Farming Community Network - supporting farmers in Powys

Pat Borland is a volunteer with the charity Farming Community Network, which supports farmers and families within the farming community through difficult times. 

Originally from Zimbabwe, Pat moved to live in Mid Wales 10 years ago and has been an FCN volunteer for the past four and a half years. She inherited the secretarial duties in October 2014 and early in 2015 the role of Regional Coordinator was added.

I caught up with Pat at the FCN national conference last Autumn at the Royal Welsh Showground near Builth Wells, and recently found out more about her role and the FCN.

How did you get involved in volunteering with the Farming Community Network originally?

My husband and I were asked, due to our experience in agriculture, to join the Diocese of Swansea and Brecon Rural Life Committee through which we met Revd Richard Kirlew. At the time he was the FCN Regional Coordinator for Mid Wales and he inspired me to volunteer for FCN.

Tell us more about your role for FCN and the work of Powys volunteers

The main responsibility of Regional Coordinators is to oversee the organisation and activities of FCN groups at county level. They are the link, with their Regional Directors, to the FCN head office and staff who provide direction for the organisation and support to the volunteers. Key duties are to receive, process and delegate case referrals but in order for this to be effective there should be sufficient, adequately trained caseworkers available as well as adequate resources and safeguards. Making sure that everything is in place in a voluntary organisation is very challenging!

Volunteers can be called on to support farmers through a wide variety of crises from running short of stockfeed to bankruptcy, and from minor family fallouts to bereavement and suicide. Some cases are resolved with a few telephone calls while others require the caseworker to provide support for months and even years. The support takes the form of listening and helping farmers work through the options open to them rather than giving guidance and advice but frequently caseworkers call on the expertise of other organisations and professional people to assist in restoring the farmer’s capacity and ability to run his/her own life.

What are some of the signs that someone from the farming community is struggling with their mental health?

These are much the same as in all sectors of the population, the difficulty being that farmers tend to be more isolated than those who live in villages or towns so there is less opportunity for others to detect the signs. One of the most obvious signs is a significant change in behaviour and another would be that the farmer is not coping with his routine work load.

Ed Ford, Chairman of the National Federation of Young Farmers said last year: “Farmers are incredibly proud people and will not ask for help.” What can we all do to encourage farmers to talk about their mental health?

We should work towards a society in which mental health issues are discussed as freely and non-judgementally as any other, and can provide opportunities and places where farmers can feel safe and comfortable about discussing their wellbeing e.g. setting up Wellbeing Clinics at livestock markets and ensuring that market places provide opportunities for individual farmers to discuss their concerns and problems in private and in confidence.

Pat speaking at the FCN AGM in Autumn 2018

What kind of support can FCN provide when someone does get in touch? 

Once farmers have contacted FCN and requested assistance they are provided with a caseworker who will ‘walk with’ them for as long as it takes for them to regain their self assurance to manage on their own. The caseworker does not give technical advice but rather gets the farmer to talk through all his/her concerns and suggests various options for moving forward. 

If the farmer needs specific professional advice or financial support then the caseworker will indicate the options available and assist with the processes involved. For example in a recent case the father of a family with several children who have special needs was incapacitated leaving his wife (in this case the farmer) to cope on her own in financially straightened circumstances. The FCN caseworker was able to advise the farmer on how to establish that she was paying far above the recommended rent for her small holding; where to apply for grants and support for her special needs children; and finally which agricultural grants and loans she was eligible for to help her through the difficult time. Unfortunately her misfortunes are not over - now she has received notice to vacate the smallholding within one month but her caseworker is still supporting her!

What are some of the most challenging issues facing farmers in Mid Wales at this time?

The combination of last year's long, hard winter with the long dry, hot period during summer has resulted in livestock farmers having used up all their on-farm feed stocks and being unable to build up sufficient reserves to take their normal stock holdings through the winter and early spring. They have been forced to de-stock when prices are low resulting in financial losses. It is at this time of year that farm subsidies are paid out and inevitably some farmers are not paid on time or as much as they anticipated which leads to enormous financial stress. Not to mention Brexit which is making the future so uncertain. Once the political situation has been finalised then farmers, like other business people, can make decisions and move forward with a greater degree of certainty and confidence.

