Written Evidence submitted by Anchor Hanover
(CLL0076)
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. We provide retirement housing to rent and to buy, retirement villages and residential care homes, including specialist dementia care and operate in more than 85% of local authority areas in England.
1.2 Of the 114 care homes we operate, 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.
2.1 The pandemic has exposed the interdependency between the NHS and social care and the urgent need to achieve parity of esteem between the two sectors. Like those in the NHS, social care staff have been in the frontline of the pandemic and, through their exceptional hard work and dedication, many of the most vulnerable in society have been safeguarded from Covid-19.
2.2 Social Care has been experiencing a variety of severe issues for a number of years and the current pandemic has only exacerbated many of these. It is now vital that the interdependency between health and social care is recognised and parity of esteem is achieved to help secure the long-term future of these essential sectors.
2.3 The Coronavirus pandemic has placed extreme pressures on social care. The problems surrounding workforce recruitment and retention have been particularly apparent during the current crisis. Going into the current pandemic, there were 126,000 vacancies in social care and warnings that the sector is facing a shortfall of 1.1 million care workers by 2037 exposing the lack of resilience prior to Covid-19.
2.4 With many providers facing staff shortages, the requirement for care workers to self-isolate has placed additional pressures on service delivery throughout the pandemic. At the beginning of the crisis in mid-March, around 1,200 of our 10,000 colleagues were self-isolating in accordance with government requirements.
2.5 The news of the potential rollout of a vaccination programme is extremely encouraging and Anchor Hanover welcomes the government’s commitment to prioritise NHS and care workers for any vaccine once it is available. We are calling on the government to now include those who work in and with older people’s housing services.
2.6 Throughout the Covid-19 pandemic, the dedication and commitment of Anchor Hanover colleagues has been exemplary. Despite the extremely difficult circumstances of the pandemic, our colleagues have continued to deliver excellent care to our residents. This is as true in our retirement housing and extra-care services as in our care homes. Prioritising all those who work in or with older people’s housing services will be a vital step in recognising the role they have played throughout the pandemic as well as in ensuring the needs of older people can continue to be met while safeguarding the health and wellbeing of residents and staff.
3.1 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 crisis:
- 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.
3.2 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. Anchor Hanover is continuing to call for a government initiative to drive parity of esteem between healthcare and care work; harnessing the boost to esteem the sector has experienced since the start of the pandemic to build a better future for care.
3.3 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.
3.4 Anchor Hanover’s own recruitment campaign has demonstrated that there is great potential to recruit a skilled and dedicated care workforce through clear focus on how rewarding and fulfilling a career in the sector can be. Beginning in March, our recruitment drive saw 2,177 applications received and 111 new staff onboarding or started between March and August.
3.5 A National Positive Ageing Strategy could help to replicate this at a national, sector-wide level as the government looks to prevent the predicted shortfall of 1.1m workers by 2037. 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.
3.6 Anchor Hanover 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.
3.7 Along with the opportunities for training and development, focus must also fall on the range of careers available in the care sector. 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 reform of the sector.
4. Social Care People Plan
4.1 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 and delayed discharge from hospital due to a lack of access to social care costing the health service £3bn per year, this interdependency has never been more apparent.
4.2 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.
4.3 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.
4.4 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.
4.5 At present, the social care sector has increased potential to recruit as other sectors of the economy have experienced a high level of redundancies, and it is likely that there will be more in the coming months.
4.6 While it is very welcome that increasing numbers of people are considering a career in the care sector, this also brings significant challenges. It is not guaranteed 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.
5.1 Funding reform is absolutely key to the future of social care. Although Anchor Hanover’s scale and associated efficiencies mean we can pay 10p above the National Living Wage to all care staff, regardless of age, this is not the case for all providers.
5.2 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.
5.3 Funding reform is now more urgent than ever. The pandemic has placed significant additional costs on providers as they have sought to maintain supplies of PPE and other means of infection control. This has also come at a time when income has been hit and costs are set continue to rise into 2021 as providers continue to ensure sufficient supplies of infection control equipment.
5.4 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. Our 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.
5.5 Funding reform can also help towards securing better pay for care staff and enhance the esteem in which the sector is held. The perceptions of the social care sector as unskilled and an undesirable career path has also left the sector with a shortage of professionals in training.
5.6 Research conducted by Anchor Hanover and the International Longevity Centre (ILC) highlighted a perception of low pay and a lack of opportunities for personal development as major barriers to recruitment in social care. It is the case that the crisis in funding for the social care sector has left many providers, particularly small providers, unable to increase staff wages leaving many care workers experiencing low pay. With this, many people who possess the relevant skills, frame of mind and experience will seek careers in the NHS rather than social care.
6.1 Along with providing lessons in social care delivery, the Covid-19 pandemic has also highlighted the importance of an approach to social care which puts prevention and independence at its heart. There are few areas as important as housing for this approach.
6.2 During the Covid-19 pandemic and the lockdown measures to control the virus, people have been more reliant on the home environment than ever before. For older people, this has had a significant impact. Anchor Hanover has experienced a significant increase in interest in our retirement housing services as lockdown has led many older people to consider their housing options and how to avoid issues such as loneliness and ill health in later life.
6.3 High quality older people’s housing must be at the centre of reforms to the social care system, including Sheltered and Extra Care housing. Research from Demos shows how, through prevention of falls, heading off crises that would otherwise end up in A&E, allowing safe discharge from hospital and preventing re-admissions, Sheltered housing alone saves the NHS £486m a year despite the current undersupply.
6.4 Of the estimated £486m in savings to the NHS, an estimated £300m of this is as a result of tackling delayed discharge from hospital. Demos also found that, despite being more likely to be admitted to hospital, residents in housing with care were discharged much sooner than the general older population due to the support they receive in the home.
6.5 Anchor Hanover services demonstrate the potential benefits to local and national services in tackling the pent-up demand for older people’s housing. The savings to public services made by Anchor Hanover services alone help demonstrate the benefits of Supported and Extra Care housing. Our research conducted with Sonnet, has found that our Extra Care services save local authorities around £6,700 per resident per year and, where Anchor Hanover activities have avoided loneliness, the saving to the NHS is around £3,000 per resident per year.
6.6 Additional investment in older people’s housing as part of the government’s “levelling-up” agenda would be welcome. It is important to highlight however that many of the measures which would help meet pent-up demand do not require large sums of money. We are calling for the inclusion of older people’s housing in local plans produced by local authorities and for a new classification focused on specialist housing within the planning system.
Bibliography
Anchor Hanover, Love living in later life, 2019
Demos, The Social Value of Sheltered Housing, 2017
Anchor Hanover/Sonnet, Understanding the social value of an Anchor Hanover tenancy, 2020
ONS, Vacancies and jobs in the UK: May 2020