Community Capacity Building

Community Capacity Building and co-production

Cheviot and Tweeddale

A report by

Scottish Borders Community Development Company operating as THE BRIDGE

February 2012 2 CONTENTS

Introduction 2

Research findings 3 1. Population growth and health of older people – and income levels 2. Local and national strategies/programmes for older people’s services 3. Published reports 4. Profile of voluntary and community organisations in the Scottish Borders

Mapping 5

Analysis of findings 6 Overview 1. Activities and services that are missing: 2. Common issues and problems

Conclusion 10 Summary of opportunities for co-production and development and ways to improve services

Appendix 1: Key Demographic information for the Over 65s and over 75s in two “Localities” in the Scottish Borders Appendix 2: Database of activities, services, stakeholders

Acknowledgements: We acknowledge the support of Berwickshire Association for Voluntary Service (BAVS) in respect of community research within Berwickshire, and the many individuals, organisations and agencies who provided us with information about their activities and needs.

Scottish Borders Community Development Company, operating as The Bridge Company Ltd by Guarantee SC305830; Scottish Charity No: SC037646 Registered and Head Office: 6a Roxburgh Street, Galashiels. TD1 1PF VAT Reg. No: 918 1477 11

3 INTRODUCTION

The Change Fund assists the re-design of public services for older people to enhance their health, well-being and independence. Within this programme, the Community Capacity Building theme aims to enhance services provided by existing voluntary and community groups and identify gaps in services. The anticipated outcomes are increased community capacity and the ongoing involvement of older people as key stakeholders in planning services, known as co-production. A proposal by Scottish Borders Council’s Social Work Services to develop community capacity building and co-production was accepted for funding by the Change Fund in 2011-12.

The Bridge was commissioned to carry out further research from December 2011 – February 2012, to identify existing networks, relevant voluntary community organisations and self help groups. The report will outline what is already happening in the Cheviot (including Coldstream, Greenlaw and Gordon) and Tweeddale areas and potential opportunities for development. It will summarise the type of support and skills required to develop services within the Third Sector to meet expressed need and fill any gaps in provision within the Cheviot Plus and Tweeddale localities.

This work will support the development of a new relationship between individuals and statutory agencies in the support of our older people

The Bridge has adopted the following definitions: a) Co-production: “Co-production means delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change. “

(from “The Challenge of Co-production” David Boyle and Michael Harris, National Endowment for Science, Technology and the Arts (NESTA) and the New Economics Foundation (NEF), 2009.) b) Community Capacity Building “Activities, resources and support that strengthen the skills, abilities and confidence of people and community groups to take effective action and leading roles in the development of communities” (from Scottish Community Development Centre: “Strengthening Communities”, S. Skinner, CDF publications, 2006).

4 RESEARCH FINDINGS

We carried out desk-based research to review published statistics, reports and surveys from public agencies and third sector organisations, covering existing services and activities relevant to the Change Fund’s primary outcomes, and any gaps they identified.

1. Population growth and health of older people – and income levels

We approached Heidi Goodship, Research and Information Consultant at Scottish Borders Council, for details of the change in population in these areas of the Scottish Borders. Her analysis of these datazones from Scottish Neighbourhood Statistics is attached as Appendix 1 and we quote as follows:

“ …the “Cheviot Plus” and the Tweeddale areas have larger population growth, overall and in the older age bands, than the Scottish Borders and Scottish averages. This shows that there is a growing demand for services for older people throughout the Scottish Borders and particularly in these two areas.”

In respect of health–related statistics, she notes:

“The number of people claiming Disability Living Allowance (DLA) in the two target areas is lower than the Scottish Borders average, which is lower than the Scottish average. Residents in “Cheviot plus” are more likely than residents in Tweeddale to claim DLA. DLA claimants in “Cheviot plus” are more likely to be aged 60-69 than the Scottish or Scottish Borders average.”

“Residents in both the target areas are more likely than the Borders average to claim Attendance Allowance (AA). Residents in “Cheviot Plus” again have a higher claim rate than residents in Tweeddale. These two sets of statistics show that there is a slightly higher rate of severe disablement and service need in the target areas than average, particularly in the Cheviot./ Coldstream/ Gordon/Greenlaw areas.”

