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Are micro-enterprises better than large providers for social care services?

Posted on 25/06/2015

With more people receiving personal budgets as direct payments to fund social care, or self-paying for services, a whole host of providers are available to help with personal care, daily tasks, activities, meals and more. These providers can range from very big, right down to individual paid carers. 

A new report by the University of Birmingham, the result of a project funded by the Economic and Social Research Council (ESRC), looked into so-called ‘micro-enterprises’ in social care, to test “the relationship between size and performance in organisations providing adult social care to see if micro-enterprises outperform larger care providers in delivering services to users that are valued; innovative; personalised and cost-effective”.

What are micro-enterprises and what are the benefits?

They are small providers offering personal care and/or support services to people in their local communities. They are generally based in the home or the community, rather than offering residential care, and they work within small areas, rather than nationwide. It can be that it is just one person working on their own or a small team operating together.

The report uncovered some interesting findings regarding the provision of services by micro-enterprises and larger providers. Looking at personalisation, it found that the smaller providers were able to offer better continuity of staff (seeing the same person every time) and flexibility for staff to vary their tasks to suit the service users. This highly personalised approach has many benefits for the service users, though over-attachment is cited as a potential problem. However, when it comes to personalising activities, both large and small providers showed good results.

The report also looked at value for money, weighed up against the service provided. It found that generally the hourly rate for smaller providers was less than that of larger providers, however, for larger providers, there was a link between cost and service. The cheaper hourly rates of large providers were from those who conformed to 15-minute home visits, for example, and a high turnover of staff with little continuity. The more expensive larger providers were able to provide a similar personalised and person-centred service to its customers.

You can read more of the reports findings in this summary document.  

How can you find services in your area?

One of the disadvantages of micro-enterprises is that they can be harder to find out about. Larger providers will have a marketing budget and often links with local authorities, so that it is easy for service users to see what is available. Smaller enterprises, however, will often not have the funds for marketing on a large-scale basis, so it may be more difficult to find out what is out there. Also, the report found that these micro-enterprises are mostly reliant on self-funders, as they have low referral rates from local authorities. 

Despite this, the first step should always be to talk to your local authority, as they will often have a list of local providers, big and small, and this might help you find what you are looking for. You might also see these enterprises advertising by traditional methods, such as posters and flyers in community centres, churches, shops and so on. 

Word of mouth is a micro-enterprise's most powerful tool, so ask friends and family if they have heard of any support services that might suit your needs.

If you are looking for personal care services, then the provider, whether big or small, should be registered with CQC, which means that you can use its search tool to find out what is in your local area.

How can I start my own micro-enterprise?

If you feel inspired to start your own home care business, then You’re the Boss can help you to get started.

The first thing that you need to determine is the type of care business that you want to set up, whether on your own, in a partnership with others or a business that will hire additional staff. You will need to come up with a business plan; put all the right policies and procedures in place; and think about the type of services that you want to offer and how you are going to attract clients (find out more about these points here).

You will need to register as a business or sole trader with HMRC to ensure that you pay the correct taxes and set up any staff you will be paying on the system. If you are going to be offering personal care services, then you will need to register with the Care Quality Commission and there is a handy guide for registering as a new provider on the website.

We can help with many aspects of the process. For example, we have a rundown of the types of policies and procedures that you will want to have in place. The Document Store also has customisable templates for many of these, as well as marketing materials, contracts and more. Our section on Paid Carers has lots of information on setting up a new care business, which covers individuals and small businesses, but if you have any questions that are not covered, then please get in touch

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