Living Life Well: a co-operative approach to care

John Roberts explains why North West Care Co-Operative (NWCC) came into being, where they have got to and what they hope to achieve.

James says: “I would like someone who is good fun to be around”. Seventeen months into the life of North West Care Co-Operative, it is this phrase that sticks in my mind. James is twenty, has a learning disability and is a ‘User Member’ of our pilot co-operative in Chester. He is describing what he wants from a Personal Assistant (PA) and his mother Janet (his ‘suitable person’), captured it for a presentation explaining why they joined the Co–Op.

I find it profound as it reflects a choice not to live a life “well cared for”, but rather a life “well lived”. Skills/qualifications required by James’ applicants are not a Level 2 Care Certificate, DBS Clearance etc, but an ability to help him enjoy his life, with fun, positive experiences and a rich relationship with his PA.

And it is with that thought in mind that our journey started around seventeen months ago…

A consortium of North West based Disabled People’s User Led Organisations comprising Cheshire Centre for Independent Living (the project host), Breakthrough UK (Manchester), Disability Equality North West (Lancashire) and Disability Association Carlisle and Eden, secured funding from Disability Research into independent Living & Learning (DRILL) and the Big Lottery to support ‘North West Care Co-Operatives (NWCC)’ a two-year project to test, develop and gather research on, “Co-Operative” models of care for disabled people.

These organisations identified that disabled people who wanted the choice of “a life well lived” had no option but to become a direct employer, which many of them did not feel ready for. Otherwise they had to yield choice and control for “a life well cared for” the use of mainstream care agencies or the unthinkable – a return to residential care.

Although funded as a research project, the consortium had an eye on a bigger prize, hoping that the project can pump prime a sustainable model for care.

Seventeen months in and North West Care Co-Operatives (NWCC) is now also the name of a not for profit company limited by guarantee, and without share-holders. Its’ Directors are the Chief Executive Officers of three of the original consortium members, with the Chair of our pilot Co-Op also co-opted onto its Board.

The purpose of NWCC (Ltd) is to provide services to small user led “Care Co-Operatives” that bring together disabled people whose care is provided in their own homes via Direct Payments or Personal Health Budgets. NWCC deals with the day to day burden of administering the care whilst Co-Op members (the disabled people) control and direct their care as “directors” of the Co-Operative.

Disabled people (or Co-Op Directors) do not “profit” from (get paid for) their role as Directors (and cannot as they using public money), but “benefit” from having a voice in directing their care. With our Co-Ops deliberately kept small this voice is significant, and members take out only whatever they put in, so that the Co-Op can handle individual care packages of different values.

And by bringing disabled people with similar needs together, we offer peer support, kinship and even friendship.

The Personal Assistants (or “Employee Members”) providing care within each Co-Op, are enabled to work as a “self-managing” team and enjoy this same peer support, kinship and friendship. As members of a small team they are all known by all the disabled people and provide cover and resilience for each other, seamlessly and without affecting the quality of care or client/carer relationships. With personal assistants employed by NWCC rather than by individuals, we are also able to offer good employment conditions, rates of pay and well-being.

As a not for profit organisation and with NWCC and Co-Op boards unpaid and PA Teams “self-managing”, our organisational structure is flatter and less costly than the traditional care provider. This means that we can pay our Personal Assistants relatively well AND provide a competitive alternative model of care for disabled people that can be attractive to commissioners.

We have registered with the Care Quality Commission (CQC) as a Domiciliary Care Provider with regulatory oversight provided by our Registered Manager and our pilot Co- Op registered as a “location”. Whilst this required process in place to tick the usual regulatory boxes, in order to show that we were “Safe, Caring, Responsive, Effective and Well Led” the fact that those who set the tone, who oversee, and resource our service – were also those receiving it, seemed to go a long way.

As a research project, we are working to develop Care Co-Ops, in different parts of the North West with a different demography, and client group to that of our pilot. We are also beginning to collate our learning in the form of a Project Evaluation (or “tool kit”) suitable to pass on to others. This learning is substantial.

As a potentially sustainable means of providing high quality care, our focus is to increase the number of Care Co-Ops and individual Co-Op members to reach the 3,500 or so care hours per month that we need to achieve long term sustainability. Whilst this increase could be achieved relatively quickly by engaging a small number of clients with significant care packages, it seems likely that this growth will not be complete before the project funding ceases, and so an increasing focus is on how we can bridge the likely gap between the end of the project and the point where we become sustainable.

And right, right now we are recruiting for a new Personal Assistant for our Chester Co-Op team to support James and the other user members.

We are looking for someone who is fun to be around….

 John Roberts

Follow our journey on Facebook: North West Care Co-Operatives and Twitter: @NWcareCoop




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