Addressing loneliness in Powys: Mental Health Awareness Week 2022

Earlier this week, to coincide with Mental Health Awareness Week, we posted about a number of new community initiatives which have recently been set up in Powys to address loneliness and isolation following the launch of the Connected Communities: Loneliness & Isolation Fund 2022 - 24.

Today we look at two more amazing projects which have both been running for several years now in Powys to support people to access services that are "right for them, which improve their independence and help maintain social networks". So often this means people have the chance to be out and about meeting others, making new friendships and revitalising old ones.

Before we dive into the detail, just a reminder about The Mental Health Foundation, the charity which has hosted the annual Mental Health Awareness Week since 2000. The Foundation explains why Loneliness is this year's chosen theme:

"The Foundation’s Mental Health in the Pandemic research has found that loneliness has been exacerbated by the Covid pandemic. The Foundation has been tracking loneliness levels in the UK during the pandemic and found the experience has been much higher with devastating impact. Loneliness has been an important factor contributing to higher levels of distress, resulting from people’s sense of isolation and reduced ability to connect with others. Further polling also found that loneliness was one of the leading issues that the public felt needed to be addressed."

So in this, the second of our MHAW 2022 week blog posts, we focus on two key services provided by Powys Association of Voluntary Organisations, both of which contribute hugely to addressing the issues of isolation and / or loneliness in the county. These services have played a vital role in supporting people throughout Powys who have struggled through the past two years of Covid lockdowns and beyond.

They are the Community Connectors and Powys Befriending Services.

Community Connector Claire Powell (bottom row, 2nd L)
& partners on the Newtown locality network

Sharon Healey, Senior Officer Community Connectors and Powys Befriending Services at PAVO, tells us more about the work of these two invaluable services, and the impact their work is having on individuals in the county who may be living with challenging mental and / or physical health conditions whilst at the same time also struggling to overcome loneliness and / or isolation.

Community Connectors Service

The Community Connector Service operates across Powys, with 13 Community Connectors based in Localities taking referrals for a wide range of issues – community activities, transport, benefits, housing, health conditions, wellbeing, loneliness and much more.

The Community Connectors can support clients to access the right local support and information. The service helps people in Powys, aged 18 years+ and their families or Carers, to access community level services and activities that will help them maintain independent lives and which will help prevent their circumstances deteriorating to a point where they might need higher level health or social care services.

Community Connectors can also support people when they return home from hospital by helping other voluntary sector services, such as the Red Cross, identify local services that may be needed. This could include occupational therapy, home adaptations, community transport, specific health related issues including dementia, medication/shopping collection or sourcing cleaning and overcoming loneliness and isolation.

During 2021/22 the top presenting issues into the CC service have been Social Isolation and Loneliness. We have supported over 510 individuals presenting with this issue, finding support and signposting them to befriending services, local groups of interest, looking at individuals' circle of support, online social groups, local social groups, etc.

Community Connector Lynda Rogers (far right) supporting Powys Pride

Feedback

“I don't know how I would have got through the last few months without the CCs and everything they had helped find out, put in place and have advised me on.”

G is an 80 year old man who by his own admission used to be a workaholic, spending as much time as he could on his farm in the work he loved. However as he got older this became physically more difficult and after he and his son employed a farm worker to help them out with the business he found he spent most days at home, alone. He hadn’t developed any interests due to his work commitments and felt anxious to leave the house.

G was being supported by farming charities Tir Dewi and the DPJ Foundation. The volunteer with the DPJ Foundation had been supporting G for 6 weeks and their support was coming to an end but G felt that he had enjoyed the volunteer’s visits so much he would like something similar to continue. He was referred into the Community Connectors' Service.

Community Connectors spreading the word out in the local community

His local Connector talked to him about befriending. He liked the sound of this and would like face to face visits. He said that with the support of a volunteer, who he had learned to trust, he would consider going out to meet other people at local group activities.

The Connector contacted the main Befriending providers and found that Age Cymru Powys had a volunteer who might be suitable for G. With G’s consent, he was referred into the Community Helpers’ scheme at Age Cymru Powys and was matched with a local male volunteer later that afternoon. Age Cymru Powys will also be offering him their Mamwlad support.

Powys Befriending Service

PBS - Powys Befriending Service is a project run by PAVO - Powys Association of Voluntary Organisations. The service supports people over the age of 50 living in Powys, to help maintain their independence, build confidence, develop their social network and reconnect with activities in the community or with a friendly cuppa and chat in their own home. The service supports people who have become lonely or socially isolated because of ill health, bereavement, disability, life changes or social disadvantage by arranging a supportive, reliable relationship with a Powys Befriender.

The service offers telephone befriending, 1:1 befriending in the client's own home or in the community, digital online groups and befriending groups in communities and letter or email befriending. Befriending is a process of bringing two or more people together with the aim of establishing an informal social arrangement. Befriending support can lower rates of depression, improve social skills, reduce isolation, improve self-management, improve self-esteem and confidence, reduce vulnerability and risk of abuse, build a sense of purpose and see a reduce in use of emergency services.

