OPERATION SNOW ANGELS EVALUATION A collaboration of organisations committed to improving the health and wellbeing of vulnerable people in mid Cheshire during extreme cold weather. Contents Executive Summary Section One: Operational Plan 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 Background Outcomes Project design Local profile of excess winter deaths Shared understanding of partnership activities and working arrangements Priorities for inclusion in the pilot Key recommendations from the National Support Team Development of Snow Angels services Development of a systematic approach Funding arrangements Section Two: Evaluation 2.1 Increase in access to preventative services 2.2 Increase in volunteering in local communities 2.3 Decrease in accidental injuries, illness and death and reduce social isolation 2.4 Improvements in partnership working and the development of an action learning model 2.5 Impact Map Section Three: Future Development Appendix A List of Partners Appendix B Cold Weather Conference 1 Executive Summary Operation Snow Angel was a collaborative project recruiting volunteers to support older and vulnerable people during extreme cold weather. The support offered was in the nature of being a pair of “helping hands” or a good neighbour, to complement services during periods of high demand. This pilot also aimed to develop a working model which could be used in the future. There were sixteen partners involved in the development of the scheme with representatives from the public sector, private sector, and voluntary and community organisations. The project was developed in response to the percentage of excess winter deaths in Cheshire West and Chester being above the regional average. This is a key priority for the Ageing Well strand of the Community Budgets programme “Altogether Better”. Whilst the previous two winters have seen some extreme cold weather the winter of 2011/12 proved to be mild with very short spells of extreme cold weather. This did however enable the main elements of the project including structure and design to be tested. The evaluation is based on the pilot that ran in Northwich and surrounding villages from January to March 2012. The full details of the operational plan are included in Section One. The evaluation is summarised in Section Two. It is based on the primary aims of the original plan and includes the results of surveys to partners, volunteers, and customers and a number of face to face interviews. The project had a major impact in terms of reducing social isolation, increasing access to preventative services, providing reassurance to older and vulnerable people and their carers, improving partnership working, increasing volunteering, and offering support which may have an impact on reducing accidents, illness and excess winter deaths. Proposals for future development are included in Section Three and these are based on discussions with a range of partners and consultation with customers and volunteers. The two key recommendations are that this service should be extended to provide support to people who are at the highest risk of excess winter deaths using the model developed and building on partners’ expertise. Secondly, that this project should operate seven days a week from late October until the end of March reflecting the seasonal adjustments for daylight hours. There are a number of options which could be considered in terms of funding future schemes including contributions from the customers, external funding opportunities, commercial sponsorship, and funding arrangements with the major partners including the local authority and the NHS. 2 Section One: Operational Plan 1.1 Background There are a number of organisations who deliver services to residents in the local area to ensure that they are able to maintain an independent lifestyle. However adverse weather conditions can mean that these services are either stretched or need to be delivered in a more flexible way. There is also a need to ensure that services are co-ordinated and accessible to the people who need them. During the extreme cold weather in 2010/11 Community Partners Cheshire regularly contacted their members and ensured that shopping was delivered by their drivers and that other assistance was offered during the few weeks when their transport service was suspended. Following discussions with other voluntary sector partners it became clear that a larger number of potentially vulnerable people would receive assistance if the effort to deliver services was coordinated. Cheshire Fire and Rescue Service were also developing an approach to Cold Weather Planning through the Local Resilience Forums and the Health and Well Being Board. The Operation Snow Angel partnership was developed in October (key partners are listed at the end of this document) and it was decided to pilot a project in the Northwich area which could be used as a case study for a national conference in 2012. Operation Snow Angel was designed to support older and vulnerable people in the local community by bringing together existing services and improving access to these services, via the support of Snow Angel volunteers, during periods of extreme cold weather. The project included recommendations from the National Cold Weather Plan published in early November 2011 and from the toolkit produced by the Health Inequalities National Support Team through their report “How to reduce the risk of seasonal excess deaths systematically in vulnerable older people to impact at population level” (2010). 