The starting point of the project is the specific actions that aim to qualify family care and to foster the organizational skills of the producers. In this regard, we think a collective action is essential, which implies switching from a model in which the residential aide acts individually on a one to one basis, to one based on the aggregation of caregivers into associations for social advancement.
These collective entities would guarantee families: a more efficient coverage of their needs, such as guaranteeing the substitution of the official employee during weekly breaks, sick days, and so on…; the simplification of the bureaucratic procedures related to payment, of which APS is in charge; the possibility of regulating and differentiating services. The benefits would also grant workers: the certainty of their contractual rights, organizational support and supervision, formative opportunities, solutions to all of the problems related to gaining credit, opportunities to integrate their own actions with those of other individuals operating within the local social economy with the perspective of bettering the capacity to take on responsibilities.

The newly created Aps – that would enrol in the CCIA with the Ateco specific codes for residential and family care – would work only for registered users, who present themselves as self-managing subjects. The active involvement of the recipients in the management of the association aims to overcome the standard market dialectic, promote recipient participation in the management of the means of production, and finally perfectly set up its activities as coherent to the logic of social innovation.

In practical terms, these actions were developed while taking into consideration the following:
— the action model of business setup while following FSE guidelines.
— the model for the statute, deed of incorporation, internal regulations of the Association;
— the model of the business contract.

As for the recipients of the “active policies of labour” (based on the analysis of the incoming requirements), the ideal target was identified as the following: women with a low level of education, over the age of 45, and unemployed inasmuch as they have been expelled from the traditional labour cycle. Other ideal targets were women under the age of 29 with a low level of education that fit within the category of “Neet”. We set up an action model that envisages outreach to the recipients, along with activities of orientation, and individual and group education. These actions aim to achieve a qualification or re-qualification, education for the set up and creation of a business, and assistance to start-ups. Regarding the degree of idea sharing, we achieved a very high level of participation from local authorities, health districts, associations, and the organisations of local beneficiaries.

The second point is the promotion, within each district, of integrated businesses that offer residential and local services. We aim to achieve this through the creation of a network of local social workers, which will act as a definite point of reference for families, local authorities, and also for those who might be interested in developing businesses with a welfare mind-set (including private business as well). The model of local network refers to a specific district and, through the diffusion of aps, social cooperatives, voluntary based associations, and several other entities, it ensures: the management of family care services; the provision of guardianship tutelary, nursing and home-based physiokinetic therapy; the provision of transport services based on individual requests; home delivery of aid, pharmaceuticals, and meals; the opportunity to purchase – through ethical purchasing groups – food from local producers with a zero carbon footprint; home maintenance. By means of specific agreements, businesses will also offer the possibility of tele-assistance services, and to make use of insurance products, which will cover the cost of a potential decline in health. The network model was defined foreseeing the creation of a syndicate association based on the sharing of a previously formulated quality system, an internal protocol of quality control, and ethical norms. This management model implies that all the direct and frontal activities involving users are managed by the APS, cooperatives, and administrative associates, while the consortium administrates the network and supervises the function of partnership development, network governance, aids and quality control. In practical terms, these actions were developed while taking into consideration the following: the business idea and business plan; the model of statute and deed of incorporation of the limited liability consortium; quality systems; and an internal operational protocol.
The following are significant variables of the plan: a special purpose project (in the executive stage) for the creation of beneficiary associations capable of self-managing scholastic and social transportation services within contexts of low demand; framework agreement with Arci Solidarietà that employs civil service volunteers to support professionals in developing the social skills of the people under their custody; a framework agreement with the training agency Città Nuove srl in order to carry out alternative paths of work-related learning, or occasions for training for young high school graduates during the summer.

