We’re talking with people involved in building the components of a new, decentralised, mutually-owned economy. Here I talk with Emma Back, one of the founders of the Equal Care Co-op, in Halifax, Yorkshire. Apart from looking at ownership, decision-making and payments, they are constantly investigating ways to make life better for care providers, care users and their families.
Here’s a summary of our conversation. Watch the video for more details.
There are some very interesting aspects to the Equal Care Co-op, for example:
- The members of the co-op include care providers (including volunteers), care users (supported people), advocate members (family and friends of supported people), plus investor members– anyone who has a stake in the outcome of the work of the co-op.
- Sociocratic decision-making.
- An internal payments system that could be described as a cross between mutual credit, timebanking, tokenising, and recognition of informal labour, including emotional labour and care work.
- There are some interesting facets of their operations, such as their ‘Teams’, that hugely benefit care users.
Motivation / what’s the problem?
Low wage rates, poor working conditions – the whole way the sector is structured is exploitative. This has huge knock-on effects on the people it’s designed to support. If you’re getting home care, especially through the local authority, you’re likely to be getting four half-hour visits per day, and you don’t know who’s going to turn up on those visits, or what time they’re going to arrive. Plus you’re likely to see a different person each day, or each visit. Care workers work shifts, they’re only paid for the time they spend in someone’s house, not the time they spend travelling (community nurses in the NHS are paid for their time, whether it’s travelling or in someone’s home).
This all leads to unhappy care workers. If care workers are happier, and if they are allowed to build a relationship with care users, you get completely different outcomes – especially for older people with conditions that cause or exacerbate confusion.
Investor members have a proportionate share of the vote – no more than 10% overall, whereas in the other membership classes (workers, supported people, advocate members), it’s one person, one vote. This is to ensure that control over the direction of the co-op doesn’t lean towards those with more money.
There are other care co-ops with care users as full members, with multi-stakeholder structures – such as Cartrefi in Wales, and Valley Care Co-op in Kirklees. These are quite new. The older care co-ops tend to be worker-member co-ops.
They make decisions using Sociocratic ‘circles’ – semi-autonomous governance units. The ECC learned about Sociocracy from Ted and Jerry at Sociocracy For All (SoFA), a non-profit based in the US – dedicated to training and helping organisations become sociocratic.
Sociocracy involves making decisions together in circles, using consent (making sure that no-one is opposed to any decisions made). Scale can be achieved by choosing delegates from circles to sit in circles at the next level, and report back to their original circle. [NB this is a very basic description – soon we’ll add Sociocracy as a Lowimpact topic.]
There are some sociocratic practices they haven’t taken up – like performance reviews, and they’ve found that some things are actually more difficult using sociocratic methods – like firing, for example. Hiring is easy, but imagine being fired from an organisation, not just by a manager, but by your entire team! Which would you choose?
The ECC have found the process quite fluid – circles form, break up and re-form. They started with too many circles, then collapsed them into one, which was too few circles, so split into just a few circles again. They use consent decision-making (no opposition, even if there might be some disagreement), rather than consensus (everyone agrees). They’ve found that this is quicker, and results in better-quality decisions.
Internal payment system
Emma knows that at Lowimpact, we’re very interested in developing the mutual credit idea, and so I wanted to talk about their mutual-credit-esque internal payments system. I asked her for a ‘baby language’ explanation of what it involves. So – a lot of care in the care system doesn’t get paid for – care given by family, friends, volunteers, mutual aid groups during Covid etc. In a way it’s good that no-one pays for that, because it’s offered as a gift. But they’re looking to put a number on it, in order to generate more of it. They’re going to start simply, based on hours – a simple timebanking principle. So as a community volunteer with ECC, you join a team, put some hours in, and those hours get recorded on the platform, as care credits, or care coins. Nothing is finalised yet – it’s still in the planning stage.
When you’ve accumulated some care coins / credits, you can either save them for a rainy day, to use yourself, or you can give them to a specific person, or you can give them into a general pool that can be redistributed. They’re not ‘coins’ like cryptocoins – they’re more like points, hours or credits in a mutual credit system. Credits are deposited in people’s accounts, but unlike in a mutual credit scheme, the idea is that you can’t go into the negative. But you can be gifted credits – because some people aren’t in a position to provide support, but they can still obtain credits, so that they can obtain more support from other volunteers. So supported people would use their credits to obtain extras, rather than essential care. In the UK, you’re not allowed to give regulated support – including medicines, personal care such as going to the bathroom etc. – as a volunteer, so it’s more about accompanying people to events, going for walks, dog-walking, cleaning, chatting, listening, errand-running etc. – all the sort of things that are not provided by the state. The state provides the absolute minimum to ensure that people remain clothed and clean – nothing else.
