Self-Care What’s it all about then?

April 25, 2019April 25, 2019robdalziel 1 Comment

Healthwatch Dudley research shows that self-care is a complex topic and what it is can be different depending, for example, on where you live, whether you have a job or not, and how old you are. We undertook work to gather people’s views on self-care to get a better understanding of what it is and how it might be supported. At the same time, we wanted to know more about how the different circumstances that people find themselves in might determine how they are able (or not) to look after themselves, stay well and get access to the care they need when they are unwell.

Choosing self-care for life

NHS England has, for some time now, been encouraging us all to choose self-care for life and suggesting how they can look after their own and their family’s physical and mental health. In turn, it wants more people to be involved in ‘Taking action for both themselves and others whilst understanding how to use health services’.^[1] But, self-care can be thought about and described in different ways.

It can be about people, events and actions located on a self-care continuum. At one end is the responsible individual making daily choices about lifestyle, health and the management of any conditions they have. At the other end there are events like compulsory psychiatric care and treatment for major trauma or illness that is administered by professionals responsible for what happens to an individual (see Figure 1).[2]

Meanwhile, there are the wider determinants of health and wellbeing – such as where we live, the jobs we have, and how we are able to get access to good quality housing and health care services. We need to understand how the circumstances that we find ourselves in can affect our capacity to self-care (see Figure 2).[3]

Figure 2: Factors that influence an individual’s health and wellbeing

It is widely acknowledged that our opportunity for good health starts long before we need health care. And consequently, our unhealthy behaviours are most often ‘Usually not the origins of poor health but the end point of a long chain of causes and consequences in our lives’.^[4] There is a strong case for thinking that responsibility for health should extend beyond the individual and the health and social care system to include the whole of society.^[5]

‘We know what we should do, but we don’t always do it’

Self-care is about understanding yourself and others understanding you. However, it was remarked that ‘A lot of people want to self-care, but they can’t do it without support’. And bureaucracy and red-tape gets in the way and stops communities and individuals from taking action to do things at the local level through self-help, leisure and other social activities.

Time and effort must be given to making the most of what exists in communities already, the buildings, facilities and group activities and individuals and their knowledge, skills and talents.

At the same time, people want help and advice from well-qualified professionals who can provide them with information, where it is appropriate, on how they can best look after themselves when they feel unwell. In turn, relations work better when there are good communications that ‘Instill confidence that something can be done’, whether it is through a conversation to get advice on what to do next, help with the management of an ongoing health condition, or information on care and treatment.

There is something about our health and wellbeing that is about having control and choice over what we do and what happens to us. And sometimes we just need to slow down, listen to our body and get through the day. Understanding that there will be days when you feel down and need to deal with knocks and setbacks. Then there are the times when you need people to be around who care about you and will listen to what you have to say. Maybe we need to reflect on what is happening in our lives and ‘Identify the positives, new opportunities, new hobbies, new experiences’.

The aim must be to give people real choice over what happens regarding their self-care. And reassure them that they will be able to get access to appropriate services and professional help when they need it.

Our health and capacity to self-care can depend a lot on being surrounded by people we love and trust and ‘Being connected with others and a community’. It can also be about ‘Finding time to look after yourself, doing things you want to do, outside of busy lives at work’ and being able to express your emotions and laugh.

Policymakers and other professionals, with an interest in self-care, need to work with people, from a wide variety of backgrounds, to learn more about what it means to them and how they might be supported to do it better. We need to know what hinders or stops people from undertaking self-care activities. It might be because they are living in poor or insecure accommodation, are struggling to live on a low income, or have no family or friends nearby to offer help and support.[6] On professionals it was remarked that ‘They should come to our natural environment’ and work with people to find out what their health and wellbeing needs are and what can be done together to promote and sustain good self-care activities.

How to promote and support self-care

Have in-depth conversations with people from all types of background to get a diversity of views on self-care and wellbeing.