1.2 Outcomes The project aimed to deliver a range of preventative and responsive services based on the needs of local people in the area with more intensive support being delivered to the most vulnerable people in the community. The outcomes that the project aimed to deliver were: Increase in access to preventative services to enable people to keep warm and well Increase in volunteering in local communities Decrease in accidental injuries, illness and deaths caused by extreme cold weather Decrease in social isolation during extreme cold weather periods Improvements in partnership working across the community and voluntary, public and private sectors Development of a model through action learning 3 Longer term development of more resilient communities and support to vulnerable people The measurements to be used include both quantitative measures e.g. number of hospital admissions for falls and qualitative measures e.g. reduction in social isolation. 1.3 Project Design The geographical area for the project was Northwich and surrounding villages and is illustrated on the map below. This area is part of the Northwich and Rural West Area Partnership Board and includes both urban and rural areas. The target client base for the most vulnerable people was developed using data analysis of the routes for assisted bin collections that included disability, age, and access to property information. Other databases considered included the data sets that Cheshire Fire and Rescue Service use to deliver Home Safety Assessments and a database of oxygen users. The number of people in the proposed catchment area who are on the assisted bin collection route was nearly 1,300. The criteria for inclusion in the assisted bin collection scheme is strict and essentially means that there is no-one in the household who is able to move the refuse bins to their collection point and medical evidence can support the claim. These households included people who are elderly with mobility issues or other disabilities, and people who have difficulties remembering the collection times and days etc. Environmental Services were not able to segment the list according to the various criteria they use although information maybe available in this format in the future. Out of the total number of households who are registered on the assisted bin scheme there were nearly 400 who are also registered with the Careline scheme managed by Weaver Vale Housing Trust. Households on the assisted bin collection route were sent a letter asking if they would like to be involved in the scheme and asking them to phone the Response Centre at Weaver Vale Housing Trust to register. When they registered the opportunity was taken to give them general advice about keeping warm and well. 4 It was decided that the best trigger for extreme cold weather would be provided by the Met Office via Age UK Cheshire who have access to the national alert system giving notice of localised extreme weather conditions four days in advance. In November 2009 the Office for National Statistics reported an estimated 36,700 excess winter deaths for the period 2008/09 which was a 49% increase over the previous year. The majority of these deaths occurred in people aged 75 years and over. 1.4 Local profile of Excess Winter Deaths (EWD) “There is evidence that isolated elderly people can be vulnerable to excess winter deaths whatever their social background. Other preconditions include fuel poverty and poverty, poor housing stock, chronic disease and co-morbidities” (NHS Western Cheshire). The rate of excess winter deaths in Cheshire West and Chester is higher than the average in the North West (CWAC rate is 20.1 and the North West average is 17.6). The difference between the actual death rate and the expected death rates is particularly high for Cheshire West and Chester with regard to respiratory diseases. Because of this the oxygen user’s database was also considered within the analysis. Further investigation of the excess winter death data made it clear that it could not be used to predict where or who would be most vulnerable but rather key factors would need to be covered. However the Joint Strategic Needs Assessment for Cheshire West shows that nearly 75% of the incidence of excess winter deaths was amongst the over 75’s, and that this accounted for 209 deaths in Cheshire West and Chester in 2009/10. During this period the incidence of excess winter deaths were highest amongst the more affluent areas. The key risk criteria were age, female, respiratory or cardiovascular conditions, living alone, or living in nursing or residential care. 5 Discussions with East Cheshire NHS Trust meant that a structure was put in place for Podiatry team and the Respiratory team to refer vulnerable patients into the scheme. This was particularly important as there was no Community Matron in the Northwich area. The intention was that District Nurses would circulate information about the preventative services available along with sources of advice and information about keeping warm and well. 