Community Housing Cymru

Health, Social Care and Housing Conference, 21st September 2017

Regional Partnership Board – Further Information

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Regional Partnership Board – Information and Reports

Cardiff & Vale of Glamorgan Integrated Health & Social

Care Partnership www.cvihsc.co.uk

Terms of Reference - http://www.cvihsc.co.uk/wp-content/uploads/2017/08/Terms-of-Reference-July-2017.pdf

Governance Structure - http://www.cvihsc.co.uk/wp-content/uploads/2017/02/RPB-Governance-Structure-May-2017.pdf

Population Needs Assessment - http://www.cvihsc.co.uk/about/what-we-do/population-needs-assessment/

Annual Report - http://www.cvihsc.co.uk/about/what-we-do/rpb-annual-report/

Cwm Taf Social Services and

Well-being Partnership Board

Population Assessment - http://www.ourcwmtaf.wales/cwm-taf-population-assessment

Greater Gwent Health, Social Care & well-being Partnership

Population Assessment - http://www.newport.gov.uk/documents/Care-and-Support/Population-Needs-Assessment/Population-Needs-Assessment-Gwent-Region-Report-May-2017.pdf

North Wales Social Care and

Well-being Services Improvement Collaborative

www.northwalescollaborative.wales

Membership - https://www.northwalescollaborative.wales/wp-content/uploads/2017/04/RPB-membership-list-updated-July-2017-external-1.pdf

Population Assessment - https://www.northwalescollaborative.wales/wp-content/uploads/2017/05/NW-Population-Assessment-Full-Report-1-April-2017.pdf

Annual report - https://www.northwalescollaborative.wales/wp-content/uploads/2017/04/Annual-report-2016-17.pdf

Powys Regional Partnership

Board

www.powys.gov.uk/en/adult-social-care/integration-of-health-and-social-care/powys-regional-partnership-board

Cwm Taf Social Services and Wellbeing Partnership Board

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Western Bay Health and Social Care Programme

www.westernbay.org.uk

Population Assessment - http://www.westernbay.org.uk/1306-2/

Annual Report - https://issuu.com/westernbayprogramme/docs/western_bay_programme_-_annual_repo_5721f9b0bd6b42

West Wales Care Partnership

www.wwcp.org.uk

Population Assessment - http://www.wwcp.org.uk/wp-content/uploads/2017/03/West-Wales-Population-Assessment-March-2017.pdf

Annual Report - http://www.wwcp.org.uk/wp-content/uploads/2017/04/West-Wales-Regional-Partnership-Annual-Report-2016-17.pdf

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Regional Partnership Board

Collaboration with Housing Case Studies

Cardiff & Vale of Glamorgan

1. Accommodation Solutions – Cardiff and Vale of

Glamorgan

Page 5

2. Market Position Statement development: ‘Me, My

Home and My Community’

Page 7

3. Preventative Interventions - Cardiff Page 9

North Wales

1. Supported Living - Conwy Page 13

West Wales

1. Maintaining Independence through provision of

accommodation based solutions - Ceredigion

Page 14

2. Accommodation Options – Pembrokeshire Page 16

Cwm Taf

1. Project 5 – Merthyr Valleys Page 18

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Cardiff & Vale of Glamorgan Case Study 1: Accommodation Solutions

Accommodation Solutions - Cardiff and Vale of Glamorgan

Service Description

The Accommodation Solutions Team includes Housing Re-settlement Officers and Occupational Therapists working with hospital staff to assess and plan for individual housing needs in preparation for their discharge. The service focuses upon practical support provision to expedite discharge and prevent re-admission. This includes organising ‘clean and clear’ of the home environment, transportation of urgently needed items and assisting in identifying alternative accommodation. The Accommodation Solutions team is supported by the provision of additional equipment aids provided via the Joint Equipment Store. The team also have access to step down accommodation facilities across Cardiff and the Vale of Glamorgan. These facilities are designed for people requiring alternative, short term accommodation following hospital discharge, or to avoid admission whilst adjustments are made to their existing accommodation. Finally the project is supported by a Rapid Response Adaptation Programme (RRAP) delivered by Care & Repair Cardiff and the Vale, providing small scale housing adaptations to prevent hospital admission and expedite discharge.