Sharon Healey (top right), Senior Officer Community Connectors & Powys Befriending Services

at PAVO joins a Powys Befriending board games session

Powys Befrienders supports clients to access social, leisure, educational or other needs and promotes personal choice, increased self-respect, supporting existing social skills and development of new opportunities. They can visit the client in their own homes or in the community to provide companionship and support. Telephone befrienders have light, meaningful conversations with their client, providing distraction from negative situations or circumstances.

As of the end of March 2022 the service supports over 420 clients through the activities offered. Due to the Covid pandemic the service had to amend its offers due to clients isolating and therefore with the huge increase in demand for support telephone and online support was developed.

Powys Befriending Service is part of a much wider team within PAVO and the wider Third Sector and any additional support required by clients can be sourced via the PAVO Community Connector Service.

Natalie Philbin-Carr (2nd from left), PBS Outreach Officer North Powys
 at a Powys Befriending session lunch

Feedback

Joyce Bettley is enjoying her calls immensely. "I look forward to the calls so much and my Volunteer ** is smashing. We talk about food, recipes, cooking, jam and everything else. It's absolutely lovely. I was reluctant at first but Natalie persuaded me to give it a try and it's the best thing I've done!”

“There is no question that the Befriending Service has been a lifeline for me at a difficult time. I can recommend it to anybody.”

Coffee & Chat Group, Newtown

Jenny Jones - “It was lovely, just to get out and meet people and so spacious, good coffee too!”

A client reported how pleased she is with her Telephone Befriender and that ‘he has made the world of difference to me’. She explained that she really looks forward to his calls and feels pleased that she has been able to help her Volunteer overcome his initial shyness and lack of confidence when talking over the telephone. She said that she is a natural conversationalist and their relationship has become mutually beneficial.

A PBS social event

And finally

If you know anyone struggling with loneliness in Powys, then let them know about services and projects that are available in the county to provide support. 

Community Connectors - contact details

Call our Duty Officer, Community Connector Service on 01597 828649 10am - 4pm Monday to Friday or email community.connectors@pavo.org.uk 9am - 5pm Monday to Friday.

Powys Befrienders' Service - contact details

Call 01597 822191 for an informal chat or email pbs@pavo.org.uk 9am - 5pm Monday - Friday.

Reaching out to people made homeless in Powys

Two Community Connectors working at Powys Association of Voluntary Organisations, Lynda Rogers - South and Rebecca Henderson - North, have been allocated to work directly with clients presenting as homeless via Powys County Council. They will be coordinating the Third sector (voluntary) support which is required by individuals.

I caught up with Lynda and Rebecca to find out more about this important work.

Why are two from the Connectors’ team best placed to carry out this work?

Within the Connector team there is a vast knowledge and experience of the third sector homelessness support, and of working with third sector organisations to find the most appropriate support for the client. This would be after having a conversation with the individual about what really matters to them.

Will you be working closely with other agencies?

Yes, we will be working as part of a triage team of support across Powys. We will be supporting clients either virtually, within a HUB multi agency drop in session, or 1:1 as deemed most appropriate and as suitable. (Currently we are working within the restrictions of Covid-19 and we are not delivering 1:1 support face to face).

The Connectors have vast experience of arranging, hosting and delivering ‘drop in’ information support sessions across Powys. For example, pre Covid some Connectors would hold weekly drop in sessions at library or health settings.

How is somebody referred in for this support?

Referrals are made into the service via our duty system. Upon receiving a referral the duty officer will assign it to the relevant Connector via our Customer Record Management system (CRM). Our duty system operates from 9am - 4pm, Mon - Fri, with an out of hours answerphone system also in place. Referral can also be received via email to a dedicated duty email account.

We have in fact been given a large list from the outset and professionals are referring new clients to us as they add them to the temporarily accommodated clients/ homeless people list.

Tell us more about how the support works

We will work with the client addressing the ‘What Matters conversation’. On identifying the presenting issues we will coordinate the support for the client, accessing the most appropriate and timely third sector support available. We work closely with third sector organisations including POBL, the Mind groups, Ponthafren Association, Age Cymru Powys and Powys Citizens Advice bureau.

As Connectors we will work with other professionals within the partnership (see below) to support the client, address any issues, and ensure clear communication regarding the support that is being given and obtained.

Our work will ensure that support is given in a timely manner, taking into account the fact that most clients are housed in temporary housing accommodation and need to receive support in order to move into more appropriate housing.

Which other organisations are in this partnership?

We are attending the meetings of housing teams and the Homeless Cell Multi-agency group. The latter is a multi agency group formed during Covid-19 to plan support for individuals presenting as homeless. We attend the meetings to ensure that true partnership support is in place for the client. We also inform partners of the support obtained to date, the progress of the support and input into discussions regarding clients.

