CARESCO History - Theme Five - Partnership THEME FIVE PARTNERSHIP...... BETWEEN VOLUNTEERS AND PROFESSIONALS "If we are clear what we are trying to do by way of Government policy and if we can build up what is required at local level from knowledge and assessment of individual need, then we can move on to look at the machinery and structure to deliver this - or rather to allow it to be delivered. The aim must be to provide structure and resources to support the initiatives, the innovation and the commitment at local level and to allow them to flourish; to encourage the success stories in one area to become the commonplace of achievement everywhere else. To prescribe from the centre will be to shrivel the varied pattern of local activity." Griffiths - Community Care: An Agenda for Action. "It should be possible to draw up detailed local interest plans. At present planning documents tend to cover things at a very high level of generality. They make comments like "there is a need for more respite services for people with learning disabilities" or "there is a need for more day services for elderly people." They do not say such things as "there are a number of elderly people living in the village of X who are a long way away from any day services and these services need to be developed in this village." Divisional Director, Hertfordshire Social Services, 1995 - quoted in Barnes & Gould - Strategies for Success in Rural Care. CARESCO is a living demonstration of the principles undelying the Griffiths Report and the subsequent (1990) NHS and Community Care Act. Despite this, Griffiths' challenge to collaborative working is still the most difficult part of his agenda to achieve. Even in 1997 many Counties have still not devised strategies for Rural Wellbeing as part of their Community Care Plans, or recognised the need for local, creative thinking if services are to be delivered as close to the individual as possible. Individuals learn to trust each other by working on projects in their own patches. But some Commissioning and Purchasing teams feel threatened both by constant , urgent demands on them to improve their standards and strategies, and also by a fear that their authority is diminished if they are seen to accept suggestions from "mere volunteers". Conversely, any care group can tell horror stories of requests from social workers late on Friday afternoons, to provide volunteer care over the weekend! An Organiser needs to have the authority to say "NO!" On the other hand a close- knit local group like CARESCO may succeed with some reputedly "difficult" clients if it is given adequate support. Many of CARESCO's best projects have been developed in response to statutory staff's suggestions and with their help, but even these projects serve to illustrate some of the pitfalls of collaboration. - 1 - CARESCO History - Theme Five - Partnership The Special Play Scheme. In 1984 a Social Worker, concerned at the potentially large number of children in the catchment area of the Village College who might have "Statements" of Special needs, suggested that CARESCO should run a Playscheme for them during the Summer holidays. The idea appealed to the CARESCO Committee. These children were sent out of the village to school in Huntingdon, and lost contact with their contemporaries, who consequently regarded them with suspicion and often hostility. We felt, however, that any benefit to the children would be negated by separating them in a different Playscheme. The mothers who successfully ran the existing Playscheme felt hesitant to undertake the extra responsibility of children with disabilities. Our idea, however, was to recruit a qualified Leader and a team of teenagers from neighbouring schools to support the "special" children. Under these conditions the Playscheme Organisers agreed to help. We turned to the Social Workers and the Doctors' Practice for details of the children we would be caring for, so that we could arrrange appropriate activities and train the helpers to meet the Special Needs. "No!" was the answer. "Confidentiality must be observed!" Fortunately for us, and for the Special children, Stuart Collins, the Deputy Head of Huntingdon's Spring Common Special School, lived in Sawtry. He came to a well-attended meeting of Playscheme helpers and told us about the circumstances of some of his pupils. Even without names, it was not difficult for the helpers to recognise the contemporaries of some of their own children. Stuart suggested how the scheme could be structured, and put us in touch with other staff from Spring Common who could help us. The project came alive for our volunteers and we were in business! A starter grant was obtained from Joint Finance, and later, the BBC "Children in Need " fund gave us money to buy extra equipment , which benefitted the main Playscheme too. Ever since that time, one or two "Special" children have been valued members of the Summer Playscheme. In 1997 there were eight of them, and all are now integrated in mainstream schools. Some lasting friendships have been made, and several of the school pupils who joined the team of helpers have been motivated to work with such children when they left school. Our Annual Reports drew on the first-hand experiences of the helpers:- "This is called SAND!" A serious young lady looked up from building a castle as I stopped to watch. Momentous and exciting discoveries like this are the right of every child, but