Book contents
- Frontmatter
- Contents
- List of figures, tables and boxes
- Acknowledgements
- List of abbreviations
- one Introduction: what size is ‘just right’ for a care provider?
- two Why study size?
- three Enterprise and care
- four Methods for co-productive research
- five What it means to be micro
- six Micro-enterprises: better outcomes at a lower cost
- seven Enacting personalisation on a micro scale
- eight Micro innovation: what, how and who?
- nine How micro-enterprise performs
- ten Sustainability: are micro-enterprises built to last?
- eleven Conclusion: scaling down?
- Appendix 1 Site one interview schedule
- Appendix 2 Adapted ASCOT tool
- Appendix 3 Developing the innovation theme codes
- References
- Index
nine - How micro-enterprise performs
Published online by Cambridge University Press: 05 April 2022
- Frontmatter
- Contents
- List of figures, tables and boxes
- Acknowledgements
- List of abbreviations
- one Introduction: what size is ‘just right’ for a care provider?
- two Why study size?
- three Enterprise and care
- four Methods for co-productive research
- five What it means to be micro
- six Micro-enterprises: better outcomes at a lower cost
- seven Enacting personalisation on a micro scale
- eight Micro innovation: what, how and who?
- nine How micro-enterprise performs
- ten Sustainability: are micro-enterprises built to last?
- eleven Conclusion: scaling down?
- Appendix 1 Site one interview schedule
- Appendix 2 Adapted ASCOT tool
- Appendix 3 Developing the innovation theme codes
- References
- Index
Summary
This chapter focuses on explaining why micro-enterprises are able to perform well on the four measures we used in the study. We begin by revisiting the hypotheses set out in Chapter Three, and consider them in the context of the evidence presented in Chapters Six, Seven and Eight. We then focus on explaining why it is that micro-enterprises perform better than larger organisations. Part of this relates to organisational structures, with very small organisations being more flexible and informal than larger ones. However, we go on to argue that structural explanations cannot fully explain our findings. There are aspects of smallness that are performative in the sense of being ‘generative of practices that produce particular forms of performance’ (Skelcher, 2008, p 40). Micro-enterprise is performed in the claims that are made for it as an identity and ethos that differentiates it from larger providers.
Returning to the hypotheses
The first hypothesis stated that micro-enterprises were better at achieving valued outcomes than larger providers, and the ASCOT data presented in Chapter Six indicated that this was the case on both of the dimensions tested (spending time on things I value and enjoy; having choice and control in my daily life). Only the first of these was statistically significant, and the small numbers in our study are more broadly a limit on the generalisability of these findings. The qualitative data also highlighted the limitations of quantitative outcomes-based measures, given that many of the older people in our sample wanted to talk about the process of care rather than articulate an outcome.
In relation to the second hypothesis – value for money – we set pricing data from the different-sized organisations alongside the outcomes data to argue that micro-enterprises do constitute good value for money. However, in Chapter Six we also provided a broader discussion of the contextual factors shaping care pricing, and the extent to which micro-enterprises are limited to serving largely self-funders and people with direct payments. For local authority-commissioned care services, large providers do remain the cheapest option. We return to the issue of local authority commissioning practices in the next chapter, which focuses on the sustainability of micro care providers.
The third hypothesis focused on personalised care, and in the chapter on enacting personalisation we argued that this was where the benefits of micro-enterprise were most compelling.
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- Micro-Enterprise and PersonalisationWhat Size Is Good Care?, pp. 143 - 156Publisher: Bristol University PressPrint publication year: 2016