In this post, I consider a study on the provision of social care and support by micro-enterprises in England from the University of Birmingham.
The ESRC funded research was undertaken by academics from University of Birmingham, University of Lincoln and Middlesex University, alongside co-researches who use and care for people who receive social care. The evaluation aimed to explore how micro social-enterprises deliver social care services and compare their effectiveness in 3 areas of England to small, medium and large providers.
The research took place between 2013 and 2015, and micro-enterprises are defined by the authors as employing less than 5 full-time staff. You can find out more on Twitter by following #microsupport.
In 2010, I was part of team that undertook ESRC research exploring the role of small social care co-operative enterprises that were supported by a Department of Health programme in England (2006-2009). The research was focused on 2 case-studies: micro-enterprises involved in providing social care (Fisher et al., 2012). We partnered with Co-operatives UK who supported us with the research.
I was interested to read the report that this blog focuses on as there were many similarities between our small-scale study and the evaluation undertaken by the authors of the report, including the value of collaborative and personalised care provision.
The evaluation used an asset-based and co-research approach. The co-researchers had experience of receiving social care and support and were involved at all stages of the research from design to dissemination. The involvement of the co-researchers was evaluated separately.
The involvement of people who use services as co-researchers was the focus of a North West People in Research Forum in June 2014. A co-research approach to understanding the experiences of those who use and deliver services is increasing and the resources available from North West People in Research are useful.
A mixed-methods approach was used to compare the 17 micro-providers with small, medium and large providers, and included use of interviews and surveys. Twenty seven provider organisations took place in the study overall.
The organisations selected were based in the North West, the West Midlands and the East Midlands, and included those providing support to older adults and those with learning disabilities. There was a project steering group which included representatives from Community Catalysts and Shared Lives.
The qualitative and quantitative findings were analysed using QSR-NVivo10 (a qualitative research analysis software programme) and thematic analysis.
The analysis resulted in 6 key findings, as follows:
A more personalised service – micro-enterprises offer a more personalised service than larger providers, and this was especially the case in home-based care. The research report provides detail on the significant aspects of this personalised care:
- autonomy of staff;
- a relationship between the small-scale nature of the organisations and the personal connections made between staff and those who used the services;
- more continuity of care and;
- greater accessibility of managers to staff and those who used the service.
Care outcomes – these provided by micro-enterprises were valued more by those who used the service than the outcomes from larger providers. For example, building confidence, well-being and employment support.
Innovation – micro-enterprises can provide a more innovative service than larger providers. However, the research did not show what these innovations were as it was inconclusive.
Better value – the micro-providers provided better value than larger providers: the hourly rate was slightly lower for micro-enterprises and this did not mean a lower quality of care.
Networks and partnerships – the micro-enterprises drew on their strong personal networks and partnerships with local authorities and other organisations. This enable their start-up and sustainability.
Barriers – reliance on self-funders was important for micro-enterprises due to a low level of personal budgets take-up. Further, the micro-enterprises experienced staffing issues due to the lower numbers of staff, and financial vulnerability.
Overall, the paper concludes that micro-enterprises are ideal for providing personalised care services, especially in the home, and that their small size enables them to be more innovative than larger providers, while maintaining a quality service and providing better outcomes.
However, in a similar vein to research undertaken by Fisher et al., (2012), micro-enterprises can struggle to gain referrals from local authorities, as compared with larger providers who known to the local authorities.
The report’s conclusion refers to the Care Act 2014 and the requirement on local authorities to ‘develop a market that delivers a wide range of high quality care and support services’ (Needham et al., 2015: online). The authors argue that the Care Act 2014, and the personalization agenda could influence the increased provision of social care by micro-enterprises.
The research report provides a very useful piece of evidence on delivering personalised care and support for students, practitioners, providers and commissioners of social work and social care.
There is a significant number of quotes from staff, carers and those who use the services provided by the micro-enterprises. These provide a rich picture of their experiences.
Needham, C., Allen, K., Hall, K., McKay, S., Glasby, J., Carr, S., Littlechild, R., & Tanner, D. (2015) Micro-enterprises: small enough to care? Birmingham: University of Birmingham. [Full Text]
Department of Health (2014). Care Act 2014. London: Department of Health. [Full Text]
Fisher J., Baines S. and Rayner M. (2012) Personalisation and the Co-operative Tradition, Social Policy and Society, 11, 4: 507-518 DOI: 10.1017/S1474746412000218 [Abstract]