New challenges face the social care sector: Now is the time for mutuals

In this guest post, Dr Guy Turnbull, director of Care & Share Associates Ltd (CASA), talks about how new models of ownership may help the health and social care sector overcome its challenges.

With the residential care system rocked by allegations of abuse and the collapse of one of the country’s leading private providers of residential care, the situation has never more needed a radical rethink of how health and social care might be delivered safely and securely.

Significant challenges

The health and social care social care sector is facing significant challenges relating to:

• Demographic pressures
• The personalisation agenda – the drive to put service users in control of their own budgets, and purchasing their own care
• The move to outcomes-based commissioning – the idea that social care should be purchased by ‘outcomes’ rather than blocks of time
• Significant reorganisation of the health service

These challenges are underscored by overall budget pressures across public sector spending.

Such a challenging environment demands a new relationship between public sector commissioners, people who use health and social care services, and care providers.

Rethinking health and social care

The traditional paradigms focus on the public sector delivering all, and the public sector commissioning private providers to deliver ‘some to all’ of our health and social care needs.

CASA is striving to strike a ‘mutual balance’ between the needs of social care’s main stakeholder groups, who are workers, commissioners and people that need support. We do this because, as a social enterprise, we put people before profit.

Social enterprise providers, such the CASA group of employee-owned franchise companies, are in a great position to meet these challenges by drawing on their underlying values of:

• People before profit
• Openness and transparency
• Concern for community
• No external shareholders means reinvestment of surplus to improve service quality
• A genuine desire to improve people’s lives through innovation and service redesign
• Commitment to education and training

What we are finding is that during these times of rapid change, there is an opportunity for mutual providers, like the CASA group, to design entirely new relationships with commissioners, service users and their families – relationships that are capable of generating creative and effective support systems.

A creative LIFE

Take, for example, CASA LIFE. Living Independently for Everyone (LIFE) is designed to provide bespoke support packages for individuals with complex needs, often 24-hour one-to-one support. Evolving from the principles that everyone has three fundamental needs for a full and happy life, LIFE addresses: somewhere to live, something to do and someone to love.

It focuses on the ‘something to do’ element, and supports disabled people to live within their communities, helping them to attend college, evening classes, engage in self-employment or enterprise activities and develop fulfilling domestic circumstances so they can enjoy life to the fullest.

A unique aspect to LIFE is that, as part of an employee-owned organisation, it allows support workers to be shareholders in the business, and have a share in success. Such mutualisation directly contributes to loyalty, commitment and pride – all factors for a high-quality positive support experience. Both public and private sectors cannot offer genuine employee ownership.

The current financial crisis has been referred to a ‘burning platform’, which will ultimately result in more creative provision. Although not comfortable for those on the platform, there are undoubtedly opportunities for those in the mutual sector to start rewriting the how-to manual for health and social care.

National Children and Adult Services (NCAS) conference

If you are interested in learning more about how local authorities can develop mutuals to deliver children’s and adults’ services, come to the fringe event at 6 pm on 20 October during the NCAS conference. I’ll be speaking along with Phil Copestake of OPM and Andy Rennison of Hammersmith and Fulham.