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© koinè cooperativa sociale di tipo A Onlus
Social Innovation Koine - Cantieri di innovazione sociale

Several studies highlighted that the lack of tailored initiatives aimed at re-thinking and re-organizing the approaches and the structure of the supply system, on one hand, could determine the loss of the “universal trait” that characterizes the Italian welfare system and, on the other hand, could also lead to a decrease in social cohesion.

An exponentially aging population, the changes to the social structure, and the progressive decrease of public financial resources are the three causes that lead to the necessity of re-defining the approaches to the maintenance and care of isolated, vulnerable, frail, and non self-sufficient elderly people. Several studies highlighted that the lack of tailored initiatives aimed at re-thinking and re-organizing the approaches and the structure of the supply system, on one hand, could determine the loss of the “universal trait” that characterizes the Italian welfare system and, on the other hand, could also lead to a decrease in social cohesion. According to our vision, we can recalculate this trajectory by treating the following “stars” as reference points: • what we call “domiciliarietà” (domesticity) or the organisation of services, actions and interventions within the family and domestic environment, preventing risks connected to elderly people eradication from their houses and their institutionalisation in impersonal structures.
• the innovation of products and rethinking the approaches to processes, or the adjustment of the modes of production and the implementation of new models of services in order to better respond to different needs; • the integration of services, activities, and programs which aim towards an overall improvement of the system’s capacity to respond to the demand and to optimize the use of its resources; • the pertinence of the response to the needs of the individual; • the search for sustainability; • the promotion of local community participation in developing systems of opportunities; • the tireless defence of the public nature of the welfare system and the complete refusal of a market-oriented approach.
The fulcrum of our line of reasoning lies within the idea of “domesticity”, as defined earlier. The qualitative and quantitative strengthening of this resource could lead to: • maintaining individuals in their everyday environment, while supporting them in the process of preserving their remaining independence and simultaneously avoiding institutionalisation; • supporting relatives and those who usually take care of the elderly people; • augmenting solutions for sustainable services for families and for the welfare state; • calibrating the services offered by the public sector at its expense to the differing needs of the people and tailoring them to the contexts in which we operate. All of the aforementioned elements allow us to concretely grasp the differences between operating in a metropolitan area or in a large city. They also shed light on the difference between those contexts and a mountain, rural, or suburban community and in the outermost regions of the areas in which we operate; • creating opportunities for the regularisation and requalification of undocumented employment in the field of family care and, thus, creating new chances for the development of a qualified labour force.
The processes of the innovation of products and approaches should – in relation to the existing needs – also concern: the supply of day-care services; the supply of temporary residential services finalised to the management of post-acute phases; the need for caregiver relief; the need for a different typology of long-term residential services than those regulated by the RSA. The spread of such resources will allow, on one hand, the reinforcement of the capacity of home services to react on the basis of the needs of the users and of their families. On the other hand, it will allow the design of services suitable to the needs of individuals living in mountainous and rural municipalities, and those living in small cities. In fact, in all of these contexts, the classical model of the RSA cannot be applied for reasons connected to its size.

Planning actions are based upon a complex vision, which can be summarized as follows:

Seeing suffering, and perceiving the need for help

The area of discomfort and of social suffering has been broadened by a mix of several factors: the economic crisis, the increase of unemployment levels and temporary employment, cuts to local finances, the increase of social vulnerability, the increase of chronic fragility and situations of lack of independence.

Toward an ethical and political leap

Considering the extent of social suffering and the increasingly loud cry for help from the most vulnerable and isolated members of society, each of us is called to push for an ethical and political leap. We define this leap as Ethical because every individual must act within the limits of their capacity to stem social suffering. We also define it as Political in order to recognize the evidence (the increasingly limited institutional power compared to the growing demand; the impracticability of a business oriented solution; the need to construct new paths for social mobilization) and act accordingly. The main point of this political vision is the defence of the public and universal nature of the welfare system. The response to citizenship rights cannot be subject to a market-based system, nor to the widespread practice of charitable approaches. This defensive approach must be pursued through strengthening leadership, applying the law equally and uniformly, and guaranteeing the efficacy of the system. At the same it must promote innovation and active participation of local communities and citizens incentivizing them to take part in developing, enacting, and evaluating the services.

Health as a common good

The starting point is considering health as a common good as the first and foremost political factor. Thus, it represents a good that citizens, their organizations, and local communities can and should contribute to regenerating, extending, and improving, while considering the subsidiary perspective.

Promoting participation and active citizenship

We consider essential the development of active participation of citizens and of community organizations in order to promote innovation and new qualified answers to social needs. This can be achieved through the extension of self-management services, which, within the boundaries of public law, are capable of increasing the contribution of beneficiaries. While implementing the methodology of Action-research, it has been already shown that the objective, although difficult, can be reached despite its complexity.

Critique of the “ratio market”

A clear understanding of the situation leads us to consider the “ratio market” as an unfeasible solution. This means that purchasing services within the boundaries of a “free” market cannot be considered a viable solution. The evidence demonstrates that the majority of the potential beneficiaries cannot afford the costs of regulated and qualified standard services; the diffusion of undocumented labour within family care services is not a coincidence. Also, the number of people who have given up medical care as a result of financial difficulties has risen significantly. A basic analysis of the market trends demonstrates that the tendency toward commercialization will penalize further the Italian southern, rural, and mountain regions, along with inland areas.

Carrying out systemic and integrated approaches

Based on the aforementioned considerations, Koinè’s proposal was developed on a systemic approach and also through a logic of integration, which complies with the needs of families and beneficiaries, while strengthening the overall feasibility of each and every planned initiative.

Carrying out models that can be repeated and scaled

Each project, and the entirety of them, is designed to be repeated. They are tailored on widespread needs and the hypothesised solution can be adjusted to several different local contexts. It is possible to scale them because their logic can be applied to different dimensions.

Connect welfare to active labour policies

It is also possible to notice the significance that the actuation of the planned actions can have from the point of view of the job market, which directly affects the ability to generate a qualified labour force, stable positions, and better employability for caregivers.