The added benefit of the Connectors attending a team meeting is also to inform Powys County Council Housing staff of third sector support that is available so that they can more readily support other clients they may be working with.

What experience does the Connectors’ service bring to this work?

The Connector Service has previous experience of working within other teams such as the Dementia Home Treatment Team and the Winter Pressures Co-ordination team, for example, to deliver third sector support to clients.

What can lead someone to become homeless in Powys?

Many things! Every case is different. It could be a breakdown of family relationships. Perhaps parents are not able to accommodate an older child over sixteen. Also there is an unstable private rentals sector and the cost of private rentals can be prohibitive for people.

Homelessness can have a massive negative impact on a person’s mental health.

During the first Covid lockdown in March homeless people were regarded as vulnerable and in priority need. This approach is continuing in the Phase 2 Homelessness Project.

Have you had any feedback about the project so far?

Feedback from clients:

'Hi just wanted to say thanks for your help recently with warm regards.'

'It's been really helpful talking to you, thanks.'

‘I would not have raised the issue with my manager, if you had not pointed out I am being bullied, by accepting the name calling from my colleagues.'

'Thanks so much for helping me find financial support to pay for the vet to look after my cats.'

Feedback from officers:

‘This is great work. We can’t believe the amount of voluntary organisations in Powys who are able to help support people.’

What are the most challenging areas of this work?

The work can be emotionally draining as well as politically upsetting and frustrating.

What are the most rewarding aspects?

Being part of a team where everyone is working towards the same goals, and helping individuals gain support whilst in crisis.

When you are not working as Community Connectors how do you like to spend your spare time?

We enjoy hanging out with our families, cooking, reading novels, gardening and walking footpaths.

Many thanks to Lynda and Rebecca for telling us about their work supporting homeless people. If you would like to find out more you can contact them by emailing: community.connectors@pavo.org or tel: 01597 828649.

Introducing our new Head of Health & Wellbeing - Clair Swales

Clair Swales recently took on a new role at Powys Association of Voluntary Organisations as Head of Health & Wellbeing after previously working as Senior Officer Community Connectors & Info Engine Wales. She originally started work at PAVO in 2016 as a Third Sector Broker & Info Engine Officer and has since overseen the development of the hugely successful Community Connectors’ team within the organisation as well as further developing the online services directory infoengine. We met up with Clair recently to find out more about her new role.

Tell us more about your new role as Head of Health & Wellbeing at PAVO

My role is to facilitate positive relationships between Powys’ Third Sector and the Public Sector in the field of health and wellbeing, enabling third sector involvement in the development of policy and partnerships, championing a joined-up approach to commissioning of services and developing and maintaining effective service user and citizen engagement.

The role incorporates supporting the Health and Wellbeing team, overseeing the work of the Community Connectors and Powys Befriending Service and contributing to the management of PAVO. I also share responsibility with the CEO for the development and delivery of infoengine.

How is the new job going so far?

I began my new post in December 2019 and the first couple of months have been very busy indeed. In January I was delighted to welcome Sharon Healey as the new Senior Officer for the Community Connectors and Powys Befriending Services. It's been fantastic to get to work more closely with a larger team of PAVO colleagues and to continue working with the sector, health and social care colleagues albeit in a new remit.

Clair (2nd from R) & PAVO colleagues saying #HelloYellow on World Mental Health Day 2019

Can you - briefly - sum up the work of the three different PAVO teams you head up - Health & Wellbeing, Community Connectors & Powys Befrienders

Health & Wellbeing - the team supports Third Sector organisations working in the health and social care fields to work closely with the Health Board, County Council and others to develop better services for Powys’ people. It provides an important mental health information service, supports the delivery of health and well-being information via various mediums, and recruits and supports citizen reps for a variety of boards, as well as facilitating networks such as the Powys Advocacy Network.

Community Connectors - The service helps people in Powys (aged 18+) and their families or carers, to access community-level services and activities that will help them maintain independent lives and which help prevent their circumstances deteriorating to a point where they might need higher level health or social care services.

Powys Befrienders Service - Powys Befriending Service helps improve the independence of people over 50 by helping maintain social networks and remain in their own homes for as long as they are able.

Clair with some of the Community Connectors

Why do you think the Community Connectors have, in such a short time, become such key players in supporting some of our most vulnerable Powys residents?

For anyone who may be vulnerable or facing a challenging time, access to the right information at the right time is essential. Often it can be a challenge to keep on top of the latest information about the support that is available. The Community Connectors have become a key link between statutory services, the client and the sector. This has been driven by the Social Services and Wellbeing Act and A Healthier Wales; and the work with the Regional Partnership Board in delivering the Health and Care Strategy for Powys.

What are the main challenges of your new role?

Juggling time and commitments! With a large team and an even larger number of meetings to attend where I represent the sector, it is always a matter of judging the best way I can support the team and the sector in the best way possible. I like the challenge though and always try to ensure that I make time for my own health and wellbeing and ensuring a good work/home life balance.

