North West Care Co-operative and Social Enterprises

This 2 year pilot project is led by the Cheshire Centre for Independent Living in collaboration with 4 other Disabled People’s Organisations (DPOs) – Breakthrough UK, Disability Equality (NW) Ltd, Disability Association Carlisle and Eden and Merseyside Disability Federation.

Disabled people and commissioners speak of a gap in the market for disabled people who wish to have as much control as possible over their support provision but who do not want to become a direct employer.

This project is piloting the concept of a Care Co-operative social enterprise model with disabled people in receipt of a personal social care budget or a personal health budget. The project is a priority because of general austerity, reduced funding within the care system, smaller personal budgets and the shortage of Personal Assistants and care workers which is being exacerbated by the impact of Brexit. Many disabled people now face the unthinkable option of a return to residential care.

Up to 3 Care Co-operatives are being established to pool the skills and experience of disabled people and the costs as a shared employer in order to take control over their own support and care.

The project, based in the North West of England is increasing the number of:

  • Disabled People’s Organisations (DPOs) who understand the concept of care Co-operatives
  • Health and social care providers who understand the concept of care Co-operatives as a solution to meeting health and social care demand
  • Disabled people directing their own care

All you might want to know about North West Care Co-operatives

What is a Care Co-operative?

A Care Co-operative is an organisation that provides care for its members and that is owned, controlled, and operated by those members for their benefit.

Who are its members?

People in receipt of Direct Payments or Personal Health Budgets provided to them for their own care or for the care of dependants.

How does it work?

A group of “members” and their Personal Assistants (PAs) agree to work as a team to help each other cover each other’s care needs. To explain how this might work take an example of some of a Care Co-operatives potential membership:

  • Member A joins the Care Co-operative feeling pretty-sorted. They have a good reliable PA who works for them for twenty hours per week. Within the Care Co-operative Member A’s PA works for them exactly as they did before they joined. But the benefit that Member A enjoys from the Care Co-operative is that their PA is now part of a team of PAs that Member A knows and trusts, who can provide cover for her PA for sickness and holidays.
  • Member B is a suitable person responsible for the care of their child, who is of adult age but has a learning disability. They join the Care Co-operative feeling much less sorted. They work full time and have struggled to recruit a reliable PA and rely on agency staff for the fifteen hours a week that their child needs. These staff have not always been available and when they are, they have not always understood their child’s needs. This has meant that Member B has often had to provide care themselves. And because Member B has been providing care, they have Direct Payment monies unspent that they are likely to have to return. The benefits that Member B enjoys from joining the Care Co-operative are:
  • There is a small team of PAs known and trusted by Members who have spare hours to support Member B’s child.
  • The hassle of recruiting and rostering PAs is no longer Member B’s problem.
  • They feel that in a Co-operative with other members and a team of PAs who share similar values, or who have faced similar challenges and has similar experiences around care, and that is well regulated that there is a means to provide for their child “after they are gone”.
  • PA One has worked for a member of the Care Co-operative for eighteen hours a week for some years and is trusted by her. She needs to work for around another fifteen hours a week to make a living and ideally would love to work for a client that she can establish rapport with. But she has been unable to find one and makes up her hours working on a zero hours contract here and there for a care agency. The benefit that PA One enjoys from joining the Care Co-operative is that they are now able to support one client that they can build rapport with (the child of Member B) for the fifteen hours per week that they need.
  • PA Two has young children and only wishes to work part time, but thanks to a supportive partner can be flexible in terms of when they work. They entered the Care Industry after their children were borne, working with an agency, and supporting clients on a short-term basis. Whilst they enjoy this work, they relish the opportunity to build rapport with clients that they can work with longer term. The benefit that PA Two enjoys from joining the Care Co-operative is that they now have small group of clients that they have built a rapport with from those occasions when they have covered for the clients regular PA. They have sustained a similar number of hours as when they were working for an agency.

Obviously, there are a host of other scenarios, but the key point is that a Care Co-operative is small enough for its members to retain control and to “know” the PAs that might work for them within it, but big enough to sustain a team of PAs that is able to cover sickness and holiday absences.

Is it not just people with direct payments working together?

No. It is a little more than that as a Co-operative is legally constituted and incorporated as a “business” at Companies House. Members are formally registered as the “Directors” of the business and have control of it. This is because (to quote an old naval saying) “anyone can hold the helm whilst the sea is calm”. An informal coming together could work… until it doesn’t at which point it gets messy. What if Members disagree or one has an issue with a PA “employed” by another etc. And as a “legal entity” some important liabilities rest with the Care Co-operative and not with the individual members of it.

If it is a business does it make profit?

No – but perhaps a tiny bit yes. A Co-operative does not have “investors” who are not part of the business but will own part of the business as share-holders and will want to see the value of the part that they own rise as profits rise – perhaps a result of the business charging its customers higher prices for its product. Nor does it have a bunch of salaried directors who can pay themselves big salaries and big bonuses on the backs of the achievement of the whole work force.

The members of a Co-operative own the business, and in the case of a Care Co-operative are also its customers or the users of its services and so can gain no benefit from making profit. As directors they are unpaid. They cannot be paid (nor can they make a profit) as the money that flows through the business is public money paid directly to them to fund their care.

As a business, cash flow and the ability to deal with contingencies is important and will require a small reserve to be maintained “for a rainy day”, but with the legal incorporation, come strict rules that limit its use to a “rainy day”.

What else do I need to know about a Care Co-operative?

Probably the most important thing is that as a legal entity, with rules that govern how members operate when they come together and protect members from the liabilities that arise when people work together, a Care Co-operative would be subject to regulation by the Care Quality Commission (CQC) In so many ways this is a good thing, as it means that the Care Co-Operative will have to meet CQC quality standards that show that it is Safe, Caring, Responsive, Effective, and Well Led. This is of course another thing for the Care Co-operative to do, and to help it do that it will have access to a “Registered Manager”, who will support the Care Co-operative in its compliance with regulation.

Who or what is North West Care Co-operatives (NWCC)?

Since the original set up in Rochdale in Victorian times, Co-operatives or organisations run on Co-operative lines have become a well-established type of business organisation. Think of “The Co-operative Group” who have supermarkets on high streets up and down the country, or the John Lewis Partnership. But the application of a co-operative model to the care sector in the UK is new. Co-operative models operate well outside the UK, the “self-managed” Buurtzog Model is well established in the Netherlands who have a strong reputation for quality community based social care.

North West Care Co-operatives (NWCC) is the working title for a project funded by Disability Research into Independent Living & Learning (DRILL), to research and test the viability of Co-operative models to deliver social care in the UK. It is sponsored by a consortium of Disabled People’s Organisations (DPOs) from across the North West, with its project management supported by Cheshire Centre for Independent Living (CCIL). NWCC will imminently become a legal entity capable of supporting a number of Care Co-operatives to become established and compliant with CQC Regulation. Currently we have one pilot group who will imminently become our first legally constituted Care Co-operative.

To coin a phrase that is in danger of becoming a cliche “we are on a journey”. It is a journey to a “new world” in terms of care, which is both an exciting and ever so slightly uncertain prospect. But those who have joined us have done so with confidence that the benefits of that new world will make the journey worthwhile.

We hope that you feel able to join us…