Care social enterprises

Social care services in England are often delivered by private companies that may prioritise profit and low cost over quality of care. An alternative type of organisation is the social enterprise, which is a business with a social mission that reinvests any profits back into that social mission. There are an estimated 5000 social enterprises operating in the adult social care sector in England (SEUK, 2021); however, we know very little about what these care social enterprises are, what they do and therefore what their potential contribution is. 

• Aims

  To understand the contribution of social enterprises to the adult social care sector in England.

  This study explored social enterprise as a potentially innovative and user-led organisational model of adult social care provision. It developed a better understanding of how social enterprise may be able to contribute not only to the supply and choice of adult social care services, but also have the potential to deliver improved outcomes for users. 

  The study also explored the potential of social enterprise to respond to care workforce challenges by offering a more positive working environment in which staff feel empowered and valued in their work.

  The study aimed to:

  1. review the existing academic, policy and practice literature to establish the existing state of knowledge on the delivery of social care in England by social enterprises and analyse current methodological approaches in the field;
  2. use existing data/evidence and undertake stakeholder consultation to ‘map’ social enterprises operating in the social care sector, to identify the outcomes they are reported to deliver and to explore the extent to which they offer innovation in service design and delivery;
  3. undertake interviews to explore how social enterprise organisations and the people working within them conceptualise the outcomes of their activities for staff, and the individuals and communities they seek to support;
  4. appraise economic methodologies in terms of their appropriateness for capturing costs and outcomes relevant to care provision by social enterprises (and potentially facilitating comparison), as identified through the review and qualitative components;
  5. share findings with policy makers, commissioners, social enterprise practitioners and users to enable a better understanding of how social enterprise is understood and may be able to contribute to the care sector;
  6. disseminate findings to academic audiences through journal publications and academic conference papers to strengthen knowledge about social enterprise in the care sector; and
  7. use the conceptual and methodological mapping developed in the exploratory study to identify future research priorities and approaches.

   

• Methods

  Research methods:

  • A realist literature review to understand the existing evidence base on social enterprises in the adult social care sector.
  • A mapping of social enterprises in three local authority areas. The mapping identified as many as possible of the social enterprises in each area and gathered additional information on each of them, including services offered, service user groups, size and governance arrangements.
  • Stakeholder interviews with 33 policy makers, social care and third sector representatives, trade unions, local authorities (including commissioners), councillors and social enterprise leaders.
  • Case studies in five social enterprises, involving interviews with five leaders or senior managers, and focus groups/ interviews with 23 staff. 

   

• Findings

  Care social enterprises project findings

  This research has highlighted the crucial role that social enterprises could play in increasing adult social care capacity, quality and diversity. The social and preventative services delivered by care social enterprises not only support older and disabled people to remain independent and do the things they enjoy, but may also reduce the need for expensive homecare and residential care services. Most of the profits they make are also retained within the social care sector through investment in quality services, staff and the community. However, there is a reported lack of understanding about care social enterprises amongst funders and they also may struggle to evidence their added social value. Whilst a lack of national policy or practice leadership leaves space for local approaches, it has also resulted in a varied and inconsistent presence of care social enterprises.

  Implications:

  • For policy makers: A national strategy for care social enterprises could be developed to co-ordinate, promote and support the efforts of care social enterprises.
  • For local authorities: The research identified good practice in Local Authorities that are working collaboratively with social enterprises as key partners to deliver adult social care. Local level financial, business and IT support were found to enable social enterprises to apply for funding, evidence their work and become more financially sustainable. Good practice that is happening locally could be replicated and shared across England.
  • For social enterprises: Social enterprises should look to become self-sustaining by diversifying their income base, including through commercial activities, local authority contracts and the direct delivery of services to people who self-fund their care or have direct payments. Networking can help social enterprises raise their profile and stimulate the sharing of best practice.
  • For researchers: There is lack of national data on care social enterprises and a gap around evidencing their outcomes that needs to be filled if the potential of social enterprises is to be understood. Social care administrative data collected by local and national government should recognise enterprises and also include social value related outcomes.

   

• Resources and publications

  Policy briefing 

  Hall, K., & Alexander, C. (2023). Exploring the distinctiveness of social enterprises delivering adult social care in England. Health and Social Care in the Community, 2023, Article 9454428. https://onlinelibrary.wiley.com/doi/10.1155/2023/9454428

  Kerlin, J., Ye, M. and Hall, K. (2023) Do social enterprises fulfil their social promise? Quality of social care CICS and other legal forms. Academy of Management Conference Paper.

  Hall, K. and Kinghorn, P. (2021) ‘Measuring Outcomes in Social Care’ Book Chapter. Social Impact Measurement for a Sustainable Future.