Co-operatives for care

Co-operatives are part of the solution to the crisis in social care, and are growing across Wales say Rhian Davies, Chief Executive of Disability Wales, and Derek Walker, Chief Executive of the Wales Co-operative Centre.

See this page in: Cymraeg

As part of his ambition to deliver 21st century socialism, Mark Drakeford wants to ‘rebalance’ the social care sector and to bring services closer to the public realm through co-operative models.

The rationale behind this pledge is pretty compelling. There is a funding crisis in social care which is unlikely to get much better anytime soon. Staff are often poorly paid and the care that is provided is sometimes not what people want. So we need to find better ways of delivering care without more money.

Co-operative approaches can help achieve that. They are not the answer to all our problems but their membership structure does enable people who use well-being and personal care services to have more say in how they are run and what they offer. And when constituted as not-for-(private)-profit businesses, they ensure scarce resources are spent on improving the quality of services and not on shareholder dividends.

The co-operative structure is suited to supporting people who receive direct payments. Direct payments are intended to improve choice, control and independence, yet take-up has remained low in Wales compared with other parts of the UK. A co-operative approach enables people to work together to manage their payments and even pool them where that can help them go further.

Co-operatives can operate at scale, not on the margins. In the Italian region of Emilia Romagna, social co-operatives account for more than 50 per cent of the care market. And co-operatives are emerging here too.

Moncare Co-operative, one of the newest of the growing number of care co-operatives in Wales, aims to support greater citizen voice, control and independence through the take-up of direct payments, via the development of a citizen-directed co-operative.

It was set up following a project led by Disability Wales in partnership with Wales Co-operative Centre and funded by the Big Lottery Fund. The idea behind the project was to test whether citizen-directed co-operatives would encourage greater take-up and more innovation than existing direct payments support schemes. They can, for example, pool direct payments to support joint social activities or set up a social enterprise to provide employment opportunities.

Moncare Co-op offers a ‘buddying’ service, which builds confidence and helps with problem-solving. It also provides social media platforms and opportunities to meet others, discuss the benefits of direct payments and share insights. It plans to offer a matching service that can be used to find a suitable PA.

The chairperson of the co-operative is Lesley Jones.  She says: “Direct Payments are not being pushed enough.  People are being given the wrong information – some are not even being offered Direct Payments. They’re not being given choices and I’d like those people to know that they have a choice.”

As Moncare has only just been established it is too early to say whether it will increase innovation. However there are already lessons for others to learn. The daily barriers faced by disabled people, parents and carers can leave little time and energy to commit to the additional responsibility of running a co-operative. External advice and support are key.

The extent of local authority commitment to direct payments is also critical. While take-up in Wales has increased, there are less than 6,000 recipients out of 160,000 receiving social care services including 32,000 receiving domiciliary care. A strategic approach to the expansion of and support for direct payments is required, if it is to become the default option for people requiring care and support.

Friends United Together is an emerging co-operative in south west Wales. It involves a group of people who access direct payments and want to constitute a small independent co-operative so that they can purchase care and support services. With support from the Wales Co-operative Centre, Friends United Together is navigating its way through the journey to set up a new co-operative, involving bringing these founder members together, learning what it means to manage the co-operative, open their own bank account and register.

As a result of a change to regulation last year it is now easier to set up micro co-operatives similar to Friends United Together. Organisations, including co-operatives, are exempt from registration when that service ‘provides care and support to four or fewer named individuals.’

“Co-ops provide a structure for users and workers to exercise power, and to be efficient and responsive in their own interests. And co-operative principles include caring about the community, and working together for the common good"

Adrian Roper, Chief Executive, Cartrefi Cymru Co-operative

Cartrefi Cymru Co-operative is at the other end of the scale. With a turnover of more than £23 million it is a large provider of services to people with a learning disability. Cartrefi converted to a co-op in 2017, and is now a multi-stakeholder co-op with a constitutional commitment to sharing power and building community. Its Chief Executive, Adrian Roper, believes co-operatives offer solutions to some of the biggest problems facing social care:

“Some problems stem from the idea that a top-down state can manage services through bureaucracy and performance indicators. Some problems stem from the idea that a competitive marketplace will be more efficient and responsive to need. We’ve got these two things happening simultaneously, with controlling bureaucrats on the one hand and competitive providers on the other. The result is the opposite of efficiency and responsiveness, with public money being wasted on badly designed services run by agencies trying to squeeze out profits at the expense of their users and workers.

“The answer requires the state to shift the locus of power and control down to where users and workers can exercise it, whilst simultaneously rewarding providers who demonstrate a collaborative public service ethos.

“Co-ops provide a structure for users and workers to exercise power, and to be efficient and responsive in their own interests. And co-operative principles include caring about the community, and working together for the common good. Nurturing co-ops and co-operation through long term supplier relationships surely makes more sense than seeking the common good through remotely conceived demands and trust-destroying competition.”

We are not starting from scratch. In recent years there has been significant growth in the number of co-operative care businesses. We haven’t yet created a new movement of care co-operatives at the scale of Emilia Romagna’s, but we shouldn’t be afraid to be that ambitious.

Find out more:

Disability Wales’ toolkit – Direct Payments and a Disabled People’s Co-operative Model

At the Wales Co-operative Centre, contact our Care to Co-operate team, for advice and support.