Written evidence submitted by Anchor Hanover [ASC 008]
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 9,000 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 Covid-19 has significantly changed the landscape in terms of long-term funding for adult social care. The pandemic has highlighted the very best of the sector, demonstrating the dedication and skill of our workforce whilst also exposing many of the challenges we are facing. The pandemic has also demonstrated the interdependency between social care and the NHS and the need to place the sector on an equal footing with the health service in terms of investment and reform.
2.2 This has increased the awareness of the importance of social care and heightened the urgency of considerations of the long-term future of the sector. Greater consideration is also being given to health and wellbeing outcomes amongst older people with housing and care needs central to these considerations. Anchor Hanover has experienced a significant increase in enquiries into our housing services as a greater number of people are exploring their options for later life.
2.3 Through the exemplary commitment of our colleagues, the social care sector has safeguarded the health and wellbeing of some of the most vulnerable in society during exceptionally challenging circumstances. This has not gone unnoticed by the public. The weekly Clap for Carers during the Spring of 2020 was an extremely welcome demonstration of recognition and our research shows that the pandemic has also pushed social care reform higher up the public’s list of priorities:
2.4 Anchor Hanover believes that this high degree of public support presents the government with a unique opportunity to address the issues which have blighted the sector for many years. The issue of workforce shortages has been particularly stark during the pandemic. On average, the sector had 112,000 vacancies on any given day throughout 2019/20 with warnings that the sector is facing a shortfall of 1.1m care workers by 2037.
2.5 During the pandemic, Anchor Hanover has experienced this shortage first-hand. At the start of the pandemic in Spring 2020, 1,200 of our 9,000 colleagues were self-isolating in line with the government requirements.
3.1 Without comprehensive and sustainable long-term funding reform, the social care sector will continue to be blighted by long-standing issues of workforce capacity, resilience and access to care. There is also a need to ensure the public are aware of their own responsibilities to fund their care needs.
3.2 At Anchor Hanover, we are witnessing the problems caused by the funding situation in social care and the confusion that is created by this. Our research has found that 25% of the public mistakenly believe that all care is state funded and only 14% are saving towards their potential future needs. Due to a lack of funding, increasing numbers of older people are accessing care at a later stage, joining providers with more varied and complex needs.
3.3 We are calling for the development of a plan to reform social care funding which includes a cap on individual care costs and provides greater education to the public on their responsibilities to provide for their care. This plan must also consider seeking to put prevention at the centre of reform in order to reduce the strain on social care and other public services including the NHS. A lack of access to social care costs the NHS around £3bn per year through delayed discharge alone.
3.4 We are also calling on the government to develop a National Positive Ageing Strategy, which aims to enhance the longevity and independence of older people and improving health and wellbeing outcomes. Housing options available to those in later life must be at the centre of this strategy with the supply of specialist older people’s housing, included Sheltered and Extra Care, failing to meet demand which has grown significantly since the beginning of the pandemic.
3.5 Despite the current undersupply of specialist older people’s housing, the estimated saving to the NHS is £486m per year, around £300m of which through allowing for earlier discharge from hospital. Anchor Hanover’s and Sonnet Advisory & Impact CIC’s 202 report, Understanding the social value of an Anchor Hanover tenancy, highlighted how our services alone can provide significant benefits to public services and residents alike:
3.6 To help increase the supply and unlock investment in the sector, Anchor Hanover is calling for the introduction of a new CR2 Planning Classification to ensure a clear and consistent approach to the development of specialist housing. We are also calling for the inclusion of older people’s housing in local authority Local Plans and support calls from the Associated Retirement Community Operators (ARCO) for the creation of a Housing-with-Care Task Force to lead on the growth of the sector.
4.1 Recruitment and retention of staff is key to stabilising the adult social care market. With the NHS seen as a more desirable career path, many of those with the necessary skills and frame of mind to work in the sector pursue a career in the health service rather than care work. As we have highlighted in paragraphs 2.3 and 2.4 the government is now presented with a unique opportunity to introduce wide-reaching and sustainable social care reform.
4.2 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. The National Positive Ageing Strategy should also focus on highlighting the wide range of opportunities social care presents and driving parity of esteem with the NHS.
4.3 The care sector offers a wealth of options for those with different skills in a variety of disciplines including care work itself, catering and activities organisation. Through highlighting best practice in social care and a clear focus on the opportunities for career development, the government can help the sector to tackle the transience of much of the care workforce.
4.4 This is a particularly pressing issue in the context of the Covid-19 pandemic. As other sectors of the economy have been closed, we have experienced an increased interest in careers in the care sector. We are concerned that, as other areas of the economy reopen, many of the sector’s new recruits will seek to return to their previous areas of work and exacerbate the workforce shortages social care continues to experience (2.4).
4.5 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 pay in comparison to others and a funding system which addresses this would be a very welcome step forward. This also impacts pay as some local authorities are able to raise fees to enable providers to pay higher wages whereas others cannot.
5.1 Anchor Hanover believes there are a number of ways in which competition and innovation could be incentivised to drive improvement in adult social care. With efforts of providers centred around tackling the pandemic, innovation across the sector has stalled and a clear focus must turn to ensuring it is restarted in the post-pandemic environment.
5.2 We are calling on the government to introduce a Social Care People Plan, similar to that produced for the NHS. We believe that the key principles of Anchor Hanover’s 2019-2022 People Plan applied nationally, will help to drive innovation and competition within the market sector-wide:
5.3 Once again, focus on best practice through a National Positive Ageing Strategy is a key component to driving competition and innovation. Despite the negative discourse, many social care providers offer excellent training and development opportunities to current and new staff; helping to improve delivery and quality within the sector. Anchor Hanover offers numerous training and development opportunities for apprentices and more experienced colleagues alike. These include: