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Micro-Enterprise and Personalisation: What Size is Good Care?

Catherine Needham, Kerry Allen, and Kelly Hall

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 ... More

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.Less