1.5 Shared understanding of partnership activities and joint working arrangements All the partners were asked to complete a brief survey which asked for details of services currently provided, needs of individual memberships, potential services etc. These results were collated and shared with the partnership and formed the basis of developing the scheme and the potential roles of the volunteers. This consultation provided a basis for developing the types of referrals to services which could be developed alongside the delivery of “helping hands” support which could be delivered by the Snow Angels. In addition the recommendations from the National Support Team for key interventions to reduce excess winter deaths were considered. The partnership was a collaboration of partner organisations with Strategic Partnerships Consultancy providing the role of Project Director. 1.6 Priorities for inclusion The following table lists the potentially vulnerable groups for prioritisation for a Cold Weather Plan. As this is a pilot exercise the plan has been limited to older adults and adults with physical disabilities. At risk Groups Datasets Scope Over 75 years old Home Safety Assessment data for over 75’s? In scope if need assistance Frail GP referrals Potentially in scope Pre-existing illness including respiratory diseases e.g. asthma Oxygen users details held by Cheshire Fire and Rescue Service In scope depending on levels of assistance currently available Severe mental illness Referrals possible through Cheshire and Wirral Partnership (CWP) Out of scope for pilot Dementia May be included in assisted bin round information Potentially in scope Learning difficulties Referrals possible through Cheshire West and Chester Out of scope for pilot Arthritis, limited mobility or otherwise at risk of falls May be included in assisted bin round information In scope 6 Young children Children’s Centres Out of scope for pilot Living in deprived circumstances MOSAIC data Out of scope – too generic Living in homes with mould Not unless deemed unfit housing Out of scope – information not available People living in fuel poverty MOSAIC data Out of scope Elderly people living on their own May be included in assisted bin round information In scope Homeless or people sleeping rough Housing Solutions Rough Sleepers count Rough sleepers targeted by Police and Fire during extreme weather to deter people lighting fires in derelict/empty buildings Other marginalised groups Recommended groups include travellers and analysis of Black, Asia & Minority Ethnic (BAME) community Out of scope for pilot 1.7 Key recommendations from the National Support Team (NST) for Health Inequalities There are a number of key recommendations from the National Support Team to reduce the number of excess winter deaths at a population level. These were considered during the project design phase and it was possible to implement some of them in the timescale. The key recommendations are summarised below: That the most vulnerable people are living in houses that are safe and warm Advice leaflets for keeping warm and well and gloves and socks were provided by Age UK Cheshire and these were part of the registration process during the initial registration visit. In addition large thermometers which clearly showed the optimum temperature range were also delivered. Referral processes to the Cheshire Warm Zone project, Cheshire West Citizen Advice Bureau and Age UK Cheshire were established for extra support regarding keeping warm, benefits or debt when needed. Annual flu and pneumococcal vaccination and provision of annual medication review and annual medicines utilisation review 7 This information is held by the relevant GP services. Through discussions with NHS Western Cheshire it was agreed that the relevant permissions to share data would not be able to be secured in the timescale available. Implementation of personal brief health interventions, assessment and support programme to prevent falls, and assessment for appropriate assistive technologies The programme to prevent falls has been de-commissioned in this area and an assessment is now provided through the Accident and Emergency services at Leighton Hospital. The catchment for the pilot area also means that some people would access the Accident and Emergency services in other hospitals particularly Warrington. There is a small telehealth pilot being developed in Northwich and there is an established telecare project through the Careline service operated by Weaver Vale Housing Trust. Development of personal crisis contingency plan (e.g. including a buddy scheme), where no close friends and families are available. This is the basis of the Snow Angel volunteer scheme and aims to provide assistance to vulnerable people during periods of extreme cold. 1.8 Development of Snow Angels services The role of the Snow Angels will be to respond to requests for assistance during periods of extreme cold weather to ensure that people are kept safe and warm. Suggested and expected requests for support were around path clearance, making sure people are warm, assistance with shopping, picking up prescriptions, and referrals to other agencies when appropriate. The Response Centre at Weaver Vale Housing Trust co-ordinated: The initial registration of people opting