Why do you think it is crucial that there is a healthy and robust Health & Wellbeing Third Sector in Powys?

There is a huge focus on health and wellbeing at the moment and in particular early help and intervention. Statutory services have changed immensely over the years and the model for delivery, and financial capability of delivering front line services has also changed. The third sector has a crucial part to play in our communities in supporting health and wellbeing but the sector itself needs to be healthy and robust, able to adapt to change and given the freedom to deliver what truly matters to people. Funding is always a challenge but I like to challenge funding bodies such as the local authority and Welsh Government to focus on early help and prevention and how this can be funded in the third sector. Volunteers play a huge role in supporting health and wellbeing in Powys so we must do what we can to look after Powys’ volunteers.

Clair with Andrew Davies, PAVO Health & Wellbeing Participation Officer

If you could change one thing in the Third Sector Health and Wellbeing world here, what would it be?

Ooh wave my magic wand……Other than overcoming funding difficulties within the sector, I would like to see more third sector involvement in the engagement and support of children and young people. Powys’ third sector has lost a lot of capacity in the remit of delivering support for children and young people and I think it is vital we play an active part in this area of health and wellbeing, to help support children and families and play a key role in reducing and preventing issues in the future.

Charities and voluntary groups (including PAVO) increasingly work more closely with statutory providers of health services - how do you think this will affect the sector from the tiniest local groups to the national big charity players?

I think the biggest challenge here is meeting demand. The SSWB Act has a focus on support close to home but we need to ensure that support for these organisations and groups filters right down to the smallest provider. The close work with statutory partners is certainly a positive step forward but I think there needs to be greater understanding of the role of the sector, in particular the smaller groups, that the sector cannot survive on thin air and it shouldn’t be the place to cut funding.

The Social Value Forum is really starting to see small groups and charities benefit from a small amount of funding that can make a big difference in the community. Sustainability of third sector services is always an issue. Powys is heavily reliant on the outstanding work of volunteers but there is only so much volunteers can do and only so much time to give for volunteering as we all work longer. 

Sharon Healey (L)  new Senior Officer for the Community Connectors &
Powys Befriending Services with Clair

How do you see co-production* working successfully in Powys to provide quality health services for all and what is PAVO’s role in this?

We have had some really positive discussions with third sector agencies such as Credu about co-production in Powys. I feel it's really important to include the service user or community’s views to shape services and this needs to be in a constructive and positive manner. To truly enable co-production we have to break down bureaucratic barriers and this can be a big challenge when working with statutory partners as they have their statutory duties to fulfill. Remove the barriers and let the sector work together with communities to shape future services.

PAVO can play an active role in bringing people together, ensuring the citizen and sector’s voices are heard at statutory level, and influence decision making on behalf of the community and third sector. PAVO’s mission is to be a CATALYST of voluntary Action, a legitimate VOICE for the voluntary sector and a HUB of essential information. We are looking at new ways of using the Community Connectors’ community workers’ meetings to co-produce services at community based level as we know in Powys one size does not fit all. It has to come from the community.

Lots of big issues are crowding out the H & W agenda, the Big 4 of Powys’s Health & Care strategy (Cancer, Mental Health, Heart and Respiratory disease), the Loneliness and isolation strategy of the Together for Mental Health new delivery plan. What skills can your PAVO teams bring to the table?

The team has excellent communication skills and the ability to decipher vast amounts of important health and wellbeing information. Using their creative communication skills they make information regarding health policies and wellbeing initiatives easily accessible to the public, and indeed statutory and third sector colleagues. The teams do this through a variety of platforms such as the ebulletins, social media, health lift films, infoengine.wales and by working with people directly; thus meaning there is something for everyone. The team uses a variety of skills to ensure the voice of the citizen and the sector is heard at all levels of the decision making processes. We also benefit from working closely with our colleagues in the development team to support the sector to meet the challenges of an ever demanding, ever changing wellbeing environment.

Clair (2nd from L) at a patient discharge home meeting with colleagues from Third Sector,
Powys Teaching Health Board and Powys County Council

If people identify gaps in mainstream and Third Sector health and wellbeing services - where should they take that information so that the gaps can be addressed?

The Community Connectors’ case management system allows the team to record gaps and unmet need when working with clients. This has proved very useful with our work with the Social Value Forum to identify needs in communities. However this is just one way of recording information, there is a huge amount of information out there and if you speak to residents or people working in Powys communities they know where there are gaps. The challenge is recording it. The team has used the Community workers’ meetings to also record data around gaps and unmet need and if you don’t already attend one of these meetings I would encourage you to do so.

There are a couple of social prescribing pilot projects in Powys. There seems to be a greater appetite for exploring new and innovative ways to tackling some health & wellbeing issues. What are your thoughts?

Firstly I am not sure I like the terminology ‘social prescribing’. We shouldn’t have to be ‘prescribed’ community based third sector services. However people do need to know what’s available to them to support good health and wellbeing. We should encourage and support people to access community based activities where medical intervention is not required. This type of service is designed to support physical activity and promote good mental health.

