Isolation and loneliness review - recommendations report

We gathered numerous examples of services and groups that support people, many of which were offered virtually during the COVID-19 pandemic. What became clear was a lack of co-ordination and communication between statutory and voluntary sector partners about what activities exist and informing people about what is available. This report aims to address those issues."

- Councillor Malcolm Tullett, Chair - Wellbeing and Finance Overview and Scrutiny Panel

Recommendations

Review findings

"On behalf of the members of the panel, I would like to express our sincere gratitude to all those individuals and organisations that contributed and a profound regret that we could not hear from more, especially those on the front line, to whom we all owe our heart-felt gratitude.” - Cllr Mr Tullett

The indication early in the review was that a lack of co-ordination in the borough could lead to the recommendation of a single co-ordinator. However, during further witness sessions it became clear there were differing views on how to focus on the need for a more joined up response to addressing isolation and loneliness across all 3 sectors.

During the review we asked witnesses if they had heard of the community map. We found a mixed response. Those that had used it, said they were aware it was out of date.

In every evidence gathering session, the lack of accessible and affordable transport in the borough was raised as being a barrier to people being able to take part in activities aimed at preventing isolation and loneliness.

Residents and representatives from organisations giving evidence said they were aware that symptoms of isolation and loneliness, such as fear and stress, were having a significant impact on people’s mental health, potentially leading to other health issues. It was agreed this issue would need further investigation.

Digital methods were increasing and could be positive, but there were examples where the skills, access or willingness of users meant they were excluded from accessing services this way. It was important for it not to be the only way to access services and to develop digital skills as well as accessibility of information.

Background information

Community Impact Assessment and residents' survey findings

To understand the impact of COVID-19 and resilience of local voluntary and charity sector groups, we carried out an assessment across the borough with our partners. As part of this work a survey was carried out in May 2020 and 32 responses were received. The key findings identified were:

• 50% of organisations reported there would be a significant negative financial impact due to reduced fundraising income
• organisations generating income through selling services forecast between 40% to 70% reduction in their annual income
• 10% of organisations with paid employees had furloughed staff, and 10% had made redundancies
• most organisations have not seen an increased need for their services, however where demand has increased, for some it has been significant
• many volunteers are over 70 years old, meaning the risks of COVID-19 are higher and they are more likely to be in the shielding groups

How well do statutory and voluntary sector partners interact with each other to address social isolation and loneliness?

"We need a simple channel of communication."

"It doesn't matter where the co-ordination function resides, they just need to be able to work collaboratively and regularly across all organisations."

Suggestions included creating a:

• single co-ordinator role
• One Stop Shop
• joint local authority, health and voluntary sector role

It was also suggested that representatives on the Health and Wellbeing Board pool their resources to achieve a collaborative, single point of co-ordination for initiatives and activities in the borough.

After considering all points of view, the panel agreed there was enough evidence to recommend that members of the Health and Wellbeing Board should agree to create a single point of co-ordination aimed at tackling social isolation and loneliness. This would have pooled resources to avoid duplication in the future, as that was where strategic guidance was set and filtered down to all 3 sectors.

Representatives from organisations highlighted examples of activities available, but all struggled to reach the ‘hard to reach’.

Have you heard of the community map?

"Don't want it to be just blobs on a map."

We asked residents if they had heard of the community map. None of them were aware of it but liked the idea of a One Stop Shop informing them where fitness, knowledge and arts groups were available.

Carers welcomed a One Stop Shop, and said that more information such as reviews and pictures would be good rather than just contact details. They also said they would like someone to welcome them to the first meeting when they attended a group.

Professionals were aware of the community map but said there was duplication in particular between the Help Yourself part of the Bracknell Forest website, Social Prescribers in the Public Health Team and Community Connectors in the Berkshire Healthcare Foundation Trust.

Discussion also took place about what measurement could be used to determine if a One Stop Shop was working to make sure targets were met and prevent duplication. It was agreed this should be part of the Health and Wellbeing Board’s targets in the future.

Overall, there was a consensus that residents needed an accessible, well publicised and accurate platform to reduce isolation and loneliness. This would need to be bought into by organisations in all 3 sectors to avoid duplication.

Transport

Residents, carers, professionals and representatives from the voluntary sector expressed concern about how to access support groups. Carers said they, and the people they cared for, were reliant on lifts unless they lived on a frequent bus route.

Keep Mobile and voluntary car schemes in Sandhurst and Crowthorne were cited as successful services but there were examples of voluntary car schemes unwilling to support each other to develop a wider network in the borough.

Cultural issues in terms of transport were explored. It was considered this was not an issue and that lack of accessible and affordable transport was the problem.

Impact of isolation and loneliness on mental health

“Lonely is not being alone, it’s the feeling that no one cares.” - Swatantra Saxena

The impact of isolation and health on people’s mental health was raised during evidence gathering sessions. One option suggested to tackle the increase in mental health issues, included commissioning non-targeted mental health services for all residents to access. It was agreed this area needed more investigation and a recommendation be made to the Overview and Scrutiny Commission to scrutinise mental health services.

Digital inclusion

"We need a digital library across the community and to stop working in organisational silos."

