Danahe Patino feeds 84-year-old Sarah Canavan as she sits in her extendable armchair. The healthcare assistant and her colleague, Suliyat Akande, have just finished their morning tasks and have a few spare minutes to talk about their jobs with the Great Care Co-op.
Blind and suffering from dementia, Sarah is calm as we talk about how Patino and Akande wash, change and feed her on their regular visits to the Canavan home in Sandymount in Dublin. “We work together like a family and I feel I have my own voice and my own say in this work,” says Akande. “It has helped me gain more confidence.”
One of about 30 healthcare assistants working for what is Ireland’s first co-operative for healthcare assistants, Patino and Akande chat confidently about how they are directly involved in decisions about the daily care of their clients and the scheduling of their visits directly with family members.
The worker-owned co-operative also provided free healthcare training to migrant women, fortnightly team meetings to talk about clients and opportunities for workers to join the board of directors. The Co-op also provides a counselling service should any of the carers need extra support.
READ MORE
“I received QQI Level 5 training to qualify as a healthcare assistant and working for the Great Care Co-op is the best decision I’ve made,” says Akande, who is originally from Nigeria and now lives in Blackrock with her family.
Patino has been caring for Sarah for two years. Akande joined her more recently as Sarah’s care needs grew. “We make the care plans for each client individually,” says Patino.
Frank Canavan (79) sits next to his wife of 50 years as her carers speak about what they do for her. The retired civil servant is effusive in his praise for the care workers. “I’m grateful for all the care we get. They are patient and kind. She can burst out in anger and 10 minutes later be happy again, but each carer accepts her as she is. It’s a labour of love how they treat my lovely Sarah.”
The Great Care Co-op grew out of an awareness in Migrants Rights Centre Ireland that some cleaners, carers, childminders and housekeepers were suffering from levels of exploitation. “We were calling for rights and visibility for these women and in spite of new laws and policies [inspections in workplaces and employment rights for domestic workers], their terms and conditions weren’t improving,” says Aoife Smith, who worked as a community development worker with Migrants Rights Centre Ireland and now works for the Great Care Co-op.
Inspired by care co-operatives in the Bronx in New York and in the Netherlands, a group of migrant women from South Africa, Malawi, the Philippines and Uganda set up the Migrants Workers Action Group within the Migrants Rights Centre. The Great Care Co-op became a stand alone social enterprise in 2020. “The status quo model [of home-based healthcare assistance] is disempowering for care workers,” says Smith, referring to how many healthcare assistants working for private operators have little input into decisions about the people they care for and the times they visit them.
“Carers are best placed to make good decisions about daily care with clients as they have the most information from observations and knowledge of the wellbeing of their clients,” says Smith.
According to Smith, the co-operative model allows issues to be resolved locally at speed with better outcomes rather than when issues are escalated up for care co-ordinators to decide on. “It also empowers the carer. In Co-ops, carers and clients are at the heart of the organisation,” she adds. Only more complex issues are reported to care coordinators or public health nurses.
Since his wife died in 2023, 88-year-old Donald Maxwell has lived alone in the family home in south Dublin, where the couple reared their four children. “I get up early and I like to have everything done before she comes,” he says, referring to his healthcare assistant, Tina Breen.
The retired Stena Line worker downplays his chronic health conditions, preferring instead to talk about his adult children and their families, who all live relatively close by. “I shower myself. I prepare my own food, and I take my medications,” says Maxwell, who played the organ in his local church for the last 47 years.
Breen smiles in acknowledgment. “He’s very independent and is one of my easier clients,” she says, explaining how she hangs out the washing, empties the dishwasher, does the ironing, puts out the rubbish and sweeps the kitchen floor.
As Maxwell has had several falls, having someone to do these everyday household duties allows him to continue to live at home safely. A stairlift and grab rails gives him ease of movement around his home and he has a rollator and a wheelchair for outdoor use.
Breen has been working as a healthcare assistant for 19 years. Having worked for various private homecare providers, she says that working for a carer-led, carer-run service is a welcome change. “We get a lovely bonus at Christmas time and all the carers have days out in the summer and at Christmas time,” she says.
To be a carer, you need to be physically strong, mentally alert and emotionally tuned-in. “It’s all about gentle persuasion with older people,” says Breen.
“We don’t just provide care, we provide kindness,” adds Akande.
The Great Care Co-op philosophy is to provide local carers for their clients with the aim of reducing the amount of time carers spend travelling between clients.
“In spite of the scarcity of carers ... this remains a low-wage, precarious sector dominated by women. Our model focuses on relationships and at scale, we feel we can drive up pay and conditions to provide ethical, sustainable and decent jobs for those who want to work in the sector,” says Smith.
About 90 per cent of the Great Care Co-op’s work is for the Health Service Executive, with private clients making up the rest. “We are 70 per cent self-funded at the moment with some funding from Rethink Ireland and the Community Foundation of Ireland,” says Smith.
Competing with the private healthcare assistant companies for HSE tenders, the Co-op started off with one team and now has four in the south Dublin area. “We want to get to 20 teams by 2030 and then go nationwide. We don’t see any reason why there couldn’t be a co-op hub in every town,” says Smith.
She believes the Great Care Co-op have the potential to scale up countrywide. “We have been approached by many people, particularly in rural areas. Our vision is that the model of six to 12 carers in each locality with a support centre is replicable nationwide, with governance and accountancy managed at headquarters. If we had 200 carers and 20 hubs around Ireland, we would be able to invest back into the social enterprise and increase wages further,” says Smith.