Have you taken inspiration from others in the fields of health and wellbeing and / or the Third Sector, and if so, who?

I have actually taken my inspiration from my late father. He was very community minded and spent years as a Town and County Councillor always striving to make people’s lives better. Seeing him work so passionately in the community helped shape me and gave me the firm foundations to strive to deliver the very best for people in the work I do today and every day.

Tell us about some of the most rewarding work you have done at PAVO

Supporting the growth if the connector service has been very rewarding and being shortlisted for an NHS Wales award in autumn 2018 was definitely a highlight. But listening to the difference we can make to people’s lives and to the communities of Powys is always heart warming. I am very clear that without the third sector in Powys the county would be less vibrant.

When you’re not working how do you enjoy spending your time?

My spare time is undoubtedly dedicated to my family. I live with my husband (pictured above on my wedding day) and I have three children and two step children. I am normally running around with various items of sporting kit from rugby to football to horse riding gear. I am very proud of the children and enjoy being on the sidelines cheering them on. I also love cooking with my husband. That's my daily de-stress hour when I get home. I enjoy going to concerts (Bruce Springsteen has to be one of my all time favourites along with The Rolling Stones but I would love to see Sir Tom Jones in concert too). I love walking the dog and getting out into the mountains. Getting fresh air into my lungs helps me to feel grounded and reinvigorated.

BIG thanks to Clair for telling us more about her new role. If you'd like to contact Clair then you can ring 01597 822191 or email clair.swales@pavo.org.uk

*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.

Definition developed by the New Economics Foundation (NEF) and Nesta, in partnership with the Co-production Practitioners’ Network

Powys Dementia Network – starting off the new decade

Powys Dementia Network continues to meet at least twice each year in different parts of the county. We wrote about the summer 2019 day, where we were treated to a surprise visit from the children taking part in Hafren School’s intergeneration project, here.

The first event of the new decade took place in January 2020 at Crossgates near Llandrindod Wells. Sue Newham, who is an Engagement Officer in the Health and Wellbeing team at PAVO, helped organise this latest day, and reports back for us now on how the network is growing and evolving to try and meet the varied needs of those attending and looking to find out more about dementia initiatives across this vast county of Powys.

The Powys Dementia Network aims to bring together those living with dementia and their carers, and third sector and statutory organisations providing services for these people. It is funded by Powys Association of Voluntary Organisations and Dementia Matters in Powys.

Getting the balance right has always been an issue, as the needs of organisations who attend and have a table on which to display their literature, are different to the needs and desires of those living with dementia. The number of individuals attending has always been smaller: 3 in February 2019, 6 in July 2019 and 6 in January 2020. Overall attendance varies between 28 and 42. Venues cycle between north, mid and south Powys and the events are held every 6 months. 

Deborah Gerrard, Chief Officer of Dementia Matters in Powys

The general structure of the day has evolved, and with strong input from Dementia Matters in Powys, the last event included a period of practical activities, including drumming, art and story-telling. People could refresh themselves at a “water bar” with a selection of waters flavoured with fruit, and there was the opportunity to experience virtual reality trips to the beach and the countryside. These activities enabled people to chat and share their stories, and proved a very popular part of the day.

Feedback from the last event was very positive with more than half of the participants rating it as excellent and the remainder rating it as good. No one rated it lower.

Positive outcomes for Jane (not her real name):

By attending the last two Dementia Network events, Jane has heard about the many services available to support older people, including those with dementia. She has become more able to discuss the possibility of dementia in herself and has expressed more contentment as a result of this.

Jane had displayed growing levels of frustration with lapses of memory, and was prone to talking negatively to herself about being “a silly old woman” and telling herself off for lack of concentration. By hearing from others living with dementia, and getting used to the term dementia in her own life, she is more positive about herself, realising that she can’t simply “pull her socks up” and perform better. She is more at peace with herself.

As a result of hearing about the “My life, my wishes” booklet at the Dementia Network, Jane has started completing this with her family. She has also made provision for powers of attorney covering finances and health and wellbeing.

After attending the Dementia Network in Newtown in July 2019, Jane felt able to speak at the January 2020 network event, which is something she has not been used to doing before. Participants were impressed by her desire to carry on with her life and to live as independently as she could for as long as she could.

Lucy Taylor, PAVO Community Connector

Positive outcomes for Lucy:

Lucy Taylor is the Community Connector for Llandrindod and Rhayader and also attended the day. The network is invaluable for her – “I’m able to catch up with people I’ve not seen for a while due to everyone being so busy! The mix of people attending, from those living with dementia to practitioners, and others on the side, is really very good. I also picked up two referrals on the day and am providing ongoing support to these new clients.

I thought it was particularly powerful to hear two people speak about living with dementia, and others have said how brilliant that was. People hear the word ‘dementia’ and start thinking – that’s the end of everything and I’ll just forget things now. But for most people it is a much longer journey and they live with dementia for a good period of time. So this was a really positive message to come out of the day. By speaking they also raised awareness of how they first became aware of small signs of dementia which occurred in their daily lives.

