Why we need social care co-ops: Graham Mitchell of Co-operative Care Colne Valley

Today I’m talking with Graham Mitchell, of Co-operative Care Colne Valley. He’s part of a group starting a social care co-op in the Colne Valley, West Yorkshire, and they’re also building a toolkit / step-by-step guide for people to start social care co-ops in their own community. I’m interested in how this toolkit can help grow the cooperative social care sector.

Hello Graham. I want to talk to you today specifically about your plan for social care co-ops. You’re looking to start a social care co-op in the Colne Valley. That’s Huddersfield isn’t it?

Yes, just west of Huddersfield, in the south Pennines.

But I know that you also want to build a toolkit / step-by-step guide for people to start a social care co-op in their own community. So I’d like to talk about social care generally, why co-ops are the best way to deliver it, and how this toolkit can help grow the co-operative social care sector. So I want to talk about what drives you, before we talk about what you’re doing – what’s the problem you want to help solve with your work?

It’s probably worth explaining a bit of history – how we got to where we are. It goes back about 3 years. I was part of a group of people interested in trying to do something on a practical level, to have an impact on the key issues of the day. We had a series of meetings / conversations about a range of different issues. We looked at various options that we might pursue. We talked about food-related issues – there are massive problems there. We looked at housing and at social care. We realised we couldn’t do all of it, so we focused our energy where we think we can make an impact, and get something working that could be model for the way things happen. We decided to focus on social care – an issue that affects everybody one way or another. It was clear that social care in this country isn’t working for anybody particularly well. That goes for providers as well as people who use social care services and the local authorities.

And again, before we get onto details, how does your idea address those problems? How will what you’re doing make the situation better?

I tend to take a simple, common-sense approach. We have a situation at the moment where the local authorities that purchase a lot of social care services on behalf of citizens are doing it from a position that’s difficult for them. Most local authorities are big, and they’re trying to purchase services (because most local authorities don’t provide direct services any more. It’s all been outsourced) on behalf of citizens, but they’re so far removed from those citizens, not through any fault of their own, but through their size, and the number of people they need to cater for. The distance between the governed and the governors is too great. They lose sight of the humans involved, and it all becomes numbers. As a consequence, the commissioning process becomes very much a numbers game rather than a human process. We wanted to be an organisation that’s very close to the people we’re looking to serve.

Another big issue in social care is that it’s not very well regarded or well paid. It’s at the bottom of the scale. People move in and out of the social care sector, because they can get a better rate of pay in a different industry. It’s like nursing or being an engineer – it’s a profession that deserves a lot more respect and better terms and conditions. That’s a historic thing, partly because it’s been seen as women’s work, and because the way the system operates, from a private sector perspective, there’s a downward pressure on pay.

How is most social care provided in the UK, and how is it paid for?

I think the bulk of social care is delivered by a mix of private and third sector organisations. There are quite a lot of charities and social enterprises in there, plus private sector organisations. Social care is very broad, so there are a lot of sub-divisions in terms of target groups etc. Certainly in the last 5 years or so, but probably longer, as austerity has driven down public sector financing, a lot of private sector organisations are exiting the social care market, because they can’t make enough profit out of it. Not that they can’t make profit at all – but that they can’t make enough. They’re looking for a minimum return on investment. So they go somewhere else, where they can get a better return. That’s left a lot of people high and dry. Everyone in the sector has a story of how private providers are walking away from contracts and leaving the local government holding the baby.

How is your social care co-op idea different from the third sector organisations, and why is it better?

I’ve got a long history of involvement in the co-operative movement – I’m a firm supporter of the whole concept of mutual self-help, rather than the charitable model, where we do good things to other people – which I always think is patronising. I prefer a model where everyone is engaged, involved and producing their own solutions together. I think that’s true with care in particular – family and community have always been the bedrock of care provision. With the process of intervention from the public and private sectors, it’s extracted that element of care from the community setting, so that now people often think of someone else providing care – not them, their family, friends, neighbours or community.

We have problems in society about how we relate to older people, and how they’re ‘othered’ and not part of the community. That model plays into this agenda, and we need to start challenging it an breaking it down. By using a co-operative model, we’re bringing the community together, around this idea of care, and re-imagining what that care is, and re-embedding care as something the community does.

So the receivers of the care will be members of the co-op as well as the providers?

Yes. The model we’re developing, and it’s an ongoing process, is a multi-stakeholder model. The people who are most important in the process are the people who receive and give care. In the conventional model, neither of them has a huge amount of power. We’ve talked about the problems of care-givers, but also, care receivers are not getting the quality of care that they could. In terms of trying to tackle those dual problems, we wanted to bring those people together and give them control, so that they’re right at the heart of the operation, and co-owners of the business.

One person, one vote, or tilted towards the care providers?

