When people are motivated by a need that inspires care, whether unpaid or paid, there can be a richness in the motivation as it is needs-driven and sustaining of both people and society.
When it comes to organisations, care is a bit more of a slot machine.
The welfare state, in particular, plays a vital role in people’s lives. It can be a lifesaver, a safety net or a transformer. As one beneficiary explained to a friend of mine, Richard Simmons, a senior lecturer at the University of Stirling, “There are things that, if I didn’t experience them here at the day centre, I wouldn’t have ever done them in my life. Before, I never got out. I was a right scaredy-cat. Now, I’ve tried so many different things, I think ‘Yes, I can do it.’ So that’s what it’s done for me.”
But the welfare state can also lose its caring touch in random acts of thoughtlessness, pervasive bureaucracy or the demeaning nature of being assessed as someone in need. Talk to any parent over the years who has had to get one of their children ‘statemented.’ The language that is used to describe and plan care services often reflect this confusion.
Richard Simmons was doing research on people who use social care services. He wanted to explore the different labels they use—citizen, consumer, client, customer, user, member of the public—all labels with slightly different connotations.
He showed the list of terms to one person and asked, “How do you think the service providers see you?” The man looked genuinely confused, and then replied, “They just call me John.”
The words that professionals use to talk about health and social care today, including that great ugly noun, personalisation, are no more than bits of Lego. Terms can be assembled, fit together and sound good, but they don’t capture the fundamentals of care. They don’t answer the question, “Why care?”
At root we need to understand care as meeting human needs and creating human dignity.
This needs to be good work. Fritjof Capra, founding director of the Center for Ecoliteracy in Berkeley, explains, “We can’t be empowered by work that destroys the environment around us or creates systems of inequality. No matter how our work is organised, it cannot fully empower us unless we believe in its purpose.”
This is how the care system, or the wider economy, currently works:
• In paid work, people are often being rewarded in terms of money and status when they are behaving destructively.
• Those who care at home or in the family that are unpaid suffer low status, poor conditions and often stress and personal costs.
• The burden of this work continues to fall disproportionately on women, whether they are part or not part of the mainstream labour market.
• The entry of venture capital into the care of children and vulnerable people shapes the culture of providers towards an instrumental model of care, where service is a means to increase return on capital.
The formal social care sector, catering for the most vulnerable people in society, has been hit hard by austerity measures. Social care costs account for one third to one half of local government core budgets and the squeeze on funding has meant that low pay has become endemic to the model of state care, as it has been among private sector contractors. In the home care sector, eight out of ten workers are on zero-hour contracts.
The demand for social care, though, is increasing, leading to an interest in hybrid models of mutual care, self-payment and state support. Drawing on the work of around seventy mutual pioneers in the social care field, in work led by Co-operatives UK associate Pat Conaty, we have been exploring the potential for a radical new model of social care, drawing on innovation from Italy.
The ‘social co-operative’ model turns the users of social care into partners, alongside the workforce, with both given an ownership stake in the business and a share in its financial success. It is an approach of services delivered ‘with and for’ care users and carers.
There is now a social co-operative in every town in Italy, with a labour force of 360,000—greater than the total number employed by private sector residential care providers across the UK.