Equal Care Co-op: using technology to redirect power in front-line social care

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Equal Care Co-op: using technology to redirect power in front-line social care

Jim was an intelligent, kind and adventurous man. He and his wife Jill lived in a rural part of the Pennines and would frequently go out for long walks in the surrounding countryside. One day, Jill and Jim were returning from a five mile walk and he started to stumble forwards, then came to an absolute halt. He stayed rooted to the spot and was unable to move. There was no one nearby to help and so they both had to stay there until he felt able to move again.

As Jim’s illness worsened over the years she needed to bring in more and more help, eventually ending up with round-the-clock care delivered by an agency. Jill oversaw the work of the agency staff, many of whom had never heard of Parkinson’s disease. Alongside this, she dealt with the increasingly complex accounting for Jim’s care, which was provided through several types of funding streams (both council and NHS) and topped up with their own savings.

Jill’s experience with agency support was a battle. “I learnt to be very demanding,” she says, discovering that just asking for things would tip her to the bottom of the queue. Regular clients were given the newest staff and there were frequent changes.

“They would swap the staff at the last minute or they wouldn’t send someone at the last minute. If they had a new customer who needed a night carer they would redirect [them]”.  

Unsurprisingly, this directly affected the quality of care and created constant emotional pain, upset and disruption.

“We needed the continuity. Jim was not a social animal…He was a quiet man with a quiet nature. He couldn’t bear being talked down to like a child and neither could I.”

Jill had to threaten to leave the agency before they agreed to send regular care workers. After being with them for some time and keeping them accountable, she achieved the standard of care she had needed from the beginning.

“In the end I was so insistent…I more or less selected who I really wanted…I wanted to develop a team. They had their insights and expertise to share with me.”

Jill’s experiences are being repeated right now, all over the country. And many won’t have a relative with the kind of dedication and focus that’s needed to prevent the dominant trends in the care industry. With an annual turnover that’s only rising year on year (currently 31%) and pay at or below the minimum wage, front-line care staff have the worst deal in the country. Everybody who matters is suffering the consequences of this.

We want to bring a few ideas together to create a service that tackles these challenges directly. We think that appalling turnover figure will drop significantly if both the person getting support and the person giving it get to choose each other. If you like someone and have trust in their abilities, you’re off to a very good start.

If you get someone turning up at your house whose name you don’t know and who you’ve never seen before, this is (obviously) not the key to success.

Consistent, respectful, empathetic support from a person or people that you like can be the difference between end of life at home or in hospital, between a longer, more comfortable life and one that’s characterised by anxiety, uncertainty, stress and shocks.

Enter the platform

Platform technology is very good at this kind of personalised matching. You can view profiles, talk to potential care workers and even build your own team.

The platform-enabled, gig economy has received a great deal of publicity in recent years – not all of it good. The formula has – inevitably – extended to the world of care work and there are now some established platforms offering a vetted labour pool and easy process for booking care workers of your choice. All of these platforms are privately owned, and all of them retain a value-extraction based business model aiming for shareholder return. In most cases, these companies are angling for an exit from the market and a windfall for the founders and early-stage investors.

The Equal Care Co-op is a total contrast.

Our platform itself has social goals (as opposed to financial ones) and we think that gives an extra boost to our trust and you can see where your money goes. We are a platform co-op – an organisation which uses a platform marketplace to deliver its primary business and is co-operatively owned by the people who use that marketplace. This is a real gig economy alternative that pays equal attention to the rights of workers and the rights of those they support.

There are some emerging principles about what a platform motivated by social good could look like. We fit with the five that have been identified by the community think-and-do tank, Ouishare. And also with the eight identified by the Good Work Code.

(If you’re interested in the detail of what we’re wanting to achieve, you can read about it in our ‘What’s the idea?’ booklet. If you’re excited about it, get in touch!)

Funding and growing the idea

Big ideals do not map well onto big profits, so our start-up route is a grant-dependent, CrowdFunder-led one. We shall be making use of Community Shares – a new-ish social investment vehicle only open to co-operative and community benefit societies. However, the equity-loaded finance that drives most ventures of this type is closed to us. The minimum amount similar care platforms have started out with is 2.5m, so we are taking a very different type of approach!

We can’t grow by just marketing at places and people, filling their twitter feeds, google searches and facebook walls with our product. This is a great thing – it means that our growth will be determined by people locally. People who have chosen us, want us to be there and want to be in control of how support happens in their community. This is a way to stay locally accountable, avoiding situations where the main decision-maker is absent or the only people who can effect change are at the other end of half an hour of on-hold music (or not).

We’re looking at “strawberry patch” principles, sociocracy based growth models and federated structures. There are many possibilities for growth that don’t entail becoming enormous and monolithic, but where you can still be large enough to offer a real alternative to the private companies taking UK care contracts. Imagine it – scaling up but keeping communities in charge!

Ed Mayo, Secretary-General of Co-operatives UK, has said about us:In Equal Care we have a viable, alternative and pioneering model for social care as well as platform co-ops, and we’re incredibly excited to see what the future holds. Co-operatives UK has been delighted to support Equal Care in its development – through UnFound, an accelerator for platform co-op, and through The Hive, our support programme for co-operatives in partnership with The Co-operative Bank”

We have had some wonderful support from many quarters, but we still need help to get up and running with our pilot project in the Calder Valley. We launched our Christmas CrowdFunder on 15th November to raise £20,000 – it’s an all or nothing campaign. Please take a look at it and even if you can’t contribute we would love it if you could share it with others.

14th November 2018

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