The most common cause of emergency hospital admissions unintentional injury for the over 65s is falls:

“The figures show that rate of emergency admissions in the 65+ age group is slightly higher in Scottish Borders than the Scottish average, indicating that elderly people in Scottish Borders are more at risk of harm than elderly people in other areas. The rates are particularly high in Tweeddale and slightly lower in “Cheviot Plus”. This shows that there is a need for services, particularly in the Tweedale area, to help elderly residents avoid unintentional injury.”

At the Cheviot Locality event in Kelso in July 2011, it was reported that the number of patients hospitalised after a fall was far higher in Jedburgh than the Cheviot Plus area as a whole.

5 A significant percentage increase in the projected number of people with dementia in the Cheviot Plus area from 2008-2018 was forecast – up by 27.5% in the 65+ age group and up by 42.7% in the 85+ group.

In respect of poverty indicators, identified through Pension Credit claimants, she notes:

“The claim rate for Guaranteed Pension Credit shows again that residents in “Cheviot plus” have a higher level of need than the Scottish Borders average. The rate in Tweeddale is slightly below. In common with a typical rural Local Authority area, where benefits dependency tends to be lower than urban Local Authority areas, the Scottish Borders average is lower than the Scottish average.”

2. Local and national strategies/programmes for older people’s services  Commission on the Future Delivery of Public Services (Christie Commission 2011) Provides an assessment of the challenges facing public services and argues for a coherent and sustainable programme of public service reform. Recognises that effective services must be designed with and for people and communities, not delivered ‘top down’ and prioritises preventative measures to reduce demand and lessen inequalities.  NHS Borders Integrated Patient Transport Strategy 2011 – to address issues on transport services for accessing health services. It aims to make sure that the most appropriate form of transport is used and will be allocated depending on the needs of the patient.  Transport for Health and Social Care – Audit Scotland 2011 – found that joint working across the public sector and with voluntary and private providers is crucial for the successful and sustainable development of transport for health and social care. Improved joint planning could lead to more efficient services.  “Healthy Communities: Meeting the Shared Challenge “ – a Scottish Government programme 2008-2010 which brought together at a local level staff from NHS , local authorities and community and voluntary sector organisations to develop the principles of community-led health (a community development approach to health improvement). This was particularly relevant for the development of collaborative strategies in respect of long term conditions.

3. Published reports  Neighbourhood Links (British Red Cross/Borders Voluntary Community Care Forum): the latest report identified the value of providing direct one-to- one support to isolated older people to enable them to integrate into local activities.

 The Future Of Preventative Services For Older People In The Scottish Borders (Social Work Services): This paper reported on the outcomes of public consultation undertaken in 2008 to identify gaps and priorities in preventative services. This was defined as:

6 “those services which are targeted at older people with low support needs (as defined within Scottish Borders Council’s Eligibility Criteria) which aim to assist people to maintain health, promote independence, prevent crisis and divert older people from inappropriate referral to statutory services.”

Priority services Identified gaps in services Transport – community + More car based transport/hire volunteer support opportunities/wheelchair accessible Support on discharge from Links/liaison between services at discharge hospital Out of hours homecare support Flexible support in the home Befriending and visiting Adapted housing Access to appropriate housing for needs Aids and adaptations within Access to information about availability of aids the home and adaptations Falls prevention Carers breaks and short term Flexible short/medium length breaks with breaks transport links. Volunteering opportunities To also help with access to services Luncheon clubs/social Reduction in charges for leisure activities activities

A key priority was the improvement of information about services and signposting to services.

This was the summary of responses at three focus groups of Elder Voice members in Galashiels, Peebles and Duns to prioritise the above lists.

Top Ten priorities Identified gaps in services Transport Transport provision at times required for social activities, shopping etc Befriending/volunteering Co-ordination/liaison between voluntary agencies Shopping Fresh meals delivery service Small repairs Gardening Affordable gardening service/enterprising garden initiatives Handyperson Decorating service Home security More support to help people ‘feel safe’ within communities Social activities Need for mens’ groups/cater for mens’ hobbies/daytime learning opportunities Signposting to services Information booklet/links between agencies Support to family/carers Specific help for carers of people with dementia. Accessibility to health screening

Subsequent to the consultation, the Neighbourhood Links service was piloted and production of the “Ageing Well Handbook” was taken forward – encouraging older people to adopt a healthier lifestyle and look after their own health and well-being.