into the scheme and recording details to assess the levels of vulnerability and need. Registration included details of GP’s, next of kin, specific services required, whether the person lives alone, age, and medical condition, along with other relevant details. Weekly telephone calls throughout the pilot to ensure that people are safe and warm. Daily telephone calls through periods of extreme cold weather to assess needs with support from Age UK Cheshire and Vale Royal Disability Services. It was intended that the Response Centre and the Snow Angels would also Determine which preventative services should be delivered including for example benefit checks and insulation services, and refer to appropriate agency for telephone contact and/or home visits. Ensure a Home Safety Assessment is carried out with appropriate sign posting to other services, including referrals to Careline to assess the potential need for adaptive technologies. Establish what other support services are already being delivered and make contact with the providers. 8 1.9 Development of a systematic approach The case management software system recorded customer details, information about the Snow Angels key interventions which took place, contact details for GP and key workers and any other interventions which have been provided. The database was web based to ensure that the system could be kept up-to-date by nominated colleagues from different organisations and closely monitored by the Co-ordinating Group. The Co-ordinating Group included Cheshire West and Chester Council, the Local Resilience Forum, Cheshire Fire and Rescue Service, Cheshire Constabulary, Weaver Vale Housing Trust, and a representative from the NHS. The Co-ordinating Group had a number of roles: to ensure that vulnerable people who have opted into the scheme had been contacted and provided with additional help where necessary; to monitor the range of requests to establish any patterns in the referrals; to provide and update the volunteers via SMS and email; and to report relevant information to the appropriate contacts in the Emergency Planning structure. During periods of extreme cold this group would meet daily and if necessary in a virtual way (due to the weather). However as the weather was relatively mild all the partners were provided with updates throughout the scheme via a weekly e-bulletin. . 1.10 Funding arrangements 9 The project started in October 2011 with an initial meeting of the partners and at this stage there was a small amount of funding for project co-ordination. The Northwich and Rural North Area Partnership Board provided funding for equipment for the Snow Angels volunteers including telescopic shovels, high visibility jackets, funding for heaters for emergencies, large thermometers for customer houses, and gritting supplies. The Department of Health funding was secured in mid-December through the “Healthy People, Warm Homes” programme and this contributed towards the software development and hosting fees, project management costs and communications such as press packs, volunteer training and expenses. Weaver Vale Housing Trust contributed towards the cost of the evaluation report of the project and Cheshire Fire and Rescue Service and Snow Angels Cathy, could you write CIC in full are jointly supporting the costs of a conference to be held in September 2012. In terms of cash contribution the total funding package was £22,000, however there was also a significant investment from partners through in-kind funding, and the investment of time from the volunteers. At a conservative estimate the value of volunteering would be £4,200. Section Two: Evaluation 2.1 Increase in access to preventative services to enable people to keep warm and well During the planning stage a range of preventative services were identified that would be useful to the group being targeted by the project. These services included access to benefits advice; energy efficiency programmes including Cheshire Warm Zone which offers free insulation and other measures; advice and information services; and home safety assessments. These partners were contacted to ensure that they were aware of the scheme and would be able to respond to Snow Angel referrals. In addition during the planning stage and throughout the pilot other agencies contacted Snow Angels to register their services including Mears Home Improvement Agency and Deafness Support Network. The original plan was to send customers a range of leaflets about services when they registered on the scheme by phone however a number of people requested that they were not sent them. At the introductory visit customers were asked if there was anything that they needed any help with or would like any further information about services and some generic leaflets were left with customers. The number asking for further information was low and whilst a few referrals were made to other organisations they did not reflect the issues that older people were dealing with. A particularly difficult area was around benefits and several people on disability living allowance, whilst stating that their disabilities had worsened over the last few years, were not prepared to explore the potential for additional financial help. They expressed concern that cuts in central government funding would mean that their existing benefits could be reduced or withdrawn. However the majority of people who responded to the evaluation postal survey, said they would like further information about a range of services, particularly handyman services. 