Step Down Accommodation showing adapted bathroom and kitchen for wheelchair users.

What resources are used?

The project was initiated in 2014 with a team of 4wte staff. This has since been increased to 7wte staff. Use of Intermediate Care Fund capital funding has enabled the development of step down accommodation from a total of 3 flats in the first instance to 12 separate units as of 2017-18. The project provides a region-wide service across Cardiff and the Vale of Glamorgan. In 2016-17 it received 532 referrals whilst 39 people were able to use the step down accommodation. The RRAP service completed 1,203 referrals in the same period.

Who are the key delivery partners and what is their role?

The Accommodation Solutions service can receive referrals from any health or social care partner. An example of how the partners are involved in working together is provided as follows:

Mr D was in hospital recovering from an amputation. Mr D could not return to his own home as he is now a wheelchair user and his own property could not be adapted. As part of discharge planning hospital staff and social care were unable to determine whether Mr D would be able to live independently or whether he would require residential care. Mr D was discharged to step down with Community Resource Team (CRT) support and completed a housing application on discharge. The CRT, after evaluation, determined that Mr D could live independently. Suitable property that could be adapted appropriately had to become available and works done to adapt the property had to be completed. The total stay in step down for Mr D was 102 days.

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The Care&Repair RRAP provision has also been extended in its scope to provide services for anyone who requires minor adaptations to their accommodation, rather than only to home owners/private sector tenants as would be the case with the Wales-wide RRAP provision funded directly by Welsh Government. An example of how the service works to support both individuals and their carers to maintain independence is provided below :

K is 87 years of age and lives with his wife, S, in Radyr. We were asked by an Occupational Therapist (OT) at UHW if we could fit a keysafe to enable K to be safely discharge from hospital. We contacted S and made arrangements for our Handyperson to go out to do these works prior to K’s discharge from hospital. K was re-admitted to hospital later that year. His wife, S contacted us as a smoke alarm was beeping at their home and needed new batteries. Two light bulbs had gone out on the landing and bedroom and needed replacing. S couldn’t reach any of these to fix them. She was very upset as she felt that everything around her was falling apart since K had been back in hospital. She very much wanted to resolve these problems before he came home from hospital. We made arrangements for our Handyperson to go out that afternoon to do these works. S contacted us the following day to say that she was over the moon and ecstatic that the work was done so quickly. She said that the Handyperson was fantastic and she could not believe how helpful we were.

What has changed as a result of the project?

Results Based Accountability is used as a tool to measure performance across the service. This enables a quantitative and qualitative approach to measuring actual activity whilst also facilitating an understanding of how this equates to overall performance outcomes. In 2016-17 the service received 532 referrals whilst 39 people were able to use the step down accommodation. The RRAP service completed 1,203 referrals in the same period. As a consequence, the service was able to assist the discharge of 221 patients from hospital. 116 of these people were listed as delays transfers of care. Use of the Step Down accommodation saved an estimated 1,550 bed days. This equates to £426,250 in cost savings. Together, these measures contribute to a reduction in the risk to patients from a prolonged hospital stay. They demonstrate how the lives of individuals are enhanced by the Accommodation Solutions Team to live as independently as possible in their own home.

Feedback and Evaluation

In addition to the quantitative measures highlighted above, patient feedback indicates that 100% of service users were happy with the services received from the Accommodation Solutions Team in 2016-17. 100% of health professionals were also happy with the service provision. 100% of users felt that the Step Down accommodation was beneficial in their discharge from hospital. In relation to the RRAP service, 96% of older people felt more able to remain living in their own home as a result of the adaptations whilst 95% felt that the service had improved the quality of their lives. Use of the Step Down accommodation saved an estimated 1,550 bed days. This equates to £426,250 in cost savings. This creates an opportunity bed saving for the University Health Board and also a potential reduction in demand for long term care provision and / or community-based care and support as individuals are encouraged and supported to live as independently as possible in their own home.