7 The report summarised that information on existing preventative services showed a good spread of services in place across the Borders, noting gaps in the availability of decorators and a “time bank” for volunteers. The consultation with stakeholders and service users in relation to perceived priorities and gaps indicated: “there were a number of gaps in services particularly in relation to transport, the development of community capacity via the voluntary sector and the need for a co-ordinated approach to signposting to services.” The report recognised that the Neighbourhood Links service was providing signposting to services, and that Social Work Services had implemented the Duty Hub as a single point of contact. The Borders Care and Repair Service is cited as the answer to requests for practical support in the home. Transport was a consistent priority, but the report noted the existing community transport services and the Red Cross Buddy Service.

The report made a number of recommendations in respect of developing services for men, a more co-ordinated approach to collecting and disseminating information, further support to develop community capacity in delivering local services, a social enterprise approach to the development of eg decorating and gardening services, and a more co-ordinated approach to volunteering development.

 Scottish Borders Carers’ Strategy 2011-15: We note that a consultation underway at present to develop this.

4. Profile of voluntary and community organisations in the Scottish Borders The Office of the Scottish Charity Regulator recently published their Scottish Charities Report 2011. The statistics for charities operating in a single local authority showed that the Scottish Borders:  has c.750 charities based here (10th highest in Scotland) and 72% of these only operate in the Scottish Borders;  is 6th in Scotland for the number of charities (67) per 10,000 of population;

But it should be noted that most of the small self help groups in local communities operate without charity status – so are not counted in the above figures.

The database of local voluntary and community activities attached at Appendix 2 gives an indication of the type and number of these groups, and the services they provide to their local communities.

Although the sector is made up of a vast number of organisations of all types and sizes, there are a number of formal and informal networks which support communication. The Bridge and BAVS organise regular network meetings in all areas.

8 MAPPING OF ACTIVITIES AND SERVICES

Using local knowledge and the Online Borders directory, we contacted local organisations for an up to date report on their activities and asked them to identify gaps in services for older people. We also contacted voluntary sector networks and forums relevant to older people’s services to find out their views. We then held a number of focus groups with a good cross section of individual older people in towns and rural communities across the Cheviot Plus and Tweeddale areas, who gave us very valuable feedback on their needs and priorities.

This research enabled us to gain a picture of local community activities and the strengths and weaknesses throughout these areas.

The results of this research are contained in the next section – Analysis of findings – and in the Mapping of Activities Database attached at Appendix 2. This information is classified firstly into three sections: Tweeddale, Cheviot Plus and Borders-wide (with an impact on these two areas). Within each section, we have grouped the information around the main towns and the satellite villages that look to them for services.

ANALYSIS OF FINDINGS AND RECOMMENDATIONS

The database of activities shows the large number and variety of local self help groups in our communities and the value placed on having a low cost, comfortable public venue for these activities in the shape of village halls, church halls and community centres. It should be noted how much activity is self-generated within the rural communities to overcome the difficulties of public transport. Coffee mornings were seen as an important opportunity for a social get-together – they are a weekly event in many towns, attended by the over 60s on a regular basis.

We must recognise the contribution already made by older people as volunteers; they are an invaluable resource, rather than as passive recipients of services.

Reflecting the population demographics, most of the activities listed in our database are not only managed by older people, but they also provide the voluntary labour to ensure their success and sustainability. A particularly important example is the large number of local lunch clubs, where older people provide healthy home cooked meals in the local Hall on a regular basis for other older people in the community, the whole sustained by a low charge and often small fundraising events throughout the year.

This shows that older people are already working hard to support activities for their peers; however we are aware of groups for older people that have folded because of the lack of new volunteers – where those running the organisation had reached their 80s and there were no succession plans when the volunteers needed to become recipients.

