Growth Outcomes
Individual Development / Individual Change Agency / Independence & Autonomy / Inclusion & Participation / Learning & Skills Development
Many interviewees emphasized the way in which Equal Care places value on individual agency and growth. This came through most strongly when explicit comparisons were made between traditional care agencies in the private sector:
Social services is a bit like getting a parcel from amazon. Its a totally passive thing, no relationship. Equal care does things differently. It tries to look at the person and try to ask questions about what they actually want and need. Everyone has different care needs.
The Amazon metaphor that this Care Owner uses to describe her previous experience of care service is revealing on two levels. Firstly it conveys the 'impersonal' or anonymised nature of the interaction, where instead of a relationship there is just a consumer transaction, the handing over of a product. The reference to a corporate platform is also significant in relation to the increased automization of care services as digital tools are deployed to monitor and control every move of care workers, reducing their role to a series of quantifiable tasks.
The importance of recognising that different people have different care needs came across strongly in many of the interviews. One of the care owners spoke about the importance of making sure that there is a good match between the care worker and care receiver in terms of specific skills and experience that might be important e.g. being able to provide support using digital technologies. She also emphasized the importance of compatibility in terms of interests, personality, energy and other characteristics: "you don't put a highly organized neat freak with a scatty person." To illustrate the lack of agency or flexibility that existing within normal care services, one of the Care Owners shared an anecdote from a conversation with a friend who was using an NHS trust:
I once asked her what she would like to be different in her life if she had the power to change it. She said that she would like to not have sugar in her tea. Can you imagine feeling so totally disempowered that you don't even feel able to say how you like your tea?
Despite the emphasis placed on agency and compatibility when it comes to making the match between care worker and care receiver, interviewees reflected that in practice "in terms of freedom and choice, there were very few choices" due to the scale of the project. Freedom of choice for this kind of project is contingent on having a sufficient number of teams, number of working hours and different options to swap between teams. A couple of the interviewees felt that it was therefore misleading or hypocritical for freedom of choice to be one of the "selling points" of Equal Care. One of the original circle members expressed regret and frustration that they didn't start recruitment from Day 0. This was because they needed support from the central office in Calderdale who didn't have capacity until several months into the project. This 'chicken-and-egg' problem regarding the scale of the project is explored in more detail in the Systems and Co-production Outcome Domain.
Another fundamental challenge that came through in the interviews was that many of the Care Owners were struggling with not having their basic needs met, for example in terms of food or their housing situation, and the Care Circle was powerless to meaningfully improve this situation. As one Care Circle member describes:
I am very aware that food provision is still a huge issue in people's lives. I often have phone calls with one of the Care Owners who says that she has no food in the fridge. It's that feeling of 'wow we still haven't managed to achieve systems change. Yes their life is better but still there is no food in the fridge. We need something like a food cooperative to meet these needs but I can't set one up myself. I live in a reality where I know what needs to happen but it won't happen.
In relation to personal development, interviewees reflected is hard to even start to think about building things like confidence and connectedness when the most basic needs are still not even being met.
Individual growth was also a theme in relation to the care workers, both in terms of professional skills-development and transformative experiences on a more emotional level. Interviews with the workers illustrate how Equal Care's circles and other organisational spaces have created what we might call a 'capacitating atmosphere' which has had a positive impact on all the factors within this Domain. One worker, for example, desribes the atmosphere of the groups she has participated in through Equal Care:
[the meetings] all have this... like energy about them, where it's a comfortable space even though it's digital. I know a lot of the time when you think of space it's like a physical room. But they all had this energy about them.
She explains how this atmosphere made it possible for her to take on new challenges:
I think sometimes having an overwhelming sense of authority kind of makes like...people shy away from saying certain things.. a complaint or something that you might want to say. Here it feels like I'm talking to someone who is going to help me solve a potential problem [...] I never felt there is stress or pressure for me to like do anything I didn't want to do. I think not being forced into anything, has made me more open to naturally finding out that I am open to doing things.
The idea of being able to choose between options is once again significant here, with workers feeling like they can take a step when they are ready rather than because they are required or expected to. This theme was echoed in comments by other care workers, particularly in relation to having a voice: "I'm quite outspoken... but a lot of people actually take offense by that. In Equal Care they've encouraged that and they say we want you to speak out."
The benefits of this culture go beyond personal development in a professional context. One worker describes "the positive influence that its had", not just on her work like but on "outside my work commitments, my own mental health, my own wellbeing, [its] been priceless for me."
Across the interviews, there were numerous examples of different ways the Clapton Circle team had found to acknowledge and to value the paid and unpaid forms of care labour that people carry out. For example, the community organiser described how she made a promise to herself that she would always celebrate people's birthdays and make them a cake.
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