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Cardiff & Vale of Glamorgan Case study 2: ‘Me, My Home, My Community

‘Me, My Home, My Community’ - Cardiff and Vale of Glamorgan Commissioning Programme for Older Persons Services

Project Description

Part 9 of the Social Services and Well-being (Wales) Act 2014 requires Regional Partnership Boards to undertake a detailed programme of work by April 2018 to help ensure the ongoing sustainability of older persons services. A specific aim of the programme is to facilitate the development of integrated services across the region, by bringing together the key delivery partners to determine the provision of services, care and support most beneficial to our older population. In response, a Cardiff and Vale of Glamorgan Commissioning Programme for Older Persons Services was established in 2016. Overseen by a project board, the programme consists of a number of key deliverables:

A ‘Summary of Current Position – Services for Older People’: This document provides the baseline from which subsequent analysis and plans have been developed. It pulled together current and historical data on 40 different health, housing and social care services/areas of work that are provided, or commissioned by, the Partnership (City of Cardiff Council, Vale of Glamorgan Council, and Cardiff and Vale University Health Board). More specifically, it provides a summary of expenditure (in excess of £220m), service activity, performance and trends in need and demand. The first draft was completed and discussed at a workshop in March 2017 and will be updated as the work progresses to reflect other information – such as third sector services – as appropriate.

A ‘Joint Regional Statement of Strategic Intent’: Also in March 2017, a Joint Regional Statement of Strategic Intent was developed during a workshop with partners to set out the shared position of how the Partnership intends to work with stakeholders and providers to improve the health, well-being and safety of older people across Cardiff and the Vale of Glamorgan. The document builds on previous work undertaken by the Partnership in relation to the ‘Shaping our Future Well-being Strategy’ and the ‘Home First Plan’, and provides a shared vision for services, an agreed integrated service model, design principles, a common language, five year priorities and three year objectives.

A ‘Market Position Statement (MPS)’: The purpose of a MPS is to present a clear picture of the market and service implications of the Joint Regional Statement of Strategic Intent to help providers understand our preferred direction of travel, and to enable them to prepare their own effective business plans. Work is currently underway to develop a MPS for Older Persons Services, bringing together material from the Summary of Current Position, Joint Regional Statement of Strategic Intent and other sources. In July 2017, over 80 stakeholders from the public, private, housing and third sectors took part in a workshop to inform the development of the MPS. It is intended that the final version of the MPS will be ready for the Regional Partnership Board sign-off in November 2017.

A Pooled Budget Arrangement: A project board, made up of representatives from service delivery, commissioning and procurement, finance and legal, has been established and tasked with developing a regional pooled budget arrangement for care home accommodation functions by 6th April 2018 (as required by Part 9 of the Social Services and Well-being Act). The Board is currently considering options and practical arrangements in relation to the hosting and operation of the budget, fee setting, provider engagement, and common contracts and specifications.

These documents are available at: http://www.cvihsc.co.uk/our-priorities/older-people/older-people-joint-commissioning/

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Images from the Market Position Workshop in July 2017

Images of the Draft Market Position Statement

What resources were used?

The Commissioning Programme for Older Persons Services is being managed by the Cardiff and Vale of Glamorgan Integrated Health and Social Care Partnership. The Partnership team have worked alongside each of the key partners in terms of data/information provision, project board membership and workshop participation. This has included contributions from senior officers, business support/data analysts, frontline/service delivery, legal, finance, and commissioning and procurement.

Who were the key delivery partners and what was their role?

There are three key delivery partners: the City of Cardiff Council, Vale of Glamorgan Council, and Cardiff and Vale University Health Board. As outlined under ‘resources’, they have each played an essential role in informing the development and delivery of the project.

What has changed as a result of the project?