10 This may be because the trust and confidence developed through the Snow Angels project was being transferred to other services offered. The project produced over 60 requests for referrals to services demonstrated in the Impact Map (see below). Access to these types of service will have benefits for differing stakeholders. For example, the NHS home adaptations service will enable older people to live independently for longer, reduce the impact of long term conditions and potential accidents and falls which impacts on Adult Social Care as well. Improvements in energy efficiency (and associated reductions in fuel poverty) will have an impact on longer term health conditions that are affected by cold and damp including cardio-vascular conditions, respiratory conditions, and arthritis. The customers requested a list of trusted trades companies they could use. Following Age UK Cheshire advice Trading Standards at Cheshire West and Chester were approached to develop the list. Unfortunately the number of local companies in this scheme was very low. 2.2 Increase in volunteering in local communities There were a number of different routes for volunteering including volunteering as an individual and through the employer. The scheme had 42 volunteers. The individual volunteers were hosted through Cheshire Community Development Trust. Organisations 11 who provided volunteers included Age UK Cheshire, Vale Royal Disability Services, Groundwork Cheshire, Cheshire Fire and Rescue Service, Cheshire Constabulary, Weaver Vale Housing Trust, Cheshire Community Development Trust, and Cheshire West and Chester. There were two training sessions to accommodate volunteer’s working patterns, and the session covered issues such as safeguarding and driving in winter conditions. Volunteers were from a range of backgrounds and included several people from Parish Councils and a faith group in Weaverham who were interested potentially developing something similar in their local community. The volunteers were asked to complete an evaluation survey to register their experience of being a volunteer with the scheme. All the volunteers who responded to the survey found it easy and straightforward to register, understood the paperwork involved, understood the reasons for Criminal Records Bureau (CRB) checking and would be willing to take part in a similar project again. The Snow Angel pilot operated from Monday to Friday each week, this did mean that some of the volunteers were not able to take part due to other commitments. Whilst the training was well received all the volunteers felt that it would have been useful to have a handbook for reference, including details such as the security codes numbers for the emergency heater storage. All the volunteers were willing to volunteer again for a future scheme and they were all interested in developing a scheme in their local community. There were several face to face interviews and a feedback session was also held for volunteers. The comments from the volunteers included; “Don’t have it limited to Monday to Friday – the vulnerable still need help during the evening and weekends.” “This is one of the most worthwhile volunteering opportunities I have ever taken part in; it makes me so proud to do my little bit to help others in the community.” “Profile key locations to see if there are any potential issues that if resolved could help local residents to deal with extreme weather conditions e.g. sloping footpaths and streets, local shop delivery arrangements”. Volunteers also came forward following the TV coverage of the scheme on Daybreak and Granada Reports including a group of ladies who knitted blankets for the scheme. 12 2.3 Decrease in accidental injuries, illness and death and decrease in social isolation during extreme cold weather periods There were 82 people registered on the scheme and over 75 % of people were living alone, and 25 customers had self-reported cardiovascular conditions. Only two customers were oxygen users. In terms of age profile 76% were 75 years old and over. The MOSAIC classifications of customers showed that the majority were groups from groups A, H, I and D which includes people from more affluent communities. The software showed the customers on a map, along with volunteers, and respective risk factors. 