A Review of the Contributionthat the VCSE (Voluntary Community and Social Enterprise) Sector

A review of the contributionthat the VCSE (voluntary community and social enterprise) sector makes tohealth and wellbeing in the UK.

This is a joint review involving the Department of Health, NHS England and Public Health England and organisations representing parts of the voluntary, community and social enterprise sectors.

Community Catalysts has been asked to take a lead on the part of the review that focuses on the contributionthat the VCSE sector makes to health and wellbeing in the UK.

The following report summarises the findings from a focus group meeting held on 26 February 2015 in partnership with the Worcestershire Volunteering Hub.

The meeting was held in the style of a world café event with 4 tablesplaced around the room, each with a facilitator asking a question. Participants were asked to move around in groups of 4 or 5, spending approx. 25 minutes at each table to share their views.

What do you do and how do you contribute to the wellbeing of the people you support and your local community?

Encourage Activity –offer a range of movement-based physical activity sessions to care and nursing home residents and is looking to provide these in community centres too. We are re-structuring to a social-enterprise and want to offer low cost sessions to older people close to where they live. The Benefits include increased confidence, improvement in good moods, general wellbeing and happiness, anxiety and stress levels lowered, increased interaction amongst residents or neighbours – during and after sessions, reduction in loneliness, positive outlook on matters, energy levels are elevated, eased muscular and joint pain after gentle movement better balance and reduced number of falls.