There were some fantastic activities on the day, such as the drumming and the water bar. And they all had a purpose, they weren’t just random activities. So, for example, the drumming was obviously social but also that kind of rhythmic tapping is very calming, whilst the water bar brought home the message that you need to stay hydrated to keep in good health!

It would be really great to try and bring in people from the smaller communities in the county at future events too if at all possible”.

The next Powys Dementia Network event will take place in Brecon on 15 July 2020. If you are interested in finding out more then please contact Sue Newham by emailing sue.newham@pavo.org.uk or ringing 01597 822191.

Wellbeing - our PAVO staff day

Earlier this month the Health & Wellbeing team at PAVO organised a Staff Wellbeing day for colleagues in the organisation. In Britain, most of us don’t tend to cultivate our minds in the same way we give to our bodies. We agreed it was important to give space to colleagues to consider their wellbeing and how they might look after it.

There are various definitions of “wellbeing,” from that promoted by the World Health Organisation to the Buddhist definition of Tibetan monk Matthieu Ricard:

"Wellbeing is not just a pleasurable sensation, it is a deep sense of serenity and fulfillment. 

 A state that actually pervades and underlies all emotional states 

and all the joys and sorrows that can come one’s way."

The day, which took place at an amazing venue - the Mid Wales Arts Centre in Caersws - was totally dedicated to experiencing activities that might impact on people’s wellbeing. No presentations. No policies. No papers. Instead people could choose from the range of activities on offer, or they could just enjoy being in an inspiring place. 

Freda Lacey, Senior Officer Health & Wellbeing, introduced the day

So I’m just going to give you a little bit of context around “wellbeing” and what that means. I think you all had the email about the Five Ways to Wellbeing – this has been promoted for many years across Wales and beyond. If I was to ask you to shout out those five ways to wellbeing to wake you up a little bit:

1. Exercise (Be Active).
2. Keep Learning.
3. Connect.
4. Be Creative & Give.
5. Taking Notice.

Mindfulness could be another, but I can see someone counting! That’s more than five! There are probably many others. In fact, in doing some of the research for today you can just get lost on the web in the amount of information about wellbeing. There are the Twelve Pillars. The Four Constituents. But it was really interesting to delve into that.

So those five key themes are what underpin lots of information around wellbeing.

It’s been a real team effort today – that sense of coming together around a theme and / or something that really means something to the team. I think it’s what unites us. In terms of PAVO, as well, it unites us in terms of our work. We hear about the wellbeing of people and organisations. There isn’t one organisation that isn’t about wellbeing on some level.

Even from providing freshly made smoothies this morning it was all about – how can we set people off in the right way in terms of really feeling that sense of wellbeing – even about what you’re taking into your body. Even the food today has been really mindfully considered in terms of local ingredients, where it’s come from, how it’s been put together. The venue has also been carefully considered in terms of what that brings for us, and hopefully it allows us to be creative and indulgent, just to be in this beautiful space.

I just wanted to talk a little bit about the day. We have had some colleagues feel a little bit uncomfortable about today. We can all put our hands up and say we are uncomfortable about some things when we head into areas we haven’t explored before or experienced before. And one of the things about today was to move away from the theory of wellbeing, ie: the words, to being more able to experience an activity and / or activities and what that looks like.

Again, we all have ways of enabling or working with our wellbeing. Today was just to give you a flavour of what could be and what different activities could augment or give you a sense of wellbeing. And most of these activities have an evidence base behind them. So they are known to lead to wellbeing. Walking, for example, or, indeed, meditation. 

And something I explored earlier this summer with Academi Wales was the concept of moving into your ‘negative capability’. If you look up the words ‘negative capability’ it’s actually been around for quite a long time, it was the poet Keats who came up with it. He talked about exploring the edges of where your comfort levels are or what you think are the things you should be good at. And what he was talking about was moving into that negative capability, about understanding perhaps those areas where you might explore which might give you a sense of capability or, indeed, wellbeing that you might not think would give you that.

And so part of today was also about exploring that, about offering new opportunities such as Laughter Yoga. How many people here today have experienced Laughter Yoga before? Okay, a couple. Even I had a particular viewpoint of Laughter Yoga which turned out not to be the case! Because I said, “we’re not going to do that are we?” And then the team said, “No, no, it’s not like that at all!” 

So I think it’s just about really exploring that edge of where your comfort level is, to risk maybe today, in terms of doing things you wouldn’t ordinarily do. And it’s also really about looking after yourself. So if there’s something you’re doing, or you’re indulging in something, and you really feel uncomfortable, and you don’t want to do it… Let’s say in meditation I’m asking you to close your eyes or to be silent and you don’t want to do it – you don’t have to do it. This is not about forcing you to do something that you really don’t want to do.

