Can you solve the UK's social care crisis by putting carers and their patients in charge?

The model could offer solutions as UK social care suffers a serious crisis of underfunding

Amber Wright, Kate Hammon, Emma Back and Fran Watson from Equal Care Co-op in Hepden Bridge (Nesta)

Angie Mossman has a way to describe managing the care of a family member in the village of Blackshaw Head in West Yorkshire, on the top of the hills outside Huddersfield.

“It feels like you’re in a Faustian pact constantly,” she says in a video by Nesta, an innovation foundation. “We were just hoping: someone’s going to turn up, someone’s not going to do something dangerous today. And when I first started to talk to Emma and learnt about what she was trying to achieve [with Equal Care Co-op] I felt that sense of power coming back.”

Equal Care Co-op is a platform for organising social care with one key difference: the people who give and receive support are co-owners and managers of the platform, rather than external shareholders or top-down managers. Its founders Emma Back, Fran Watson and Kate Hammon set out to end the revolving-door approach to home care, in which neither the care worker or the receiver of care knows who they will be working with from day to day. Instead, they are fostering closer circles of communities to care for people in a local area, while making sure that everyone is properly treated and properly paid.

It’s no secret that care work in the UK is suffering from a crisis of underfunding. In the last five years, the Government has cut a total of £160 million from older people’s social care at the same time as the population has been ageing. The demand for services has been growing, according to Age UK, estimating that 1.2 million people over the age of 65 do not have the care support they need. At the same time, cuts in local authority care services have placed increasing pressure on unpaid carers, such as relatives and friends of people receiving care.

Michelle is one of those people. Over the last 11 years she has provided care at home for her mother and father while working full-time as a professional and looking after her own family. “I felt very isolated as a carer,” she says. “I couldn’t attend any meetings about being a carer because I worked full-time and I was out every evening at my mum’s. The minute I heard about Equal Care Co-op I knew it was something I would have really appreciated.”

In January, Michelle got a phone call from Back, who invited her on a training course. Over six days and a dozen assessments, she trained for a care certificate to formalise her skills in care. Michelle has now left her profession of 30-years to work part-time as a carer in the Equal Care Co-op, convinced that it offers a better way to provide care than an endless rotation of poorly paid agency workers.

Michelle says Equal Care Co-op offers her a sustainable way to make a living and a way to attract skilled workers to a profession that they might otherwise have thought was not for them. “I have experienced good and poor care,” she says. “I had lots of discussions with the girls that used to come about their conditions, the travelling, the level of pay. There’s a lot of money goes into this sector, but there’s not a lot of money going to people who do this work, and it can be tiring, it can be a bit repetitive and you do have to do deal with not very nice things that other people don’t want to deal with. The sector loses a lot of talented people who would like to do it, but can’t afford it.”

Equal Care Co-op has a particular focus on formalising care in rural areas that have traditionally been difficult for agency staff to reach. In Blackshaw Head, Angie Mossman brought together a circle of volunteer carers to look after her mother-in-law. “We got dumped going into two winters,” Mossman says of her agencies, who refused to come up onto the tops of the hills once it got icy. After speaking to Back, Mossman found people in her village willing to train as carers in return for paid work and professional support. Others volunteered kindnesses, like fetching shopping, or dropping in for a cup of tea.

The increase in the proportion of rural residents over the age of 65 increased by 37 per cent between 2001 and 2015, according to Age UK, compared with just 17 per cent in urban areas. The NHS increasingly relies on private agencies and voluntary and community-based carers to meet demand.

In Somerset, health services supported by The Richmond Group of Charities have worked with the voluntary and community sector to connect patients with sources of emotional and practical support. Meanwhile in North Craven and North Yorkshire, local people have adopted a village outreach scheme where people based in the village operate as voluntary “agents”, providing support.

But Back says that Equal Care Co-op goes further by creating new paid hours to fill the gaps in professional support, rather than placing the burden of care on volunteers. “This is about changing the parameters in which you give care, so rather than doing it independently, you can get paid £14 or £15 an hour to offer independent support with clients that you choose and who live locally to you,” Back says. “It’s a completely different proposition to working voluntarily or for an agency.”

In June and July, Equal Care Co-op is raising £300,000 through community shares on Ethex, a not-for-profit impact investing platform. Through Ethex, people can invest between £100 and £30,000 in Equal Care Co-op until July 17 and receive three per cent per year returns on their investments, with the option to start withdrawing their investment after four years.

Lisa Ashford, chief executive of Ethex, says community shares allow co-operatives and community benefit societies to raise money without compromising their autonomy. “Co-ops are different from other companies, because they are formed and operate for the benefit of members – making them in many respects a much fairer, equitable and democratic alternative to conventional business structures,” Ashford says.

Back says the funding will be used to develop two “support circles” in Hebden Bridge and Blackshaw Head, including training new carers like Michelle to deliver care to people in each area. These circles include a mix of support workers including carers, assistants, co-ordinators and health professions who collaborate to care for vulnerable people, so one carer ever has to operate alone.

Jenni Lloyd is a programme manager at Nesta, where she works on the ShareLab Fund, which previously supported Equal Care Co-op with £30,000. “Most tech platforms needs to scale fast in order to deliver the kind of returns that investors demand,” Lloyd says. “But [Equal Care Co-op] is a people-centred service before it is a platform. If the kind of relationship-centred care that they are busy defining can be replicated at scale then there’s every possibility that the whole system of care – and our expectations around it – can be changed.”