Contents Background About the project Evaluation information Learning Project Development
1. Background1.1 Purpose of the evaluation Ciaran Bingham Foundation Trust has undertaken an evaluation of its services. The purpose of the evaluation has been to assess the effectiveness of the approach for addressing social isolation amongst older people. In particular; the evaluation has sought to assess: The outcomes achieved by the project; The effectiveness of the approaches Areas for improvement. The methodology has included the capture of quantitative and qualitative data. To this end we have: Reviewed activity data; Reflected on the challenges experienced and how these have been responded to; Undertaken a survey (41 responses) and 1-1 interviews with 35 service users Undertaken telephone interviews with 2 volunteers 2. About the project2.1 History, Aims, Activities The Ciaran Bingham Foundation Trust (CBFT) is a registered charity founded to support older people in the South Leeds community when they are most socially isolated at weekends, evening and bank holidays. The organisation was set up in 2011 by family and friends in memory of Ciaran, a young man who died in an accident at the age of 19.
Very quickly the charity identified social isolation amongst older people as a major issue and in particular a need for "out of hours" services and social activities for older people to take place in the evenings, at weekends and over holiday periods such as Christmas. It was also identified that there was a need to supplement the weekend activities and bad weather services provided by statutory and other voluntary sector organisations. CBFT seeks to meet this need by running breakfast and lunch services on Saturdays and Sundays in Holbeck, Beeston, Tingley and Belle Isle in South Leeds:
The breakfasts and lunch sessions provide a hot nutritious meal at a low cost and are run by volunteers, with the meals prepared by experienced cooks. The sessions provide the opportunity for individuals to socialise, play games and do other activities they are interested in. For example, one of the volunteers leads an arts and crafts session for the group, making Christmas cards. The service users also go on day trips arranged CBFT, most recently a Christmas meal in Skipton as well as visits to the Yorkshire Coast.
In addition to the above activities, CBFT also provides Christmas lunches, home delivered meals during bad weather, informal telephone befriending and support.
For the purposes of this evaluation, we have focused upon the individuals taking part in the regular CBFT sessions, as this is where the majority of activity takes place.
2.2 The needs in the area At the time of the 2011 Census, in Beeston and Holbeck, there were 374 individuals categorised as the ‘oldest old’ (aged 85+) and 1144 people of pensionable age living alone. City and Hunslet ward had 278 people aged 85 + years and 863 single pensioner households. This ward had seen a growth in population from 18000 in 2001 to 34000 in 2011 because of the expansion of city centre and student housing and now almost half of its population is now aged 16-29 years, leaving older residents marginalised as a very small minority in an area which has experienced profound change. Middleton Park has 383 people aged 85+ and 1311 single pensioner households. Information provided by Leeds City Council has estimated that there are around 8,500 people living in the city with dementia. This represents around 8% of those aged 65 and above. Over the next 15 years, it is anticipated that the number of people with dementia in the city will rise by 40% to 12,000. A significant proportion of people living in South Leeds live in deprivation. According to the West Yorkshire Observatory, some 36,500 individuals live in the ‘deprived quintile’. Child poverty is high with 40% of children growing up in poverty in some areas e.g. Middleton Park. To demonstrate the statistics more starkly, according to Leeds City Council a staggering 56% of the Leeds deprived population live in the Inner South area of the city.
