THE ESSENCE PROJECT

Transport services

Evidence

Evaluation of Redcar and Cleveland Community Agents Project: Outputs and Outcomes Summary Report
Watson P and Shucksmith J Social Care Institute for Excellence, London. 2015

The Community Agents Project, a programme jointly funded through health and adult social care services, is an innovative approach to meeting the social needs of the elderly and vulnerable population. Community agents act as a one-stop shop, signposting people to the appropriate service that meets their needs. This could be an organisation or voluntary group that can help with shopping, arrange transport to the GP surgery or hospital appointments, help to complete forms, offer encouragement to maintain a care plan, organise a befriender, accompany to a local social activity or signposting to other agencies. The project has received a total of 486 referrals across the borough of Redcar & Cleveland for the period September 2014-September 2015, generating positive outcomes in the following areas: maintaining independence; faster discharge from hospital; reducing admissions to hospital; reducing isolation; improved financial status; appropriate use of health and social services; cost saving; and increases in community capacity. The report estimates a social return on investment of £3.29 for every £1 invested in the Community Agents Project

How can Local Authorities with Less Money Support Better Outcomes for Older People?
Centre for Policy on Ageing Joseph Rowntree Foundation, York. 2011

Research shows that older people want and value low-level support – ‘that bit of help’ – but the benefits of investing in this are realised over many years, making it harder to prove impact and protect funding in the face of severe pressure on spending.

This ‘Solutions’ published by Joseph Rowntree Foundation provides examples of imaginative, affordable and effective ways of supporting older people’s health, well-being, social engagement and independence. It highlights projects with some local authority involvement whether as lead commissioner, subsidiary partner, or through small grants or seed-funding.

The projects demonstrate the importance of:

involving people who use support and services in shaping them;
investing in collective solutions, small grants or seed-funding for self-help groups, and developing local markets to provide the support people want and value;
greater emphasis on the assistance that older people need and choose, and their experiences rather than on conventional social care and/or services;
developing place-based approaches that reflect the whole of people’s lives, and delivering value for money, for example by including transport

Preventing Loneliness and Social Isolation: Interventions and Outcomes. SCIE Research Briefing 39
Windle K, Francis J, Coomber C Social Care Institute for Excellence, London. 2011

This is one in a series of research briefings about preventive care and support for adults.

Prevention is broadly defined to include a wide range of services that:

promote independence
prevent or delay the deterioration of wellbeing resulting from ageing, illness or disability
delay the need for more costly and intensive services.

Preventive services represent a continuum of support ranging from the most intensive, ‘tertiary services’ such as intermediate care or reablement, down to ‘secondary’ or early intervention, and finally, ‘primary prevention’ aimed at promoting wellbeing. Primary prevention is generally designed for people with few social care needs or symptoms of illness. The focus therefore is on maintaining independence and good health and promoting wellbeing. The range of these ‘wellbeing’ interventions includes activities to reduce social isolation, practical help with tasks like shopping or gardening, universal healthy living advice, intergenerational activities and transport, and other ways of helping people get out and about.

Just as the range of wellbeing services is extensive, so too is the available literature examining how well they work. For this research briefing, the focus has been narrowed to the effectiveness and cost-effectiveness of services aimed at preventing social isolation and loneliness. Our review question was: ‘To what extent does investment in services that prevent social isolation improve people’s wellbeing and reduce the need for ongoing care and support?’

While ‘social isolation’ and ‘loneliness’ are often used interchangeably, one paper examined the distinct meanings that people attach to each concept. ‘Loneliness’ was reported as being a subjective, negative feeling associated with loss (e.g. loss of a partner or children relocating), while ‘social isolation’ was described as imposed isolation from normal social networks caused by loss of mobility or deteriorating health. This briefing focuses on services aimed at reducing the effects of both loneliness and social isolation. Although the terms might have slightly different meanings, the experience of both is generally negative and the resulting impacts are undesirable at the individual, community and societal levels.
Key messages

Older people are particularly vulnerable to social isolation or loneliness owing to loss of friends and family, mobility or income.
Social isolation and loneliness impact upon individuals’ quality of life and wellbeing, adversely affecting health and increasing their use of health and social care services.
The interventions to tackle social isolation or loneliness include: befriending, mentoring, Community Navigators, social group schemes.
People who use befriending or Community Navigator services reported that they were less lonely and socially isolated following the intervention.
The outcomes from mentoring services are less clear; one study reported improvements in mental and physical health, another that no difference was found.
Where longitudinal studies recorded survival rates, older people who were part of a social group intervention had a greater chance of survival than those who had not received such a service.
Users report high satisfaction with services, benefiting from such interventions by increasing their social interaction and community involvement, taking up or going back to hobbies and participating in wider community activities.
Users argued for flexibility and adaptation of services. One-to-one services could be more flexible, while enjoyment of group activities would be greater if these could be tailored to users’ preferences.
When planning services to reduce social isolation or loneliness, strong partnership arrangements need to be in place between organisations to ensure developed services can be sustained.
We need to invest in proven projects. Community Navigator interventions have been shown to be effective in identifying those individuals who are socially isolated. Befriending services can be effective in reducing depression and cost-effective.
Research needs to be carried out on interventions that include different genders, populations and localities.
There is an urgent need for more longitudinal, randomised controlled trials that incorporate standardised quality-of-life and cost measures.

Releasing Somerset's Capacity to Care: Community Micro-providers in Somerset
Community Catalysts Community Catalysts, Harrogate. 2017

An evaluation of the Community Catalysts project in Somerset. Community Catalysts is a social enterprise working across the UK to make sure that people who need care and support to live their lives can get help in ways, times and places that suit them, with real choice of attractive local options. In Somerset, the project aimed to increase the number of flexible, responsive, high quality local services and supports that can give people real choice and control over their care. As part of the project Community Catalysts has worked with partners to develop the Community Somerset Community Micro-enterprise Directory. The directory features 275 community-enterprises all of whom offer services linked to health, care or wellbeing. 223 offer help to older people to enable them to stay at home. 58% of these providers offer personal care services, including for people with more complex care needs. This care is often provided alongside home help, domestic and social support. 42% offer home help type services including support, companionship, domestic help, gardening, cleaning, trips out, transport. 3,500 hours of care a week are delivered by Community micro-enterprises in Somerset. Community Catalysts also undertook a survey of 45 families who have used both a micro-provider and a traditional domiciliary agency. The results showed that community micro-providers are able to deliver strong and valued outcomes for the people they support, and significantly outperform traditional domiciliary care delivery. The evaluation indicates that 32 community micro-enterprises in rural West Somerset are delivering £134,712 in annual savings. Projected across the 223 micro-enterprises supported by Community Catalysts in Somerset, the project delivers: £938,607 in annual savings; 56% of people supported use direct payments, showing £525,619 of direct and ongoing annual savings to the council.

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