Analysis: Research suggests worker co-operatives offer an ethical, effective and sustainable model for elder care in Ireland
Ireland's population is ageing rapidly, a trend that will significantly impact care responsibilities of families and the state in the coming decades. However, the country currently faces a serious shortage of quality elder care. Data derived from high-income EU countries, including Ireland, show that between 56.6% and 90.4% of the population are unable to access quality long-term care services, primarily due to a lack of formal care workers.
Although the need to expand the care workforce is widely acknowledged, research highlights that many long-term care workers, especially those employed in conventional investor-owned care businesses, are experiencing insecure, low-paid, and undervalued employment. These working conditions deter many individuals from pursuing careers in elder care, despite growing demand.
In this context, worker co-operatives may offer a viable alternative model. As organisations owned and operated by their workers, they have the potential to improve both working conditions and care outcomes.
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From RTÉ Radio 1's Drivetime, Minister of State at the Department of Health with special responsibility for Older People, Kieran O'Donnell says legal entitlement to home care will be delivered in the lifetime of the Government
A recent study examined the impact of worker co-operative elder care provision in Ireland. It focused on the Great Care Co-op (GCC) which is the only worker co-operative engaged in home care in the Republic of Ireland. The research entailed interviewing care-worker members, GCC clients, family members of clients and Health Services Executive (HSE) officials with responsibility for elder care services in Ireland. The findings indicate that the GCC has an overwhelmingly positive impact on the lives of the care-worker members, clients, and the clients' family.
The quality of care can be attributed to several interrelated factors. First, the GCC’s status as a worker co-operative—with a mission to provide quality employment for its members and a governance model based on collective ownership and control—fundamentally shapes the delivery of care as it priorities the care needs of clients. A client’s daughter highlighted this ethos: "Not a business but a genuinely caring service that’s deeply committed to the wellbeing and dignity of its clients. Thank you so much for taking such good care of my father in his final weeks".
Read more: What's the effect of being a carer on the caregivers themselves?
Second, GCC clients highlighted that receiving care from the same carer over time fosters trust not only between them and the care worker, but also with the client’s family. Jean, a 78-year-old client, shared: "I love both of my carers, I couldn’t fault them. They are so consistent, they always come on time. I don’t want to go to day care or into respite, I want to be at home and they are always great company".
Third, both clients and families appreciate GCC’s punctual and dependable service, which they attribute to its localised model and consistent staffing. Pat, a family member, noted: "This problem of no shows has never happened with the Great Care Co-op. If our carer cannot make it then somebody else shows up. I have never been let down by the Great Care Co-operative. It is a really reliable service. Overall, the experience is really good with the Great Care".
This enables the development of trusting relationships between care-worker members, clients and their family members. In addition, the needs of clients and commitment to a person-centred model of care is central to how GCC operates. Care worker members, clients and their family members described how this ethos is operationalised in practice:
- The time of care delivery is determined by the clients, ensuring flexibility and respect for care recipients’ routines.
- Care plans are shaped from direct consultations with clients and their families, who inform care-worker members of the type of assistance required.
- Sufficient time is allocated between appointments, enabling care-worker members to travel between appointments so that they are not late.
- Prospective clients are only accepted if there is adequate capacity to provide a high-quality service.
- If delays are unavoidable, communication is maintained with the client promptly to inform them that the care-worker members may be delayed.
- Care-worker members engage with relevant organisations to help to resolve broader issues that clients are encountering.
The clients and family members of clients rate the quality of care provided by GCC as being of a high standard. They directly link the quality of care they receive to the work conditions and motivation of care workers. Frank, an 84-year-old client, explained: "I consider the GCC to be a most excellent organisation which treats their Carers in a proper manner which means the Carers are happy in their work and this is evidenced by how they treat their clients - with kindness, compassion & dedication".
Read more: What needs to be done about Ireland's growing home care crisis?
Tony (91 years of age) a GCC client spoke of the professionalism and support he receives: "I am feeling better week by week. It is great. My physio exercises are intensifying as I get stronger and I need help with them. I couldn’t do it with co-op carers, Lily is here with me twice a day, she encourages me and keeps the routine going. I really can’t express how important this is to me. The care team is excellent".
The evidence from the GCC research suggests that worker co-operatives offer an ethical, effective and sustainable model for elder care. Finally, the positive impact of the GCC on the lives of clients would indicate that the HSE should prioritise contracting elder-care services provided by a worker co-operative.
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The views expressed here are those of the author and do not represent or reflect the views of RTÉ
