Developing practical ideas for the Community Care service

Introduction

The key feature that sets the Community Care Co-op model apart from other service providers is the ambition to build a culture of highly organised good ‘neighbourliness’. This assumes that while paid staff members are responsible for delivering quality regulated care, many of the other things that make life worth living can only be realistically accessible to people receiving care if the wider community gets involved.

Each community - and therefore co-op - will be different. So rather than provide a lot of general advice we have provided below our own Co-operative Care Colne Valley (CCCV) operational plan and vision for a Colne Valley Care Store as an exemplar. Hopefully this provides some useful ideas that you can apply.

In developing a service that cuts with the grain of your own community it would however be useful to begin by asking some general questions:

What are your aims - how does this fit in with your vision as a co-operative?
What are the communities you hope to reach in terms of geography, age, needs etc?
What community resources and assets already exist?
What resources, especially in terms of staffing, from within the co-op itself will be required?
How could you communicate your plans with the community and existing groups and statutory organisations? Council officers and Primary Care Networks would, for example, be important points of contact.
Are there funds and grants available that you could access?
How would you like the community services to fit with the regulated care work undertaken by staff members?

Ultimately, the answers to these questions will shape your service.

Colne Valley Co-operative Care Store

Operational Plan for the Community Care service Year 1

When most people think about ‘co-ops’ they immediately think of their local Co-op food store. So building on that, we should brand our Community Care offer as a ‘Co-operative Care Store’ that both receives income in time, cash and kind, and then pays out a dividend to the people of the Colne Valley.

At the core of this service will be community and family members of the co-op willing to contribute their time, energy and compassion. Our co-operative approach is for community volunteers to work with paid staff to help service user members stay independent and well.

Aims and Targets

Pilot a fully operational ‘Colne Valley Co-operative Care Store’ which mobilises the community to work alongside our staff members to support and deliver care
Tackle social isolation and promote ‘social prescribing’
Allow people to fulfil their full potential, remain independent and live well in their own homes
Help coordinate and promote a co-operative approach with external agencies, including existing community, voluntary and faith groups and as far as possible
Generate income for Co-operative Care Colne Valley (CCCV) which can then be ploughed back into the community in the form of care services

Principles we will seek to apply

In organising the Community Care we will seek to apply our co-operative principles:

Make the service as widely available as possible irrespective of social, ethnic or economic background
Incentivise and benefit all members of the co-op – service users, families, staff and volunteers
Promote an inclusive, friendly and supportive culture and service
Stay place-based - seek to root the service within a particular area
Encourage team working and genuine opportunities to meaningfully shape outcomes
Treat everyone as an individual with individual needs

Our approach to meeting people’s needs

The legal and market framework applied to domiciliary care providers seeks to distinguish between ‘regulated’ and ‘non-regulated’ care. This can often encourage a ‘time and task’ culture in which the needs of people receiving care are narrowly defined and care workers undertake a limited range of tasks agreed in the Care Plan/contract. So while care needs may be met this leaves other elements of life essential to maintaining independence and well-being neglected.

A wider vision of ‘need’ identifies four key elements of a person’s daily life that impacts on their sense of health and well-being, which are set out in this table:

Elements of independence and well-being	Examples encountered in daily life
My Life	Attending appointments, Tenancy Support, Using IT, Managing Finances, Family and Relationships, Faith and Culture, Bereavement Support
My Home	Shopping, Cleaning and Laundry, Cooking, Property Maintenance, Garden Maintenance
My Community	Sense of belonging, Friendships, Social Outings and Events, Plus One Arrangements, Holiday Support, Sitting Service
My Care	Hygiene and grooming, Medication, Mobility, Nutrition, Continence Support, Emotional Wellbeing, Health

While the ‘My Care’ element will be more the responsibility of the staff members there are many other opportunities where staff, volunteers and family members can contribute to promoting independence and well-being. Here are a few – practice will allow more to be developed:

Elements of independence and well-being	Examples where service users and families can actively participate with staff and volunteers so it's being done by/with them, rather than to them
My Life	Helping someone else with an aspect of their life Sharing responsibilities/time spent in return for respite for yourself or a family member later on
My Home	Participating in joint shopping trips and maybe a meal out with a few others Shared meal at home, facilitated by the Co-op
My Community	Participating in social outings and events facilitated by the Co-op Visiting people who can’t get out The Co-op acting as a befriender that can bring people together with shared interests, such as sport, hobbies etc Help with technology – internet shopping, skype and telephone conversations Participating in community and democratic decision making
My Care	Through actively engaging with others receiving a boost in mobility, health and a sense of mental well-being

