In the creation of a care co-operative (as outlined in Chapter 2) a broad range of backgrounds and skills is important for the formation of an initial group of volunteers to take the project forward. Once the project begins to take shape, however, it is a significant advantage to engage care professionals, given their hands-on experience of the care industry and how it works on the ground. In the development of policies, procedures and practices in a social care co-op, such knowledge and understanding is essential. Once operational too, the delivery of social care to user members will of course be carried out by care professionals. They are, in this sense, the public face of a social care co-operative as well as being a key aspect of its membership.
This is not of course to underplay the contribution of others involved in the project. It is often those outside the care profession itself who recognise the failings of much of the common model of social care, and are motivated to seek a better model. Nonetheless, this energy and innovation for a values-driven project is invariably strengthened by the industry awareness that professionals can bring. Similarly, professionals are often inspired by new approaches that meet the needs of a community. It can be a powerful combination.
In the case of Colne Valley, a ‘belt and braces’ approach was sought. Care professionals from a range of specific backgrounds across the care sector were identified and engaged. The developing board therefore included an active social care worker, a member with significant regulatory experience within the Care Quality Commission (CQC), an experienced Registered Manager in the residential care sector, and a further manager in local authority care, specialising in care commissioning. All have provided invaluable guidance and support to the care project on every level, as will be examined in this chapter.
What care professionals can bring
As has been highlighted previously in this Toolkit, getting a social care co-operative off the ground requires a group of people with enthusiasm, commitment and belief in the value of co-operative structures, but who also have, between them, a variety of backgrounds and life-skills that can help to take the project forward.
Nonetheless, such ‘generic’ skills can only take the project so far. Beyond the energy and values that can initiate such a project, the detailed experience of the actual practice of social care is vital. In this sense, bringing care professionals on board facilitates the following aspects of a care co-operative:
Any initial group developing a care co-operative can have a range of skills but the specific experience of workers in the field itself is key. Worker members can and of course should develop their own awareness of domiciliary social care and will gain a clearer insight in this way over a relatively short space of time. But there is no short-term replacement for the detailed practical understanding of the operational side of social care. This can include key aspects such as:
- the complexity and range of user members’ needs
- specific operational methodology for dealing with service users and meeting these needs
- the relationships that need to be maintained and fostered between service users, carers, co-op managers, local authorities, ancillary bodies and the local community
- day-to-day detail in care practice, such as working rotas, resources for the delivery of effective care, and training needs of staff.
Policy development and compliance
Care work, whether in a residential or domiciliary setting is, by necessity, a highly regulated industry and any practice (co-operative or otherwise) must comply with procedures, expectations and rules which are established and in many cases legally required. Care provision therefore requires a range of policies outlining key aspects of the design and delivery of care, covering aspects such as health and safety (including safeguarding of adults), employment / human resources procedures and rules, operational conduct of care and meeting users’ needs, and roles and relationships within the co-op itself.
The engagement of care professionals in this capacity - in particular those with managerial experience - is a considerable advantage to both the speed and quality of establishing a sound (and legally compliant) policy basis on which care delivery is built.
In the CCCV project, the engagement of an experienced Registered Manager (RM) proved vital in the creation of a raft of required policies which would otherwise have been a significant obstacle for the co-op (links to examples of policies are given later in this chapter). Indeed, in the case of processes such as the actual application to register the co-op with the Care Quality Commission (in England), qualification as a Registered Manager is required by law.
Modelling / ensuring good practice
Care professionals often have experience of the industry in a number of settings and with a number of providers. This gives valuable understanding of good practice, which can be ‘designed’ into a project, and which can be modelled in training and in actual delivery of care. This aspect of quality assurance is key not only to training and practice of staff, but also in performance management procedures across the co-op.
In CCCV, it was particularly advantageous that care professionals from a range of specific backgrounds were engaged. In addition to those with RM experience, who were able to bring their in-depth understanding of effective practices to the project, CCCV were also able to engage a working personal care assistant who was able to reflect how effective care is delivered in the day-to-day job. This practical experience is vital, especially in a co-operative model where worker members have a genuine role in decision-making.
Review, trouble-shooting and project development
With the range of experience outlined above, care professionals can be a valuable ‘critical friend’ in the development of a co-operative care project. During any development phase, review and trouble-shooting of outlined procedures, based on solid understanding of the care sector, is essential in avoiding what can be relatively common pitfalls and mistakes.
For example, experienced professionals often have knowledge of the social care market, and how important effective business planning is for a social care enterprise. Even where the business is a co-operative and may be intending to operate on a ‘not for profit’ basis, business planning in the sector is key. Margins are often extremely narrow in social care, and effective business planning can be the difference between survival and collapse.