Develop strong relations with communities, be inquisitive, and adopt a non-judgmental approach to understanding lifestyles and aspirations.

Determine what opportunities exist for self-care and wellbeing quick wins targeting resources appropriately to achieve them.

Get the messages out on self-care, thinking about what it is and how to get help with it.

Get people involved and more in control of what happens in the area where they live and the design of services to meet jobs, environment, housing, leisure, transport, education and health needs.

Make the most of existing community strengths and bonds, buildings and facilities and people’s knowledge and skills in a place based approach to partnership working that celebrates the good things already happening in an area and identifies and deals with gaps in services and support for self-care.

Clearly identify how self-care and staying healthy, the prevention of illness, and getting access to treatment when it is needed are intimately bound together and can be part of a well thought through population and personal health and wellbeing pathways

Set out personal and collective community and organisation responsibilities for promoting, supporting and doing self-care so that it works for everyone

[1] NHS England (2018) ‘Encouraging people to choose self-care for life, https://www.england.nhs.uk/2018/11/encouraging-people-to-choose-self-care-for-life/

[2] Self Care Forum, http://www.selfcareforum.org/about-us/what-do-we-mean-by-self-care-and-why-is-good-for-people/

[3] Dahlgren G, Whitehead M. (1991) ‘Policies and Strategies to Promote Social Equity in Health’, Stockholm, Sweden: Institute for Futures Studies, https://ideas.repec.org/p/hhs/ifswps/2007_014.html

[4] Lovell, N. and Bibby, J. (2018) ‘What makes us healthy? An introduction to the social determinants of health’, The Health Foundation, https://www.health.org.uk/publications/what-makes-us-healthy

[5] NHS England (2014) ‘The Five Year Forward View’, https://www.england.nhs.uk/five-year-forward-view/

[6] Department of Health and Social Care, ‘Prevention is better than cure: Our vision to help you live well for longer, 2018. https://www.gov.uk/government/publications/prevention-is-better-than-cure-our-vision-to-help-you-live-well-for-longer

Find out more about Healthwatch Dudley’s work and research at www.healthwatchdudley.co.uk

Grace Community Church: Working together to build a vibrant new community space for local people in Pensnett

April 5, 2019April 5, 2019Helena 3 Comments

Grace Community Church, based in Pensnett, is a passionate congregation of people, committed to making their local area a better place to live by responding to the changing needs of the community around them. As a community, they have pulled together using their individual skills and connections to build a vibrant new community space that will become a place where local people can come together, learn new things, and get support.

I recently visited Nigel Rowe, Pastor at Grace Community Church, at their new community building to find out more about their recent asset transfer success and future plans for the building and the local community.

It was in early 2018 when Nigel approached Dudley CVS looking for a community space in the Pensnett area to use as a base for their group’s activities. After an initial discussion about potential buildings they could rent in the area, Becky, Dudley CVS Small Groups Officer, suggested community asset transfer as an option to consider and pointed in the direction of Dudley Council to find out more about potential buildings available in the area.

After a short period of looking around, Nigel found a local building that wasn’t being fully utilized. It had previously been used for a senior citizens club, which only met once or twice a week for bingo. The space had the potential to offer lots more. After expressing an interest in the building, they put together a business plan and worked with Dudley Council to start the asset transfer process. They received the keys in October last year.

Community asset transfer involves the transfer of responsibility for buildings or land from the local authority to a voluntary or community organisation. It presents opportunities to ensure that facilities can continue to be available locally for social, community and public use. The process starts with an expression of interest, followed by a business plan to show community support for the transfer, the kinds of activities that would take place in the building that would benefit the community, and financial sustainability.

Although they found the asset transfer a lengthy process, it gave them some extra time to raise the funds to renovate the building. Roughly £25,000 has been spent on the renovations so far. The Ibstock Enovert Trust, an environmental body that supports community and environmental projects, awarded £15,000 for the project, and the church’s congregation worked hard to raise the rest of the money.