Care Ceramics CIC- provides skills training and offers therapeutic benefits associated with working with clay for adults with a learning disability. Produces a high quality saleable end product. This service is being externalised from a local day care provision where it will no longer be provided and gives the opportunity for people to continue to use the skills they have learned.
Action on Hearing Loss (RNID) – offers hearing tests, hearing aid checks, replacement of batteries and tubes.Provided in local communities close to where people live. Is being set up in churches, social centres, libraries and any area where people already meet, taking the service to them and thereby offering support to audiology departments. Also offers information and advice and supports people with tinnitus. It is a known fact that for people who suffer hearing loss it can take them up to 10 years to get this checked out which often leads to them becoming isolated due to their hearing loss. Working in local communities offers them opportunities for face to face contact in a familiar environment where this can be checked out sooner.
Vestia – Stronger Familiesprovides intense family supportfor vulnerable families who have been identified from checking their employment, their education, crime and social behaviours. Support is offered to look at all issues and they are provided with someone who is there for them and who links with schools, housing and social care in addressing their issues.
Vestia - Improving Futures provides support for families with children between the ages of 5 – 10 in an attempt to resolve any early issues.
Onside Advocacy – provides a range of advocacy including NHS complaints, IMCA, IMHA, ICAS and generic advocacy. The Lifelinks project connects people back to their communities, empowering people to join in with local activities. We help to protect people’s rights and to access their rights, re-build lives, reduce isolation, build friendships and confidence. We also support people to get access to justice by increasing access to legal aid.
AshaWomens Group- provides asafe environment forwomen of all ages to work through issues. The group was born out of criminal justice and although it is a holistic group issues may be around domestic violence, sexual abuse, relationships or substance or alcohol abuse. Our Freedom Programme uses peer mentors who are trained for this and both our professional and peer workers provide mentoring, coaching and 1:1 work. We work towards re-integration for women and part of that work has involved employability training and skills.
Worcestershire Association of Carers-provides support for all adult carers. We provide publications, training, phone line support, 1:1 support. We raise awareness about who is a carer and what is available to them. We have linked with St Richards’s hospice to offer some of our end of life support for carers. We work with 68 G.P. practices to identify carers. We signpost and facilitate carers to access other support. Our most important work is in giving carers a voice and ensuring engagement, involvement and co-production for them. We are the interface of Health and Social care for carers and their families.
St Richard’s Hospice- provides both community and in-patient support. We have 17 in-patient beds, a day hospice, a hospice at home team and teams of volunteers who offer practical help in the home for people who we support. We have clinical nurse specialists, we are connected to G.P. practices, we have our own team of doctors, social workers, physiotherapists and occupational therapists, a dementia therapist, a chaplaincy team and a C.A.B Advisor, this enables someone to be referred to us once and access all of the support without them being passed from pillar to post. We have a Triage and on call 24/7 telephone advice system. We also provide transport for people to access the day hospice where people can see specialists, have lunch and have complimentary therapies or just socialise. We provide support for the whole family, before, during and after people have used our services. We have an Education and Training centre which we use to pass on our expertise to enhance patient care.
Voices – Street Pastors provides volunteers for night time support for people in trouble in town and city centres. This includes handing out flip flops for those struggling on high heel shoes, blankets for those who are cold. Our role involves providing a peacemaker between people openly in conflict on the streets, this might be between police and pedestrians, domestic arguments on the street, or people using drugs or alcohol and who are confronting each other or others. We have reduced the number of arrests made using our non-adversarial approach, provided counselling and signposted people for further support. We have reduced the number of call outs for ambulances by de-escalating violence on the streets.
Simply Limitless- is a wellbeing centre providing family activity sessions and fitness and gentle exercise for adults over 65. We also offer fitness and fun sessions for toddlers, parenting courses, and a youth group. ‘The Puxtons’ is a group that helps young people gain confidence through music;we have a night café for homeless people where they can get a hot meal, warm clothing, sleeping bags and a shower. We also provide hot food for children in school holidays, English and Maths tuition for adults and for children and most recently a befriending service.
Art in Minds Foundation –Art in Minds Foundation has existed as part of the NHS since 2004, within vocational services where we worked with those under secondary mental health care. This meant that we could only work with people who fit into certain categories and for certain periods of time within those services. We became a registered charity in 2014. This leap from statutory to community focused care has meant that we are no longer restricted by an individual’s diagnosis or status within the NHS as to whether they can be part of our service. With currently over 160 registered members from within Worcestershire who have experienced or are experiencing mental ill health we act as a supportive community for those who can find that their ongoing support or treatment comes to an end. As part of our service we offer a non-judgmental space to engage in art making and create both supported by volunteers, and peer supported artist’s space. We produce a newsletter and maintain a website that is user led and produced, keeping people up to date with events, competitions and other member support services. Adults with ongoing or fluctuating mental health issues can become forgotten or neglected by society and when in isolated situations AIMs tries to re-engage and encourage community focused activities with individuals in our county. Our members create art work both with us and at home, we have a keen group of volunteers who support them to complete their work professionally and on an annual basis we exhibit work to mark World Mental Health day each year. We are able to do this with project funding but the members need more consistent support and a port of contact they can rely on. When somebody does become unwell and disengages we try and keep track of their progress and send cards or notes to the family and reach out to re-engage when they are ready. This is vital to try and lower rates of readmission and in worst cases severe depression and suicidal tendencies. We try where possible to offer our services at a subsidised rate to encourage inclusion and reduce discrimination. Exhibiting art work that has been produced raises confidence and self-esteem and provides a focus and quality of life that individuals find incredibly helpful. We have also done a lot of work training up our members as volunteers to get back into employment. Our aim is to promote recovery, responsibility and awareness through our members and their work and give them the support they need on their terms.See case study Richard Bray.
Sight Concern – provides information and advice for people to be able to make informed decisions. We offer expert support via face to face, phone or email which enables people to increase their independence, find out about aids and equipment and technology and try them out. We provide a living with sight loss course that supports people to come to terms with their sight loss. We also provide 1:1 volunteer support for people for social and leisure activities. Peer support groups also run activities that take into consideration people’s sight loss. See case study Shirley.
Charisma Training- provides training on using assistive technology and equipment for people who have sight loss or other disabilities. An independent trainer can give advice on a variety of equipment from different suppliers, whereas a big supplier hard sells all their equipment regardless of whether it is relevant.An example of support offered to someone who was deaf and blind and has autism: **** is very bright, and wanted to exchange emails and surf the net with her Deaf blind communicator which uses Braille output. She cannot concentrate for long enough to benefit from half a day's training, which is the shortest time the big supplier of the equipment could give her. I did several 2 hour sessions with her, and now, there is no stopping her.
ME Lifeline group –provides support for people who suffer with ME (chronic fatigue syndrome).

Also in attendance:The County Council’s Voluntary Sector Co-ordinator
How do you demonstrate your impact?

