Written Evidence submitted by Anchor Hanover (HSC0027)
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 full CQC inspections. This makes Anchor Hanover the most compliant of large residential care providers in England.
2.1 At Anchor Hanover, we believe progress on integration has not gone as far as is suggested by government. Greater integration of health and care services is one of the central aims of the government’s White Paper, Integration and Innovation: working together to improve health and social care. Statutory Integrated Care Systems (ICSs) are integral to the aims of the White Paper, comprising of ICS Health and Care Partnership and an ICS NHS Body.
2.2 Whilst we welcome steps to improve integration between care providers, the NHS, local authorities and other partners, we are concerned that ICSs will not give social care a sufficient role in the integration process with the NHS and local authorities given primary roles ahead of social care providers.
2.3 New roles as part of greater integration must also be created for social care providers and not just the NHS and local authorities. Social care has, for many years, been blighted by disparity with the health service and policy which fails to recognise the interdependency between the two sectors. Parity between health and care is key to any significant, long-term reform of the care sector and to the future of the NHS. This cannot be achieved without a greater role for social care.
2.4 Anchor Hanover is also concerned that the White Paper’s plans for integration will not address many of the underlying issues which have held the care sector back for some time. Sustainable long-term funding must be central to any reform of the social care sector and plans to improve delivery and outcomes. Additionally, a greater appreciation of the social care’s complexities and range is needed to help drive parity between health and social care and to support long-term reform.
2.5 Funding reform and parity with the NHS are vital if integration is to be as effective as possible. Anchor Hanover is calling on the government to adopt funding reform which introduces a cap on individual care costs and provides greater education for the public on their responsibilities to fund their potential care needs – our research shows that 25% of people wrongly think social care is funded by the state and only 14% are saving towards care.
2.6 We would also stress to the government the importance of securing a consistent approach nationally in terms of funding reform. There is a clear disparity between what some local authorities are able to pay in comparison to others and a funding system which addresses this would be a very welcome step forward.
3.1 Funding reform is essential to social care, but this must be accompanied by reform elsewhere. As the UK’s society ages, it is vital that policy reflects the changing expectations of people in later life and how this growing demographic approaches their existing and potential care needs. The government’s recognition in the White Paper of the need to enhance people’s longevity and independence is welcome though it is disappointing that the central role of housing in achieving this is not fully acknowledged.
3.2 Anchor Hanover is clear that specialist, older people’s housing, including Sheltered and Extra Care, must be at the heart of social care reform. The positive impact of specialist housing on the lives of older people is proven and its full potential can be recognised through action from government to increase supply and meet the pent-up demand amongst those in later life.
3.3 Our research into the social value of Anchor Hanover tenancies has demonstrated clear benefits for residents of specialist housing as well as public services such as the NHS. Our report, published in partnership with Sonnet Advisory & Impact CIC, Understanding the social value of an Anchor Hanover tenancy, highlighted multiple benefits:
3.4 Research from Demos has also found £486m is saved by the NHS and social services as a result of specialist older people’s housing - £300m of this through reducing in-patient stays in hospital.
3.5 There is significant interest in investment in the retirement housing market from private providers and a number of simple steps would help to unlock this investment. We support calls from the Association of Retirement Community Operators (ARCO) for the government to establish a Housing-with-Care Task Force to work across government to help grow the sector. Anchor Hanover is also calling for the inclusion of older people’s housing in local authority Local Plans and for a new classification focused on specialist housing within the planning system.
3.6 We also support the recommendations made by the APPG on Housing and Care for Older People’s report, Housing for those with dementia – are we ready?. The report emphasises the importance of cross-government collaboration to develop an overarching strategy for housing and care for older people along with a Cabinet lead/Minister for Older People across the Department of Health & Social Care and the Ministry of Housing, Communities & Local Government.
4.1 Addressing the issues facing the social care workforce in the long-term should be paramount to the government’s plans for the sector and the relationship with the NHS. With an average of 112,000 vacancies at any one time throughout 2019/20 and warnings of a shortfall of 1.1 million care workers by 2037 the workforce issue could hardly be more pressing for the sector. 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.
4.2 The pressures of the pandemic have exacerbated the challenges faced by shortages in the social care workforce. Anchor Hanover have experienced these first-hand with 1,200 of our 10,000 colleagues self-isolating in the early stages of the pandemic in the Spring of 2020.
4.3 Anchor Hanover’s response to this has highlighted the importance of presenting social care as a fulfilling and rewarding career in order to address the challenges the sector is currently facing. Our recruitment campaign, undertake in response to the pandemic, saw us receive 2,177 applications and 111 new staff onboarding or started between March and August 2020. Our new colleagues have helped us to continue delivering our services, despite the challenges of the pandemic.
4.4 We are concerned that the current plans will not be sufficient to address the workforce problems the sector is facing. The government has not yet presented a long-term workforce plan and the NHS People Plan does not acknowledge the interdependency between the health service and social care.
4.5 Anchor Hanover is calling on the government to develop a Social Care People Plan which aims to build a committed, highly skilled and professional workforce for the sector. The plans must also aim to achieve parity of esteem between social care and the NHS to help attract those with the necessary skills and frame of mind into a career in care.
4.6 Research conducted by Anchor Hanover and the International Longevity Centre highlighted negative perceptions of social care which are continuing to blight the sector with concerns surrounding pay and career progression as major barriers to recruitment in care. However, the exemplary work of our colleagues during the pandemic has not gone unnoticed by the public with the weekly Clap for Carers in 2020 a clear demonstration of the nation’s appreciation.
4.7 Anchor Hanover is calling for the launch of a National Positive Ageing Strategy with recruitment to 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 our workforce to be recognised.
4.8 Highlighting best practice within social care is key to tackling negative perceptions, demonstrating how fulfilling and rewarding a career in the sector can be and in achieving parity with the NHS. 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:
4.9 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 as a whole. These problems will persist as long as these perceptions dominate the public discourse. The recognition of the vital work of care workers during in the pandemic is our opportunity to reverse this. Anchor Hanover research has shown that the pandemic has significantly increased the public’s awareness of social care and the need for reform. We have found that:
4.10 Through a regular focus on care, in particular best practice, Anchor Hanover believes that a greater degree of quality and innovation can be achieved - improving care for our colleagues and service users alike. With efforts of providers centred around tackling the pandemic, innovation in some areas has stalled and a clear focus must turn to ensuring it is restarted in the post-pandemic environment.
4.11 Much of the NHS People Plan produced by the government is similar to Anchor Hanover’s People Plan for 2020 – 2022 in terms of supporting staff wellbeing and recruiting and retaining staff and these principles ought to be at the centre of a national plan. These include:
It is now vital that the government now responds positively to level of public support as Anchor Hanover and other providers have done.
James Floyd, Public Affairs Officer