The project is still underway, so its impact is yet to be fully determined. However, some of the benefits to date include:

Greater partnership working between health, housing and social care within and across the three partner organisations

An improved understanding of older persons services, in terms of the total amount of money spent on delivering these services, the range of provision available to older people, and figures regarding current need and demand

The development of a shared vision and integrated service model for older persons services, enabling providers to build and shape their services accordingly

The development of a five year commissioning strategy to drive forward the new shared agenda

The delivery of three stakeholder engagement sessions attended by a range of stakeholders and service leads, to ensure the development of appropriate services for older people

Other benefits that are yet to occur under this project include:

The development of new accommodation with care models

The establishment of a pooled budget arrangement for care home accommodation functions.

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Cardiff & Vale of Glamorgan Case Study 3: Preventative Interventions

Preventative Interventions - Cardiff

Service Description

The service brings together a number of pre-existing and new services into a combined approach, streamlining access to information, support and advice to Cardiff residents to maintain their independence and reduce the need for long term care and support. The service was launched in October 2015 and includes:

- First point of contact for services to older people – a telephony service providing advice and information tailored to individual needs including signposting to local social activities and events. The contact centre also provides a single point of contact for all Independent Living Services (ILS) and Adult Services across Cardiff Council (community case management, occupational therapy, hospital discharge assessments).

- Independent Living Officers: the development of this team allows 10 Officers to visit older people in their own homes with the aim of providing a person-centred approach to ensure their ongoing health, safety and financial and social wellbeing.

- Healthy Active Partnership: a third sector provided service matching volunteers with older people in their local communities to help alleviate social isolation.

Previously, access to services was provided in various ways (telephone, fax, email) and through a variety of contact points. The formation of the Centre provided a single point of contact for access to all housing services across the Cardiff region. More recently the service was further developed to incorporate the management of telephone referrals to adult social services. In 2016-17, this led to 72% of calls being dealt with by the Preventative Services team with no onward referral to adult social care. A flow chart providing an overview of the service is attached as Appendix 1.

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What resources were used?

The service was initiated in October 2015 and covers the Cardiff Council geographical footprint. In 2016-17 it:

dealt with 28,228 calls via First Point of Contact;

opened 3,244 new cases via First Point of Contact;

Independent Living Officers (ILOs) carried out 3,846 visits ;

provided 2,057 interventions as a result of the ILO visits;

supported 736 people via the Healthy Active Partnership.

Who were the key delivery partners and what was their role?

First Point of Contact can be accessed by citizens and representatives from all sectors for information, advice and signposting to other relevant services. An example of how the service facilitates and co-ordinates the involvement of various partners is provided below:

Mr X lives alone ... he wanted to move, as he felt isolated from his family who live on the other side of Cardiff and can only visit him occasionally. Mr X has been in poor health for a while and finds it difficult to get out of the house to do his shopping, pick up prescriptions and meet people. A Visiting Officer called to Mr X at his home where they discussed his housing and personal and financial concerns. During the discussion it transpired that Mr X used to be a member of the Welsh Guards. The Visiting Officer discussed a number of Third Sector agencies that may help with his getting out and about more, and established his preferred location for moving if necessary. They also discussed how he managed getting in and out of the bath along with any issues he may have getting around his home. The Visiting Officer arranged for: - Welsh Guards to visit Mr X on a social basis;

- The Befriending Society to do light shopping and pick up prescriptions;

- An Occupational Therapist to evaluate his washing needs (which resulted in a new shower);

- A community alarm to be installed;

- Mr X to be in receipt of Attendance Allowance;

- Mr X to be placed on the waiting list for a potential move to his desired location in Cardiff.

For Mr X, this resulted in: - Safer access to washing facilities preventing slips, trips and falls;

- Additional income;

- Greater security;

- Reduction in social isolation.

The Visiting Officer called back a few weeks after the above arrangements had been set in place and noted a marked difference in Mr X’s demeanour and confidence. Mr X said that he had not known that this type of help was available; he felt that he had taken back control of his life; he now felt that there was a purpose to getting up in the morning and that his life was now more meaningful.

What has changed as a result of the project?

