“Our social care system is in urgent need of reform. Private companies profiteer, whilst older people, those who rely on social care and the staff that deliver it, pay the price. The market in social care services is broken – incentivising a race to the bottom on quality and workforce conditions, a lack of accountability, and de-personalisation of services.
“Shrinking budgets and increasing demand has meant tighter eligibility criteria. Hundreds of thousands fewer people are getting help, and there is a financial imperative for local authorities to commission services at the lowest price regardless of quality. All the while the numbers providing care informally to family and friends is growing . . .
“When frontline staff are squeezed by their employers, and owners seek higher returns on their investments, the quality of care falls. Domiciliary visits are shortened and high staff turnover undermines the relationship between the care workers and service users”. Extracts from Taking Care: a co-operative vision for social care in England, written by James Scott and published by the Co-operative Party in September.
The report concludes: By sharing knowledge of how to build and maintain co-operatives, focusing on the development of micro, community-led co-operatives, and celebrating fully cooperative providers with an accreditation system, the wider co-operative movement can play a significant role in overcoming the care crisis in England today.
The Taking Care analysis finds that the shift to private provision of care has reduced the quality of care, undermined labour market conditions and reduced cost efficiency within the sector. The report argues that improving the adult social care requires the establishment and promotion of social care co-operatives . . . and cites Community Lives Consortium (CLC).
The Welsh government wants to foster initiatives like CLC under a three-year programme, Care to Co-operate, which aims to develop the role of co-operatives and social enterprises in the care system. Run by the Wales Co-Op Training and Development Centre, it reflects growing interest in the potential of not-for-profit care co-operatives.
David Brindle’s Guardian article describes CLC as “a not-for-profit social enterprise that uses co-operative principles in its decision-making and management”. It supports 300 people with care needs, most of whom have learning disabilities; they are treated as partners in the way it operates.
According to the Co-ops UK network, there are 88 co-operatives in the UK delivering adult social care, with a combined annual turnover of almost £100m. Only 33 of these are in England, however, where they represent less than 1% of the total market.
Care and Share Associates (Casa), which provides homecare across the north of England, was set up in 2004 but grew out of Sunderland Home Care Associates (SHCA), which in turn came from Sunderlandia, a pioneering building co-operative set up in 1973. One of Casa’s founders, Margaret Elliott, Casa, which is based in Newcastle upon Tyne, SHCA has remained separate and continues to operate successfully. But Casa has grown from scratch to employ more than 850 people, who are also its owners; it provides 20,000 hours of care a week in the north-east, north-west and Leeds and has an annual turnover of £14m.
The co-op sets recruits from, and invests in, low-income communities and has a strong track record of helping people break out of long-term unemployment, Training is provided by the Casa Academy and employees are guaranteed a minimum 16 hours’ work a week, holiday and sick pay and, after six months’ probation, a profit share. At the October meeting of Co-operatives West Midlands this case for ‘Fair Care’ was ably and eloquently made by community worker Cheryl Barrett, founder of Change AGEnts (right).
The co-operative advantage: there is not much profit in the care market at the moment: “We’re hardly making anything currently,” Guy Turnbull, Casa’s managing director and co-founder admits, “but because we don’t have external shareholders, and we’re backed by [social investor] Big Issue Invest, we don’t have to make a 10% return like others do.”
The Co-op Party report concludes that a new model of care is needed, one that uses the principles of co-operation to build upon the first-hand knowledge of those who rely, receive and provide care:
“Care recipients, their families, and care workers know how to create a care system that will deliver consistently high quality care. They should be allowed to lead the care sector”.