This article is part of a series and has been written by the Master’s students in Global Politics and Society at the University of Milan. As attending students of “The Welfare States and Innovation” course, they explored the connection between Social Innovation and new forms of Welfare in contemporary societies. The article highlights the development of new synergistic partnerships among actors involved in multi-stakeholder networks and innovative multi-level governance models for social policies.
“At the European level, challenges linked to the processes of population aging are among those most frequently evoked to justify the need to stimulate Social Innovation” (Maino and Razetti 2019, p. 240). Scholarly production on the topic has increased over the last decade, as a result of the considerable attention devoted to Social Innovation especially at the EU level, paying special attention to social support and Long Term Care (LTC) for older people by describing, comparing and analysing different approaches to funding, organisation as well as regulation in LTC. Furthermore it also identifies potentials for and on-going practices of Social Innovation in the areas of LTC as well as consolidating knowledge to inform policy at EU and national level.
Departing from the academic and political relevance outlined above, two cases – which combine both, Social Innovation and the provision of services for the elderly – have been investigated.
The Italian Case: La Cura è di Casa
The first case is the Italian La Cura è di Casa, part of the projects of the Cariplo Foundation’s “Welfare in Azione” call in 2016 to offer support to the elderly in the province of Verbano Cusio Ossola (VCO) and seven municipalities of the Alto Novarese area. A network of 23 public and private entities participates in it, including the Province of Verbano Cusio Ossola (acting as leader), the three Social Services Consortia of the VCO, the Local Healthcare Company, some nursing homes, voluntary organizations, three donor foundations and the Cremit Research Center of the Catholic University of the Sacred Heart of Milan.
Accessing services, activating prevention and monitoring actions
The aim is to support elderly and their families in situations of fragility, taking up the challenge of an aging population, the burden of care and the growing demand for services for chronic diseases. It aims to develop a support network designed for those over 65, making it easier to access immediate services, activating prevention and monitoring actions and trying to encourage the development of community contexts that facilitate the stay and care of the elderly in their own homes.
The German Case: Bielefelder Modell
Due to demographic change, the topic of "self-determined living" is becoming more and more important. With the increase in the proportion of elderly in our society, the number of people in need of care is also rising, and with it the need for barrier-free housing and neighborhood-based, low-threshold care services. Against this background, the Bielefelder Gemeinnützige Wohnungsbaugesellschaft (BGW), together with a social service provider and the city of Bielefeld, developed the "Bielefeld Model" back in the 1990s, a pioneering concept that has attracted nationwide attention and is now also being implemented in other cities.
Accessing to social care support, while living independently
The Bielefelder Modell started in 1996 in the city of Bielefeld in North Rhine-Westphalia as a partnership between a housing association, Bielefelder Gemeinnützige Wohnungsbaugesellschaft (BGW), and a voluntary organisation providing outpatient and social care services in the community, Verein Alt und Jung e.V with the support of the local municipality and a range of other social organisations. The aim of the model is to enable older people to live independently in an accessible environment, with access to social care support. This also provides improved physical safety for older people through accessible housing reducing the risk of falls. The model now operates across 14 housing projects in 12 districts in the city of Bielefeld and provides support to approximately 450 households containing older people who are in need, or close to being in need, of low level social support in order to live independently.
One of the peculiar aspects found for both organisations is the “multi-stakeholder governance”. In recent years, multi-stakeholder governance has become an increasingly important subject in academia and the political sphere – and may be regarded as a key feature of social innovations.
With “Multi-stakeholder governance” we refer to a form of governance where multiple stakeholders are integrated, in order to respond collaboratively to a jointly observed problem, by jointly participating in dialogue and decision making processes.
La Cura è di Casa: Equal partnerships and innovative networks
La Cura è di Casa consists of a multitude of actors from different spheres working closely with each other. It has adopted a logic of "equal partnership" in the internal organisation. For example, in the stakeholders’ meeting, each person – public or private – participates in the management of activities and the allocation of financial resources for each territorial aggregation. The intention is to modify the relationship between these actors and create new networks and partnerships, ultimately transforming social relations.
