The social care crossroads is before us – let’s choose the right direction

Michael Voges, Executive Director, ARCO

It’s crunch time for social care. The pandemic has shown us that radical change is needed, and the Government has promised to bring forward proposals for reform before the end of the year.


Much of the focus will inevitably be on finding a sustainable funding formula for social care, and striking the right balance between state and individual contributions. Rightly so. The social care system is only going to thrive if it finds itself on the right financial footing.


But it’s equally important the social care reforms address the question of “how?” social care is delivered as well as “how much?” money can be given. Now is the time for a radical transformation of social care provision that enables older people to live independently for longer, to stay physically and mentally healthy, and to stay connected to their local community.


While the existing options of care homes and care at home will continue to have a vital place in the social care system, they are not going to be enough alone. A greater variety of options are needed that lie in between these two ends of the spectrum and which help to boost prevention and free up capacity and resources for the social care system For example, Shared Lives schemes which involve younger people supporting older people.


Housing-with-care must have a key place in this. Combining independent living for older people (through them renting or owning their own flat), with 24/7 onsite staffing, CQC-registered domiciliary care for those who need it, and a wide range of communal services and facilities, housing-with-care is a big part of the future.


The evidence shows it improves the physical and mental health of residents, reduces loneliness, saves money for the NHS and social care system, and even frees up housing for younger generations. The pandemic has proven just how valuable it can be, effectively keeping older people safe and shielded, and giving them the chance to maintain strong social connections at a time of physical distancing.


OK, so housing-with-care is a good thing, but why does the Government need to act now to support it? Firstly, because current provision is so low by international standards. Just 0.6% of over-65s have the opportunity to live in housing-with-care in the UK, compared to at least 5-6% in New Zealand, Australia and the US.


And secondly, because current supply is creaking under the weight of the overwhelming demand for housing-with-care from older people. Our research with Later Life Ambitions in 2020 found that 56% would be interested in moving to housing-with-care, rising to 70% if as an alternative to a care home. According to Octopus Real Estate, there could be up to 2.5 million older people in the UK who would like to live in a Retirement Community. No more than 100,000 currently do so.


The demand has also been there from leaders inside and outside of Parliament this year, in abundance. In March over 40 MPs, Peers, academics and charity and private sector leaders wrote an open letter to the Prime Minister calling for the 2020s to be the “decade of housing-with-care”. In July, MPs from four parties used the first ever Parliamentary debate on housing-with-care to urge the Government to move ahead with ARCO’s proposal for a cross-department housing-with-care task force.


There has been such a strong focus on a “task force” because only by bringing together different Government departments can good policy be developed for the multi-faceted housing-with-care sector. Planning reform sits with MHCLG. Social care sits with DHSC. Consumer protection regulation lies with BEIS.


Taking action to grow housing-with-care is not rocket science. New Zealand, Australia and the US have shown the way through sector-specific regulation and legislation to produce rapid growth. We can easily do the same.


With social care reform on the horizon, now is crunch time. We can either use this opportunity to put a sticking plaster on the social care system, or use it to revolutionise provision in a way that puts prevention at the centre and transforms the lives of older people up and down the country.



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