The previous chapters have considered how and why to study size, the participative approach taken in the research study and the organisational identities at work among our case study micro-enterprises. The next three chapters present the findings from the research, focused on the four hypotheses. The issue of whether micro-enterprises achieve better outcomes and value for money than larger providers is considered in this chapter. The next chapter looks at the process of care and whether micro-enterprises are more personalised in the support they provide than larger care providers. Chapter Eight considers whether or not they are more innovative. These chapters draw primarily on different dominant data sources. This chapter utilises two main data sources: the quantitative outcomes data gathered from the ASCOT survey and the pricing data given to us by the organisations – although qualitative interview data is also brought in so as to better understand these quantitative findings. In the next chapter, the personalisation section draws predominantly on interview data from people using services and family carers. The innovation chapter draws most heavily on the staff interviews that we did for the project. Here we begin by setting out the findings about outcomes of care, and then go on to compare outcomes with pricing data to establish how far micro-enterprises offer value for money as compared to larger providers.

Care outcomes

In Chapter Two we set out six ways of measuring performance, covering output quality and quantity, efficiency, value for money, outcomes and consumer satisfaction. For several years now, measurement of the performance of public services has focused on the outcomes that they deliver over other measures of performance (Commission for Social Care Inspection, 2006; DH, 2006; Wanless, 2006). Outcomes are presented as a move away from a naïve focus on outputs (number of care visits a day, number of operations performed), which can hide poor-quality service. Outcomes are more sophisticated: in relation to social care they are ‘the valued consequences of social care support for service users and other people’, and include quality of life and well-being (Caiels et al, 2010, p 1). As Caiels et al point out: ‘measuring wellbeing outcomes, rather than units of service output (e.g. the numbers of care home placements), gives us a much better indication of value’ (2010, p 1).