Results Based Accountability is used as a tool to measure performance across the service. This enables a quantitative and qualitative approach to measuring actual activity whilst also facilitating an understanding of how this equates to overall performance outcomes. In 2016-17 the service:

dealt with 28,228 calls via First Point of Contact;

opened 3,244 new cases for the Independent Living Officers via First Point of Contact. The following improvements have been measured in 2016-17:

3,846 visits were undertaken to review the needs of citizens needs across Cardiff. Each visit involved a review on each individuals’ circumstances such as their financial status, accommodation requirements, welfare needs and a general holistic assessment of their wellbeing;

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4,464 alternative solution outcomes were attained as a result of those visits;

736 people received volunteer support visits via the Healthy Active Partnership;

909 people maximised their income;

£4.289m additional income has been accessed via the income maximisation service provided via the Preventative Intervention services;

£323,973 has been saved by health and society by making housing safer through adaptations (based upon Building Research Establishment methodology).

Together, these measures demonstrate how the lives of individuals are enhanced by the Preventative Interventions service to live as independently as possible in their own home.

Feedback and Evaluation

In addition to the quality measures highlighted above, in 2016-17:

99% of citizens who responded felt that the first point of contact service had enabled them to live in

their own home more independently;

95% felt that the first point of contact had improved their quality of life;

93% of clients felt that independent living services had improved their quality of life;

76% of people using the Healthy Active Partnership felt that their quality of life had improved as a result

of using the social isolation services;

By the end of quarter 4, 72% of clients had their needs addressed by the First Point of Contact without

the need for further referral to other services such as Adult Services.

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Case study- Supported Living, Conwy

Conwy are working with Health, specialist Registered Social Landlord, First Choice

Housing and an independent social care provider to establish a supported living

project for two people with severe learning disabilities, sensory impairment and

challenging behaviour.

The individuals are currently inpatients at Bryn y Neuadd and have been for a

considerable length of time due to the difficulties in finding appropriate housing.

The property is a fully adapted bungalow and First Choice Housing have further

adapted the property to take account of the individuals’ specific needs.

Health and Social Care, along with the prospective tenants’ families were involved in

the tender exercise for the care & support for this jointly commissioned service. All

parties are currently working together to transition the two individuals to their new

home. This work is complex and involves considerable planning to ensure that the

move is successful for individuals.

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Improving care and support in partnership with housing

Case Study: Maintaining independence through provision of accommodation based solutions (Ceredigion) This project is funded through the Integrated Care Fund (ICF) and was developed specifically to provide accommodation based solutions in rural communities and add value to West Wales Care and Repair (WWC&R) services for vulnerable clients including older people with complex needs and long term conditions such as dementia; people with learning disabilities; children with complex needs due to disability or illness and carers. It also link into a range of ICF funded programmes such as Accessing Alternatives to Admission, Community Falls Clinic and 3rd Sector Community Resource Team. The project has two strands: 1. Home based visiting service to assess and advise on safety issues and affordable warmth

options within the home, followed up with an advice letter and agreed repairs via grants

and additional agreed services.

2. Assessment and referrals for Emergency Repair Assistance Grant that enables elderly and

vulnerable people to remain within their homes through the provision of essential repair

and delivery of care packages carried out to improve housing standards and access roads

that will safeguard their health and safety and maintain independence.

As well as identifying hazards in the home, there is opportunity to undertake a ‘what matters conversation’ with the citizen, that will identify further opportunities to signpost and refer to other third sector or other services as appropriate. The Housing Health Cost Calculator (HHCC) is used to calculate the health costs of hazards in the homes and the associated savings to the NHS and wider society gained by improvements made. From previous Emergency Repair Assistance provided, it is known that the primary needs led demand for assistance include electrical works, heating systems, leaking roofs, replacement windows and doors. When such works are inputted into the HHCC database, a calculation is provided of the savings to the NHS from carrying out these works in preventing admissions into hospital. The examples listed below serve to demonstrate the specific needs of clients in more rural and dispersed communities that have been supported by the project and the value added to the services provided by WWC&R: Example 1: An elderly lady had taken in a lodger with mental health problems who had a carer. However, the carer ceased to call due to the condition of the property, the floor to the kitchen had dry rot and was in a dangerous condition. The ERA covered the cost of the new