Care workers are linked with users, so that users always see the same person. During the pandemic, they developed a system called ‘Teams’, which is at the heart of what they do. Teams are built and owned by the person getting support. They choose who they want in their team, and there’s a platform to enable that. Their team might include friends, family members, private care workers, other agency workers. Everyone in their team is in a shared chat. Because the care user and care provider have chosen each other, it creates a completely different kind of relationship.
Doing things this way is logistically difficult, but it’s resulted in really strong bonds, resilient teams, people being able to stay at home longer, people’s dementia systems weakening and softening, mental health conditions improving, family members able to go back to work.
A lot of the inspiration for doing things this way came from the disability activists in the 80s, who campaigned for personal budgets, that supported people can spend as they see fit, on their own support.
The Equal Care Co-op is in Calderdale local authority. They’re very supportive, but they commission in the traditional way – i.e. four half-hour visits. Councils tend to believe that support should be bought like a package off a production line. Calderdale love the ECC’s model, but they can’t see a way to get from A to B with council care provision at the moment. Care providers will get basic contracts and information, so it’s difficult to build an effective team quickly or easily.
There are now councils around the country who are looking to commission in very different ways. The ECC are working with Islington council at the moment, who are looking to change the way they do their home-care contracting. Tower Hamlets and other London authorities are moving in the same direction. The Co-operative Councils Network are also looking at alternative ways of commissioning. They could provide a springboard to providing this kind of care in the rest of the country.
The ECC is in its pilot phase, and has been hampered by the pandemic. They’re looking to stabilise in Calderdale, then pull together the capital to launch in other areas.
Since applying to become a regulated organisation in 2020, their focus has been on trying to get paid care and support to work in the way that they want it to work, even though that’s really going against the grain of regulated care, which is very command-and-control, risk-averse and passing the buck. A lot of care provision is currently based on fear – of being reported, of ratings, of reprisals. The culture reflects that. A lot of ECC’s work is about how to create a bubble to protect them from this culture – the various bureaucracies, practices etc. – anything harmful to the co-op and the provision of care. By introducing a care currency that recognises informal work, we can build a system that supports everyone involved.
Listening to Emma talk, it seems obvious that this should be the future of social care. But there are barriers. The biggest is funding. They’re developing a digital product, which are expensive to build well, to get right, that are able to iterate and grow. The vast majority of venture capital funding goes into projects run mainly by white men and tech. As a result, developer salaries are high, and they are seen as the wizards of our society at the moment. That’s hard to compete with. If you compare ECC’s development with that of some of the venture-capital-backed platforms in the marketplace, ECC look slow – because they haven’t been able to attract that kind of funding. They were the first platform co-op in the UK to use community shares to raise seed capital, without any collateral. The pilot project started at the time of lockdowns, which was really bad timing. Community shares are the only route for them at the moment to build capital.
If you’d like to see ECC’s model of social care spread around the country, then consider getting yourself some of their community shares. If they succeed, then other platform co-ops will have a better chance of succeeding. Their little part of the internet is owned by the people who use it, rather than by profit extractors. Their motivation is completely different. Going down the venture capital route means that you’re locked into a system where money is siphoned out of your organisation and your community forever, which is soul-destroying.
Social care is a fundamental part of a strong and healthy community. It’s right at the heart of things.
- Membership of the co-op includes care providers (including volunteers), care users (supported people), advocate members (family and friends of supported people), plus investor members– anyone who has a stake in the outcome of the work of the co-op.
- There are some very interesting aspects to the co-op, including ‘Teams’, sociocratic decision-making and an internal payments system that could be described as a cross between mutual credit, timebanking, tokenising, and recognition of informal labour, including emotional labour and care work.
- You can invest in ECC’s ‘Back on Track’ community share offer; offer your skills to support Equal Care; tell other people about the offer and see if they’re interested in helping.
The views expressed in our blog are those of the author and not necessarily lowimpact.org's