Filling up the Care Store

Before the Co-op Care Store can release a dividend back into the community it has to receive an ‘income’ and generate a surplus and fill up the store. This would have a number of inputs from a wide variety of sources (Fig. 1)

Resources directed from any surplus generated by the paid regulated care part of CCCV.
Income from charging for non-regulated services delivered by volunteer and staff members
Grants and income from statutory agencies, the NHS and Kirklees Council
Time donated by community volunteer members
Time donated by service user and their family members
Resources and joint-working with local community and faith groups
Voluntary contributions from local businesses
Shared activities and resources with sister community care co-ops elsewhere in Kirklees

This has implications in terms of a work plan.

Given the vital role individual co-op members/family members, CCCV will have to play an active and positive communication strategy to recruit new volunteers and maintain our profile with external funders and community organisations is required
Our aim is to act as a mobilising and co-ordinating force in the Colne Valley, both as an Anchor Institution and in our own right. We will work harmoniously with other existing agencies and community organisations
There are three broad sorts of inputs can therefore be measured and monitored in quantifiable terms:

Cash
Services in kind that can be allocated a cash value - there is considerable potential to develop links with local businesses who may offer to put time, money or resources into the Care Store.
Time donated by individual volunteers or family members. If the co-op has financial resources in the Store this will also allow us to employ specialist staff to deliver elements of any Community Care Package and allocate ‘non-contact time’ hours available in the local teams.

Fig. 1. FILLING UP THE CARE STORE…

Summary of Work Plan required to fill up the store

Develop a communication and volunteer recruitment strategy
Develop a communication strategy to explain our service to relevant external organisations, funders, local businesses and community groups and build relationships
Identify potential funders and submit applications/initiate discussions to secure external funding
Develop a schedule and system of charging
Develop a system to accurately measure and monitor the resources held by the store so realistic decisions can be made about how they are then distributed and by whom

Distributing the dividend

Once potential resources have been built up in the store they can be rolled out into the wider community (Fig.2).

(Fig. 2) DISTRIBUTING THE DIVIDEND

The process of distributing the dividend has a number of operational implications:

The potential needs of Service User Members, over and above the paid for care package, will need to be assessed accurately and systems developed to do this. The key question the Community Operations and Business Manager (COBM) will need to think about when drawing up an individual Community Care Package is, realistically, which individuals or groups are available to actually do the work? ie What resources are in the Care Store? (Please note, the COBM is the staff member tasked with leading Community Care Services within CCCV).
Bearing in mind that these resources will not simply be volunteer hours, but could also include financial and staff resources, as well as partnership activities, a clear system of recording of who is getting what and when will need to be maintained.
Our aim is to provide care to everyone in need we can in, but at the same time the service has to remain financially viable. Systems will therefore have to be developed to allow people in the community who are not necessarily receiving regulated care, cannot pay or are eligible for public funding can access the service.
The Co-op will not necessarily have to deliver a service directly so part of the answer to that could be referrals to other organisations and agencies. They in turn may refer people to us, so everyone should benefit from positive partnership arrangements

Summary of work plan to pay out the Dividend

Develop procedure for assessing of needs of service users and matching those with resources from the store
Set up recording systems of who gets what, from whom?
Develop system by which people in need who would not otherwise be eligible for the service can apply. Who makes that decision and on which criteria?
Develop a referral system and make agreements with other relevant organisations

Our Co-operative approach to community volunteering

The potential value of a large, lively and above all well organised volunteer service to support social care is obvious and there are many organisations already in existence that seek to do things like befriending, transport, drop-ins and so on. However we will also seek to develop new co-operative approaches.

Co-operation is based on the simple principle that by working collectively with others we can achieve more than by acting alone. Our multi-stakeholder approach begins with the different people and groups involved in delivering social care and then asks how they could pool their collective energy and genius to achieve better outcomes. The following table sets out the key elements of our approach, identifies practical means we can achieve it and some possible risks:

Element of our approach	How will we ensure this?	Risks
A safe, professional and truly person-centred, holistic service	Safeguarding policies and procedures DBS checking Training Clarity of roles - a clear accounting needs to be made about which parts of the service could be delivered by paid staff and by volunteers from within the community.	Insufficient resources or focus from staff Cost and staff resources Although there is a ‘regulated’/’unregulated’ care divide in reality there will be considerable potential overlaps and lines could become blurred
Promoting staff member well-being	Clear systems of accountability and job descriptions Staff member involvement on the Board	Volunteer work becomes a substitute for tasks that should be undertaken by paid staff
Ensure benefits for family and community member volunteers	Feeling valued - respect and recognition for any contribution. The potential to gain satisfaction by working cooperatively with others, make friends and quite simply have a laugh! Build in flexibility so not too onerous Opportunities for family and carer members share worries and support each other Travel expenses and child-care paid for directly, alongside vouchers/payment in kind for meals and clothing if appropriate Scheme where volunteers could bank hours and receive a voucher/benefit in kind from a local business? Family members/carer members earning and exchanging time credits for their mutual benefit. Eg volunteers with caring responsibilities could bank hours and cash them in to 'buy' some respite care delivered by other volunteers. Training and the possibility of moving from volunteering into paid employment within the co-op – especially valuable for women whose careers have been interrupted by caring or family commitments	Not enough volunteers or community buy-in Not enough/too much work to do? Quality of volunteers skills and capacity insufficient Costs and staffing resources Conflicts between staff and community volunteers about what’s their proper role? Willingness to facilitate priorities of user member
Democratic and inclusive	Training Community volunteer member representation on the board and meetings	Low levels of participation Confusion about structures
Team working - collaboration between different stakeholders within the co-op	Operational policies and procedures Structures within the co-op that talk and interact with each other Team meetings and communications procedures	Willingness of all stakeholders to work collaboratively
Partnerships and collaboration	Strategies, operational procedures and referral agreements/systems	Conflicts of interest and ‘turf wars’

Organising the Volunteer service

All co-op staff will be expected to support and help develop the Community Care strand of the service, but more specifically the Community Operations and Business manager, reporting to the Board, Nominated Individual and Registered Manager, will develop and oversee the service.
Any elements of non-regulated care allocated to staff members will be discussed by the teams and supervised by the Registered Manager, Field Care Supervisor etc
In terms of the volunteers themselves it could be seen as operating on two basic levels, although there is no reason why volunteers shouldn’t operate in either or both if so inclined:

General pool of volunteers

Managed by COBM in communication/co-operation with Care Staff within the area teams
Focus more on the ‘My Life, My Home and My Community’ generic type activities, such as organising transport, events and outings, help with home and garden maintenance
Once fully developed, over time teams of volunteers up for particular activities could develop that could operate fairly independently eg assistance with basic home and garden maintenance.
Communications IT and social media can help organise. Staff would be present on all social media platforms and ensure confidentiality and safeguarding is maintained.

Person-specific care circles

Managed by COBM in communication/co-operation with Care Staff within the area teams
Focus on facilitating the ‘My Care’ type activities, as well as the other ones. The Care Circle would be to ‘rally round’, help out, visit and generally be there for the person
Up to 10 members of the Care Circle, that would ideally include one or more family members/significant others, existing friends and neighbours, co-op member volunteers plus of course relevant members of staff to provide oversight and direction as required. Size of the care circle would have to be wide enough to spread the work so membership will not be too onerous or time consuming. BUT it also mustn’t be too big to become impersonal

IT based social media platforms will be an important organising tool and policies and procedures will have to ensure safeguarding concerns are consistently addressed.

Modelling the stages required to deliver the Service

Stages	Description of Task	People involved
Initial meetings and assessment of need	Assess and record care needs of service user member when they first present through their Care Plan Through discussion with service user members and their families identify which elements of the Community Care service they might wish to access and/or contribute to. Clearly explain how co-op membership works and any charges that may arise for any of these services Make agreement to receive/deliver care	RM and COBM Potential family and service user
Draw up Community Care Package	Assessment of the capacity of the co-op to meet these needs from the Care Store. Allocate resources as appropriate and record them Draw up clear statement of what services we hope to deliver and any charges that will be made	COBM
Communication and negotiation	Communicate the Community Care Package to the service users and relevant staff Amend as appropriate in light of their response	COBM Service user members & families
Implementation – deploy resources from the Store	This will depend on what is agreed in the Community Care Package and the capacity of the store	COBM Community volunteers Care workers in local teams
Charging	Send invoice and monitor payments received	Office based staff
Monitoring and oversight	This could take place on a number of levels and will be crucial if we are to receive external funding from statutory agencies: Record of services delivered/hours etcFeedback arising from staff, whether in the teams, supervision with the RM etc Feedback from service user members and their families	All relevant stakeholders

Community Care Services