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floor and covering, replacement window in the kitchen and two storage heaters in the living room. The cost of the works was £3,000, resulting in a saving of £344 with a payback period of 8 months. Example 2: Involves an elderly gentleman living on his own. The Grants Unit was contacted as he had a leak in the roof. Following the Technical Officer’s visit it was established that the leak was from a loose water pipe in the attic which the Officer tightened. The water leak had caused an electric fault and half the house was left in darkness with no electricity. The ERA was approved to undertake the electrical work at the property. The cost of the works were £3,000, the cost saving to the NHS was £311 which resulted in a 9 month payback. Example 3: An elderly lady who was taken into care, whose property was filthy and verminous. The Community Wellbeing Section undertook the cleaning of the property while the property was vacant. The oil was stolen, resulting in the oil tank and boiler being damaged. The ERA covered the cost of replacing the oil line and re-commissioning of the boiler. This enabled the lady to return from hospital. The cost of the works came to £3000, with a £585 cost saving to the NHS, resulting in a payback period of 5 months. Example 4: An elderly gentleman who was in hospital and was ready for discharge, on discharge he would need palliative care and a care package set up. The track to his property was in a poor condition, and the carer’s vehicles could not be driven down the track to provide the care needed. The works undertaken under the ERA was to improve the condition of the track. Example 5: An elderly gentleman in hospital was ready for discharge, and a care package was being drawn up, however the access to his property had been deemed unsafe. The works undertaken included the preparing of the drive and resurfacing and providing timber rails either side of the bridge. Without this intervention the gentleman would not have been able to return home. WWC&R operate an administrative charge to the client of £45/£50 on the Handyperson scheme which generates income and contributes to the long term sustainability of the service. In addition clients are offered a Pay Private Service for works that exceed the £300 threshold if they are ineligible for referral into the local authority housing service. Grants provided by the local authority are issued with the lifetime recharge i.e. upon sale or transfer of the property then the value of the grant works becomes repayable. Contact for further information: Gaynor Toft, Community Wellbeing Manager, Ceredigion County Council Gaynor.toft@ceredigion.gov.uk

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Improving care and support in partnership with housing

Case Study: Accommodation options (Pembrokeshire) This project was developed specifically to address the lack of specialist social housing-based solutions in response to specific needs identified. The project has two strands: 1. To purchase two accommodation ‘pods’ which would be attached to existing local authority properties to meet the needs of those requiring adaptations. This pilot project is to assess the viability and long-term suitability of this approach as an alternative to permanently built extensions, which if it proves to be viable, has the potential to be adopted as an alternative option to fulfil specific social housing needs in future. Depending on the outcomes of the pilot, the scheme could be broadened to include privately owned properties also. The scheme will provide dedicated accommodation solutions, adapted where appropriate, and suitable for clients for whom there is traditionally a deficiency of provision and significant time delays in identifying suitable options. This will decrease admissions to and enable increased numbers to move on from secondary care (e.g. bariatric / complex needs). Provision will be for medium- to long-term needs, and will enable clients to be accommodated locally in properties that will maximise their potential for independent living in addition to providing local accommodation solutions for people who otherwise would be accommodated out of area, allowing them to maintain their existing circles of support. The purpose-built units will be made to individual specifications comprising of a bespoke units that will be prefabricated off-site by a supplier and transported to site. When there is no longer a need for the pod, it can be removed and transported for use at another property. Match funding will cover the initial groundworks required to site the pod and connect it to the existing property, along with minor works required to access the pod, e.g. widening of existing doors, plus any associated equipment that may be required. Having designated properties suitable for client groups with complex needs will provide a much needed facility for meeting a complex area of housing need. The ability to deliver an adapted extension to a property quickly rather than a permanent extension that may take months to deliver from initial planning to completion has the potential to save costs on hospital beds, supported accommodation or out of county placements. 2. To purchase properties that address the lack of social housing that meets the needs of learning disability or bariatric clients, those with mental health and physical mobility issues and complex needs and allow them to remain in their own communities. The suitable properties would be identified through a process of selection, mirroring existing processes used by PCC’s