Similarly, establishing a team of board members to initiate such a project invariably requires a degree of enthusiasm and commitment to key values. A belief in co-operative enterprises is clearly the core of such a project. Co-ops may also seek to place other values at the heart of their business, such as community engagement, environmental concerns and fair working practices. Such principles are of course fine, but they have to be balanced and measured against what is achievable within the ‘real-world’ framework of social care provision in its current context. Review and trouble-shooting of proposed policies and practice can therefore facilitate effective design of care delivery, terms and conditions of employment, financial planning and allocation of resources, especially in a social care environment where new models of delivery are widely being developed.
In CCCV’s development of a care co-op, care professionals were important in developing the role of community volunteer members as part of the overall provision of care. Their awareness of regulated and non-regulated care allowed a clearer understanding of the roles of care assistants as opposed to those of volunteers.
Care workers themselves, once the co-operative is operational, are also the ‘eyes and ears’ of the service, working with service user members and their families, and within the community, on a day-to-day basis. As core staff members of the co-op, they are therefore a key asset in terms of reviewing, developing and improving both service delivery specifically, and the effective functioning of the co-op and its membership altogether.
Contacts and industry networks
Coming from the social care setting, care professionals almost always come with an array of useful contacts within the industry and in other ancillary bodies and organisations. The CCCV project’s initial board was able to identify appropriate professionals to be engaged in the project, having established positive relationships with the local authority. In turn, however, securing the secondment of two senior care professionals to the Colne Valley co-op strengthened the working relationship, and the range of positive contacts in connection with the local authority. This has been of significant benefit in terms of identifying further funding streams, establishing credibility with service commissioners ahead of going operational, and even in securing additional board members from the local authority itself.
Nonetheless, it should also be noted that secondment as a source of engaging care professionals does not come without its potential problems. In times of crisis and / or severe need, seconded staff can be recalled - as was the case with one of the professionals engaged by CCCV, as a result of the local authority’s efforts to manage the impact of the COVID19 crisis in the spring of 2020. Such issues can of course be mitigated against by aiming to engage professionals in sufficient numbers and from a sufficient range of ‘specialisms’ to cover absences or departure and to sustain the development of the project, even in times of crisis.
Once the co-op is in a position to begin employing staff members (particularly care workers), care professionals are ideally suited to play a key role, having working experience within the industry and often having, at some stage, been a functioning part of care delivery teams themselves. Awareness of what roles are required, appropriate job descriptions and rates of remuneration, desired skill-sets and person specifications are all strengthened by in-depth understanding of the sector. In addition, professionals often have personal contacts, either as potential recruits or as sources of valuable information.
Industry knowledge in this sense also allows a more efficient approach to recruitment as a clear understanding of hours required for the amount of service delivery to be provided enables a more accurate assessment of working rotas and possible combinations of full- or part-time workers.
How to engage care professionals
Having outlined the reasons why care professionals can make such a positive difference to a co-operative care project, we now need to address the questions that might arise when seeking to engage them:
- What should we look for in care professionals? What roles / skills do we need?
- Where should we look for them?
- When to engage them?
It may help to examine this in two ways: firstly by seeking to address each question in turn on a generic level (i.e. that may be of use to any given co-operative social care project); and the, secondly, by providing a case study of how professionals were engaged by the CCCV project.
Identifying the right staff (care professionals)
From the very onset of a co-operative care project, it is important to assess what roles and skills are required in any / all care professionals you would like to engage. This will depend on the individual project and co-op, as some initial development groups / ‘boards’ may be formed with or without members with care sector experience.
Nonetheless, overall, there is significant advantage to be gained in looking to engage professionals possessing the following skills and experience:
Management / delivery of care
Having operational or managerial experience in the actual delivery of care services to user members is hugely beneficial to any care project. This could be in
- staff or ‘field’ management
- organising shift patterns and rotas
- care delivery procedures and processes
- health and safety in care delivery
- safeguarding of (vulnerable) adults
- building relationships with user members
- negotiating care programmes with user members and stakeholders
- handling care resources.
Staff recruitment, training and assessment
When seeking to recruit the care worker members who will actually deliver services, it is clearly important to look for appropriately qualified and experienced staff. It is equally important to seek staff who identify with the values and objectives of the business, albeit that these can be cultivated and encouraged over time. It is therefore important to shape recruitment processes (application forms, interviews, etc.) with a view to identifying and prioritising these aspects in potential care workers.
Experience in the administrative aspects of care provision are equally valuable, including understanding of payroll functions, income generation and oversight, general business administration, etc.