9 People identified the following in each area:

1. Activities and services that are missing:

Cheviot area  Printed booklet with activities/services for each area  Volunteers for trips out  Befrienders for residents with limited family contact  Volunteers for activities eg gardening  More volunteers to visit older housebound people and to help with shopping.  More volunteer time spent with the elderly eg taken to Clubs or to the shops  More volunteers would be ideal to help people with dementia integrate into groups being run in local Halls etc (Mental Health for Older Adults Team)  More Day Centre places needed in Jedburgh.  Lunch Club at Howdenburn (now moved to Jedburgh Community & Arts Centre)  Could do with larger forum to promote/increase numbers of members for hobby groups  Condition-specific carer support - ie support for carers of stroke patients/service users.  Lack of transport facilities for elderly residents - there is no public transport coming into the village (Lanton).  Jedburgh lady had difficulty organising transport to Edinburgh Hospital for 20 consecutive days to receive radiation therapy.  Transport in/around Kelso  Transport/bus service for Smailholm  Perhaps a weekly bus service into Jedburgh from Edgerston.  Keep fit for over 60s at Edgerston Village Hall  Bring back Post Office to Edgerston  Exercise class with gentle exercise in Oxnam Village Hall  Would like to have more Day Centre facilities available for the elderly in Kelso.  Specifically men's groups in Kelso/rural area are needed  Perhaps outings to Music Society concerts could be organised through retirement homes and U3As.  Little or nothing in the community for people with dementia, that is not run by the NHS. (Mental Health for Older Adults Team)  Daytime physical/leisure/hobby activity in Heiton  More social/daytime space to be together (Morebattle/Yetholm)  Yetholm Youth Hall could be used more during the day where possible.  Chiropodist services needed.  Similar service to Care and Repair needed for those in housing association property (eg moving furniture, putting up curtains, changing light bulbs).

10 Coldstream/Greenlaw/Gordon  More regular Chiropodist visits (Greenlaw Medical Practice)  Improved Diabetic Support in some rural areas - a lot of patients now go private, as little NHS support for this condition (e.g.. Greenlaw).  More regular Newsletters telling communities "What's Gaun On?" - Community Councils could produce this, (suggestion from Greenlaw community)  More local clubs specifically for the Over 60 yr olds, (e.g.. resurrect the Happy Club in Greenlaw)  Raise awareness of the Neighbourhood Links Project (Greenlaw would like to find out more).  Book compiled with Walks around local areas - produced by Community Council. Potential to widen the coverage of the Walk it Walks project (e.g.. In Greenlaw, Gordon & Westruther)  SBC support to improve any existing facilities (e.g. Greenlaw tennis courts)  Very little on offer for men. More groups specific for men, or to appeal to men (ALL Communities)  More Keep fit specifically for older people e.g.. Widen coverage of Guid Fettle project across ALL Communities  An interest in wider availability of lunch clubs (ALL Communities interested)  Cinema (ALL Communities)  Drop in Centre  Poor Transport links (especially bus routes) - impacts ALL communities in differing ways  Better Quarry Bank Taxi Service - offering service more than 2 days a week and more flexible with times of day (ALL Communities)  No mobile post office visits Westruther or Gordon  Potential for Greenlaw Pharmacists to deliver repeat prescriptions to Westruther VH or PH as it does to Gordon's shop.  Outreach Sight Clinic to be re-introduced in rural communities (ALL Communities)  Gardening / Horticulture Club (with plant sale, shows, etc) (Leitholm)  Craft Groups / Patchwork / Felting (Gordon & Westruther)  More yoga & keep fit classes (Gordon & Westruther and Leitholm)  Quiz nights (Leitholm)  Reading Group (Gordon & Westruther)  Lunch Club (Gordon)  Coffee mornings with cakes (either in the village hall or local pub - Leitholm)  Table Top Sales in hall - to help attract good cross section of community (Leitholm)  Memorabilia Displays / Museum collection of local artefacts and photographs, etc. (Gordon & Westruther)  More Outreach long term condition support groups - responding to needs, e.g.. CHS, Heart Groups, Lung Support Groups, etc. (ALL Communities)  Nothing for men in Leitholm (Evergreen is the only mixed group)  Keep fit for older people (Leitholm)  Both OAP and Lunch Clubs previously in existence have been abandoned due to dwindling numbers and organiser's commitments (Gordon).  Services for Greenlaw community limited - lack of suitable premises to deliver courses.  Drop in centre, lunch club, cinema needed in Coldstream

11 Tweeddale  Post Office or local shops are under threat but are focal and information access points for rural communities  Local Healthcare professional in rural areas  No local chiropodist or dentist.

2. Common issues and problems

Cheviot  Reliance on web-based info - need printed version  Poor public transport, including links between town/main services and condition of buses.  If you can get to event/appointment, can't always get back easily on public transport, so don't go.  Lack of Day Centre places  Many groups supported by older 65+ volunteers on committees/active - hard to find younger people with time to help. Issue of long term sustainability.  Have to go to out to all activities/services - prescription delivery is exception. Reliance on public transport/CT once can no longer afford a car in rural areas.  Lack of hospital beds locally.  Being discharged at night from BGH without suitable transport  Some premises (eg Legion) still not fully accessible  Lack of sheltered housing in town centres - have to wait for someone to die to get a flat.  More volunteers/support needed for everyday activities including gardening, shopping  Even though patients are over 60, many still have to pay for dental treatment unless on benefits (eg Pension Credit guaranteed credit).