If people don’t receive the support they need, what can happen to them and their farms?

As in other families and businesses this can lead to severe personal and family stresses which may end up in family breakdown or even suicide, and if the family cannot function properly, the farm cannot be run productively which means it will probably have to be sold or in some cases just abandoned! Of all professions in the UK, farming has the highest number of suicides: nearly one per week!

We hear that isolation and loneliness can be a big issue for some farmers. Are there any networks that farmers can tap into?

Farmers can and should participate in community activities and interact with their neighbours and colleagues. More formally young farmers can join Young Farmers' Clubs while all farmers can join the NFU (National Farmers' Union) or FUW (Farmers' Union of Wales). Through these organisations, or other sources of information, farmers will learn of conferences, seminars and short courses designed to strengthen their skills and should make a point of participating in these on a regular basis. One appreciates that it is not easy for them due to the distances they may need to travel and the difficulties of leaving the farm unattended however resolving these issues is easier than sorting out the consequences of long term isolation and loneliness!

Which other organisations do you work closely with, either locally in Powys, or in the rest of the UK, to provide support to the farming community?

Traditionally FCN works with the other farming help organisations namely RABI (Royal Agricultural Benevolent Institute) and the Addington Fund and of course the Government Agencies as applicable to various cases and in some instances in specific programmes like Cymorth Bovine TB control. In Wales the various FCN Groups, led by our Regional Director, are forming working relationships with all support agencies and charities that supply specialist services that may be applicable to achieving FCN’s objectives. The cooperation and information provided by PAVO is an essential component resource for us.

What are the main challenges of the role?

The main challenge of my job is in matching volunteers to cases particularly as we actually do not have enough caseworkers and most of our volunteers do not speak Welsh.

Tell us about some of the most rewarding work you have done at FCN so far

For me the reward is to hear that a caseworker has been able to support a farmer to the point where he/she has overcome their problems and is once more living happily and productively.

When you are not volunteering for FCN, how do you enjoy spending your time?

Walking in beautiful Wales. 

If you want to find out more about the Farming Community Network you can go to the website at www.fcn.org.uk or email help@fcn.org.uk or ring 01788 510866.

If you want to talk to a sympathetic person who understands farmers and rural life you can call the FCN helpline: 03000 111 999. Calls will be answered in person from 7am to 11pm every day of the year. Alternatively you can email the e-Helpline at chris@fcn.org.uk

Powys Dementia Network Day - housing

by Jen Hawkins & Jackie Newey

Health & Wellbeing / Mental Health Information Officers

On Wednesday 20 February we attended the latest Powys Dementia Network event at the Elim Church in Brecon. It was organised by our colleague Sue Newham, Engagement Officer in the team, and attended by a huge variety of organisations and individuals. These included Community Psychiatric Nurses from the Brecon Community Mental Health team, the Macular Society, Mid & West Wales Fire Service and Care & Repair Powys to name but a few.

We will try to capture some of the spirit and information from the day below, but if you would like to find out more and / or attend future events then please get in touch - further details at the end of the post. The last Network event was also captured for the blog in Powys Dementia Network event Spring 2018.

Overview - Heather Wenban, Dementia Lead Nurse, Powys Teaching Health Board

Heather emphasized the importance of continuing to raise the profile of dementia as we have been doing. It is high on the Welsh Government agenda with increasing numbers of people living with dementia as the population ages. She reminded us of the 6 pledges in the Powys Dementia Plan, and also highlighted the significance of working collaboratively with Powys County Council and the Third Sector to achieve the best possible outcomes for people living with dementia.

There have already been many achievements in Powys, including the introduction of the Butterfly Scheme on hospital wards, a rolling programme of dementia awareness training for health board and care home staff, and specialised RITA (Reminiscence Interactive Therapies and Activities) training too.