Community relations / community engagement
Developing strong community links and volunteer member involvement is likely to be a core feature of any cooperative venture, but it plays at least some part in the operation of all social care provision, and is therefore a skill that care professionals can bring.
Experience of the regulatory framework in which all social care takes place, including how care provision is monitored and assessed on an ongoing basis, is a significant advantage.
Where and how to look for care professionals
A key challenge for any social care project is finding, identifying and attracting the right staff, and finding ways of resolving the difficulties that can be encountered. On the whole, care professionals - both in an advisory capacity and a service delivery role - are involved in care work because they care! They value their role in providing care to user members and their families as a social good. In this sense, many are attracted to projects that are community-based, and of course which seek to value their staff more, both in terms of remuneration and in their involvement in the operation itself.
Nonetheless, obstacles can arise in the path of recruitment and solutions have to be found.
From the start of the project, it is essential to form solid working relations with the local authority. The type of local authority you have, and the structure of care commissioning, varies from area to area
Local authorities (LAs), largely, still fund adult social care and manage the overall service (in accordance with national frameworks and legislation), even though the actual provision of social care is largely contracted out, most often to private providers.
LAs will therefore be the key source of funding for the service to be provided by a new co-operative project, but it can also be a key source for identifying care professionals to work in or alongside the project. It will come as little surprise that LAs have suffered recently under a wave of cuts from central government. These cuts have generally been to the part of any LA’s funding that derives from the Direct Government Grant (funding from central government to pay for the provision of vital local services), which has been reduced by around 60% over the last decade.
LAs have faced increasing pressures to maintain appropriate adult social care whilst facing rapidly reduced income, and this has often led to cuts in social care provision. Providers have therefore faced cuts in terms of the funding they receive for delivering care and many have proved unable to sustain their business. This is clearly a sad state of affairs, but it may provide some opportunities for new providers seeking to deliver care in their area.
LAs are not only seeking alternative, potentially more sustainable and community-based providers, but they are often willing to form working connections with such projects. This can provide opportunities for engaging care professionals in the development of co-operative projects, which can often raise wages, empower workers and service users, and provide a greater quality of care.
Similarly, cuts in LA funding as well as the failure of many private providers in the social care sector have meant that many qualified care professionals, with a range of specialisms, are available. Alternatively, even where LAs have been able to maintain the bulk of their managers and officers, they may be open to offers of secondment.
The same is largely true of those professionals engaged in other aspects of the sector, in regulatory agencies such as the CQC. As seen above, knowledge and understanding of the legal and compliance framework faced by social care providers is of great benefit to a potential provider.
In addition, professional journals or publications within the care industry can provide important sources for the engagement of care professionals. Some of the key ones are listed below:
The Carer - online only
When to engage care professionals
The simple answer here is ‘as soon as you can’. Generally however, the engagement of both professionals with ‘care worker’ experience and those with managerial experience is of huge benefit from the inception of the initial project development team or board. As pointed out above, the earlier the experience that these professionals can bring is built into the design of a new project, the more potential pitfalls and issues can be avoided.
Ultimately, care professionals will also be employed to deliver the actual care services as the project goes operational, but this will take place at a later stage, once the project is better established, at least as a proposal with costs and income predictions in place.
Case Study: Co-operative Care Colne Valley’s engagement of care professionals
At the outset of the process in Colne Valley (CV), the board or development team were constructed as outlined in Chapter 2 of this Toolkit. From an early stage however, we looked to engage care professionals as none of the original board members (development team) had industry-specific experience (see Chapter 2).
All in all, CCCV engaged four care professionals from a variety of specialist backgrounds. Still at the early stages, we engaged an existing care worker as a board member - let’s call her ‘CP1’. Not only did this bring experience and knowledge of the delivery of care to the board’s developing proposals, it also brought strong awareness of working practices and how a new project might be able to address some of the weaknesses and problems of the current common model of care delivery across local authorities in England. CP1’s engagement came via word of mouth, raised among community contacts of the original board members. As a practising care worker, she was known within the community and contact was made in this way.
CCCV then decided to begin spreading awareness of the co-operative project by organising a public meeting within the community. One of the ways in which this meeting was advertised was via the community’s Facebook page, and it was this notice that was seen by the second care professional to be engaged - CP2. LAs often have their own Facebook pages as well, where opportunities can be found.
CP2 had had long experience of working within the CQC, the main regulatory agency in England, and was currently employed by a large regional provider of social care. CP2’s experience in both fields gave her valuable insight into the project, but also encouraged her engagement in a co-operative project that could potentially address some of the flaws in the current system.
