Rotherfield St Martinresearch into a community group

in an English rural village

It’s not steamrollers and hatsMarylynn Fyvie-Gauld

Setting the Context

• The numbers of older people are increasing and set to increase steadily over the coming years

• Particularly of issue are people aged 75 and over because they generally require more help and social care than other age groups

• Expenditure on older people is also increasing especially on home care

• Home care hours have increased but the numbers of home care recipients has dropped

• The countryside faces particular problems:– More older people (age-specific migration flow)– Fewer younger people– Mostly a wealthier population than urban dwellers– Rural communities have the same percentage of poor

people as the town– Rural communities have the same percentage of

people with restricted mobility as the urban areas– People are widely dispersed in rural areas often with

little access to public transportation• The mixed economy of care varies with no lower

threshold of provision• Patchy delivery of services involves greater

reliance on community groups in rural areas

• The local authorities have a new role to play in the care and support of older people in a climate of spending cuts and increased demand as set out in ‘Equity and Excellence: Liberating the NHS – Opportunities and Challenges’ (2010):– A critical role in the assessment of need and

allocation of resources– Commissioning and monitoring services– Overseeing local care markets– taking action in case of neglect or abuse

• In order to fully discharge their obligations Local Authorities will have to work closely with others to find innovative ways of meeting needs

tShropshire Voluntary Sector, 2007)

• This small-scale study was sponsored by the University of Brighton’s Community University Partnership Programme

• The aims of the research:– To assess the effectiveness of the services

provided by RSM to older people (including low-level)

– To determine volunteer motivation within the success of RSM

– To evaluate RSM in terms of a mutually beneficial college of people within the community

– To assess if RSM as a model could be transferable

15.3% are registereddisabled

Services Used (in percentages)

Exercise Classes

‘Making new friends and improving my activity level’ (80-89 female)‘The exercises classes were very beneficial’(70-79 female)‘exercises classes have helped since having heart problems’ (80-89 female)‘useful exercises’ (70-79 male)‘more mobile now thanks to the exercises classes’ (70-79 female)

Benefits of Exercise

• Evidence indicates that exercise is associated with lower risks of dependence and mortality

• Physical activity decreases the incident of chronic disorders

• Exercise is linked directly to a reduction in falls and therefore reduces costs to both the National Health Service and Social Services

The effect of falls – and therefore the need for exercise

• Fear of falling can lead to loss of confidence and affects the ability to perform activities safely

• Falls and accidents are the fifth leading cause of death in people aged 65 and over

• Falls cost the NHS millions; in 2002 in excess of £942 million was spent on osteoporotic fractures of which 87% was spent on hip fracture

• Falls have financial disbursement for the NHS as well as the person themselves, family and carers

• Research indicates that older people will not admit to falls because it undermines their status as independent.

Social/Chats/Friendship

• Over 51% of people aged 75+ live alone (Age UK, 2010)• Over 1 million people aged 65+ say they are always or

often feel lonely (Age UK, 2010)• Over 5000 older people spent Christmas day alone in

2006 (Age UK, 2010)• Isolation is one of the causes of depression and affects

10-16% of people aged 65+ (NIMH, 2003)• There is a key role for the voluntary sector in

combating depression and preventing isolation and depression among older people (Manthorpe and Illiffe, 2005)

‘I get out more and meet different people’ (80-89 female)‘The social side, as being on your own can be lonely, making new friends’ (80-89 female)‘It has given me a more positive attitude, opportunities to meet and make friends’ (70-79 female)‘I’ve got someone there I can always go to for help or just a chat’ (70-79 female)‘Its lovely to get out of the house and have some social time with other people’ (51-69 male)

Isolation in Context• According to Age UK (2010)– 12% of older people (1.1 million) feel trapped in their

own homes– 6% of older people (that is nearly 600,000) leave their

house once a week or less– Nearly 200,000 older people in the UK do not receive

enough help to get them 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

• ‘isolation has become one of the main problems for people in the country. St. Martins in all villages would help’ (80-89 female)

Other important services• The car transportation Scheme:– The shrinking world of one member– The transport scheme versus the taxi – a tale of the

hospital visit• Trips out: ‘When you no longer have a car it is easy to

become housebound, especially when you do not live in the centre of the village. The Scotney project has forced me to use old skills, such as embroidery and painting which I had lost confidence in doing’(80-89 female)

• ‘not everyone has the means of transport and any trips are well organised with transport, especially for people in wheelchairs’ (80-89 male)

• Meetings with speakers: ‘I look forward to meetings each week, also the speakers – I have leaned a lot from them’ (80-89 female)

• Bereavement support: ‘Visiting Rotherfield St Martin when feeling at a low ebb was so helpful’ (70-79 female)

• Odd Jobs: ‘as one becomes old, the little jobs that seemed so simple become difficult and it is very difficult to get professionals to come. (80-89 female)

• Computer help and training: ‘the computer training was beneficial and enjoyable’ (70-79 female)

Making a differencepast and current service use

• the vast majority of respondents felt that Rotherfield St Martin had made some difference or a big difference to their lives– Reduced use of the district nurse– Reduced use of home care services– Reduction in the use of Social Services– Increased use of neighbours and relatives– Reduction in the use of other services– Reduced use of personal care

Volunteer Characteristics

• Traditionally more women than men volunteer especially in caring organisations because of the link to the carer as female (Kuntz 2001).