When I visited Nigel at the building, I was amazed to find wonderfully welcoming, bright and spacious rooms, beautifully decorated with modern fixtures and fittings, a vast improvement from the old photos I’d seen of the building. Although not entirely finished, it’s very nearly there, even as I arrived there was somebody busily painting away!

Nigel told me about the incredible support from the local community, how everybody pulled together to make this project happen, not only the congregation but also local businesses that had donated fittings, materials and equipment.

Tiles were donated by a local business doing a renovation job in the area. Electricians, Sunny Electrical, and local plumbing company Gill Mechanical Service offered their skills at a reduced rate. Will Hire from Lye hired out scaffolding and core drills free of charge. Howdens donated a fitted kitchen after hearing about their various food-related projects for local people, including hampers during the winter, and ‘Make Lunch’, providing free school meals to young people and children during the school holidays.

It’s unbelievable to see old photos of how the building looked before the renovation work began:

And today, the incredible transformation – a bright and modern space!

And, the congregation are not just a vibrant and friendly bunch, they themselves are also very ‘handy’ with skills in decorating, painting, plastering and building work. Locally, Grace Community Church has taken on gardening and DIY projects for elderly people that can’t get out of the house, or for people that might be struggling for other reasons. Nigel told me, “It’s surprising how much you need for a renovation project like this that you don’t realise. We’re already using a lot of these skills out in the community, and we’re now using them to complete this project so that we can bring the community in. Local people and businesses just wanted to help because they had heard about all the good things we were planning to do with the space.”

All Nations Church Wolverhampton, their parent church, has also helped and supported the work in the area.

The building is now equipped with everything that is needed for a fully functioning community space. It has a large bright main room for events, a brand new modern kitchen space, toilet facilities and a day/activities room for toddler groups.

The vision for what takes place in the building has been built around what they have learnt from the changing needs of the community around them. They will start with a toddler group to support isolated parents in the area, as since the closure of the local children’s centre there hasn’t been a great provision for parents. Their aim is to ensure that people can drop in at any time, and there will always be someone available in the building to support parents. Nigel added, “It will be a place where answers can be found. We don’t have all the answers, but we can work together to find them”. The Toddler Group meets every Tuesday morning from 9:30am until 11am.

Nigel is also a Chaplain at Crestwood School, offering extra support for young people during lunchtime. This helps them to understand the needs of young people in the area.

The space will be used to run activities with young families, to start youth groups, art clubs, coffee mornings, and in the future, they hope to put on parenting classes, and workshops to support people with managing their finances. There will be summer school meals in the new kitchen and big events during the summer and Christmas time. Currently, they run a music workshop on a Wednesday evening and are looking to expand. People of all ages are welcome to come and use the equipment. They also plan to link up with the local food bank and potentially use the building as a distribution point.

Their aim is to build up better relationships with local people through running groups, classes and events. It’s also about connecting people socially by offering a safe place to meet to get to know other people, with a hope that new friendship groups will blossom.

Nigel tells me, “Isolation affects people of all ages. There is nowhere local to just sit down and have a coffee. We want to have drop-ins so that people can come in and have a friendly face to share a hot drink and a cake with.” Exciting future plans include potentially opening a coffee shop in the building to provide people with a place to meet and do things, also giving local people job opportunities.

Grace Community Church is now focused on getting over the starting line so they can bring exciting new projects and activities to the community. It’s wonderful to see such a transformation, providing the Pensnett community with a place to be for many years to come. I’m very much looking forward to seeing what comes next.

Grace Toddler Group meets every Tuesday morning from 9:30am until 11am. There is also a meeting every Sunday morning from 10:30am for an open and friendly church service with children’s activities and refreshments at the end. All are welcome.