Once planning had reached a significant stage, the board decided that a registered manager (RM) was needed within the project. A job advert was constructed but no-one was recruited. The need for further care professional experience was highlighted by this failure as, in retrospect, the board lacked the appropriate understanding of what was required in such an advert. Having failed to recruit, however, the board sought the assistance of the Director of Social Services at the local authority. Links had already been made with this officer in order to ‘flag up’ the potential creation of a new care provider in a situation where these were badly needed. Discussions took place as to the possibility of secondment(s) for strategic reasons, from the council’s social services team. Fortunately, two posts (‘CP3’ and ‘CP4’) were subsequently seconded to CCCV - one for an initial period of 6 months, and one on an effective week-by-week arrangement.
CP3 had significant experience as a social care manager within the local authority, including as a qualified RM in a residential care setting. This proved essential in the development of the care co-op’s policies, ahead of going operational. CP4 was also a senior manager with the LA, had previously been a RM in social care, and had recently conducted specific work into the commissioning and contracting of care, giving her very detailed awareness of many aspects relevant to the project.
Immediately, both these recruits realised, with their industry experience, that not only had the original compilation of the job description for a RM post been inappropriate, but that what was required for the project at this time was actually beyond what a RM could have brought. Both development experience and awareness of operational practice were key to progress and these two appointments brought this.
It was also through the industry contacts of CP3 and CP4 that a further board member was appointed in March 2020. ‘CP5’ was a recently retired senior officer for adult social care at the LA. CP5 was rapidly elected by the board as the co-op’s ‘Nominated Individual’.
The engagement of these care professionals has proved invaluable for CCCV’s development, providing expert guidance, trouble-shooting and leadership on policy development, recruitment processes, financial planning and resource planning. Prior to the engagement of these professionals, at least some of the planning of the project had lacked a thorough awareness of the practical context of social care, and had therefore been somewhat unrealistic, focusing on the co-operative ‘vision’, sometimes to the exclusion or under-emphasis on the operational possibilities of care in the current setting.
In this vein, development teams or boards are well-advised to be open-minded in engaging care professionals, and cognisant of their industry skills and understanding, while maintaining their principles and key aims. Practical considerations can sometimes challenge or even contradict desired outcomes and practices that have previously been based on the ‘ideals’ of the board’s own values. Similarly, when questioned on their experience later, care professionals we had engaged reported that, on joining the board, one of the key problems they had faced was the tendency of the original members to focus on ‘end-gaming’ - i.e. emphasising what they wanted the project to ‘prove’ and achieve, rather than the more practical aspects of process that would enable this. Care professionals nonetheless found that they were able to establish a positive balance that weighed the evidence base of their expertise against the principles and ‘red lines’ of the project.
With these professionals in place, financial planning proved to be significantly more accurate, given the weight of knowledge of how things operate ‘on the ground’ in the actual delivery of social care. For example, having initially based some financial predictions (in the process of establishing a workable business model) had to be based on assumptions. Once care professionals were engaged, it proved much more possible to apply ‘real world’ costings and income estimates in aspects of the business operation, such as:
- working rosters and staff management,
- care resources (Personal Protective Equipment, etc.) and their use and renewal,
- impact of sickness rates / holiday allocations,
- operation and management of electronic monitoring systems in domiciliary care,
- relevance of care ‘pathways’ and the acquisition of assistance by service users, and
- likely funding income for varying levels of care, etc.
At the same time, the creation of the co-op’s policies was carried out by one of our care professionals in preparation for applying for registration of the business with the CQC, and accurate job descriptions were drawn up to recruit roles that were specifically required within the project in the Colne Valley. In all of these aspects, the professional contacts and networks of our appointments were also very helpful.
Care professionals also proved invaluable throughout the process of recruiting the team of care workers who would deliver care, once operational. Their understanding of the appropriate balance of skills, qualifications and personal characteristics required or beneficial in a care worker, their understanding of past experience and references, past experience of interviewing care worker applicants and what to look for, all strengthened the co-op’s recruitment process.
In many of these areas, CCCV would have had to seek consultancy advice, if the care professionals we engaged had not been available, and as a result of their engagement it is clear that we have developed as a board. In particular, what our care professionals helped develop was a recognition that, in order to achieve our aims, the process to get there is more than simply a set of steps. It is vital to recognise how one step can enable us to get to the next, what problems may arise, and how we might address them, in order to keep moving forward, always with our goal in mind. Moreover, working alongside care professionals helped us to have a more thorough understanding of the context of social care. In particular, that success in our own project may well mean the failure of other businesses in the field. Co-operative models, as seen, can produce better wages, fairer conditions and a higher quality of care for users. This can, in a very competitive market, lead to the failure and collapse of some businesses. We need to understand what this means for service users and what we might be able to do to adapt to and accommodate these developing needs.