And if you’re in an activity where you think – argh, I just cannot get into this, this is not what I want to be doing – don’t do it. Just leave or sit and be observant. Be mindful if you’re sitting on the outside what that might feel like to the group, but it’s not about forcing you to do something you don’t want to. It’s really about your wellbeing and your responsibility, your ability to respond to that yourself. 

I was speaking to S earlier, something that came up about that sense of moving into something you’re uncomfortable with. When we were talking about the day S said – “Oh, I’d like to do ALL of those things, apart from meditation. It’s not really for me.” So I laughed and I said, “oh, that’s interesting because I’m actually leading the meditation.” And she said to me, “Well, if you can be quiet for that long…!” 

And I think it’s really important to add that S said that she doesn’t feel that it’s the right thing to do this morning because she’s had a family upset and she’s really looking after herself in that way because she feels that being in that environment – maybe being quiet, closing your eyes or whatever might come up – is not what is comfortable for her today and I really honour that – that you’ve looked after yourself in that way. And that you’re vulnerable and saying that I’m not in that good space today. Again it’s really about saying if that’s the place you’re in then that’s OK.

OK, so the aim for the team today is that you have fun! And that you explore different things that you’ve maybe not indulged in before. That you in essence flourish. That there’s a sense of wellbeing when you walk out this afternoon. So we’re hopeful that that is going to be the case. 

Feedback following the activities:

• I really enjoyed it.
• I loved doing the Dabble with Art. It was a new thing to try.
• The singing, that was fab. Really good. I didn’t expect that to be so professional! We just sounded good from the start!
• It’s discovering those hidden talents of colleagues. We’ve just come out of a jamming session and again just aware of colleagues’ talent.
• I think the whole day, the venue itself is really interesting and thought-provoking – just a pleasant place to wander round and kind of absorb things. And first time Tai-Chier – loved it. Fab.
• I think that jamming session was fantastic. I didn’t realise we had so many musicians in PAVO. Loved it.
• I’ve had a really nice day spending time with my colleagues in a different context – not working.
• It’s actually been nice seeing colleagues that you don’t normally see, and speaking to people you don’t normally speak to on a regular basis.
• There was one session that was definitely out of my comfort zone – that was Dabble with Art – and I deliberately went for it. And Sue was brilliant, and even I came out of that session having both enjoyed it and benefited from it.
• Seeing people with smiles on their faces – quite often we’re all quite serious at work. I know we all smile from time to time! But people have been generous with their smiling. 

Going forward

Freda rounded off the day by suggesting how colleagues could link with community organisations to pursue activities they may have enjoyed:

We’ve experienced quite a lot of different things today and the opportunity is there to use our Community Connectors to connect ourselves with our local communities for those of us who would like to go forward and maybe take opportunities to do classes / activities, whether it’s pottery or Tai Chi, meditation, or anything really.

If you have any thoughts about wellbeing, and how to encourage it to flourish, let us know in the comments’ box below.

Compassionate Communities

Dr Julian Abel and Dr Helen Kingston

Last month I attended a seminar with colleagues from Powys Teaching Health Board, PAVO’s Community Connectors and our Health & Wellbeing team at Bronllys Hospital in South Powys. It was to learn about a new model of Primary Care working to provide health services. Compassionate Communities is its name and it has been operating in Frome in Somerset successfully for the past 3 years.

Dr Helen Kingston, a Senior Partner at Frome Medical Practice, and Dr Julian Abel, Director of Compassionate Communities UK, were travelling throughout Wales to spread the word. 

In brief, the three key messages, which I took away from the session

1. People – you, and me, our families and friends (the actual or potential patients or users of the health service), benefit hugely from this way of working. 
2. People – the ones working to provide the health service, from GPs, nurses and pharmacists – right the way through primary care services – are enthused, reinvigorated and actually enjoying jobs where their actions make much bigger differences to people’s lives. 
3. Money – is saved. Emergency hospital admissions drop drastically. 

The Compassionate Communities' approach is about joined up or “integrated” working. The focus is on people. The community in Frome appears to have been transformed. It looks like a genuinely supportive network. We all hope (but don’t necessarily expect) that people would rally round if we were struggling to deal with not just our health, the unexpected curve ball life had thrown, or even the mundane challenges of day-to-day life. In Frome it appears to actually happen. People help each other within this system. And, as a result, their health and wellbeing improves. 

Maggie Sims (Regional Partnership Board public representative) and
Andrew Evans (Assistant Director of Primary Care, Powys Teaching Health Board) listening to Julian

The original motivation – Julian tells us more

“We asked - how can we do what’s best for people? It’s common sense that if they are lonely they need support. Friendship. Love. Companionship. That’s what’s needed. Not a tablet.”

Julian described the essentials that are required for this kind of approach – specialist care, generalist care, compassionate communities and civic actions – and how these can affect health and wellbeing in local populations. It was all these components, working together, that led to the dramatic impact in Frome.

