Review of adult social care: co-operative approaches

Two major reviews of adult social care in England are now scheduled for the autumn of 2018.

Through a Green Paper on older people's care and a "parallel review" of care for working age adults, government will try to answer huge questions about how care is funded, organised and delivered. When they finally come, these reviews should be a once in a generation opportunity to press for public policy that supports a flourishing of co-operative approaches to wellbeing and care.

"Now we have the opportunity to make the case for co-operative approaches to wellbeing and care in national policy. It is an opportunity everyone who supports this agenda should try to seize."

In recent years Co-operatives UK has worked to bring together those inside and outside the co-operative movement who believe co-ops offer a better way of organising and delivering services in the wellbeing economy. This has manifested itself in the now fully independent Co-op Care Forum for England; the identification of care as a ‘future sector’ in the National Co-operative Development Strategy; and our Development Unit’s work with a number of new care co-ops. Now we have the opportunity to make the case for co-operative approaches to wellbeing and care in national policy. It is an opportunity everyone who supports this agenda should try to seize.  

We have published a concise position paper on the issues that we know will be covered in these reviews, making the case for what we call ‘co-operative approaches to care’ and setting out how public policy could create an environment for these approaches to flourish. We encourage everyone who thinks the wellbeing economy should share agency, ownership and control through networks of solidarity and reciprocity, to respond to the government’s coming consultations. Please use our position paper as a resource if you find it useful to do so. 

download position paper Here 

If you would like to work with us in responding to the reviews this autumn or want to comment on our paper, please contact our policy officer: [email protected]

What do we want?

We need a wellbeing economy that nurtures and mobilises social capital and empowers citizens and practitioners with genuine agency and control. We want policymakers and practitioners to recognise and understand co-operatives as a practical tool for making all this happen. In homecare, day services, care homes and in fact all parts of the wellbeing economy, there are three key approaches we believe should become significantly more prevalent.

Three co-operative approaches

  1. Service users, family, communities or practitioners are members actively co-creating wellbeing, where the starting point is what people do better together than they do alone
  2. Service users, family, communities or practitioners are empowered with individual and collective agency through the exercise of democratic membership, ownership and control
  3. Organisational purpose is orientated towards facilitating members’ co-creation of wellbeing

In practice these approaches can manifest themselves in many ways including: co-operatives comprised of small values-driven providers; care agencies owned and controlled by frontline care workers and/or their clients; democratic community organizations; and co-operatives of personal budget holders.  

We need national policy to create the conditions within which these approaches can flourish. This includes action in areas such as market shaping, regulation, innovation funding and investment in community development. 

There are a number of key realisations that tend to come naturally to those thinking co-operatively, but that seem lacking in the discourse to date. One is that while we need significant new funding to develop community-based and user-led organisations, we also need significant new funding to develop the capacities of communities more generally at the grassroots. Another is that while technology is indeed set to disrupt the existing care industry, this will not necessarily generate the outcomes we want. We need technology to be used deliberately as a tool to empower citizens and practitioners and to nurture and mobilise social capital.

When it comes to making the case for community-based, person-centred and user-led services, we know there are plenty of informed and well respected voices that will be heard in the coming reviews. But we also know that in all this, an understanding of co-operatives as a practical tool for making this happen is too often lacking. So it is vitally important that those who support a co-operative agenda for the wellbeing economy make themselves heard this autumn. 

Recommendations to government

  • Refine market shaping under the Care Act to include more emphasis on: empowering service users, practitioners and communities; nurturing and mobilising social capital; combining personalisation with social solidarity and collective empowerment
  • Regulate the wellbeing economy in a way that enables co-operative innovations and values the wellbeing generated by activities that nurture and mobilise social capital
  • Direct more innovation funds towards piloting co-operative approaches, including those that use digital platforms as a tool to empower service users, practitioners and citizens
  • Invest in grassroots community development so that people have the capabilities to exercise real agency and control in the wellbeing economy
  • Support the conversion into co-operatives of care businesses where profit-motivated owners are divesting
  • Sustain the wellbeing economy by fostering a more inclusive economy in general