A better understanding of cooperative approaches to social care could help transform services to benefit service users and employees in the financially squeezed sector, according to a report by the Co-operative Care Forums for England and Wales.
The report, Owning Our Care, published today, analysed four organisations that are attempting to put in place co-op models based on user, practitioner and community ownership.
Done correctly, the report said, co-operative approaches could be “seen as a way of bringing aspirations in care legislation to life” by creating more flexible and responsive services that benefit from a sense of “shared purpose”.
But the research found that the success of cooperative setups hinged on “nurturing an engaged and empowered membership” who will participate in new organisational structures.
It recommended that those commissioning services, such as local authorities, do more to encourage and support the growth of community and user-owned services – something that in Wales, is written into care legislation.
Mervyn Eastman, chair of the Co-operative Care Forum, which helped design and raise funding for the research, described it as a “wake-up call to everyone involved in social care”.
Eastman said: “If we are to fundamentally address the present fragmented and failing market, [we have] to evidence why co-operative care can address present relational power imbalances between people using, providing and commissioning care.”
The four case-study providers had adopted co-operative systems for various reasons, ranging from the input of community activists to a decision taken by a chief executive.
The report noted a series of problems faced by providers as they attempted to put their new structures in place, with one of them watering down its co-op aspirations as a result.
One provider suffered from a perception that it remained “too top-down” in its approach. Elsewhere the report also observed legal problems, families and practitioners being “reluctant to embrace new rights, roles and responsibilities” and volunteers being seen by commissioners as as “untapped cost-saving resource”.
The study nonetheless found that three out of the four organisations said they were more in touch with their service users as a result of going co-operative. “This meant they were both better able to identify when someone’s health deteriorated and also to adapt services according to preferences,” it said.
But it warned that the cooperative providers continued to depend to varying degrees on external support, meaning they faced an uncertain future.
‘Doing the right thing’
Adrian Roper, the chief executive of Cartrefi Cymru, which provides services to people with learning disabilities in rural Wales, told Community Care his organisation has adopted a co-op model in order to “do right by the people we support”.
Roper said that choosing the right model is crucial, and that Cartrefi Cymru had opted to become a multi-stakeholder co-operative (as opposed to being steered only by workers or service users) – in part because not everyone the organisation supports has the capacity to take decisions.
Cartrefi Cymru now has more than 200 active co-op members, including about 10% of its 1,200-strong workforce and smaller numbers of service users and community members. Each group has the power to elect four out of 12 members of the organisation’s national council, which sits above its board and will have the power to appoint and dismiss members.
But Roper warned that the benefits of the co-op system, in terms of giving agency to workers and service users, were likely to remain limited as long as the “negativity of the competitive marketplace” persisted in the sector, driving wages down.
“As long as commissioners make us fight like rats in a sack, it’s hard to achieve the win-wins that come from collaboration rather than competition,” he said. “Our employees’ voice is now stronger, but we can only pay what we are funded.”