The motto which often accompanies La Cura è di Casa is, translated into english, “the community for the wellbeing of elderly people”. In a nutshell it expresses two essential elements: taking care of the elderly with the help of the community, by promoting a new organisational structure that sees public and private entities as collaborating – and where citizens themselves have an active role. The close collaboration is also mirrored in the assemblies; for example, voluntary associations were immediately involved in the design and implementation of people raising and fundraising activities. At the same time, the fact that the Social Services, the ASL (Azienda Sanitaria Locale) and the Third Sector were seated at the same table to decide how to manage the budget, made each subject co-responsible in its use and strengthened the cohesion of the partnership.
Bielefelder Modell: the public-private mix
Second, the Bielefelder Modell is also composed of multi-stakeholder governance structures. The actors involved in this project include the City of Bielefeld, the housing association (BGW), a voluntary organisation providing outpatient and social care services in the community (Verein Alt und Jung e.V.), volunteers and the local municipality. The project is financed via multiple sources presenting a public-private-mix. The philosophy and strategy of multi-stakeholder governance is integral for this model: according to the University of Bielefeld, the collaboration of a variety of actors presents the “basis for all structures and activities in the Bielefelder Model” (Wingenfeld et al. 2020). If a new project is planned, a cooperation agreement forms the binding basis for the cooperation. This agreement describes in a differentiated manner which tasks the housing company and which tasks the respective service providers have in establishing and stabilizing a project location.
For general exchanges as well as for the coordination of ongoing activities or special projects, the implementation of regular meetings of the cooperation partners is particularly important; in practice, six to eight meetings of all stakeholders per year has proven useful. In general, the governance-mode is characterized by flat hierarchies and the division of tasks is decided on a case-to-case-basis, whichever actors is perceived to be suited best. The authors of a study on the Bielefelder Model strike the role of trust as a vital mechanism for the functioning of the collaboration between the actors and thus, the functioning of the project itself (Wingenfeld et al. 2020).
The integration of the “Community” and the relation to Social Innovation
Another striking similarity we found in the previous analysis was the emphasis on the community, as both cases express the willingness to first, involve various local actors and second, to enhance community building. Hence, the integration of the community may be regarded as an integral part of the organisation’s approach and strategy.
The concept of Community Development broadly refers to “a process where community members come together to take collective action and generate solutions to common problems” (UNTERM 2014). According to Bianchi (2021), Community Development can be investigated taking two approaches into consideration: first, community development may be regarded as an outcome, “such as physical, social and economic improvement” (Green and Haines 2008 by Bianchi 2021); second, Community Development can be regarded as a process, which broadly refers to the “ability of a community to act collectively and enhance […] the ability to do it” (Hughes and Traynor 2000; Craig et al. 2011 by Bianchi 2021).
If we look at the cases at hand, the organisations seem to integrate the process and the outcome in their philosophy and in the way they provide their services. As depicted above, both cases integrate various stakeholders on the community level in the provision of the services they offer, the provision of services is directed to the community and the participation of the community is enhanced.
Firstly, in the Italian case, La Cura è di Casa, the vision dominates that the community needs to integrate its own needs, rebuilding the bonds of trust, network and create shared paths to enhance the wealth of the social fabric. As expressed above, the motto refers to “a community for the wellbeing of elderly people”, hence helping the community while integrating and enhancing it. Therefore, local actors should be included and a sense of community created. Secondly, the German case, the Bielefelder Modell, for example claims that it provides a comprehensive range of services in a local area, which addresses the needs of older people and the wider community within the framework of existing social provision; here again, a sense of community and the integration of different local actors is emphasized (see for example the “Wohncafe”). Hence, the organisations “make use” of the community, integrating the different stakeholders and voices, and address the community as a whole.
Recommendations and further research
The analysis of these two cases highlights how social innovation and its intersection with Long-Term Care has the ability to transform relationships between territorial subjects, private and public partnerships as well as creating innovative networks between institutional actors and the community. For further understanding the cases and their relation to Social Innovation, analyses should concentrate more in-depth on the relevance of institutional settings and path-dependency, integrate more cases to increase generalizability, and investigate the consequences of the Covid-19 pandemic on the welfare state and the implications for Social Innovation.
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