History of SCA
The National Health Service and Community Care Act 1990 led to the transfer of funds from the NHS to local authorities for community care. However, local authorities were required 
to outsource 80 percent of community care services and this created a business opportunity for entrepreneurial care providers. In Southampton, the local Council for Voluntary Service (CVS) was already delivering a small number of transport and daycare services but spotted an opportunity for a local third sector organisation to get more heavily involved in service delivery. As a result, in 1991 it formed SCA Community Care Services . (Pictured Southampton Council Community Service mid 1980s, from left to right, Founder CEO: Brian Strevens, and two now senior local council officers, Roma Andrews and Kathryn Rankin).
Initially the company modelled itself on housing associations which it perceived to be a best practice vehicle for ‘not-for-profit' service delivery. The new organisation took with it the contracts the CVS had previously held but made the decision to focus on homecare services in particular. An approach was made to its local Health Authority for a small amount of development money, with a promise never to come back asking for more, and the company was given £90,000 to get going.
SCA's first contracts were from Southampton City Council, soon followed by Hampshire County Council, Bournemouth City Council and a number of other local authorities across the south coast and by 2000 it had a £4m turnover and 400 employees. At this point in time the board chose to become less involved in day to day management and more strategic in its focus. It took an ‘inward look' at the company's direction and considered various options: to become the social care arm of a housing association; to expand the care business geographically; or to diversify the range of services it offered. The decision was taken to opt for diversification and SCA began to explore new business ventures.
The first development following the organisation's new strategic direction was the Quinn Centre. The centre was established to provide NVQs and other training courses for carers in response to a shortage of high quality, affordable training within Southampton. Set up primarily to train SCA's own staff, about half of the centre's work now involves training local authority care staff.
At around the same time, SCA began to recruit care staff from EU accession countries to address local shortages of nurses and care workers. The company was determined to ensure staff from overseas were properly supported, both in terms of training and settling into life in the UK. It established a programme for new recruits including language training, transport to and from the airport, help with setting up a bank account, and the offer of a loan to cover the deposit on a house. SCA has also placed more than 150 health and social care staff with other employers, primarily with local authorities such as Hampshire County Council.
One unexpected discovery SCA made as a result of its recruitment drive was that a surplus of newly trained dentists existed in many Eastern European countries, where they were struggling to set themselves up in private practice. SCA was aware of severe dental shortages in areas of the south coast and contacted a number of PCTs to see if they would be interested in a new approach to the provision of NHS dentistry in these areas.
The proposal met with an enthusiastic response and in 2005 SCA secured financial support from two PCTs to set up its first dental surgeries. SCA Trafalgar Dental Services was established to house the group's dental services and the company has since opened an additional four surgeries, taking its total to six. The company is registered as a ‘Dental Body Corporate', enabling the signature of contracts directly.
Governance and legal structure
SCA Community Care Services is an industrial and provident society. It is both the holding company for the SCA group and the provider of the majority of the group's services is social care.
Other companies in the group include SCA Community Support Services, a company limited by guarantee, the Quinn Centre, a company limited by guarantee and a registered charity, and SCA Trafalgar Dental Services, an industrial and provident society. There is common membership of the board across the group, made up of the chief executive and nine non-executive directors.
Board members are appointed by recommendation and chosen from a range of backgrounds to ensure an appropriate mix of skills. The senior management team, who attend all board meetings, have various powers devolved to them, and these have expanded in scope as the team has grown with the organisation. An Audit Committee has also been set up which reports directly to the board. There are no formal governance channels for staff to input into strategic decision making, and staff involvement in the running of the organisation varies across the different companies and services. For example, staff in SCA Healthcare, which provides dental services, meet primarily on a surgery by surgery basis, except for clinical governance issues which are dealt with at a corporate level, whereas in SCA Community Care Services - the largest of the companies - decision making is devolved to individual teams delivering area based services.
Approach to service delivery
The SCA Group's aim is to provide effective solutions for the health and social care sector. SCA Community Care Services and SCA Support Services (which operates the group's community transport services) continue to account for the majority of services the group provides, with domiciliary care representing over 64 percent of group turnover, day care accounting for fifteen percent and transport for another ten percent. However, its strategy of diversification since 2000 means that other companies within the group represent a growing proportion of turnover.
The group's approach to developing new services is to work in partnership with local authorities and other clients to identify gaps in provision and design new services to meet them. For example, its ‘Welcome Home' service was set up to ease the transition from hospital to home and assist the Health Authority in increasing the number of hospital beds available, and its ‘2 to Care' service was commissioned by Southampton City Council specifically to meet the needs of high dependency clients who require an additional care worker.
Measuring performance
SCA Group has a business plan with auditable Key Performance Indicators around growth, contracts retained, financial performance, quality of service, health and safety and staff recruitment and retention. Targets are devolved to the relevant member of the executive team.
There are different performance management regimes in place across the group in line with the particular business objectives of each company. For example SCA Community Care Services and SCA Support Services are ISO 9001:2000 accredited while the Quinn Centre, with its emphasis on training and development, chose to implement the ‘Investors in People' standard. Each contract the group holds also has its own measurement and reporting requirements and in addition the group undertakes its own internal ‘quality audit' in which a member of staff from a different part of the organisation looks at each contract and talks to the managers, users and commissioners.
In January 2007 SCA Group was selected to take part in the Department of Health's ‘Pathfinder' social enterprise programme. Pathfinders are eligible for financial support and access to business advice and training, and in return they take part in a research and evaluation exercise, with learning from the programme shared across the health and social care sector to enable others to benefit from their experience. The group has an environmental policy in place and is aiming to become carbon neutral.