Through recording individual outcomes i.e. now in receipt of benefits
Through monitoring the well-being of the individual - preventative
By ensuring there ismore choice of services
Increase in independence supporting more people to remain at home
Increase in the number of clients able to use assistive technology in their daily lives and reduction in the amount of support required for daily living
Increased mobility and reduced number of falls for people in care homes
Reduction in the number of people who say they are feeling isolated
Production of an end product that is saleable and could provide an income for the client
Increase in numbers of people accessing the range of support and activities on offer
Reduce social isolation
Increase confidence
Increase independence
Improve health and wellbeing
Increase community participation
Break down barriers to participation
Enable people to learn from peer support; from experts by experience

What evidence do you gather that helps you do this and how do you gather that
evidence?

Database for quantitative evidence
Outcomes based questions for qualitative max. 10 questions
Case studies
Outcomes star
Baseline assessment
Feedback sheets
Focus Groups
Mystery shopping – calling clients for feedback
Testimonials
Key Performance Indicators
Talks by service users
Intrusive questioning
Visual evidence – chart for each client
Data plus narrative and qualitative evidence
Dependent on funder for type and presentation of evidence
Complex and multiple ways
Formal gathering / informal anecdotal
Warwick-Edinburgh Mental Wellbeing scales (WEMWBS) – under review – tick boxes are subjective
Reaction of clients analysis
Conversations – independence, financial, emotional and social interaction
Support workers needed to undertake monitoring which creates admin costs and confidentiality issues
Transparency of policies
Case study – video of group session in care home
Additional study – request carer to monitor improvement selecting 2 people from each care home for the study
Triangle Outcomes Monitoring Stars – cost is £900 per annum for licence for each star – used in mental health, not intrusive in gathering evidence, balance between staff and engagement with clients
Initial assessment, then chart progress
Use the compelling national evidence for carers
Information from the support team, the families and other contributors
Providing proof of the negative link for not raising confidence of client
Using Proxy values of outcomes (Social Return On Investment)
Review the Social Care Act as the purpose of the evidence is critical
Numbers Attending/accessing activities/services
Age range
Eye condition
Information sent out

Do you get grant funding? Who provides that funding? How useful has it been in helping you establish your enterprise and grow?

Statutory Funding
Contracts
Lloyds Funding
Lloyds TSB do provide core funding but there is none from statutory organisations
Charitable Trusts
NHS Grants – debatable that it is a contract
Contracts are for a limited period only it takes 2 years to get up and running, then you only have 1 year at capacity and then nothing.
Eligibility for Start-up grants – the criteria is very specific and limiting
Core Funding is never or rarely available
Creates the position where we are forced to always be re-inventing the wheel
More time is spent searching for funding than doing the work and this curtails growth
Unreasonable targets are set
Too short a period to get infra-structure in place – longer grants
Huge time implications for small groups
There have been huge cuts in funding – replacing grant funding with a charging policy is not viable
Mostly project funding – no core funding – no staff funding either
Survival means writing funding applications and not doing the job
Lots of NHS work – but hardly any or no funding from the NHS
There is a lack of recognition of the services provided
Reduced staffing cost available – resulting in redundancies
Can’t plan for the future because of no long term funding
Always having to come up with new projects to gain funding
No feedback that is useful on grant refusals despite fulfilling the criteria
Monitoring for funding is time consuming
No recognition of what needs to happen for clients at the end of a project when the funding stops
Grant funding helps you survive, but is growth limited and restricted because of having to change project focus in order to gain grant funding
Restricted money for set services only
Contribution towards a project and not total amount
Cessation of services at end of project means loss of expertise
Always innovative pilots that end with the funding
There is an impact on others in the VCSE sector when closures occur as they have to pick up the slack with no funding for this
Pump priming – but no longevity
Short notice periods on de-commissioning a service are not helpful
Tendering for contracts can prove difficult if you do not ask the correct questions when doing this
Requirements of documentation is not in proportion to the amount of grant
The tender/procurement process needs revising
Raise the ceiling on tendering contracts
Lower the ceiling on tendering contracts and break the contracts down into delivery that the very small local providers can tender for too
Organisations are expected to go through too many re-structures
Having to find match funding for the European Union Fund stops many small enterprises from accessing this fund.
It is difficult when different issues become ‘flavour of the year’
It is difficult when there are different systems for collecting evidence and there is so much inflexibility in the statutory sector
Smaller services with viable services are disadvantaged
Poor access to grants for people with disabilities who are providing services and support
One size fits all or pigeon holing isn’t viable for smaller VCS organisations
E.U. start-up grant – match funding, time consuming forms, payment by results all create barriers