What is co-operative care?

It is Equal Care's keystone, but not the whole bridge

Co-operation

Co-operative social care refers to a model of social care service delivery that is owned and managed by the people who use the services and/or the workers who provide them. They come in different flavours of co-op, which you can read about here.

This approach is grounded in the principles of co-operation, mutual aid, and democratic governance, aiming to empower both care recipients and caregivers. Find the seven principles and the ten values here.

A word of caution

Given that Equal Care was founded with the intention of restoring healthy power dynamics to the most important groups in social care, being a co-operative society was an obvious choice to make. However, although co-operation is an essential foundation for Equal Care's model of support, that is all it is.

We believe that simply creating a domiciliary care agency and incorporating it as a co-op does little to tackle the really tricky problems in social care. Wages are still low, rotas are still set by the office, recruitment remains challenging and a 'compliance-first' culture is just as difficult to escape from as it is for other organisations. To address these issues, more is needed.

Key elements of co-operative social care

Ownership and Governance

Co-ops are democratic businesses, seeking to share out the benefits and the responsibilities of ownership as an antidote to inequality. The first co-op structure was set up in Rochdale in 1844 to tackle injustices in shopkeepers charging high food prices for poor quality products. Co-ops have always been concerned with redressing social injustices and fixing broken markets.

There are several types of co-ops:

• Consumer Co-operatives: People getting support are sole owners of the co-op. Sadly, we haven't found an example of this yet. The Co-op Group is the best known example of this type of co-op.

• Worker Co-operatives: Care workers are owners, one member, one vote. The Great Care Co-op is a good example. There is also an allied type which are employee-owned businesses. These are not co-ops under the legislation but they operate very similarly with employees owning a share of the business. An example of this is one local to us that transitioned from an owner-operated business to an employee-owned trust, Welcome Independent Living.

• Multi-stakeholder Co-operatives: In these, there are multiple classes of members which may have different vote shares and voting rights. Equal Care has adopted this model with its four membership classes. Colne Valley Co-op has also chosen this and another example is NWCC with its two membership classes: Principle members (supported people) and PA members.

• Community benefit societies: A type of co-op which has a statutory requirement to benefit the community beyond its membership. A great example is Belong, building multi-generational care home settings.

Democratic Decision-Making

• Each member (whether user or worker) has one vote, ensuring equality in decision-making.

• Major decisions are made collectively, often through general meetings and elected boards.

Equal Care uses a model called sociocracy to empower collective decision-making.

Sustainability and Community Focus

• Surplus (known in traditional business practices as profit) is reinvested into the co-operative to improve services or distributed to members directly involved in the co-op.

• Investment in co-ops is by Community Shares (in the UK) - this is a form of withdrawable capital that isn't related to how much profit the co-op makes, so is very friendly in terms of allowing the co-op to grow.

• Strong emphasis on community engagement and local service provision.

Empowerment and Mutual Support

• Users and workers feel more empowered and valued, which improves job satisfaction, staff retention, and care outcomes.

• Encourages a supportive environment where the well-being of all members is prioritised.

Key benefits of Co-operative Social Care

Research on co-ops in social care is largely confined to European models, although the pace of interest has been gathering in recent years. This Co-ops UK report, Owning Our Care states the case for co-ops and Equal Care has been involved in several research initiatives including SASCI and the University of Kent. Australia has also done a lot of research as part of a big co-op initiative across their rural areas.

Enhanced Quality of Care

Co-operatives tend to provide higher-quality care due to their user-centred approach and commitment to continuous improvement based on member feedback.

Increased Job Satisfaction

Workers in co-operative models typically experience higher job satisfaction because they have greater control over their work environment and conditions.

Economic Sustainability

Co-operatives are generally more sustainable economically because profits are reinvested into the service, improving stability and growth potential.

Community Engagement

By focusing on local needs and involving the community, co-operatives can offer more relevant and effective services.

Ethical and Inclusive Practices

Co-operatives embody ethical business practices, including fair wages, transparent operations, and inclusive decision-making processes.

Further research

EO mutuals long read

Together for Greenwich: Co-operation for the future | Co-operative Commission report

Providing Care Through Co-operatives - ILO

Work together Care EN version

2021 Case Study Coop Care Colne Valley

Cooperate with Care

The Cooperative Difference in Care - Cooperative Councils Innovation Network

Social Cooperatives In Italy

CARE HOMES IN WALES: PROMOTING SOCIAL ENTERPRISE

Increasing the social value of care - Cwmpas

Challenges and Considerations

While we know that the benefits of creating and running a cooperative are many and manifest, there are problems to overcome:

• Initial Setup: Establishing a co-operative can require significant initial effort because there is a higher governance overhead in the process of working out rules and decision-making structures. These are usually taken for granted in 'normal' companies.

• Time to market: Developing a co-operative to the point where it can deliver services, return revenue and become sustainable can take longer than owner-operated businesses.

• Funding: Co-operatives require significant capital to start up, and in the UK, there are currently lots of restrictions on investment in this business form (although this is changing).

• Training and Education: Members must be educated about co-operative principles and practices, which takes additional time and resources on top of the already heavy training requirements in social care. Additionally, many co-ops practice role diversification, which favours training existing members over buying skills in. This benefits retention but disbenefits the ready availability of specialist skillsets.

• Scalability and sustainability: While highly effective on a local level, scaling co-operative models can be challenging due to investment restrictions. For co-ops to pay people more, this reduces available capital for growth activities and back-end infrastructure.

• Voting: Even if a co-op attempts to make decision-making and voting more frequent than an annual AGM or quarterly members meetings, majority and minority voting practices tend to result in unsatisfactory outcomes for the minority. This care creates lingering resentment, a culture of 'picking sides' and it is impractical to vote on everything. If a co-op only permits voting and member participation at the AGM, it is somewhat meaningless as a choice of business form.

• Management: It is quite simple to be constituted as a co-operative and yet to continue operating a business-as-usual form of homecare or residential care, with line management, low waged pay, long hours and siloed roles. Co-operation does not protect organisations from the requirements of the Health and Social Care Act to have a registered manager in place, nor does it adequately protect organisations from participating in the race to the bottom seen in so many localities in our country.

The many additional elements to Equal Care's model of support are built on the foundations of the co-op principles and values, but they are designed to go far beyond co-operative governance methods to reach into the day-to-day experience of giving and receiving care, which is where it really counts. The model described in this Playbook, together with our platform, is structured to address all of the challenges above.