2.3 Social isolation and older people In 2016, CBF held a survey of older people to understand better what their needs were. In total, 41 individuals who currently use the CBFT service responded. Individuals were asked to indicate what they would be doing at the weekend, if they weren’t using the CBFT service. The table below outlines their responses. If you didn’t come to this session today, what do you think you would be doing/feeling? (Please tick as many statements as you think are appropriate)
I would be spending time with friends and family 9 I would be pursuing a hobby 5 I would be quite happy at home doing nothing 4 I would feel lonely 25 I would feel bored 24 I would feel anxious 19 I would not have any one to speak to all weekend 19 I don’t think I would leave the house 17 I don’t think I would eat properly 23
The data above demonstrates the stark realities that face the older people CBFT seeks to support: Less than 10% felt they would be happy at home if they weren’t attending the CBF session; Just 12% said they would be pursuing a hobby if they weren’t attending the CBFT session; Less than 22% said they would spent time with friends and family if they weren’t attending the CBFT session; This experience is reflected nationally. The Age UK Evidence Review on Loneliness July 2014 highlighted the following key statistics for the experience of loneliness for older people in the UK: Over 1 million older people say they are always or often feel lonely Nearly half of older people (49% of 65+ UK) say that television or pets are their main form of company Loneliness can be as harmful for our health as smoking 15 cigarettes a day People with a high degree of loneliness are twice as likely to develop Alzheimer’s as people with a low degree of loneliness 86% of over 65s say they are satisfied with their personal relationships. This is the lowest of all age groups. Only 46% of over 65s said they spent time together with their family on most or every day, compared to 65-76% for other ages. 12% of over 65s said they never spent time with their family. Over 65s also spent less time with friends: only 35% spent time with friends most or every day in the last 2 weeks, and 12% never did. People who took part in more health-maintaining and independence-maintaining behaviours were less likely to feel isolated and more likely to feel that their community was a good one to grow old in. Nearly half (49%) of all people aged 75 and over live alone 9% of older people feel trapped in their own home 6% of older people (nearly 600,000) leave their house once a week or less 30% say they would like to go out more often According to research for DWP, nearly a quarter (24%) of pensioners do not go out socially at least once a month Nearly 200,000 older people in the UK do not receive the help they need to get out of their house or flat 17% of older people have less than weekly contact with family, friends and neighbours 11% have less than monthly contact 41% of people aged 65 and over in the UK feel out of touch with the pace of modern life and 12% say they feel cut off from society
A recent report by the British Red Cross and the Cooperative; Trapped in a Bubble (2016) also outlined the impacts of loneliness and the urgent need to address it in our society: Biological impacts: increased fatigue, low levels of wellbeing, lower energy; Psychological impacts: stress, anxiety, mood disorders, hypervigilance, low confidence, negative emotions, suicide ideation; Social impacts: shutting themselves off, engaging less, taking less care of appearance and hygiene;
3.0 Evaluation Information3.1 Levels of participation Data collected by CBFT shows that during the period 1st December 2015 – 30th November 2016, 683 people received support from the organisation either through attending weekly/monthly breakfast and lunch sessions, or through one off events such as Christmas lunches. This evaluation has focused upon the people who have attended regular activities as it is this group that can be most accurately assessed in relation to the outcomes achieved. However, the level of engagement overall should not be dismissed as it is through activities such as the Christmas lunches that individuals eventually become engaged as regular participants. DemographicNumber
5.2 Service user surveys In 2016, CBFT surveyed the existing service users to try to understand, what, if any, difference had been made to their lives as a result of their support. The survey asked them to rate the level of change in their lives across a range of indicators (using Likert Scaling) and these are outlined in the table below: Since you started taking part in the sessions, have you noticed a difference in any of the following areas of your life?
Significant improvement A bit of an improvement No improvement It wasn’t an issue in the first place
I feel less lonely than I did before 24 7 6 2 I am more active than I was before 20 7 12 0 I am less bored than I was before 26 5 7 1 I feel happier now than I did before 24 7 6 2 I have made new friends 33 3 3 0 I feel more physically well than I did before 13 12 13 1 I have been able to do new things 17 9 10 3 I feel more valued than I did before 25 5 7 2 I feel better in myself than I did before 23 8 7 1
5.3 Service user interviews We have also held interviews with 35 service users. Recognising the varying levels of health, cognitive ability and frailty of the individuals, the interviews were held during the sessions and focused on four key areas: Whether the project had made a difference to the lives of older people in the community; What the service users liked about the services; Whether there were any aspects of the service that wasn’t working so well; Whether there were any other kinds of activities the service users would like to take part in; Overwhelmingly, the service users felt that the project had made a difference to their lives. In fact, 100% of the interviewees were able to state ways in which a positive impact had been achieved. The three key areas were: The project provided opportunities to meet people, make friends and feel less lonely; The project gave the service users something to look forward to; The project provided opportunities for individuals to get out and about; When asked to describe the aspects of the service that individuals like the most, the most frequent statement was “everything”. Those who were able to provide more detail highlighted: the friendliness of the staff and volunteers, the quality of the meals provided, the additional activities and trips provided by CBFT throughout the year. Out of all of the interviewees, only one identified a need to improve the service by increasing the frequency of activities. No other suggestions for improvement were provided by those taking part. Finally, the interviews provided the service users with an opportunity to describe some of the activities they would like CBFT to run at the regular sessions. These included: Trips and overnight visits; Social events Games, raffle, bingo at the sessions as well as trips to Mecca Bingo Indoor bowling Arts and crafts Gardening and gentle physical activities 5.4 Volunteer survey A survey of the volunteers and the impact they had experienced as a result of volunteering was also conducted this year. There were nine responses and these have been outlined in the table below: Since you started volunteering with Ciaran Bingham Foundation Trust have you noticed any improvements in the following areas?