At the moment we’re looking at a very simple model. There’s a recognition that we’ll probably need to get more sophisticated, and learn as we go, and get into the kind of detailed conversations we need to get into with all the various stakeholder groups that are involved, so that we can build a more nuanced approach. At the moment, we want to keep it simple, and make sure everyone has a voice, and can influence what happens at every level.

What kinds of care will your co-op provide?

At the moment we’re focusing on the needs of older people, but not necessarily exclusively. But it’s where the bulk of the need is, so it makes sense for us to learn by working with that constituency. What we want to do with our model is build a wraparound service that’s not just about regulated personal care – there’s also a range of ancillary, non-regulated, community-type services that can be added into that mix. They might need help with cleaning or gardening. They might want to pursue interests or go to social events, but aren’t able to do it alone. Our theory of change is about looking with a holistic lens at the issues, so it’s not just about a certain person having a specific assessed need, but looking at the wider picture, at how we can work with that person, their family and their neighbours to enable them to become more engaged and fulfilled, and to improve their well-being and reduce social isolation. We think this will have a positive impact on the service user, but also on the people around them.

A bit like mutual aid groups?

A bit like that, although a bit more formalised. We’ve been doing a lot of work with mutual aid groups over the course of this year, with COVID kicking in in the spring, there were groups here just as everywhere else. We were fortunate in being in the right place at the right time to give a hand to those mutual aid groups, and there’s been a really positive process of relationship-building and learning how we can operate as a second-tier service in supporting the needs of those mutual aid groups. Some groups have fallen back, but others are still going strong, so we’re working to maintain dialogue with those groups, to understand their needs and how we can work together as the situation changes. We’re moving from a health crisis to a social and an economic crisis now. People are losing their jobs in significant numbers, and that’s going to have knock-on effects in communities.

I’m thinking of the effect of austerity measures and reduced state funding for local authorities. Is there a plan B? Maybe a move back to the old Friendly Societies idea, where people paid a weekly subscription, like a little insurance policy?

We haven’t looked at that specifically. We’re talking to the local authority, who have been hugely supportive, from day one. That’s been crucial in enabling us to get where we are now. So there’s a good dialogue there. But the commissioning process that the local authority use isn’t really very good for them. So they’re looking to evolve what they do to a more helpful model that works better for the, for providers and for users.

Do you think your local authority is particularly good, or might that be typical?

Difficult to tell. I think our authority here have understood that as a result of 10 years of austerity following the financial crisis, they’ve had to shift their position. They’re no longer an organisation that does anything. They’re an organisation that acts to enable community to get on and solve problems. There’s a real sense of partnership there, which is great. I was cynical initially, but they’re deadly serious.

Do social care co-ops already exist in the UK?

There are a number, and we’re still mapping that. We’ve come across quite a few, and we’ve started a dialogue with as many of those that are interested. I think there’s a massive opportunity here to make co-operative models mainstream in this sector. We don’t know what’s going to happen in terms of national government. They’ve been talking for more than a decade about how they’re going to tackle the problem of social care, but they’ve yet to do it. So it’s unclear as to what that might look like. Part of it has to be more public money coming into the sector – there’s insufficient funding. There’s an understanding among people I talk to that this isn’t really a commercial thing – that doesn’t fit well. It may be appropriate for some, but for the vast majority, in an ideal world, they might say they’d like the state to look after them. but I don’t think the state is in a position to do that, and I don’t think it has any intention of doing it in the future. So it’s about trying to find appropriate models that have that same public sector ethos, but are able to operate independently of the state. The co-operative model fits that really well, because it gives that community ownership and accountability that I think is crucial in terms of building solid trust relationships.

Do you think social care will come down to some sort of subscription model – to co-operative insurance maybe?

There’s no reason that couldn’t happen. The majority of social care is self-funded as I understand it. Most people pay for their own social care. That might be because of historical reasons. Baby-boomers are now the people needing social care, and they’ve done well from the economy by and large. A lot of pensioners are pretty well off, and it’s the generation coming after them – a lot of them are really struggling. They haven’t had the opportunities to get into the housing market, and they’ll come out at the end of their working lives (much older), much less wealthy, so they’re going to be more reliant on funding coming from other sources than themselves. We’ve got an ageing population that will need more care as they get older, and yet they don’t have the personal wealth that people in that age group have now. So it’s going to get quite nasty over the next 20 years. We need to start developing solutions now to tackle those problems.

Part 2: building a national network of social care co-ops.

Highlights

1. It was clear that social care in this country isn’t working for anybody particularly well. That goes for providers as well as people who use social care services and the local authorities.
2. The distance between the governed and the governors is too great. They lose sight of the humans involved, and it all becomes numbers.
3. We’ve talked about the problems of care-givers, but also, care receivers are not getting the quality of care that they could. In terms of trying to tackle those dual problems, we wanted to bring those people together and give them control, so that they’re right at the heart of the operation, and co-owners of the business.