eleven - Conclusion: scaling down?

Summary

“How awful must it be to have strange faces creeping over your threshold on a regular basis?” (Staff 106, Micro day service)

This interview quote, from one of the micro-enterprise staff that we interviewed, is a fitting start to this concluding chapter, because it reaffirms the relational essence of care, the importance of being cared for and supported by someone familiar, and the anxieties of getting it wrong (Barnes et al, 2015). It also captures the distinctiveness of the home as a setting of particular significance: a place with a threshold separating it from the outside world in which the presence of strangers is particularly unsettling. The home is known to be a distinct site for care practices (Milligan, 2009) – although our interviews did also show the importance of secure and trusting relationships in community environments. The extent to which different care organisations are likely to be able to sustain such relationships was a key focus of our account of personalisation as enactment: what organisational conditions are likely to enable a person-centred service.

A crucial question that we have addressed in this book is whether micro-enterprises are better placed than larger organisations to meet this demand for person-centred care and support, based on secure and trusting relationships. Earlier chapters have outlined the findings from the research study in relation to the personalised care, improved outcomes and lower prices of micro-enterprises, and have considered what we learned from the local sites about which contextual factors help micro-enterprises to thrive. In this chapter we leave the focus on the research sites and look at the care system more broadly to consider the scope for micro-enterprises to become a more secure part of future social care provision.

The chapter suggests that care can be framed as a complex adaptive system, which has implications for the ways in which micro-enterprises can be supported and sustained. In particular it is recognised to be difficult for local authorities to shape and manage care markets because of the weakness of their coordinating tools. The chapter then goes on to suggest that, rather than seeing organisational growth as the best way to share the positive experiences of micro-enterprises, we should focus on non-replication forms of scaling, with networks of very small organisations sustaining each other.