Coldstream/Greenlaw/Gordon  Bus transport often means individuals have to walk a fair distance still to get to destination, (i.e.. if take a bus to get to local surgery, the bus often stops a good 10 - 20 minutes walk away from the surgery).  Bus service coverage is patchy - some communities well serviced to local towns, others are very disadvantaged, (e.g.. Hard to get to Kelso from Gordon & Leitholm can't get to Berwick or Galashiels easily)  No local taxi service (Greenlaw)  Transport is expensive  Lack of awareness of Community Transport Services for patients.  No local cash point (Greenlaw)  Crossing roads is very dangerous with fast travelling traffic - there is a real need for more Pedestrian Crossings in rural areas. (Greenlaw) In Leitholm a petition is in place to reduce the volume and speed of traffic through the village. Also, a lot of heavy haulage lorries from Swinton and Eccles travel through.  Pavements are very dangerous in places.  Restricted access to public buildings as poor ground floor accessibility in some.  Not as much neighbourly support and community spirit in some communities now a days - more commuters living in rural locations who are at work during

12 the day and have less involvement in community activities at night and at weekends.  Hard to get people to join groups locally and few interested in volunteering to run existing/new groups as don't want the responsibility or have the time.  Very much an "Aye been" attitude - hard to change!  Lack of interest / Apathy / Hard to motivate people  Careful naming of a group can increase attendance levels! e.g. instead of "Senior Citizen's Group" call it "Young at Heart" Group. "Patchwork Group" changed to "Craft Group" widening appeal as less restrictive description of activities possible to cover at group.  Stigma attached to some over 60 yr old groups - people don't like to be labelled "old!"  Individual mobility can affect decision to participate in a group, especially if no- one able to take them.  Hard of Hearing - no hearing loop in some halls and often other community facilities where groups run.  Bad weather puts people off  Hard to gain male interest in groups - Men need more male support at groups and then may encourage them to get involved more - Questionable whether men feel they "need" or "want" to be involved in some community groups!  If there could be more relief / care support provided locally they would then be able to focus on other activities and groups.  Hard to find out what's happening at neighbouring village halls (explained that the updated Federation of Village Halls website should make this easier).

Tweeddale  Poor Public Transport  Reliance on technology  Lack of information  Cost of keeping warm  Poor links between GPs and Social Work Services  Lack of accessible health professional in rural areas (District Nurse)  No difference in provision of services or activities for male or female  Keeping well is a generational issue - young people are not so well educated in looking after themselves;  Poor eating comes from convenience;  Health and social care being provided by different authorities with no connection.  Have to learn how to us a computer - Cost of PC and Broadband connection  Attending a GP surgery raises issues of cost, transport and distance  Poor communication between Hospital and GP  Street Lighting and gritting are poor  Personal Alarms (Bordercare) are very good but cost £110 pa  Traditional activities such as pubs and clubs should not be excluded

13 CONCLUSION

The most common elements in the list of needs and priorities from our focus groups and research have changed little from those in the Preventative Services report. The priorities for 2012 onwards can be summarised as follows:

 Information on activities and services in small local geographic clusters should be available and regularly updated and distributed to all residents over 65. A piece of paper through the door with local information, regularly updated, is more valuable than a website or a handbook, for those who don’t need additional support. As former focus points in smaller communities such as shops and post offices have disappeared, so there is a need for clear information distribution points to be established and networking and information sharing between service providers whether statutory or voluntary to be a key priority.

 Support and training is needed for existing voluntary organisations to remain sustainable and very specifically more accessible (appropriate, accessible, affordable transport as well as appropriate facilities). Community capacity building support and accessible community transport services are already available throughout the Borders, but are constrained by lack of resources.

 Recognition that the name of a service is important – older people do not like to be classed as Seniors.

 The recruitment of volunteers in younger age groups to replace current volunteers who are increasing in age. Support and training for volunteers to become skilled and confident and to be enabled to encourage more vulnerable people such as those with dementia to attend local activities.

 Encourage statutory service providers including NHS clinics and other services such as hairdressers to take their services out to small rural localities such as village halls rather than expect people to travel to them.