13 Despite the extreme weather of previous years, the winter of 2011/12 was mild. However the customer feedback demonstrated that this element of “knowing that someone cared” was extremely valued and that social isolation is not limited to periods of extreme weather. The customer evaluation was carried out using a postal questionnaire and there was a response rate of nearly 65%. A representative sample of the responses to the main questions is included below. Why did you register with the Snow Angels scheme? “My husband and I are both arthritic and fear falling especially in icy weather. Our friends are getting too old to help us, and we felt we needed help clearing the drive if the weather became dangerously snowy etc.” “I registered my mother because she has Alzheimer’s and I can’t be with her 24/7. She has carers but they are not there all day.” “Having a number to call for help is comforting.” “I live alone and am 88. My family live quite a long distance away and having two bad winters to contend with I thought Snow Angels was a very good idea.” “I felt that someone cares enough to help.” “Because I live alone and my family thought it was a good idea.” 14 “My husband has been ill and now unable to do work such as snow clearing or going out on icy roads. Thought it was an excellent idea if we had an emergency e.g., shopping that we could ring Snow Angels and they bring essentials.” How would you like to see Snow Angels develop? “In any way your volunteers can manage.” “Into a major concern, as it was very nice to know that there is always people there to help.” “Wish they could take you to the doctors.” “I feel that it should operate at the weekends and have a register of honest workmen. Our builder/woodworker is old now too!” “Keep up the good work and attract more volunteers.” “Very happy with the scheme as it was – ideal for my purposes.” Do you feel that the project would have been of use during extreme cold weather like last year? There was a resounding yes to this question– all the respondents felt that the scheme would be of use during extreme cold weather and wanted it to continue. Was the telephone contact during the scheme useful? All the respondents felt that the telephone contact was useful and there were many references to the reassurance it provided. “Just to see if I was all right, and indeed a welcome voice to talk to – it is very re-assuring.” “It was good to know someone was checking that I was OK and if I needed anything.” “Yes if I needed anything I could have asked, for people like me who are independent and don’t like to ask for help, you threw us a lifeline.” “Yes it was good to have the regular call each week giving the thought that Snow Angels were totally dependable – doing what was said at our first interview.” The focus group with the Response Centre at Weaver Vale Housing Trust suggested that the weekly phone calls could be reduced in frequency as a fairly low percentage resulted in further action. However it is clear from the customer response that the phone calls were valued by the customers and were having an impact on wellbeing. Were the visits made by Snow Angels useful? Initially the full registration of customer details was planned to be completed over the phone including details of next of kin, key holders, preventative services needed etc. However after several calls it became clear that this would be much more effective if it happened face to face and this would also give the opportunity to explore any immediate issues. Therefore the majority of customers had an introductory visit to explain the scheme and complete the registration details, and some customers had an additional visit if they requested help. 15 “Very useful. They arranged a special alarm with the Fire Brigade because I am deaf and cannot hear the fire alarm.” “I had one initial visit and it helped to know there was someone else to turn to.” “They just made me feel they cared.” “The one I had was, as there was going to be a ground frost and someone came to put grit down.” 2.4 Improvements in partnership working across the community and voluntary, public and private sectors and the development of an action learning model The partnership evaluation was carried out using Survey Monkey and was also discussed at various partnership events. All the partners were interested in being involved in a future scheme and thought that the scheme made a positive contribution to the wellbeing of older people. About half of the partners who responded to the questionnaire had not been aware of the issues of excess winter dealth prior to the project and just over half of partners confirmed that they would be changing their working practices in the future. “It has been wonderful to understand vulnerable people’s point of view and what they need. There is a lot of very independent people out there who just need a bit of extra support when the weather is extreme and a scheme like this almost allows people/volunteers to be “good neighbours.” “The partnership working was excellent and has increased networking.” “Generally very good learning through action—though of course we would probably have learnt more if we have had more severe weather conditions.” “Better identification/selection procedures to identify more people who are likely to be at risk in severe winter weather. Not least those who live in private accommodation.” “Scaling up and being an option on the menu of services re hospital discharge/Reablement/LTC’s/primary care.” The partnership evaluation included a focus group with the Response Centre staff at Weaver Vale Housing Trust. The staff were all supportive of the scheme and had enjoyed being part of a wider initiative. The scheme was supported and co-ordinated using a software package developed and hosted through Blue Door Software Company. Training was provided to lead organisations who nominated “super-users” and a series of meetings were held to discuss alterations to the software as the scheme was implemented. The feedback from all the users was extremely positive. The software meant that the Response Centre at Weaver Vale Housing Trust could schedule and monitor calls and deploy Snow Angels; Cheshire Community Development Trust could communicate with all the volunteers and referrals could be made to other services for example requests for adaptations. The software recorded the main contact details and risk factors for all the customers and details of all the Snow Angels. 