The third point is the planning, testing, and the evaluation process of daytime socialization centres capable of supplying services to the non self-sufficient elderly people of various degrees of dependency in badl (Basic Activities of Daily Living). The aforementioned centres should also be able to offer support to caregivers in reconciling the care for relatives with the professional needs of the patient. This specific project aims to spread an innovative formula of daytime socialization service designed for the non self-sufficient elderly and for their families. It is characterized by: the “commercial” nature of this type of service; the flexibility of its opening hours, which gives beneficiaries the possibility of using the structure everyday from Monday to Sunday between 8 am to 8 pm (and also on specific days according to their needs); the variety of the different services provided, which include personal assistance, non-pharmacological treatments of early-onset dementia aimed at preserving residual cognitive capabilities, support for relationships and for the enhancement of intra-personal abilities, scheduled baths, laundry and ironing services, meals, the provision of nursing and physiotherapy services tailored to the needs of each user, and personal transportation; the potential of integrating each specific service with pre-existing residential assistance offered to users and their families; the possibility of integrating the centre into the caregiver’s day off (Thursday afternoon and all of Sunday) and to safely manage the operations – such as assisted bathing – which in a family context may lead to a high risk of injury (such as the fracturing of femurs and humerus bones which could occur during assisted bathing in improperlyequipped rooms with just one caregiver.) The centre can also be integrated with activities of co-housing: in fact, the users of the second structure could improve their possibilities of integration and socialization by participating in the daytime activities; the organisational flexibility, which ensures users a well-redistributed load in line with the day-time ones for non self-sufficient individuals (medium organizational complexity; medium assisted-living complexity) but employs a variety of professional resources with the chance of employing specialized healthcare resources (lp, physiokinetic therapy, psychologists) only when they are necessary.

The fourth point is enacted through the design, experimentation, validation and standardization of a residential structure developed in order to manage the post-acute phases of home-care services. The “Casa di Michele” is a service that ensures standards superior to the RSA basic module. It is defined by the temporary hospitality service that offers 60 + 60 days maximum of hospitality to the elderly who, after being discharged from the post-acute phase, would not have convenient home assistance. This includes home-care assistance to the elderly in case of the need to provide support and relief to their caregivers. Other elements that characterize the model are: the small dimension (12 units); the recreation of residential and organisational formulas similar to a family environment; the commitment to act in service and support of a specific district; the high social quality, which is the result of a braiding of a family model, a small scale environment, a systematic and massive appeal to volunteers, and finally considering as reference point a community context. Experimentation – which stemmed from a specific licensing measure authorized by Regione Toscana with the active support of the Usl8 – managed to deliver an apprised response to the demand to manage the relief of caregivers, but also to manage the post-acute phases of the elderly, taking on also the profile of a structure capable of treating intermediate care of patients arriving from geriatric orthopaedics, cardiology, and internal medicine wards.

In practical terms, these actions were developed while taking into consideration the following: the set up of a specific project with its own business plan; the purchase and the preparation of a living area, thanks also to a significant match-funding of the Fondazione Ente Cassa di Risparmio of Florence; the stipulation of specific agreements – through a procedure of co-elaboration – with the Conferenza dei Sindaci of the area of Arezzo, and also with Usl8; the authorization by the Giunta Regione Toscana to test the new model; the management of the experiment through continuous monitoring and evaluation activities in itinere and ex post (during and at the end of the testing phase).

The experience highlighted a very interesting fact for the profiling of public policies and of service models. There is a widespread criticism against residential facilities of big dimensions, which frequently are perceived as inadequate in guaranteeing respect toward each elderly individual; according to the aforementioned observations, the management of the Casa di Michele reported that the children of the elderly exercised considerable pressure in order to push the administration to accept their relatives permanently. This need was visible through the planning of the co-housing for non self-sufficient individuals on a small scale and the reproduction of the self-managed family model by the families themselves.

The fifth point – which in some ways closes the circle – is relevant to the designing, experimentation and validation of co-housing formulas for the non self-sufficient elderly people on the small scale (up to a maximum of 8 people), the reproduction of family type housing formulas, the homogeneity of the needs and of the pathologies of the residents, and the active involvement of the residents and of their relatives in the management of the structure. The working plan, in fact, calls for the involvement of the recipients in the constitution of associations of social promotion, through processes of action-research, with the aim of managing the specific co-housing, delivering, also in this case, the principles of social innovation and a different approach to the one that is triggered when money is given in exchange of services. In practical terms, these actions were developed while taking into consideration the following: the co-housing model of which experimentation was approved by the Giunta Regionale Toscana; the model of statute, deed of incorporation, the internal regulation of the Association, which self-manage the co-housing and the account model.

While referring to the management of the processes of construction and referring to the action-research process (Levine), we have developed a set of operational guidelines that envision: the deployment of action of information geared to the involvement of local public stakeholders and organizations that represent the beneficiaries; the deployment of a local communication campaign on the initiative with the goal of gaining a larger number of beneficiaries; the identification, mediated by the collaboration with municipalities and the UVM zone, of the individual-family potentially interested in participating directly to the initiative; the development of processes open to deepening and establishing a co-elaboration brought about by those interested in validating, modifying and sharing the work hypothesis already elaborated and approved by the Regione through the work of entertainers and facilitators; the start-up of experiences for which Koinè puts forward its own structures as professional resources.