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Housing Department for property purchase. They would be adapted if necessary and managed through PCC’s Housing Management team, with support provided to individuals according to their needs by the appropriate support agencies. Funding may also be used to provide generic adaptations and / or equipment as required dependent on the property and the needs of identified clients. There are currently 35 out-of-county placements, of which several could move back to Pembrokeshire if the appropriate accommodation was available, with potential associated annual revenue savings in the region of £300,000. More bespoke or adapted accommodation should also result in less demand on other funding sources, such as adaptations budgets. Contact for further information: Andrew Davies-Wrigley, Housing Manager, Pembrokeshire County Council Andrew.davies-wrigley@pembrokeshire.gov.uk

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Case Study: Project 5 - Impact Report Through Project 5 Merthyr Valleys Mind is addressing the issues of loneliness and isolation in in older people which has become an epidemic resulting in physical health deterioration, people becoming more prone to falls and decline in mental health. Many older people become embarrassed and lose confidence when their ability to live life as they once did changes and they begin to recognise they need a little support, many worry that they will be forced into a care home. Many also share with Project 5 staff that they feel they have had their life and they feel pushed aside by society. Working in partnership with housing associations Project 5 focuses on providing opportunities for older people to participate in ‘The Five Ways To Wellbeing’ as prescribed by Public Health Wales. These being Connect, Be Active, Take Notice and Give. Staff consult with older people to initially discuss their needs and choices. We will inform beneficiaries of the types of activities and events they could get involved in but more importantly inquire as to the activities they would like to explore, this way groups are co-developed and continuously developing to meet the needs of beneficiaries. Staff will listen to issues that may prevent people attending social gatherings and look for solutions and create action plans to enable engagement and participation, sometimes this can be done by one beneficiary calling on their neighbour and supporting each other to attend, or maybe a family member or support worker assisting a person. People can enjoy spending two hours in company with friends and enjoy a range of activities such as; seated exercise, arts and crafts sessions, quiz sessions, ‘times of our lives’ reminiscence work, ‘breakfast together’ or ‘fish and chips’ lunch, inter-generational activities through local schools visits, darts afternoons, film afternoons, ‘high tea and favourite tunes’ afternoons and beneficiary led gardening sessions, sing a longs, games afternoons and pamper sessions. Each session will have tea and cake provide time for people to chat with each other. Many sessions will include a variety of activities to allow for choice and suitability. Through attending a weekly group facilitated by a consistent team of volunteers and staff beneficiaries begin to build trusting relationships which can result in them discussing issues of concern and ask for help. Many beneficiaries begin to identify with each other’s difficulties and so are able to offer and receive peer support. Friendships are made and communities strengthened. For a person that may not have regular contact with loved ones or indeed any contact with loved ones, once they become withdrawn they can actually become invisible to the rest of their community. People often report difficulty in areas such as getting provisions from local shops, feeding themselves properly due to economic challenges or degenerative health conditions which impact on them maintain fundamental personal care. Project 5 staff have a successful record in quickly developing trust with beneficiaries and so have been able to identify warning signs of possible self-neglect and have the relevant conversations with appropriate agencies promptly, the importance of this can never be undervalued. Many people living in older person’s accommodation have undergone changes in service delivery from their RSL, many now experience a very different way of living than when they initially moved into their accommodation with a sheltered manager available on a full time basis. Many older people living in sheltered accommodation and the wider community are struggling to deal with their own health needs but also to adapting to changes in society and their community around them. It is vital that the professionals they engage with allow for co-developed services that enable choice, independence and for people to continue enjoying a life that matters. The work that Project 5 does is centred around and supports this particular area of people’s lives. Merthyr and the Valleys Mind commissioned Tantrwm to create a short film that captures Project 5 sessions and the beneficiaries' experiences.

Cwm Taf Social Services and Wellbeing Partnership Board

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