Presentation to Welsh Assembly Cross Party Group on Co-operatives and Mutuals. Why Co-operative Models of Social Care need to be developed in Wales
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1 Adrian Roper, CEO, Cartrefi Cymru Presentation to Welsh Assembly Cross Party Group on Co-operatives and Mutuals 23 rd January 2013 Why Co-operative Models of Social Care need to be developed in Wales I m the Chief Exec of Cartrefi Cymru, a charity which employs 1000 staff and provides social care in 14 counties across Wales. We re not a housing association but a domiciliary care agency supporting people in their own homes. Most of our clients are people with learning disabilities, but we support a growing number of older people. My interest in cooperative models of social care began a few years ago when I met a guy called David Smith from the Wales Progressive Cooperators. We both had a shared interest in the current problems facing the users of social care services. I ll come back to those in a minute. Firstly, I d like to offer a definition of social care. It is the positive interactions that each of us exchange with our families and friends...so that we can enjoy good health and a sense of well-being. We all face risks and challenges to our health and well-being...and we all need help. Every family, and circle of friends, embraces infancy, disability, illness, aging and frailty. Everyone of us will experience needs like these, sooner or later. And it is family and friends that we hope will help us, and that usually do. Recent Welsh research has revealed that 95% of the care of older people in Wales is provided by unpaid carers. 5% is provided by a mix of private, statutory and voluntary agencies. It is a similar picture for people with disability, mental illness and other care need. The vast majority of public funds for the elderly is NOT spent on the 95% with unpaid carers. The public funds are nearly all spent on the 5% - what we might call social services. You can see one of the problems with current services in these statistics: scarcity. Public funds, as they are currently spent, won t stretch beyond the 5%
2 The system is geared towards rationing Money is fed into services that don t add value: Don t support unpaid social care Don t create or access other resources Don t build community Another problem is complexity: Assessments... Eligibility criteria... Waiting lists... Buck passing... A jungle of agencies... Another big problem is disempowerment. Access is decided by professionals What you get, and when, is decided by others You have little say in how you are supported All the things you have to offer are ignored You are an isolated recipient of care Another problem is social disconnection: No provider interest in: your family or friends activities which enhance your local community enabling you to participate and contribute You are isolated from other service users Or congregated in an institution Another problem is provider self-interest: Doing what s easiest for profits or the system...
3 Avoiding the hassle of user empowerment... Avoiding the hassle of family involvement... Filling the rota and ticking the boxes... Creating a facade of quality... And finally there is the growing problem of marketplace competition: Turning people into commodities Putting people s lives out to tender Procuring for cheapness, rather than value Undermining collaboration between agencies Undermining local connections, trust and goodwill All of these problems with the current set up were a concern to activists like David and I, but they are also the concern of academics, senior professionals and political leaders across the political spectrum. Whether it s Wales or Scotland or England, whether its Labour, Plaid, Liberal Democrat or Conservative, everybody agrees that social care services need to be transformed. In Wales the Social Services Minister echoes many in, quite rightly, calling for changes which will give social care users a stronger voice and real control. The question is...how? What I have been discovering over the past few years is that at least a sizeable part of the answer should be the application and encouragement of cooperative values and principles and the development of cooperative models of service. I m sure many of you know the seven internationally agreed cooperative principles, but perhaps you haven t thought about them in terms of social care. So I ll quickly go through them making some comments about their relevance: Voluntary membership. No one can place you in a care co-op. You have to choose to join. Democratic member control. The decisions about your care and support are not made by faceless bureaucrats or shareholders or trustees, but by people you have elected or can challenge as a voting member. Member economic participation. You are not the helpless recipient of someone else s largesse, but a contributor, and potentially a significant contributor.
4 Autonomy and independence. Your agency cannot enter into agreements or contracts which undermine democratic member control or any other of the cooperative principles. Education, training and information. You are not the helpless recipient of care from an agency that develops the skills and knowledge of its staff and managers whilst you get nothing. You are an essential part of the coop too. Co-operation among co-operatives. Your agency is not alone, but part of a network of agencies with shared values, potentially shared resources, and an interest in each other s success. Concern for community. Your agency is outward looking, and seeking to support not just you as an individual member, but also the wider community in which you live. And the application of cooperative principles to social care is not an untried fantasy. In February last year, David and I brought Jean-Pierre Girard over from Quebec to tell the H&SS Committee and others all about the successful growth of 101 social enterprises, 47 of which are social co-ops, since 1995, providing 600 jobs and 6 million hours of home-based support. In June we brought over another global cooperative leader, John Restakis who told us about the 7000 social coops in Emilia Romagna, where in the capital Bologna, 87% of social care is provided by coops. And closer to home, we discovered that there is a thriving Industrial and Providential Friendly Society operating in Swansea that is supporting 250 people with learning disabilities not as service recipients but as voting members. And it is surely no coincidence that this cooperative agency, Community Lives Consortium, is actively building community and partnership in the Swansea area and is a hot-bed of innovation and best practice. What has become clear is that cooperative models of social care have a number of fantastic attributes, particularly the multi-stakeholder coop in which workers, users and community supporters all have membership rights: A stronger voice and real control for the user is hard-wired Workers and users have a valued status Users are not isolated or kept in the dark Strong community links are part of the ethos Inclusive decision-making promotes responsiveness Collaboration and enterprise increase resources
5 With cooperative models of social care, agencies will not just be focused on delivering care tasks...they will be building community. They will not just be serving the 5%, but everybody. The experience of users will not be they do it to me, but we do it together. And it seems to me that we have an opportunity to build social coops into the fabric of Welsh society in a way that could solve so many of our problems, not just in social care but in community cohesion and the need for economic enterprise and initiative at the grassroots level. To get some grounding in the reality of cooperative action, I am not only encouraging democratic user forums and staff participation groups to grow within Cartrefi Cymru, I have co-founded a Music Coop in Penarth where a dozen and growing number of ordinary citizens are learning to work democratically for mutual benefit and the benefit of the local community. The level of interest has been really encouraging. The potential for this citizen energy to be switched on all over Wales has got to be enormous. And with a long-term political consensus at the national level, and the nurturing of cooperative values at the county and community level, I believe we could make Wales a much better place for the old and the disabled, and for the young and the able - for all of us. Thank you.
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