• Living well at home

Equal Care Co-op Equitable relationship-centred care and support

Organisation

Equal Care Co-op is on a mission to change the power dynamics within adult social care, re-balancing relationships to favour the giver and receiver of support. They give care and support at home and in the community and they are relationship-centred (as opposed to person-centred).

What is the innovation?

Together with the person receiving support, Equal Care builds a ‘team’ owned and led by them. Team members are chosen by the person receiving support and/or their advocate. Members of the team hold specific roles and responsibilities. Each team is associated with a ‘circle’ comprising care and support workers, people receiving support and other members of the community responsible for supporting teams to flourish.

Equal Care is a ‘platform co-op’: it’s owned by people receiving support, workers and family members and is building a piece of digital technology to enact its alternative model of care.

That’s not the only innovation Equal Care is working on, but it’s the one that’s up and running at the moment.

What is the problem this innovation solves?

Equal Care reinstates mutual consent as a core component of adult social care, with choice and control in the hands of care givers and recipients. Relationships have time and space to evolve, providing for consistency of care typically absent in models driven by time and task rotas that are de-humanising for everyone in their orbit.

It rarely, if ever makes sense, for example, for a person living with dementia to receive care and support from multiple visiting carers, often different people each day and throughout the week hence the focus on relational care, where people involved in a team/ circle properly get to know each other with benefits for everyone.

Equal Care experience very low levels of staff turnover, fixing job roles to reflect the value of adult social care with better terms and conditions. It’s attractive to people with the right values, often joining the co-op with high level skills.

Solution

Relational care based on mutual consent with activity designed as Teams (which hold the care and support decision-making), supported by semi-autonomous circles of care and support within a multi-stakeholder co-operative structure binding all elements cohesively together. Fundamentally, the notion of ‘no decision without me’ is reinforced by the democratic structure of the co-op, giving primacy equally to the care giver and recipient of care.

Evidence base

Buurtzorg

Patient-doctor depth of relationship

TLAP’s InControl surveys on impact of personal budgets

Co-production and learning via history of time-banking and Edgar Cahn’s work

Expected impact

• Trusted matching: workers and people looking for support are connected based on location, skills, interests etc and the co-operative checks quality / carries out due diligence of care workers and risk assesses clients
• Facilitate: build Teams owned by the person getting support, help with logistics, regulated care and on-going quality review
• Reciprocate: the company builds a community of peers and advanced practitioners to provide advice, support and structured assurance activities. Offers a new means of exchange for voluntary work and provides credits for further care hours or small financial rewards (Care Coins)
• Belong: semi-independent community circles enable Teams through welcoming new people looking for support and recruiting local workers

We're working on making the job much more attractive through higher rates of pay and real choice. We're introducing an alternative currency to facilitate voluntary work from people receiving support themselves and community members. We want to help redefine care and support as an abundant resource that we (i.e. all us humans) can all contribute to and benefit from.

Our activities will create an environment which produces more community volunteering, widespread peer support, diversity of choice and effective, safe, consistent, respectful paid care and support. We expect this to lead to a system capable of providing abundant support, better relationships and higher quality care and support at home. These outcomes will lead to people being healthier and happier and for the people who matter (caregiver, care receiver and their family) saying that the power balance feels right. Find our theory of change here.

We expect to increase the status of both care giver and care receiver. This means recognising, respecting, developing and using the skills and expertise of both groups.

We expect caring for others to be a respected career path, with proper opportunities for better pay, qualifications and advanced job roles.

We expect to increase the availability of care and support across professional, peer and community resources.

By enabling people receiving care and support to also offer their skills and experience to others (including supporting other care workers), we will challenge traditional notions of giving and receiving, which tends to create fixed roles and identities.

Stage/spread

Equal Care launched in March 2020, amidst the pandemic, somewhat limiting development, however, prototyping during this period enabled ‘Teams’ and ‘Circles’ to emerge and mature as the relationship-based structures driving fulfilment of the mission, re-setting home care as a fair, equitable arrangement for both care givers and recipients.

Initial community share offers attracted c. 150 investor members enabling Equal Care to move towards sustainability, identified as c. 70 people in Calderdale buying their care and support from Equal Care.

What would councils/health organisations/local areas need to do or have in place to enable it to develop?

A strategic commitment to re-engineer the shape, purpose and means for social care to be an attractive profession to the many people, resident in all communities, that could contribute to meeting the collective need for care, support and employment on an equitable basis.

More flexible framework agreements that reflect how people want to receive care and support. Current models dominated by assessment processes deciding, for example, that four 30-minute calls per day at fixed times, to fit a rota, is distant from optimum (in terms of well-being, recruitment and retention).

Decentralised commissioning with development support, including to establish local ‘investment-ready’ co-operatives, reversing policy from process first, towards people first, outcome focused practice that nurtures growth of the core and circular economy.

What would kill it?

Rigid adherence to time and task procurement processes that diminish continuity of care and support to the detriment of care givers and recipients. Also, if councils were to close down or significantly limit the use of personal budgets, which are a perfect fit for how Equal Care works.

Where to get more information

hello@equalcare.coop