Yes – a significant improvementYes – A bit of an improvementNo improvement at allIt wasn’t an issue in the first place
I feel less lonely than I did before 3 4 1 1 I am more active than I was before 2 5 0 2 I am less bored than I was before 4 2 0 3 I feel happier now than I did before 5 1 0 3 I have learned new things/developed new skills 5 1 0 3 I have made some new friends 6 3 0 0 I feel more physically well than I did before 2 3 0 4 I feel more valued than I did before 6 3 0 0 I have more confidence than I did before 4 3 0 2 I am more employable than I was before 4 4 0 1 I think I have better mental wellbeing than I did before 3 4 2 0
The data above shows clearly that the volunteers who responded have experienced some real benefits as a result of working with CBFT. For example they have: Made new friends; An increased sense of value; Improved their employability Increased confidence and skills Reduced their own experience of isolation 5.6 Volunteer interviews Two volunteers were able to be interviewed as part of this evaluation exercise. They were asked to consider the needs of older people in South Leeds, whether any positive difference had been achieved by the organisation and also to describe their experience of volunteering for CBFT. Both volunteers felt that older people in the area were isolated, remarking that people in their own neighbourhoods as well as those who attended the sessions, often lived alone and rarely spent time with other people. They were able to indicate a number of weekday services for older people, but strongly agreed that during the weekends and holiday periods, these people would go without support were it not for CBFT’s intervention. They expressed concerns for the safety and wellbeing for older people in South Leeds, particularly during winter months and were keen to emphasise the additional work that CBFT does to provide further support such as through keeping in contact by telephone and delivering hot meals to people’s homes when the weather is inclement. “We definitely make a difference… If it wasn’t for us, they wouldn’t get a hot meal down them” Mrs A, Volunteer “Some people don’t see anybody else at the weekends, if we weren’t there, they wouldn’t talk to anyone at all” Ms B, Volunteer The interviewees were also keen to emphasise the positive difference they had experienced as a result of volunteering for CBFT and how much they had enjoyed it. They commended the flexible approach that the organisation takes which ensures that they can volunteer in ways which suit them and also the fact that the organisation takes the time to recognise and thank them for their support. They both held the founder and trustees in high regard and felt that they motivated, encouraged and supported the volunteers well and in particular listened to their ideas and supported them to develop and run activities. “We’ve just started an arts and crafts group. That was the idea of one of younger volunteers. Margaret and the team have helped her to get this off the ground… this will be just as good for the volunteer as it will be for the service users” Mrs B, Volunteer Both interviewees were asked to explain what kinds of an impact they thought they and their volunteers had experienced. They told us that the main areas of impact were: An increased sense of value and self-worth A chance to spend time with others Increased skills and confidence 5.7 Partner Feedback The project works with a range of statutory and voluntary partners which include (amongst many others): Leeds City Council – Adult Social Care; Older People’s Forum Hamara Healthy Living Centre Leeds Health and Irish Homes The Vale Circles All partners have been invited to provide their own feedback about the services CBFT operates. Six partners have written to the project to present their views about the service. Key aspects highlighted were: CBFT plays a significant role in addressing social isolation amongst the elderly in South Leeds; The willingness of the staff and volunteers to ‘go the extra mile’ The opportunity the services provide for volunteers to recognise deteriorating physical and mental health issues and signpost accordingly, helping to ensure the most vulnerable stay safe and well As Chief Officer, Commissioning, for Adult Social Care, and co-chair of the Leeds Ageing Well Board, Leeds Dementia Board and the Carers Partnership, I would like to comment on the valuable work of the Ciaran Bingham foundation.
The foundation goes way beyond the work of some traditional (albeit valuable) charities in that as well as directly supporting older people, they deliberately take those extra steps to support those less able to engage in mainstream activities. The foundation also uses a very broad range of interventions and support – from Dementia friendly cafes, to trips, to Xmas meals, to individual support and much more.