It is a whole population intervention – equally as valid to a teenager as a frail elderly person. The teenager might be bullied at school, cyberbullied at home, become depressed and have poor educational outcomes. Drug and alcohol misuse could establish leading to life-long problems. The solution in the context of Compassionate Communities is at school – the civic community, and at home – the community.

It is the union of the new model of primary care and the Compassionate Communities approach which brings about change. But, how you implement change is as important as the change itself. We are used to the permissions effect of top down change. This approach requires the people who do the work to implement change in a systematic way, determined by ground up change.

It is also about looking at people rather than the medical conditions they may have. “If someone is suicidal because of loneliness then their chronic lung disease might not matter to them,” said Julian.

It is about not having treatment rather than having treatment. It is about networks of support. Fifty years ago people would rally round to give extra support – but this response has been lost to some extent in local communities. Yet the resources at our fingertips are enormous, and our natural networks can extend up to five hundred people. So much is going on in communities that may be untapped. It makes sense to use that, to have a profound impact on people’s health and wellbeing, and because this is the focus, almost the unintended consequence is that emergency admissions drop. 

Dr Mary Hughes and Dr Sean O'Reilly from Haygarth Doctors' Practice

The Compassionate Communities approach in a little more detail – Helen tells us more

There are three main components to the model:

1. Clinical team and GPs. 
2. Community workers. 
3. Integration across the Health & Social Care sector. 

Previously staff in Frome worked in separate silos depending on the disease they were treating. They wanted to get back to basing care around what the individual needed – to improve care, and also their working lives. Helen described the anguish staff experience sometimes. A human being in need sits in front of them but they can only focus on just one small part of the story and have to ignore the rest. It is about recognising firstly that life is complicated – separating self-esteem from physical issues is not possible; and secondly that human relationships are powerful and in many instances, the most beneficial in maintaining and achieving health and wellbeing.

First on left: Freda Lacey, Senior Officer Health & Wellbeing Team at PAVO

Setting up a hub in Frome

The hub is the single point of access in the community. Staff - the primary care team (GPs and nurses), work alongside the new Health Connectors (akin to our Community Connectors). Volunteer Community Connectors (akin to Community Champions) are out in the community, they can be post people, the hairdresser, local shop keeper, milk person, taxi drivers, sixth form students, but have a route into liaising with primary care staff at the hub, if this is needed.

So, when people call, it’s not just about discussing medical matters, but also other things that are important to them. “We have turned life’s difficulties into a disease and medicalised everything and then use the medical model to manage it,” explained Helen.

There may be a window of opportunity in a crisis situation. It is about empowering staff to take a different approach. But, also, about meeting people where they are. “There’s no point telling someone about community groups if they have to work up courage to go and buy milk”.

Mentors work with staff to help them change their approach. Stories at team meetings can turn hearts and minds and people begin changing their way of working. Helen suggested finding key people in practices who are enthusiastic to work with initially, so the energy goes with the flow.

Mistakes will be made, but we can learn from them. It is about being creative in our approach.

Suzanne Iuppa, PAVO Community Connector, contributing to the discussion

The voluntary sector

In Frome, the paid Health Connectors (now mainstream, funded for three years) work very closely with an “amazing voluntary sector”. Health Connectors offer one-to-one appointments and do care planning (“they are the glue, but not necessarily the experts”). They recognise that 95% of the support that people need is around them in the community, and link them in. Some people may not be ready to accept help immediately, but Helen’s advice is “have courage and be persistent. They will come back when the time is right for them.” Many of people’s problems are solved outside the medical practice in this model.

Over 400 groups and services are listed in Frome’s electronic healthcare recording system so social prescribing is at their fingertips. When patients are signposted this is coded on to the system. The nature of the conversation changes with this website directory immediately to hand. (In Powys we have the online service directory infoengine, and although it is not currently linked in to the GP electronic system here, we are in discussions about this with a provider of this type of technical service).

Then there are over 600 trained volunteer Community Connectors (Community Champions). These are interested members of the public, whose role is not 1:1 work but to raise awareness of the service. In an ideal world, everyone would be a Community Connector or Champion! Each person signposts on average twenty times a year.

Building community resilience

Other options for people:

• Talking Cafés – drop-in sessions run by the Health Connectors. Anyone welcome. Signposting to other resources and places to make friends. 
• Health Connectors’ groups – peer support groups following 1:1 work. 
• Self-sustaining groups – leg ulcer, diabetes, macular degeneration, stroke support… and many more. 

Helen finished the session with a couple of detailed case studies which brought the Compassionate Community approach to life.

“Most small acts of kindness happen with individuals. It’s building that capacity. It’s about face-to-face relationships, and people caring for each other. About having that conversation that might not have happened.”

What do you think about the Compassionate Communities approach? Here in Powys we already have a lot of the elements of this model in place – we have our Community Connectors’ team, an equally amazing voluntary sector, and the online service directory infoengine. And work is well underway to further integrate systems and teams to do what’s best for people here too.

Once we know how this work progresses we’ll update you in another blog post. Watch this space!