16 There was a high level of interest from the national and local media with TV coverage through ITV Daybreak and Granada Reports, and requests from the BBC (who lost interest once they learned that ITV had already covered the story). There were also articles in “AGEnda” the newsletter for the English Forums on Ageing and a number of websites including the Met Office. Local coverage was provided through the Northwich Guardian. There were clear links with the climate change agenda and the Cheshire and Warrington partnership were represented on the Steering Group for Snow Angels, and a presentation about the scheme was made to a regional seminar including Department for Environment, Food and Rural Affairs (DEFRA) and the Environment Agency. Press packs were sent to all the communications staff in partner organisations and a number of them carried the story on their web pages. The Snow Angels project was presented at the West Cheshire Together conference as an example of good practice, and was one of four exhibitors at the national conference about Cold Weather Planning held by the Health Protection Agency and the Department of Health (attended by the Secretary of State for Health). 2.5 Impact Map The cost per customer is £268 for the twelve week period or £22 per week per customer. However this included all the start-up costs of developing an action learning model for future development and the numbers of customers on the pilot scheme were kept at a low level to ensure that the scheme was deliverable. The potential savings to the scheme include: reduction in falls, reduction in admissions to hospital, improvements in discharge times for patients, and a reduction in carer costs. Whilst it is possible to quantify these using a Social Return on Investment model the numbers are small and a projected forecast may be unreliable. However in terms of cost recovery the scheme would only need to prevent 5 falls resulting in simple hip fractures to recover the expenditure (just over 5% of the total customers) using the estimate of £5,000 per simple fracture. Through the evaluation a number of customers highlighted that they would be willing to contribute to the cost of the services and several people asked how they could make donations. This information was not specifically sought as part of the evaluation and further research would be needed to quantify this. 17 Stakeholders Intended/unintended changes Inputs Who will we have an effect on? Who will have an effect on us? What do we think will change for them? What will they invest? Customers Reduction in falls and fear of falls and accidents Time Customers Improvement in confidence Time Customers Knowing someone cares Time Customers Improved access to services Time Customers Reduction in social isolation Partners Improved awareness of excess winter deaths Time Time, commitment, experience, training Partners Partners Partners Improvements in partnership working Development of a model for future action Commitment to future working in this area Time Time Time Cheshire West and Chester Borough Council Reduction in care costs Time NHS Reduction in admissions to hospital Time NHS Improvement in discharge times for patients Prescription delivery NHS Improvements in mental well being Time Snow Angels Improvement in mental wellbeing through helping others Time Snow Angels Increased contact with older people Time Snow Angels Development of skills through involvement in project Time Northwich Area Partnership Board Delivery of project in area Cash Department of Health Contribution to reducing fuel poverty and excess winter deaths Cash Northwich Area Partnership Board Improved rates of volunteering in local communities Time Weaver Vale Housing Trust Improved service delivery to tenants and Careline customers Cash NHS Time Time Total 18 Logic Model (Based on GHK, 2011) Rationale The main aims of the pilot were to increase access to preventative services, increase volunteering, reduce social isolation, reduce ill health during extreme cold weather, improve partnership working, develop an action learning model, and develop more resilient communities. Inputs Activities Outputs Impacts Department of Development Reduction in social Improved mental well Health of partnership isolation being plan Cheshire West and 42 volunteers Reduction in hospital Chester Council Recruitment recruited admissions Cheshire Fire and and training of Software and Improvement in Rescue Service volunteers management discharge times system tested Improved partnership Weaver Vale Recruitment working Housing Trust of customers Call system Increased NHS Development through Response volunteering and of software Centre developed more resilient Cheshire Police Delivery of communities support to 80 Over 80 Cheshire customers customers Improved rates of Community Referrals to supported independent living Development Trust other