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The Care Act aims to give people greater choice and control over the care and support they receive. It places a duty on councils to make this happen – and to ensure people have the right information and advice to make informed decisions about their care and remain independent for longer.
Introduction
“What does a good life look like for you and your family and how can we work together to achieve it?” Giving people choice and control over the support they may need and access to the right information enables people to stay as well as possible, maintain independence and caring roles for longer.”
Care and Support Statutory Guidance 2.21 p.13
The Care Act aims to give people greater choice and control over the care and support they receive. It places a duty on councils to make this happen – and to ensure people have the right information and advice to make informed decisions about their care and remain independent for longer. It also aims to rebalance the focus of care and support on promoting wellbeing, and diversity and quality of service provision. Ten years on from the introduction of the legislation, how has Community Catalysts’ community micro-enterprise development programme helped realised this ambition?
In this article, we provide an overview of our community micro-enterprise development programme and the impact it has had, and continues to make, on the landscape of health and social care. We also set out what further action is needed to improve the implementation of the core policies so more people can benefit.
Leading the way on community micro-enterprise development
Community Catalysts believes passionately in social innovation and collaboration to enable people who need care or support to be able to live their lives in the way they want to, as connected and contributing citizens.
We focus on what communities and people have rather than what they lack. We see abundance when others see deficit. Over the last ten years we have worked towards realising the ambition and vision of the Care Act, influencing the people we work with to make changes where necessary.
Our community micro-enterprise programme was created to help councils develop an enhanced range of good quality local support options, that would fulfil their obligations and enable people greater choice and control over the type of care and support they use.
The programme, underpinned by our tried and tested Advice Framework and Doing It Right standards, has gone from strength to strength.
Over the last 15 years, we have worked in over 75 areas across the UK to help local people deliver social care and health services for other local people. In these areas where community enterprises have been set up, we have supported 34,188 people, created or sustained 5,662 jobs, and nearly 3,000 volunteering opportunities.
Community micro-enterprises enable:
- Person centred care – care and support that is tailored to the ambitions of the individual and promotes wellbeing in a way that traditional care packages struggle to achieve. This is due to the flexible and local nature of micro-enterprises.
- More choice and control for people using direct payments – employing others to support them is not their only option. This drives up the use of direct payments.
- Diversity and quality in provision – more care capacity in the care system, reducing the time people must wait to find support, particularly in hard to reach (often rurally isolated) areas.
However, the legislative and regulatory framework within which micro-enterprises operate in health and social care is complex, ever-changing and designed for traditional provision. Commissioning and procurement practices often inadvertently place impassable barriers in the way of smaller, more preventative services and supports. Without intentional, targeted support, micro-enterprises in the health and care sector are unable to flourish. There is a risk that they are not set up to the standards we would expect.
Our community micro-enterprise programme helps tackle this. We understand the barriers and challenges and have developed a model that addresses these, ensuring that micro-enterprises operate safely and legally and are connected to the local health and care system for sustainability and lasting impact.
How community micro-enterprises support the aims of the Care Act
Person-centred care
The general duty of a local authority, while exercising a function under this Part for an individual, is to promote that individual’s well-being."
Clause 1, The Care Act 2014
Our community micro-enterprise model gives people choice and control over how they live their day-to-day life. This includes how they can contribute to wider society. We have extensive testimony from people who draw on the support of micro-enterprises that demonstrates the difference this type of support has made to their whole life, not just their basic needs.
‘Connie’s Companion Care’ is a micro-enterprise that supports elderly and disabled people over the age of 18 in Kent.
I offer absolutely everything… companionship, I do light housework, pet care, all sorts of things that support people to stay in (their own home and environment)”
Micro-enterprise lead
I don’t know what we would do without you”
Family member
The main difference that microenterprises (like Connie’s Companion Care) offer to people is the flexibility of choosing what their support looks like”
Social worker
We are delighted at the number of people being supported by Community Catalysts to start their own adventures in offering care and support services. Local people are being empowered to explore their own potential and, in turn, are offering support that is right for the people in their communities to help them live the way they want”
Council commissioner
Promoting diversity and quality in provision of services
A local authority must promote the efficient and effective operation of a market in services for meeting care and support needs with a view to ensuring that any person in its area wishing to access services in the market: (a) Has a variety of providers to choose from who (taken together) provide a variety of services. Clause 5, The Care Act 2014
Our approach supports people to build on their skills and talents to create an enterprise that they are passionate about. This results in people inventing service models and approaches that look very different to the traditional care offers. Aggregated, they create a range of creative (often quirky) support options that can stand alone or complement traditional provision. This helps councils meet clause 5 of the Care Act.
We also work closely with council leads to identify gaps in provision, so we can target our development programme in key areas and ensure that services are tailored to the needs of each local area.
Case studies
Rotherham Council
Our Community micro-enterprise development programme in partnership with Rotherham Council has had a lasting legacy. In 2017, we started work to support local people and groups develop small enterprises to offer innovative, community-based daytime support for adults with a learning disability.
As a result, people with a learning disability in Rotherham now have an extensive range of community-based support options to choose from; helping people to have new experiences, form and maintain friendships and networks, contribute to their community and gain volunteering and work opportunities.
Choice and control – use of direct payments
Social care is often defined as ‘personal care in the place where people live’. This narrow view can govern what is commissioned, or what people are ‘allowed’ to use. This has a huge knock-on effect with real implications on people`s lives. Therefore, as part of our community micro-enterprise programme we also support social work teams and commissioners of health and care services to think and act creatively. We also encourage people to try something new. Just building the choice is not enough!
Case study: Hertfordshire County Council
In partnership with Hertfordshire County Council, over 188 micro-enterprises have been supported, creating more choice and flexibility of options for people in the local community. This video case study shows how having a supportive direct payments strategy and policy at a council level helped enable local people to access this support.
There is more to do
The Care Act 2014 has underpinned much of our work, supporting the growth of thousands of small and micro-enterprises across the UK.
However, quality, local supports are still not available to everyone. We encounter risk-averse practice that does not put people, their strengths and aspirations at the centre of assessments, care plans and reviews. We hear from people frustrated at the barriers that are put in their way when they seek imaginative support.
Nationally, the use of direct payments has declined and support options available remain limited in many areas. This is partly due to a lack of investment in developing a creative, local care market, and partly through stringent local direct payment policies and processes that restrict what they can be used for.
So, what needs to happen?
Strong leadership is required to hold the vision, change processes and unblock barriers to making progress.
Practitioners need to feel safe and supported to try different ways of working.
All parts of the health and care system, including direct payment support organisations need to widen their understanding of the changing health and care market, so they can provide good advice that enables people to make informed choices.
People need to understand that there is so much more they can use their direct payment for and the difference it can make to their lives. They don’t need to be an employer.
Our hope for the future is that all councils, health and care systems rise to the challenge and grasp the opportunities that the Care Act sets out, so that ‘a good life’ is a reality for all. We will continue to play our part in supporting it to happen.
