NEEDHAM Catherine, et al
Outlines the findings of an evaluation of micro-enterprises in social care in England, which ran from 2013 to 2015. The report focuses on very small organisations, here defined as having five members of staff or fewer, which provide care and support to adults with an assessed social care need. The research design encompassed a local asset-based approach, working with co-researchers with experience of care in the three localities. Twenty seven organisations took part in the study overall, including 17 micro-providers, whose performance was compared to that of 4 small, 4 medium and 2 large providers. A total of 143 people were interviewed for the project. The study found that: micro-providers offer more personalised support than larger providers, particularly for home-based care; they deliver more valued outcomes than larger providers, in relation to helping people do more of the things they value and enjoy; they are better than larger providers at some kinds of innovation, being more flexible and able to provide support to marginalised communities; and they offer better value for money than larger providers. Factors that help micro-providers to emerge and become sustainable include: dedicated support for start-up and development, strong personal networks within a localities, and balancing good partnerships (including with local authorities) with maintaining an independent status. Inhibiting factors, on the other hand, include a reliance on self-funders and the financial fragility of the organisation. The report makes the following recommendations: commissioners should develop different approaches to enable micro-enterprises to join preferred provider lists; social care teams should promote flexible payment options for people wanting to use micro-enterprises, including direct payments; social workers and other care professionals need to be informed about micro-enterprises operating close-by so that they can refer people to them; regulators need to ensure that their processes are proportional and accessible for very small organisations; and micro-enterprises need access to dedicated start-up support, with care sector expertise, as well as ongoing support and peer networks.