Panel members wanted to investigate how technology could be used to enhance communication and co-ordination of services. Bobby Mulheir, Assistant Director: Customer Services, Digital and ICT gave a presentation explaining how technology and existing platforms had helped with isolation and loneliness before and during the COVID-19 pandemic. It was explained there were plans to further harness intuitive and assistive technology, such as using Alexa to allow people to search for council services in the future, requiring search engine optimization and correct meta data. It was agreed that a review of how technology could underpin activity and platforms to inform residents about what support was available would be useful and knowledge should shared.

Bracknell Forest Council loans of audiobooks, e-books and other digital resources more than doubled to 6,000 loans a week.

Phil Cook, Chief Executive of INVOLVE told Panel members about someone living in the USA who joined a cancer survivor meeting in England during lockdown as they could not find a suitable group at home, which highlighted the benefits of technology.

Berkshire Healthcare Foundation Trust had loaned tablet computers to carers and people with dementia during lockdown and video consultations had risen from 3,000 to 12,000 a month.

Skilling up residents

Many volunteers who led groups were often run by older members of society and there needed to be a recognition some of these groups had not continued during the pandemic due to the leader or members not being able to use technology. It was agreed this was an issue the Health and Wellbeing Board needed to address when looking strategically at recovery of activities and services after COVID-19.

Promise Inclusion (PINC) had already recognised the need for their members to be skilled up digitally and had been successful in obtaining seed funding from Royal Mencap for this type of project. However, during the evidence gathering session with carers of people with learning disabilities it was noted some people did not want to use digital services during the COVID-19 pandemic and some people could not. An example was given of a resident with autism who had become frustrated because they could not touch people they saw on screen, so had not been able to communicate with people during lockdown.

Bracknell Churches Together said they had received varied feedback from residents about the digital divide with some residents saying they felt depressed and others coping well.

The importance of security when using technology in the home was recognised. There was a need to teach digital skills to help people make best use of technology but there should always be another method of asking for help available.

Review panel

Review panel members were Councillors:

• Nick Allen
• Michael Brossard
• Lizzy Gibson
• Tricia Brown
• Mary Temperton
• Tina McKenzie-Boyle
• Ray Mossom
• Pauline McKenzie
• Tony Virgo
• Nigel Atkinson
• Alvin Finch
• Mike Gibson
• Ash Merry
• Isabel Mattick (Vice-Chair)
• Malcolm Tullett (Chair)
• Rob McLean
• Moira Gaw

Contributors to the review

Examples of good practice

Examples of good practice gathered during the review includes the following:

• Bracknell Forest Council (BFC) sent out hard copies of a booklet containing key contact information to residents who were advised to shield
• residents said PINC and AGE UK very helpful
• residents said library services in the borough were very useful
• PINC put details of other organisations on the back page of their newsletters
• Healthwatch advertised what support was needed by local residents which allowed volunteers to choose which task to do
• one carer reported a social worker had checked on her during the pandemic and that the crisis team had also helped in an emergency
• PINC supported carers by phoning them during the first lockdown but moved online and then met face-to-face when allowed, responding to demand from carers
• Bracknell Churches Together (BCT) had a team of people making regular phone calls to parishioners since the COVID-19 pandemic began
• BCT held weekly ‘life groups’ allowing people to catch up and host Christian activities
• one church leader met individually with 16 parishioners a week, in line with COVID regulations, and had more people requesting support
• BCT had been in touch with 3 local hospitals to set up links between local churches and chaplains to communicate who was going into hospital or being discharged home
• online library services were well attended including the highest take up of story time ever
• audio and e-book loans increased to 6,000 a week during the first lockdown - more than double the normal usage
• the work by social prescribers and community connectors was thought to be very useful to other professionals
• good provision of day centres - activities for people with learning disabilities and carers were thought to be good before the COVID-19 pandemic
• parish websites were often referred to as a good place to go for local information.
• Bracknell Islamic Cultural Society (BICS) said they had been able to identify some vulnerable people in their community by putting out communications
• BICS website had more than 2,000 subscribers
• BFC had supported BICS to increase the uptake of the COVID-19 vaccine in their community and completing the census
• staff from the Community Mental Health Team for  Older Adults carried out welfare calls during lockdown periods to monitor people’s wellbeing
• Bracknell Healthcare Foundation Trust (BHFT) staff members, including Memory Clinic Nurses and Community Support Workers, adapted their roles to offer additional patient contact
• Community Support Workers supported Bracknell Forest Dementia Advisory Service with welfare calls – over 110 calls made in a 3 month period
• the Dementia Advisory Service newsletter and directory was distributed to over 350 people in the borough
• the Dementia directory was regularly updated with nearly 100 community resources for people with dementia and their carers - it was also available on Bracknell Forest Council’s webpages and advertised in GP Surgeries
• Bracknell Forest Council’s website included links to ‘Help Yourself’ and the Bracknell Forest Community Map 
• BHFT updated their carers' strategy and assessment template which was used by both Health and Social Care staff - it included links to the Community Map and a section exploring loneliness
• BHFT loaned laptops and tablet computers to people with dementia and carers to help with IT access
• additional support for carers of residents of Prospect Park had been well received