They harness the local power of many volunteers – making sure that any funding they get brings added value, and they are always willing to try new ways of working and to tackle new issues that affect local older people, be that loneliness, healthy living, nutrition or safety It is always a pleasure to engage with them Mick Ward, Adult Social Care, Leeds City Council
4.0 Learning4.1 What outcomes has the project achieved? The data collected through this evaluation process has shown that the service users, partners and volunteers feel that the project is making a tangible and positive difference to the lives of older people. In particular, the service users reported that they had experienced the most significant improvement in: Reductions in loneliness and isolation; Reductions in the experience of boredom; Increases in the experience of happiness Personal wellbeing; However, there were some areas where although some difference had been achieved, the level of impact was not as strong. These were: Increases in physical activity; Taking part in new things Improvement in physical health; The results of the volunteer survey also shows that they experience a positive difference too. For example, the volunteers highlighted improvements in feeling valued, confidence, employability, skills and social isolation. The project has a good track record of engaging socially excluded people and supporting them to take up their place in society and be part of their community. The project has worked with people with learning disabilities, young offenders, survivors of domestic abuse, older people living in sheltered accommodation and at least six out of CBFT’s volunteers have left the project to secure good jobs with leading employers in Leeds, such as: The Royal Mail, ASDA, NHS, B&Q, The Police P.S.O and Leeds and Bradford Airport (Catering). 4.2 What has worked well?4.2.1 Growth and cost effectiveness The project has grown rapidly since its inception in 2011 and in just the last year has supported 250 individuals through the regular breakfast and lunch sessions and at least a further 400 individuals have taken part in the Christmas lunches CBFT provides. CBFT has been transformed from an organisation initially reliant upon community donations to one which has successfully managed grants on behalf of a number of funders: Leeds City Council; LCC Housing; The Brelms Trust; Garfield Weston Sport Relief Financial summary Financial year end (FYE) Income Spending
31 Dec 2015 £72,702 £52,084 31 Dec 2014 £24,426 £20,834 31 Dec 2013 £40,847 £28,369
The project makes effective use of its volunteer resources and also pro-bono support (food donations) from local organisations in order to reduce costs. As a result, the unit cost for those older people regularly using the CBFT sessions is just £290 per year. Individuals able to use services independently are able to continue living in the community for much longer and so this unit cost represents excellent value given that the average weekly cost of residential care provided by Leeds City Council is £611 (Leeds City Council 2014). 4.2.2 Method of delivery The consultation with stakeholders identified that of most value to the service, was the friendliness and committed nature of the staff, trustees and volunteers. Partners and service users alike commented on the welcome and support they receive. “They make you feel like you are part of the family” Mr A, Service User The quality of the meals provided and the opportunity that eating together offers for social interaction was also highly commended by the service users. “It’s nice to eat and natter with others. Much better than cooking and eating on your own” Mrs B, Service User The approach employed by CBFT is particularly effective in reducing isolation because it enables the development of sustained, informal networks. Typical isolation reduction interventions tend to focus on volunteer-led befriending, which can leave an individual isolated whenever the volunteer befriender is not visiting. CBFT differs in this, because the befriending activity takes place between the service users, who have developed strong relationships with each other which continue beyond the individual CBFT sessions. Another area where the project is most effective, is in mobilising community support. CBFT capitalises upon the assets in the community, encouraging local people to volunteer, working in partnership, supporting the willingness of the service users to fundraise for them (a number of service users have pledged to join the Coast to Coast cycling fundraiser planned for next year) and regularly deliver flyers for CBFT in the community. Indeed, at least 15 service users now volunteer in the project directly. This not only enables the project to be lean and cost effective, it also ensures that: It can avoid duplicating other activities; It maximises the resources in the community Local people have influence and ownership over services for individuals in their community 4.2.3 Focus on the most in need The demographic analysis of the project shows that of the service users: 40% have a mental health problem, including people with dementia; 42% are aged 81 and above 20% have a physical, sensory, learning disability or other long term health condition The project is clearly engaging with individuals who have the most complex needs and who are often the most invisible in their communities, and therefore at the highest risk. Case Study: Ms J Ms J started attending her local CBFT lunch club in 2014. She lived on her own and had very little contact with her family. Within a few months she confided in one of the trustees about a health problem and was encouraged to go to the doctor. Ms J was very anxious and had no transport of her own. The trustee helped her to make the appointment and accompanied her to it and the subsequent tests.
