the frontline are reduced? To what extent are staff establishments in line with current and future resilience requirements?

 

6.1 At present, the social care sector has increased potential to recruit as other sectors have experienced a high level of redundancies, and it is likely that there will be more in the coming months. While it is very welcome that increasing numbers of people are considering a career in the care sector, this also brings significant challenges.

 

6.2 The rhetoric surrounding care work continues to view the sector as undesirable and unskilled. While an increase in interest in careers in the sector is a positive development, there is no guarantee that a majority of applicants will possess the relevant skills, frame of mind, or experience which makes them suitable to work in care. Furthermore, it is not clear how long renewed interest in the care sector will last once the pandemic ends and other sectors of the economy begin to recover. This could lead to new recruits leaving quickly after joining the care sector to return to positions in their previous field. This again means that we would have to recruit and train once again.

 

6.3 As we have stated, the care sector faces a shortfall of 1.1m workers by 2037 and a further one million care staff will need to be recruited by 2025[iii] to meet the needs of an ageing society and the implied increase in disabilities. These new recruits will also need to diversify the workforce in order to deliver more personalised care. To meet this challenge, care work must be framed for what it is: a skilled and rewarding career with opportunities for progression. The resilience of the workforce will not be bolstered if the sector is an afterthought following the NHS.

 

6.4. While much of the focus is, correctly, on colleagues providing care, our homes are also dependant on excellence in food preparation, nutrition and dining, on housekeeping, and management roles. The circumstances of Covid-19 have affected these staff groups and ensuring that these skills are also recognised is part on the ongoing resilience of the sector.

 

  1. To what extent are there sufficient numbers of NHS and social care professionals in training for service and resilience planning? On what basis are decisions made about supply and demand for professionals in training?

 

7.1 The perceptions of the social care sector as unskilled and an undesirable career path has left the sector with a shortage of professionals in training. Research conducted by Anchor Hanover and the International Longevity Centre highlighted a perception of low pay and a lack of opportunities for personal development as major barriers to recruitment in social care.

 

7.2 Anchor Hanover pays 10p above the National Living Wage in all care roles, regardless of age, and offers numerous training and development opportunities for apprentices and more experienced colleagues alike. These include:

 

-          Our National Apprenticeship Service recommended apprenticeship scheme; rated in the top 100 by Rate My Apprenticeship. With around 100 apprentices at any one time, around 75% of these go on to a full-time role with Anchor Hanover.

-          Numerous training opportunities for colleagues both as face-to-face courses and online with free training courses earning participants NVQs.

-          Our myFUTURE leadership programme which helps colleagues into more senior roles such as Team Leaders and Deputy Managers. Around 80% of Deputy Managers will use this programme to progress to Home Managers.

-          Our recently launched 10 new CPDs - Level 2 certificate courses which are recognised by the Health and Social Care sector. This further enhances the

development we offer and aids attraction. 

 

7.3 While there are clear benefits to individuals from pursuing a career in care work, these exist against a backdrop of negative perceptions surrounding the sector. These problems will persist as long as these perceptions dominate. The recognition of the vital work of care workers during in the pandemic is our opportunity to reverse this.

  1. Will measures announced in the People Plan so far be enough to increase resilience, improve working life and productivity, and reduce the risk of workforce burnout across the NHS, both now and in the future?

 

8.1 While the 2020/21 NHS People Plan has many positives for the health service, the plan does not acknowledge the interdependency of the health and care sectors nor is there a People Plan for social care itself. With 40% of the NHS budget already spent on the over 65s[iv] and delayed discharge from hospital due to a lack of access to social care costing the health service £3bn per year[v], this interdependency has never been more apparent.

 

8.2 We are calling on the government to produce a Social Care People Plan. Many aspects of the 2020/21 NHS People Plan are similar to those in Anchor Hanover’s People Plan for 2020 – 2022 in terms of supporting staff wellbeing and recruiting and retaining staff. These include:

 

-          Designing new and effective means of learning and development to increase opportunities for career progression.

-          Developing our leadership capability.

-          Continue to enhance the means by which we support colleague wellbeing.

-          Drive higher colleague engagement.

 

8.3 With so many similar aims, recognition of the interdependency between health and social care is crucial if the care sector is to help the NHS to reduce the strain on resources as a result of an ageing population and tackle challenges of our own.

 

8.4 With no People Plan for social care, the NHS People Plan risks reducing the resilience of the care workforce as, with no focus on achieving parity of esteem between healthcare and social care, many people with the necessary skills for the care sector may choose the NHS as it is seen as a more desirable option.

 

  1. What further measures will be required to tackle and mitigate the causes of workforce stress and burnout, and what should be put in place to achieve parity of esteem for the social care workforce?

 

9.1 Parity of esteem between the NHS and social care is vital to achieving greater resilience for social care and reducing the strain on care workers. As the weekly #ClapforCarers and Anchor Hanover’s recruitment drive have demonstrated, there is potential to recruit a skilled and dedicated care workforce with clear focus on how rewarding and fulfilling a career in the sector can be.

 

9.2 Anchor Hanover is continuing to call for a government initiative to drive parity of esteem between healthcare and care work which harnesses the boost to esteem the sector has experienced since the start of the pandemic to build a better future for care. The initiative could celebrate the work of the care sector during the pandemic and beyond and form part of a wider National Positive Ageing Strategy to help celebrate later life and drive greater intergenerational cohesion.

 

9.3 A National Positive Ageing strategy could also encourage greater physical activity amongst older people, helping to enhance physical and mental wellbeing amongst those in later life. This would help to reduce the strain on health and care services and, when coupled with a government initiative to drive parity of esteem, help to highlight the breadth of career options available in the care sector from care work itself to catering to organising leisure and social activities.

 

9.4 Funding is a key area which can help to boost resilience in the care sector. Although Anchor Hanover pays 10p above the National Living Wage to all care staff, regardless of age, it is clear that pay will be critical in tackling negative perceptions of the sector and attracting a skilled workforce. While interim measures during the pandemic such as the Infection Control Fund have been welcome, it is imperative that the Government delivers on its commitment to provide a new funding framework for social care as a matter of urgency. This must reflect the criticality of a skilled, supported, and growing workforce.

 

9.5 Further reform of social care funding is also required to provide a clear and fair approach for those older people who need social care. Anchor Hanover is calling for a cap on individual care costs and greater education for the public on their responsibilities to fund their care – Anchor Hanover research shows that 25% of people wrongly think social care is funded by the state and only 14% are saving towards their future care needs[vi].

 

Contact:

 

James Floyd, Public Affairs Officer

james.floyd@anchorhanover.org.uk

07541 955 226

 


[i]https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/jobsandvacanciesintheuk/may2020

 

[ii] https://www.anchorhanover.org.uk/media/campaigns-and-research/programme-change

 

[iii] https://anchorv3dev.s3.eu-west-2.amazonaws.com/documents-pdfs/within-media-section/Future_Care_Workforce_Report_2014.pdf

 

[iv] https://www.anchorhanover.org.uk/media/campaigns-and-research/programme-change

 

[v] https://www.anchorhanover.org.uk/media/campaigns-and-research/programme-change

 

[vi] https://www.anchorhanover.org.uk/media/campaigns-and-research/programme-change

 

Sept 2020