Heather noted the huge focus on housing in the new Welsh Government Dementia Action Plan for Wales. She is keen to share best practice with colleagues and work towards the goal of ensuring people can live well at home for as long as possible.

Making our communities and housing dementia friendly - Steve Huxton from the office of the Older People’s Commissioner

Steve began by addressing the discrimination and stereotyping that many older people living in Wales face on a daily basis. He said that older people need to feel valued and respected, to lead healthy active lives, to have their voices heard and be acknowledged as “experts by experience” in building communities for the future.

He is pleased to see the rise of dementia friendly communities in Wales, which can make transformative changes for people living with dementia, but recognised that there is a spin-off for communities which become better for all of us as a result.

Whether housing is provided by housing associations, the local authority or Third Sector organisations it is key that important questions are addressed such as - can people access transport, socialise with friends or enjoy green spaces? Steve believed that no one sector can do all that is required - it is important to look at innovative but practical solutions to meet the needs of the over 55,000 people who will be living with dementia in Wales in just the next two years. 

Housing is critical in all aspects of our lives - and creating warm, safe and accessible housing that allows people to live independently for longer reduces the impacts on stretched public sector services as well as improving individuals’ lives. It’s essential to recognise the importance of housing as more than just accomodation, it’s where our days begin and end, where each daily journey starts, it’s the heart of our world that allows us to live the lives we want to lead. We need to move away from theoretical practice and implement something that can make a big difference to people’s lives, creating a Wales that everyone is happy to grow old in.

Understanding housing support needs - Terry Flynn, Powys County Council

Terry is both a team leader for the council’s housing strategy and also a pensioner! After acknowledging the changing demographics of Powys whereby younger people move away for work and education whilst retirees choose to settle here in later years, Terry focused on two specific areas of his work: the bricks and mortar, and housing support needs.

The old sheltered housing model of the 60s and 70s is not fit for purpose in this day and age. Council and housing association stock is being reviewed and refurbished where appropriate to suit the needs of today’s aging population. He was shocked to discover that 30% of accommodation originally designated for older people was no longer suitable, for example, not accessible.

Terry went on to describe a new approach called Extra Care. Working with the health board and housing associations in Powys some of the care homes are being replaced by a different kind of provision. An example of this is Llys Glan Yr Afon in Newtown. Here people can live independently in their own homes but be reassured that extra help and support is available throughout the year. Similar projects are being developed in Ystradgynlais, Welshpool and eventually Brecon.

Terry championed the “unsung service” of Housing Support Needs, who in conjunction with voluntary sector agencies work for one purpose - to ensure people can live independently in their own homes, “to make sure they are on an even keel.”

Sharing information & networking during the day

Approaching dementia differently - Sam Bolam, CEO Dementia Matters in Powys, with Frances Isaacs and Gill Garner

Sam asked us all to think if there is a different way of doing things when working to improve the lives of people living with dementia. “We need to have a beginner’s mind and look at how we can constantly improve and change what we’re doing. It is time for a dementia revolution.”‘When we pause, allow a gap and breathe deeply, we can experience instant refreshment. Suddenly, we slow down, and there's the world,’ Pema Chodron

Sam highlighted the need for change in how we approach supporting people with dementia. It’s not acceptable to just adopt a technical approach, but to recognise and adopt a person centered approach, changing from ‘what matters,’ to ‘you matter.’’ Considering person centered approaches like colour coded tarmac to support people in their daily journeys to and from their homes. Sam showed some stereotypical images of people with dementia and challenged the preconceived view held by many, she called for a dementia revolution, looking at supporting the whole human. 

There followed a conversation between Frances (who lives with dementia) and Gill (who cared for her father who lived with dementia) about some of the difficulties they have and do face and strategies they have used. Frances described, very entertainingly, how she once found herself in a broom cupboard instead of a toilet, and her “Psycho” experience when trying to extricate herself from a steamy shower. But, she said, “there is a life I had never imagined between diagnosis and before I go down the pan.” She went on to describe some of her most rewarding experiences as a volunteer with Dementia Matters in Powys, her love of the open air, and the fun times at Brecon’s Meeting Centre. Frances also impressed upon us that “it is important that you do the things that you love, that are you.”