Reduced fear of Changes in working agencies falling in extreme practices for Groundwork weather organisations Cheshire Evaluation of pilot Increased access Model for future Snow Angel to other services action Volunteers Delivery of Development of Blue Door thermometers, social enterprise – Software warm clothing, Snow Angels CIC blankets SPC Ltd Age UK Cheshire Snow Angel Volunteers 19 Section Three: Future Development The original aim of Operation Snow Angel was to provide services to help to reduce excess winter deaths. There have been a number of suggestions from partner organisations, customers and volunteers that the scheme should operate throughout the year and the scheme has clearly had an impact on wellbeing. However if the original aim is retained then the scheme should operate throughout the winter. The partners agreed that the scheme should operate from late October to the end of March, reflecting the changes in daylight hours, and volunteers should be called out during periods of extreme cold weather and snow. The scheme should also operate seven days a week. The alerts from the Met Office whilst useful did not always reflect local conditions and an element of interpretation of the local situation was at times needed. There were a number of organisations with volunteers who with a longer lead in time could be more heavily involved in the project such as Rotary, Cheshire Lowland Rescue, and Raynet. Also other organisations could be approached from the faith sector through Link Up along with other umbrella organisations such as the Woman’s Institute. The response from Town and Parish Councils was very positive with a number of volunteers responding to an email sent from the Northwich and Rural North Area Partnership Board Team and a clear role should be developed for these organisations including recruiting volunteers, identifying vulnerable older people who meet the risk criteria for excess winter deaths, and providing local gritting supplies. Whilst encouraging resilience in local communities it is also important to have some central infrastructure through the provision of training, call centre, volunteer support, software support and project development, management and evaluation. Snow Angels Community Interest Company has been established as a social enterprise by Blue Door Software Company Ltd and Strategic Partnerships Consultancy Ltd and further details are on the web site www.snowangels.org.uk There are a number of sources of potential funding including external funding opportunities, contributions from the customers (a number were willing to pay for the service although they were not specifically asked about contributing to the scheme), commercial sponsorship through associated products, commissioning arrangements with local authorities, the NHS and other public sector organisations. A regional conference on Cold Weather Planning is being held on the 14th September jointly sponsored by Cheshire Fire and Rescue Service and Snow Angels CIC and a copy of the programme is at Appendix B. 20 Appendix A Partner Organisations Northwich Area Partnership Board Cheshire Fire and Rescue Service Department of Health Weaver Vale Housing Trust Groundwork Cheshire Age UK Cheshire Cheshire Community Development Trust Cheshire West and Chester Council Vale Royal Disability Services Cheshire West CAB East Cheshire NHS Trust Western Cheshire PCT Cheshire Constabulary Blue Door Software Environment Agency Cheshire and Warrington Local Resilience Forum Cheshire Community Action Mears Home Improvement Agency Supporting People Northwich Town Council Central and Eastern Cheshire PCT Strategic Partnerships Consultancy Ltd 21 Appendix B Cold Weather Planning in the North West September 14th 2012 Cheshire Fire and Rescue Services HQ, Winsford, Cheshire Programme 9.30 am Registration and coffee 10.00 am Introduction and Welcome – Cheshire Fire and Rescue Service Key Note Speakers 10.15 Evaluation of the Cold Weather Plan, Frank Whiteford, North West Strategic Health Authority Key interventions to prevent Excess Winter Deaths, Professor Chris Bentley, National Health Inequalities Unit Extreme Weather and Community Resilience, (speaker to be confirmed) DEFRA Question and Answer Session 11.30 Coffee Break 12.00 Operation Snow Angel, Cathy Boyd, Director, Snow Angels CIC 12.30 Lunch and Networking Opportunities to visit emergency planning suite, software demonstration, exhibitors etc. 13.30 UK Public Health Association & Greater Manchester Fuel Poverty Initiative, Les Laws, Salford City Council 14.00 Spring Board Scheme – Ken Clemens, Chief Executive, Age UK Cheshire 14.30 Keeping Warm in Later Life (KWILLT) project, Amanda Stocks for the Centre for Health and Social Care Research, Sheffield Hallam University 15.00 Round Table discussions Identifying the main challenges in your areas 15.30 Q and A Session 16.00 Closing Remarks 22 23 Thanks to Western Cheshire NHS and particularly Alison Paul, GHK Consulting, and Weaver Vale Housing Trust for their support in producing this evaluation report. For further information please contact Cathy Boyd on 0788 151 0304 or email cathy@snowangels.org.uk or Chris Hill on or email chris@snowangels.org.uk or visit our website www.snowangels.org.uk Copyright © 2012 Snow Angels Cheshire CIC. All rights reserved 24