Barcelona Metropolis

The Vila Veïna municipal initiative was created with a view to building environments where care takes place as part of a community, rather than individually. Vila Veïna acts as a step further from the social superblocks, aiming to tackle care from small territorial units that offer local services, support and well-being, both for carers and for those who require care.

‘I feel lonely quite often. I’m glad it’s Thursday so I’ll have company’. This is Pedro, a user of the Vila Veïna centre in the neighbourhood of Vilapicina i la Torre Llobeta, in the district of Nou Barris. There are a lot more people like him, who need support or assistance to carry out many basic tasks. Though he is not considered dependent and goes about his life more or less autonomously, a few months ago, he and his daughter decided that he needed someone to help him in the home. Since then, both Pedro’s and his family’s time have been taken up by accepting his fragility, searching for someone reliable, starting the process of hiring someone with decent conditions, and activating and generating a network so that he does not become dependent prematurely.

Pedro’s and his loved ones’ experiences are extremely common. To support care processes, to facilitate spaces for well-being and respite, and to offer collective activities that build a community are just some of the aims of the Vila Veïna project, a pioneering municipal initiative created with a view to building environments where care takes place as part of a community, rather than individually. Vila Veïna aims to tackle care from small territorial units that provide local services and support resources, both for carers and for those who require care.

This project is no flash in the pan. It has emerged from a process of analysis and reflection around the need to implement changes and organisational improvements in the management of a key service that is essential to the city: the Home Care Service (SAD, by its initials in Catalan). It all started six years ago, when an in-depth analysis of SAD was carried out. At that time, this service, outsourced by the City Council, had seen eight-fold growth in its number of users, since the implementation of the Law on Dependency. It had become the second biggest contract within the City Council in terms of economic volume, and the biggest when it came to staff numbers.

The growth of SAD and its funding system (with a contract-programme with the Government of Catalonia and between the Government of Catalonia and the Spanish State, based on hours of service provided) had generated a model with serious shortcomings, in terms of both the employment conditions for the professionals providing the services and the conditions experienced by the dependent people and their families.

The concentration of families’ demand for the service in the morning (80% of demand was for services lasting one to three hours per day between eight in the morning and one in the afternoon) resulted in most employment contracts being part-time. The type of working day, combined with a poor collective labour agreement (a scourge resulting from the lack of social recognition of care tasks), led to professionals being paid very little. These elements, on top of the solitude and isolation these professionals experienced in their work, resulted in high absenteeism and employee turnover rates, which had a direct impact on service provision. Imagine what it feels like to have the person who comes into your home to help you to shower or make your lunch change every other week.

SAD’s growth predictions were high: partly because of demographics (350,000 people over the age of 65 in Barcelona, 90,000 of which live on their own) and partly as places in the alternatives – care homes or day centres – were very limited in the city, with waiting lists that could easily exceed three years (more time than the average person lives in a care home). What could we do? We had to think of new solutions that both fulfilled growing demand for the service and improved employment conditions. What did we have? We had density and proximity, characteristics specific to cities, now referred to as the ‘fifteen minute city’; mobility superblocks, an urban innovation made here in Barcelona; and an organisational system we discovered in the Netherlands, namely the Buurtzorg home care model.

The Buurtzorg model

The social organisation Buurtzorg showed us how to put together self-managed SAD teams that could look after around fifty people, with a more flexible, higher-quality model for workers. The city’s density meant that many groups of people requiring care lived very close by, less than a five-minute walk from each other, sometimes in the same building or block of buildings, and always in the same small area, which we named ‘SAD superblocks’ or ‘social superblocks’.

The idea is simple, but powerful: elderly people want to live in their home and their neighbourhood for as long as they can, but as their health deteriorates due to age or chronic illnesses, they need more and more services to continue to live autonomously, but this should not necessarily mean that they need to move into a care home. Nor should this create a high degree of dependence on a family member, who tends to be a woman and often has to put their life on hold to become a full-time carer.