We are pleased to share the findings of our study on social care co-operatives in the UK, carried out in partnership with the Centre for Health Services Studies (CHSS) at the University of Kent, the Centre for Adult Social Care Research (CARE, Wales), and IMProving Adult Care Together (IMPACT).
The study is funded by Co-operatives UK and Cwmpas, which represent the co-operative sector across the UK and in Wales. The research involved 15 representatives of social care co-operatives across England, Wales, and Scotland.
Download the report
English Version
Welsh version
What are social care co-operatives, and why do they matter?
Social care co-operatives are organisations where ownership and control are shared among members. There are different types.
User-led co-operatives are governed and managed by people drawing on care, who pool their personal budgets or direct payments to employ personal assistants. One example is Friends United Together.
Multi-stakeholder co-operatives bring together diverse member groups (such as people drawing on care, care workers, community members, and families), each having a say in how the organisation is run. Examples include Cartrefi Cymru and Equal Care Co-op.
Worker-led co-operatives are owned and managed by care workers, and aim to improve working conditions, job security, and the quality of care provided. One example is Leading Lives.
The central role members play in decision-making distinguishes care co-operatives from many for-profit providers in local care markets
Care co-operatives remain unevenly distributed across the country, and awareness of this approach is limited, making it important to understand how they work and what enables them to grow. The study examined how co-operatives deliver care, the barriers they face, and what and what supports their development. It also identified policy and practice changes needed to expand the model.
This report comes at a time of change for the sector. Key developments include the review of adult social care in England led by Louise Casey, the 10-Year NHS Plan, and the Welsh National Framework for Commissioning, which places greater emphasis on social value in commissioning decisions.
What are the key findings?
• A small sector with a broad offer
Around 25 social care co-operatives are registered with Co-operatives UK and deliver regulated adult social care services. This likely underestimates the true scale of activity. At the same time, interest in the model is growing. This is reflected in the increasing number of councils adopting ethical commissioning frameworks, which make it easier for small providers, including co-operatives, to enter local care markets.
Despite their small number, the co-operatives that responded to the survey supported over 3,000 people. They provided domiciliary and residential care for older people and adults with physical, learning, and mental health needs, alongside support for independent living and group activities to promote social inclusion.
• Delivery of co-produced and relationship-focused care
What distinguishes co-operatives is not the range of services they offer, but how they deliver them. In this study, care quality meant helping people live the life they value, not just completing tasks. This means valuing relationships, continuity of care, and co-production.
People drawing on care help shape services through forums, assemblies, and tailored participation methods. Where co-operatives are led by people who use services, appropriate oversight maintains high care standards.
•Fair working conditions
Across the surveyed co-operatives, 2,919 people were employed, 83% of whom were frontline care workers. All organisations paid at or above the Real Living Wage and supported workers’ voices in decision-making. They reported lower recruitment pressures, improved retention, better gender balance, and success in attracting younger workers. These are promising signals in a sector where vacancy rates reach 8.3% and turnover stands at 24%.
• Added value for families and communities
Co-operatives generate value not only for the people they support but also for the wider community. They support unpaid carers, run community activities, and stay connected with people who have previously used their services. To illustrate the scale of this contribution, Cartrefi Cymru Co-operative estimated that in 2024 it delivered the equivalent of £250,000 in unpaid assistance. Co-operatives also reinvest locally by sourcing goods and services from nearby businesses and contribute to innovation through new organisational models and approaches to care delivery.
• Commissioning is a key enabler (and barrier)
Access to social care relies mainly on local authority and NHS referrals (78% and 14% respectively), making commissioning the main factor shaping whether co-operatives can grow. The current system is based on competitive tendering at lowest cost, which often rewards task-based care rather than quality. Co-operatives are often treated as equivalent to for-profit providers, despite their different aims and ways of working. Limited access to start-up and stabilisation funding further restricts their development.
However, there are signs of change. There is a shift toward ethical, outcome-based, participatory, and longer-term commissioning, alongside policy interest in reducing the role of profit in some areas of care, especially children’s services.
What needs to change: recommendations
In the short term (1–2 years), priority could be given to improving commissioning practices. Local authorities should adopt criteria aligned with what social care co-operatives offer, including co-designed services and fair work practices, to ensure more balanced competition with large for-profit providers. A national platform should also be established so that co-operatives can agree shared priorities.
In the medium term (3–5 years), regional commissioning partnerships could be piloted, building on approaches already used in children’s social care. These partnerships could support collaboration among local authorities and facilitate social care co-operatives’ entry into care markets. In parallel, the development of regional support hubs would provide shared administrative infrastructure for smaller providers.
In the longer term (over 5 years), legal reform, fiscal incentives, and sustained investment in research and evaluation will be needed to strengthen the evidence base and include more co-operatives within the social care system.
Social care co-operatives represent a potential resource for the social care sector. This study adds to the evidence on what is already working in practice and responds to the growing demand for care models that are high-quality, financially sustainable, and responsive to the needs of those who both draw on care and support and work in care.
What our collaborators say
The researchers have found evidence that co-operatives and mutuals can help fix our broken model of social care by putting those giving and receiving care ahead of distant investors. They are the future of care.
James Wright, Policy and Development Lead at Co-operatives UK
Cwmpas has been promoting the social care co-op model in Wales for a number of years. This research has been important to provide more information on the current success stories and the challenges that exist to seeing more social care co-ops develop.
It will help to further promote the model and break down some of the barriers that are preventing further growth in this area.
Glenn Bowen, Director of Enterprise at Cwmpas
What next?
Co-operatives UK is holding two sessions to further explore the research findings:
- A dedicated social care session at Co-op Congress – the co-operative sector’s annual conference – taking place at The Eastside Rooms in Birmingham on 12-13 June. Find out more and book tickets at: www.uk.coop/congress
- A webinar to explore the findings in more detail and ask questions, with report author Serena Vicario from the Centre for Health Service Studies at the University of Kent, on 23 June at 2-3.30pm. Sign up for the webinar here.
Ahead of these sessions, anyone with ideas or questions about the research, is invited to get in touch with Co-operatives UK by emailing policy@uk.coop.