The Volunteers of Rotherfield St Martin

I’ve always volunteered’‘Able to give back to the community in which I enjoy living in’‘Because that’s what you do – you don’t really think about it as volunteering’‘social contact and giving of self worth’‘Getting to know other people and their needs’‘I’m very pleased that I have been able to meet so many lovely and happy people’‘I’m lucky to be 81, fit and able to give my time’‘I am proud to be associated with such a useful project’‘I think you can enjoy giving and still be altruistic’

‘It has strengthened the sense of community. The benefits of the services and the facilities it provides are recognised not only by the members but also by their families and friends. It has shown how readily people are prepared to give their time and money for the benefit of other’ (volunteer)

• Professor Heinz Wolf has proposed a time-bank concept called ‘care-credits’- RSM volunteers have already established this concept: ‘Those who are well, look after those who are poorly until they die, and then the next lot underneath will have retired and be able to volunteer to look after that lot, and so on. It will fuel itself’ (Volunteer)

Support for volunteers‘Rotherfield St Martin is good to is volunteers’

• 97% of the volunteers said that their expectations of volunteering had been met

• Women were more inclined than men to rate their experience of volunteering as excellent (χ2 = 4.381, df=1, p= 0.014)

The Community and Rotherfield St Martin

‘Provides a focus for the elderly members of the village’‘Puts Rotherfield on the map! Brings the community together i.e. surgery church, school, all involved’‘Helps community relationships, saves them some money, enriches their lives’‘Stronger sense of community, bringing people together in an area where the population is widespread’ ‘It provides a fantastic community spirit, which appears to be unique to Rotherfield’

Rotherfield St Martin – a unique community group?

• ‘Absolutely, it is so successful. But it really needs another Jo and there are people like Jo, full of enthusiasm and energy. The problem is the cash. They need premises and this is so expensive and so that is the problem that needs to be overcome. It is not the idea or the person probably, but it is the money’

• ‘ I believe it could be a local and national model’• ‘This model could be adopted in other rural areas

designed to support all aspects of people’s needs; emotional, social, physical and mental’

Small is beautiful• ‘I think this organisation is suitable to a village

such as Rotherfield. I don’t think it could be quite the same in a town, more people to satisfy’

• ‘Great for a local area, local people, local services. If you think nationally you get too big and centralised and lose the local character’

• ‘It is no use thinking you want to do good, that will not work. You have first to establish a need. A group is successful by knowing the community and tailoring the needs to that community

• Don’t make it too big because people become alienated outside their community’

• ‘If it became larger and more people involved, it would become more bureaucratic, more paperwork, more rules and the nice touch would be eroded, the nice touch of Jo and the helpers’

• ‘RSM is a prime example of what can be achieved in a small community, borne of the vision and the enthusiasm of one person, Jo, now with the encouragement and backing of her team of knowledgeable Trustees and hard working Committee. We are lucky to live in such a caring and friendly village

But, of course, not everything can be perfect

• ‘Please, please may we have savoury or sweet biscuits available at all meetings in addition to cakes (which are fattening and unhealthy) also the ‘Cona’ coffee in the office should be discontinued’.

• ‘Opportunity for voluntary drivers to share tips (e.g. hospital parking, how to know if your passenger is ready to go home, etc)

• ‘list in the office of things that need doing to which one could sign up’

• ‘Use the central village notice board’• ‘Encourage volunteers to bring a plate of savouries,

salads or puds to the Annual Party’

In conclusion

• Research indicates that low level services such as those provided by RSM is important in primary prevention and reduces or delays the use of hospital services

• Low-level care is being ‘squeezed out in favour of crucial and substantial care services’ (Counsel and Care, 2007)

• Low level care helps in the prevention of older people having to go into residential care

• Government is clearly intending to become increasingly reliant on community groups to be partners in provision of services

• The cost of running RSM is the equivalent of employing one senior social worker

• 250 volunteer hours per week translate to approximately 30-36 pence per ho

• Volunteer England suggest that every £1 of volunteering return £4-8 in direct economic value not including added value benefits

• The potential exists within the voluntary sector to produce a wide range of services and clearly a capacity that needs to be harnessed in the future by health and social care

Final words from the volunteers and members of Rotherfield St Martin

• ‘… what I consider most important is the commitment of all the volunteers from the Trustees and Project Manager, the Committees and Sub-committees to the many volunteers’

• ‘There can be no doubt that the fame and good works of Rotherfield St Martin have spread well beyond the village boundaries’

• ‘… where there are large numbers of elderly people in need to similar services. With growing numbers of elderly people in need to help in many areas of their daily lives, would not all welcome such close community support? I believe so’.

• ‘I would like it to continue forever, it is an inspiration to many. God bless everyone involved’