Sociocracy and Residential Care

Commentary by Anna Betz on an article by Harris Kaloudis originally published by Sociocracy For All.

The Living Well Group of Residential Care Homes for Elders embraces a deliberately developmental model

I was excited to learn about this ground-breaking case study of the Living Well Group, a not-for-profit organisation offering residential care to older adults in Vermont, USA.

This case study was written by Harris Kaloudis in November 2017 as part of his contribution to the Sociocracy Leadership Training run by Sociocracy For All.

It shows how the introduction of sociocracy into care organisations that had previously operated under different systems leads them to outperform industry averages in

  1. the quality of care provided,
  2. employee wages, and
  3. financial sustainability.

The Group has embraced sociocracy as its governing and operating model because, among other reasons, sociocracy is deliberately developmental for people and for the organisation; sociocracy complements and supports person-centered, holistic care and support; and ​sociocracy supports a fluid, effective, and values-based way of team working.

Of course there was also a set of challenges: Sociocracy is an unfamiliar, counter-normative way of governing and running an organization, and thus required that the organization underwent a process of culture and operational change.  Sociocratic ways of working might not be desirable for all employees; introducing sociocracy might require external support from facilitators or consultants as well as internal support; and finally, the process of introducing sociocracy might take place in the difficult context of addressing the previous model’s failures as inherited at the time of change-over.

This case study is useful if you are interested in:

  • Health and social care
  • How sociocracy supports and complements person-centred, holistic, effective care
  • The organisational benefits of working sociocratically
  • The challenges of introducing sociocracy into a care organisation

Some important conclusions which became apparent thanks to the study were that introducing sociocracy might require external as well as internal support, coaching, clear intention, and competency in listening and dialogue.

For example, the sociocratic transition at Ethan Allen (one of the carehomes) was supported by a certified sociocratic consultant and a consultant-in-training. Two employees from the Bristol facility (another carehome) were also brought in to help. Care staff and staff in key supporting roles were trained in non-violent communication. External and internal expertise and training added to the resource demands and the complexity of transitioning an organisation to sociocracy.

For more about sociocracy, see this one of the several articles published by Enlivening Edge Magazine

Published with permission from Harris Kaloudis, reach him via Twitter @Harri_Kaloudis or by email at [email protected].


Holistically Speaking TV YouTube channel, (09 November 2013), Living Well: A Holistic Model for Eldercare with Paul Kervick [Available at:; Accessed 06 December 2017]

Dr. Sheella Mierson and Elana Kann, 2012. Got DG? Healthy Transformation in an Eldercare Facility​. The Sociocracy Consulting Group [Available at:; Accessed 06 December 2017]

Living Well Group webpage:​

AnnaAnnas background is in Health and Social Care with training in Herbal Medicine, Socialwork, Mindfulness Practice, Transparent Communication, and Systemic Family Therapy. She practices a pro-active evolutionary approach to Health and Wellbeing and leads on projects in the UK National Health Service using Mindfulness and diet for people suffering from chronic inflammatory diseases like diabetes and dementia. Her passion for building thriving and sustainable communities inspired her to co-found the HealthCommonsHub. She feels at home in places where individual, communal, organisational, and social evolution meet, and where people support each other in becoming whole and feel enlivened.


  1. it’s really impressive to see an organization that provides a higher quality of care for elders, pays staff better wages, and continues to be economically viable as a non-profit. Kudos to all involved with the Living Well Group. Are there any studies available that measure this success, showing by how much they outperform industry standards? This information would be very helpful in persuading other organizations to consider the Sociocracy model.

  2. Hi Rudy, I am the author of the case study. I am not aware of any studies undertaken by external people (academic or otherwise) and published in peer-reviewed journals or as stand-alone reports (so called ‘grey literature’). As I hope is clear from my text, all information used in the case study comes from Living Well representatives and from the two sociocracy consultants who supported Living Well. Regarding financial efficiency, the main measures are: 1) the impressive percentage of people on Medicaid (near 80% if I remember correctly) as opposed to an estimated industry average of 15%, and, 2) the higher than industry average wages. Regarding quality of care, the main measures are: 1) reduced spend on medication per patient; 2) quality (provenance (local), agriculture method (organic), freshness, variety) of food provided; 3) variety and number of activities and services offered; 4) community involvement; 5) participation of residents in the governance and running of the care home.

    Dee DeLuca from the Living Well Group will be speaking in this online conference if you would like to have a discussion with her:

    Unfortunately documenting their operations and outcomes is a major challenge for many organisations because of the expense, time, skills and resources required. And sadly universities often stay well within the ivory tower.

    Warmest wishes,

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