Ms J was diagnosed with terminal cancer and would have been left to deal with the impact of the diagnosis and the palliative treatment, were it not for the dedication of the CBFT team. Every week Ms J was taken out for a coffee, she was supported to join the CBFT events and trips and CBFT continued to provide the hand of friendship, ensuring that she was not alone during her final days and moments
4.3 Which areas could be improved?4.3.1 Extend the range of activities further The consultation with stakeholders did not identify any aspects of the service that they felt was weak. Instead the suggestions for improvement concentrated on how the project could develop the additional activities to accompany the lunch and breakfast sessions. This should be a key focus for the project development as it was apparent from the survey findings, that the service users were not experiencing the same level of impact in relation to being physically active or opportunities to try new things as they had in other areas (such as reductions in loneliness for example). The service users and volunteers have identified a number of activities they want to continue as well as new things they would like to try. For example: Trips and outings Social events (such as fish and chips supper) Breakfasts and lunches Arts and crafts group; Bollywood dancing; Singing club; Gardening group; Dementia cafe; Walking group Laughing yoga sessions
4.3.2 Monitoring and evaluation The limited staff capacity within the organisation has had an impact upon the organisation’s ability to monitor and evaluate its work. The organisation could improve the frequency and consistency of its data collection by implementing a validated Outcomes Measurement Tool such as Outcome Star or the Warwick-Edinburgh Mental Wellbeing Scale. These tools would enable the organisation to capture a more accurate picture of the levels of loneliness, physical and mental wellbeing, independence and safety of those it supports and the progress they make as a result of project interventions. Capturing this data on a frequent (at least quarterly basis) will enable the organisation to generate relevant evidence of both need and its effectiveness and should be used to inform future service delivery as well being shared with funders and commissioners. However, the majority of CBFT’s service users are individuals with complex needs and some have cognitive diseases such as dementia. This will inevitably create some challenges in capturing monitoring data from every individual and use of validated measures will require 1-1 support from project staff and volunteers. To this end, it is important that as the plans for the future service develops, so too does the staffing capacity of the organisation, so that there are sufficient resources for this activity.
4.3.2 Staffing capacity The project has achieved a great deal since its inception and this is all the more remarkable given that it is almost entirely run by volunteers. There is just one paid member of staff (Project Development Worker) responsible for overseeing the project accompanied by one sessional cook. The trustees and project development worker regularly undertake additional volunteer hours to ensure the sessions are delivered and whilst this is commendable, it is not sustainable. If the project is to expand its reach to support more people and deliver more frequent sessions, it will need to increase staffing capacity, so that the volunteers can continue to be effectively managed and supported and that quality can be maintained. At the very least, it is recommended that the project structure involves: 1 x Project Manager – responsible for coordinating the sessions, partnership development, administration and reporting 2 x Project Workers (part time) – oversee the sessions, lead activities, undertake monitoring Sessional cooks to attend each session Team of volunteers for each venue
5.0 Project development 5.1 Continued need The Time to Shine Team responsible for implementing the Ageing Better programme in Leeds have confirmed that some out of hours services will be commissioned in March next year, but expect that: Services will not begin until the Autumn; Demand will outstrip capacity; Provision will be across Leeds and therefore support in South Leeds may be limited The project was established because it was identified that there was no weekend or holiday support for older people in South Leeds. Since then, little has changed and there remains a breadth of provision for older people during the week but nothing for them when the week-day service is closed. 5.2 What could the project do with more funding? The recommendations of this evaluation is that CBFT continues to deliver the service using its current approach. It is meeting a clear need and is delivering good outcomes for the older people it supports and its volunteers. There is limited provision at weekends and holiday periods and CBFT makes a vital contribution to helping individuals stay safe and well at times when other statutory and voluntary providers are not available. If the project continues and with an appropriate level of funding is able to implement the recommendations set out earlier in the report, then it could: Increase the frequency of breakfast and lunches in areas where provision is currently restricted to once a month. This would ensure that older people who are vulnerable and isolated not only have a weekly opportunity to interact and enjoy a hot meal, take part in an activity they enjoy; but also provides a weekly opportunity for the project to monitor their wellbeing and ensure their safety during the weekend Gather better evidence of the needs of older people in South Leeds and the types of approaches needed to support them; Improve the range of activities on offer for the older people. The regular sessions provide an opportunity to engage older people and encourage them to take part in new activities which can promote and protect their mental and physical wellbeing. It is important that this is also robustly evaluated as any evidence gathered which highlights a link between the activities and improvements in wellbeing and/or reduced visits to the GP would be of high interest to the Leeds South and East CCG. Provide more volunteer opportunities for local people, particularly focusing on the most socially excluded and isolated and enable them to improve their life chances, health and wellbeing; Deliver a sustainable approach to reducing isolation and improving the health and wellbeing of older people
We would like to thank all of the trustees, staff and volunteers who have been involved in running this successful service and for taking part in this evaluation. :