If you would like to find out more about the project contact gracechurch@allnations.org.uk

“JUST GO FOR IT” funding success Dudley Voices for Choice

April 1, 2019March 28, 2019Martin 3 Comments

Dudley Voices for Choice (DVC) is a user led self-advocacy organisation that supports and empowers people with learning disabilities and autism to speak up for themselves and their peers, actively participating in community meetings and strategic meetings with the council and health services around the borough. Recently the charity celebrated a funding success, having been awarded a grant from the National Lottery Community Fund totalling £415,720 to maintain a regional self-advocacy network.

Martin, Funding Officer at Dudley CVS tells us more about his support, the application stages and the success achieved at the end of a long but rewarding process.

Almost 2 years ago (April 2017) I was approached by Sarah Offley (Project Manager at DVC) enquiring about funding for a regional forum comprising 12 West Midlands Self Advocacy charities previously in receipt of statutory funding. Following cuts by local authorities they were concerned that their essential work may not be able to continue. They wanted to maintain the network and work on a consortium bid to secure funding.

I met with the network in June and was enthused not just by their passion and desire for the work they were doing but also, and most importantly, by the ongoing involvement of their beneficiaries in the work they were carrying out. The self-advocacy was guided by support workers however the direction and decisions were led by beneficiaries i.e. people with learning disabilities. This influenced me in suggesting they approach the Lottery large grant programme Reaching Communities bearing in mind their stipulation that all funded projects must involve beneficiaries throughout the various elements of the work e.g. planning, delivery and evaluating. I provided them with a contact at the Lottery who they could speak to.

Over the remainder of 2017 and into January 2018 Sarah and her team worked on putting together a stage one application receiving support and encouragement along the way from Dudley CVS and the Lottery grants officer. I explained the time-scales involved over not only two application stages but also the possibility of a telephone interview along the way pointing out the importance of having strong evidence of need to show the Lottery how essential their work was and the need for it to continue.

They took on board the challenge led by Sarah. It was decided to submit the application via DVC rather than as a consortium bid. The emotion and passion provided by Sarah was key in the success of the application. Working closely with Sarah we were able to capture all of this translating it into words that would convey the message to the Lottery whilst at the same time highlighting the massive importance of their plans and what they wanted to achieve.

Having been invited to submit a stage two application they were guided and supported by initially Dudley CVS but, very importantly, all along the journey by the new Lottery grants officer for Dudley John Goodman. Sarah received great support also from Claire who was there to proof read her submissions and give her feedback where appropriate. An excellent team effort all round.

In early December 2018 Sarah received the news that they had been successful and that the Lottery had agreed to provide them with a 4-year grant totalling £415,720. The good news was embargoed until February 14^th when a launch event was held at DY1 where all the charitable organisations involved in the network attended along with many beneficiaries, all celebrating together having achieved a fantastic result.

All of this would never have taken place without the dedication and hard work of everyone involved in the network. Detailed planning and many discussions took place over an 18-month period to rejuvenate the regional forum looking at what they wanted and how they would approach the work/do things differently in the future. Everything centred on the importance of people with learning disabilities having their voices heard and being able to be remunerated/paid for delivering excellent advocacy work to others. This was a key issue throughout as they looked at what was important to people with learning disabilities so they could understand their rights and consider the many opportunities available to them alongside the challenges they may face.

One of the interesting areas of the application, and the ongoing work that will take place over the next 4 years, is the involvement of Regional Champions. They will champion the great work going on throughout the network and feedback key information and case studies so evaluation of this great work can take place throughout the 4 years and beyond. They will have a defined role and purpose continually learning and developing so that they have transferable skills that they can use now and in the future in the work place providing them with good employment prospects and opportunities that they can take to the job market.

All of this will be delivered alongside Local Community workers who will ensure everything runs smoothly and people with learning disabilities are given fantastic support throughout.

To sum up all of this is a short quote from Sarah when she said “we were encouraged to just go for it” which is directed at the process of applying to get the money but can also be used as a mantra for the beneficiaries in all of this as people with learning disabilities are encouraged to “just go for it”.