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Shifts to independent delivery of health and social care services has led to increased numbers of micro-enterprises. Could these tiny organisations with just 5 or fewer employees be the best way of delivering cost-effective health and social care services in the context of decreased budgets and increased demands? What size is 'just right' for a care provider? This book explores size as an independent variable in care services, comparing outcomes and value for money across micro, small, medium and large organisations. Using interviews and surveys with 108 people using services and careers in 27 case study organisations it focuses on the contribution micro-enterprise can make to the care sector. Findings indicate that the quality of service provided by small organisations does support the assumption of an affinity between being small and being personalised. Small and micro-enterprises can deliver more personalised services, particularly in the home. They also offer better outcomes than larger providers for a similar cost. However stability can be a problem for micro-enterprises, particularly those that employ staff and need to have a relatively consistent financial turnover. The Care Act 2014 creates a conducive policy environment for micro-enterprise, as local authorities must stimulate a diverse local market and facilitate personalisation of services. However the challenges of austerity are a powerful counterweight, discouraging the sorts of innovative and experimentation which would allow micro-enterprise to thrive.

Conventionally, poverty is often represented as a lack of resources, but it is much more than that. A considerable amount of work has been done in recent years to establish a view of poverty as a complex, multi-dimensional set of experiences. The poverty of nations goes further still. The nature of poverty is constituted by social relationships - relationships such as low status, social exclusion, insecurity and lack of rights. The relational elements of poverty tell us what poverty really means – what poverty consists of, what poor people are experiencing, and what kind of problems there are to be addressed. The more emphasis that we put on such relationships as elements of poverty, the more difficult it becomes to suppose either that poverty is primarily a matter of resources, or that poverty in rich countries means something fundamentally different from poverty in poor countries. The book considers how poverty manifests itself in rich and poor countries, and how those countries can respond to poverty as a relational issue.