A report from Co-operative Care Forums for England and Wales warns there is a substantial “lack of awareness” about the tools available that can help make community-led care a reality.
The report, Owning our Care, explores the benefits, barriers and catalysts for the development of community and user-owned social care services, based on in-depth case studies from England, Scotland and Wales.
It looks at different ways that care – which is owned and controlled by the community and individuals that use it – is offered, and how others can learn from their journeys.
The research, conducted by the Co-operative College and Change AGEnts, was commissioned by Co-operatives UK, East of England Co-operative and the Wales Co-operative Centre, following initial work by the Co-operative Care Forum (CCF).
“Over the course of our initial conversations we found that there is no basic history in UK of social care co-ops,” says Mervyn Eastman, chair of the Co-operative Care Forum. “We were talking about care co-ops and what they were, but had little information on what’s out there.
“We started to think about the models we were particularly interested in exploring, and settled on multi-stakeholder co-ops. What is it about coops in social care that is so unique? What is the unique proposition? What makes them different? We were interested to explore the challenges faced by these models and the journey these early care co-ops have been on.”
Mr Eastman believes this difference lies in “shifting the balance of power away from the owners and investors to the receivers of care, the families, workers and communities”.
“If we don’t move the power from those providing to those receiving acre, there will always be an imbalance,” he adds.
The report highlights that although politicians are “committed to overhauling how we fund adult social care […] it’s not all about money”.
“No overhaul of the funding for care will be sufficient,” it warns “unless there is also a simultaneous shift in our approach to providing care and wellbeing.”
The report deals with some of the practicalities of how that shift could occur, and highlights the benefits of a co-operative approach. This approach – putting users and practitioners at the centre of everything the organisation does – brings people together in a community that gives them agency and enables their wellbeing.
But the research warns that difficulties can emerge when there are conflicting ideas between co-operative ‘models’ and co-operative ‘approaches’.
The report found that groups need better access to quality advice on the different legal, organisational and cultural dimensions that come with adopting, or trying to adopt, co-operative approaches.
And user and community-led organisations need holistic, nurturing relationships with anchor institutions, on everything from commissioning through to use of premises.
“This research should be a wake-up call to everyone involved in social care if we are to fundamentally address the present fragmented and failing market,” adds Mr Eastman.
“The co-operative way in both approach and models has to evidence why co-operative care is not just unique in market terms, but in showing that it can turn the rhetoric into addressing present relational power imbalances between people using, providing and commissioning care.”
Owning our Care makes a series of recommendations, including the need to “develop a body of good practice for communication, engagement, debate and learning” on care, and to “improve access to quality advice about how co-operative approaches can work in practice”.
In addition, policymakers and commissioners need to “get better at recognising and responding to the realities of genuine user and community empowerment”, says the report, while “commissioners and anchor institutions in and around local care systems, such as housing associations, should recognise and nurture the added value and potential demand reduction generated through approaches that give ownership and control to users, practitioners and communities”.
Among the case studies used is Cartrefi Cymru – the largest social care provider in rural Wales, which converted to a co-op last year in order to give the people who work for and use the service a say in how it’s run.
“It’s still early days, but the benefits of being a co-op already include better feedback about how we can improve what we do, a significant increase in activities which make our communities better for everyone – at no extra cost to anyone – and a host of new contributions from local suppliers and community members,” says chief executive Adrian Roper.
“To date, our commissioners appear to be relaxed about our transformation to a co-op. The challenge will perhaps come when services have to be re-tendered. Will our member’s voices and our added value to the local area count or not? We hope so.”