Information sessions

Alzheimers’ Society’s New Deal on dementia 2017 - 22, and it’s new service model, Dementia Connect - Kerry Phelps

Kerry Phelps introduced the Alzheimers Society as the leading support charity for people with Alzheimers. As an organisation they’re increasing their reach irrespective of circumstances and engaging as many as 1000 people in their consultation processes. She introduced their new service ’Dementia Connect,’ a staged transitional process with five different tiers.

Dementia Connect was trialled in the Pennines, then Birmingham and is now being rolled out in Wales as an early adopter model. The programme followers a befriending model with a dementia support worker assigned to support people with their dementia journey from diagnosis, through to end of life. In Powys Anne Clark is the point of reference for South Powys, whilst Alvine Stewart has been newly appointed as the point of reference for North Powys, both posts offer 28 hours of support a week and are currently based in Talgarth.

The first point of access to the new service is by telephone call to a professional support hub, staffed by trained dementia workers, where each caller has the option to talk to a Welsh speaking support worker should they require it. Most people are able to access support and receive the support and help they need with triage and generalised support. However 70% of people whose queries cannot be dealt with there and then are escalated to the next level of tier 2 support.

Tier 2 support workers offer one to one support in the home with commissioned care plans. After the Tier 2 support has finished a KIT, ‘Keeping In Touch,’ support worker will proactively be in contact six months after the cessation of support to monitor progress and assess whether further support is required. This tiering of service is designed to prevent ‘slippage,’ of people falling through the net and not accessing the support they need.

Access to the service is possible via several pathways. The online referral portal is popular with 90% of current referrals from HSC professionals. Side by Side is a similar model to the Befriending model with the capacity to refer people to the service. Dementia Connect is slowly building momentum in Wales with 30 callers since January to the Welsh speaking support line. There is a wealth of information online with 100 factsheets on the website that anyone can easily access Publications and Factsheets Another useful service provided as part of Dementia Connect is an online talking point forum, lead by people with dementia and their carers, putting people at the heart of the service and helping people to truly connect, sharing support through lived experience, Talking Point - Online Community

Sue Newham, Engagement Officer - PAVO, with Frances Isaacs who spoke about living with dementia

Ambitions in later life

Gill Garner & Frances Isaacs facilitated this workshop looking at practical solutions for people living with dementia.

Finding out about new activities in local areas for people living with dementia - Jenny Hall / PAVO

Watch out for a separate blog post about this recent research project.

Q & A session

The afternoon session gave everybody attending the conference the chance to share their views and opinions about the network and how we shape and develop it moving forward. Sitting in a circle gave a real sense of coming together, connecting and sharing, rather than a “contribute from the floor, more formal feedback” session. The session began by asking what is the purpose of the network? How do we drive it forward? How do people have their needs met and what do we focus on next?

The consensus of opinion was that the service users are our priority and as such they should be more proactively involved in the network, giving us the insight and opportunity to take more purposeful action on specific services. It was suggested that a pre-meeting consultation could be held with a dementia steering group to determine what our focus should be. There was also a felt need to forge stronger, valuable links with other groups working towards a common goal such as the Alzheimer’s Focus on Dementia groups.

To actively engage people with dementia and to be led by their needs and requirements was commonly felt to the best way forward, considering how we actively engage communities, focussing on tangible issues that make a real difference on a daily basis. Recognising that we all need a plan for aging, asking ‘Are you OK? Can I help,’ are questions that can make a real difference to people’s lives.

Trish Buchan, trustee for Powys Teaching Health Board, summarised the day by saying that ‘Today is a giant step, we have moved forward and come a long way. PAVO’s Engagement Officer Sue Newham agreed and added, ‘big picture thinking starts with lots and lots of steps to get there,’ Lets see what else we can do to make a real difference to people’s lives and change what Frances Isaacs, an attendee living with dementia, calls ‘pyschobabble,’ to productive babble.

To sign up to the Powys Dementia Network and find out about future Awareness Days then please contact Sue Newham, Engagement Officer at PAVO, by emailing sue.newham@pavo.org.uk or ringing 01597 822191.

Perinatal Mental Health Services in Powys

Sophia Bird was, until recently, a Principal Health Promotion Specialist at Powys Public Health. Before she moved on to her new role, she updated us about the work of the Perinatal Mental Health Services in Powys. Sophia was also previously on the Powys Perinatal Mental Health Steering Group.

Colleagues from different sectors across Powys who sit on the Powys perinatal mental health steering group have one shared goal: to ensure that all new parents and their families receive the right care, by the right practitioners and at the right time, irrespective of where they live in Powys.

It is estimated that between 10 and 20% of women will experience poor mental health during pregnancy (antenatally) or after the birth (postnatally) and men can suffer from poor mental health during this time too. After all a new baby means many changes for parents and it can take a while to get comfortable with this new role.

The parent-infant relationship is the key relationship for the infant during the early years and helps shape healthy brain development and patterns for future social and emotional relationships. This developing relationship starts during pregnancy, so it is really important that the parent is well and able to support and nurture their infant. A parent’s poor mental health may affect their relationship with their infant and if there are difficulties in this relationship it can result in a less-securely attached infant because babies need parents to respond sensitively and consistently to their needs. If a parent is not well enough to provide this then there can be longer term effects on the infant.

Over the past few years a number of people from statutory and third sector services have been working to develop services in Powys that support women experiencing poor mental health during pregnancy and after the birth. The steering group has representation from midwifery, health visiting, primary and secondary mental health services, third sector and service users and this partnership has been working to improve the support received by women and their families during this special time.

So the steering group has been keen to ensure that Powys services are set up to provide as much support as possible to new parents and their families. Since 2015, midwives and health visitors have been able to refer any women identified with moderate to severe mental health concerns directly to adult mental health services, and alongside this can offer structured ‘listening visits’ which have been proven to be helpful for those with mild to moderate mental health concerns.

In addition, the nursery nurse service can also provide some practical support, alongside community-based services such as Action for Children, Mind's Mums Matter groups, Bump to Buggy walks and Sblash a Sbri - water-based parent and infant sessions.

So, if a pregnant woman, new parent or family member is concerned about their mental health, what should they do?

The best thing they can do is to talk to their health service provider – their midwife or health visitor in most cases. They will be able to support the family, and can refer and suggest other services that can also help.

More generally, the points below are general top tips from Health Visitors:

• Babies are born ready to relate, to build relationships and seek companionship.
• Skin to skin contact helps to build relationships.
• Good relationships help baby’s brain develop well.
• Babies know their parent’s voice(s) and find it comforting, so talk and sing to your baby.
• Engaging with your baby by talking, touching, looking at your baby helps to build your bond with your baby.
• Looking and gazing at your baby’s face helps your baby’s brain to develop well as well as building your relationship.
• Mirroring your baby’s expression and tone can help baby feel understood and manage their feelings.
• Babies communicate using expressions, tone, and body language. When you watch your baby you learn to understand them better.
• When your baby cries, think about what the crying may mean. Touch and comfort can soothe your baby.
• Try putting yourself in your baby’s shoes, babies need their parent to help learn to manage their emotions. Give them a loving, timely response.
• What your baby experiences, what they hear, feel and see, will shape their brain development, personalities and experiences of relationships and the world, so show them your love.
• How a mother/ father feels may impact on their baby – so their needs are really important too, they need support.
• Happy parents = happy baby.
• Breastfeeding is best for your baby, but however you feed, try to respond to your baby’s feeding cues and hold them close when feeding.
• Offering your baby lots of opportunity to explore and play will support their physical, social and emotional learning and development. Tummy-time is great for this when they are little.
• Providing a loving, calm and consistent home life will help your baby regulate and feel secure.

For further information about Perinatal Mental Health Services in Powys contact Suzy Fairclough, tel: 1597 828711 or email: perinatalMH@wales.nhs.uk