some parents hesitate to allow their children to join in the fun of a playscheme. Sawtry's 1985 Playscheme was different. CARESCO recruited a team of young helpers, led by a welfare assistant from Spring Common Special School, to care individually for any children with special needs whose parents wished them to come. We felt it was particularly important to welcome these children to a village holiday activity, because during the term time they are taken to school over ten miles away, and people in Sawtry don't know of their existence. Several people said to us "ARE there any children with special needs in Sawtry?" and were surprised to learn how many there are. Those who came to the Playscheme enjoyed it and began to play with other children. One 'Down's syndrome' girl organised games of tennis with three or four other little girls, but only the two sixth form boys were "good enough" to play with her properly, and one day she refused to go home unless one of them went with her. "I like Playscheme," she said," because you're nice to me here." - 2 - CARESCO History - Theme Five - Partnership The helpers enjoyed the two weeks, "although it was tiring, it was fulfilling...and showed me that in the near future I would like to be involved with children, possibly handicapped." "The children learned by copying each other...while they played or talked. This special playscheme helped overcome prejudice and showed that it is better to be friends that to be prejudiced." CARESCO's ANNUAL REPORT, 1984/5 Dorothy Slater, Deputy Head of Spring Common Special School, came twice to speak to the potential young helpers at Sawtry, and they all spent a morning at Spring Common, getting to know the children they would be dealing with. One of the most difficult things to learn, for adults and young helpers alike, has been knowing when to do things for their charges - and when to leave them alone and watch from the sidelines without fussing. The children had varying degrees of disability, but it was striking that the "normal" children accepted them for what they were, responding appropriately and responsibly. The success of the project rested on the skill with which the Playscheme as a whole was organised, and the team-work of the young helpers. One of these helpers, Vicky Jones, wrote " I would be very happy to work at Playscheme again as I got a great deal of enjoyment out of it and I'm sure the smiles I saw from all the chldren will be with me for a long time." CARESCO's ANNUAL REPORT 1986/7 .....There was a full range of outings - bowling, coast, zoo, cinema - and activities - swimming, football, sports, handicrafts. One little boy attended for the first time this year although his mother was more than a little apprehensive. He took to it like a duck to water, badgering his mother for extra sessions and even talking her into coming on the day out to the zoo. The teenage helpers were all willing to help out with anything that was asked of them and supported each other when faced with a difficult child. CARESCO's ANNUAL REPORT 1990/91 The success of the Special Play Scheme illustrates the benefits of insisting that any welfare project must be designed with close attention to the PEOPLE whom it is to benefit. Slavish adherence to bureaucratic regulations would only have reinforced the fears of the mothers who were running the original Playscheme and impoverished generations of children with disabilities. PARTNERSHIP WITH THE HEALTH PROFESSIONALS - Swimming Therapy. . The suggestion for this project came from members of the Day Centre. We were given advice and support by Sheila Sherwood, the Senior Physiotherapist, but, as always, Health Authority funds were tight, and it was a number of years before we were able to bring together our local GP and the Family Health Services Authority to devise the best means of persuading the hard-pressed Community Health Team that extra Physiotherapy hours in Sawtry would be cost-effective. - 3 - CARESCO History - Theme Five - Partnership Katy came home from hospital and enthused at the Day Centre about the exercise she had taken at the hospital's hydrotherapy pool. "Why can't we use the school pool?" she said. Voluntary lifesavers were found - (public swimming sessions were run by a voluntary committee.) Then Anne, who also needed help because she was quite severely paralysed, was persuaded to join in. She had to be lifted bodily into the pool and at first clung to the side in fear. Advised by the physiotherapist, the volunteers reassured her. Gradually others who came to the Day Centre joined in to enjoy the exercise and the company. Pupils from the school came along to help those who were slow in changing. Steps with grab rails were added to the learners' pool to help those who could climb in for themselves, (steps which, incidentally , came in very useful for primary school children at other times.) Soon there was quite a gathering of people referred by the G.P.s for the benefit of the exercise. They and many others helped to raise over #4,000 for a hoist to facilitate getting in and out and to save the helpers' backs: a wonderful community achievement. But the new physiotherapist, upon whom the project depended, had only half a day in the village each week, and this gave her no time to support and advise the volunteers. More severely handicapped people, many of them young, were confined to their own homes and needed all her time. So what was to be the answer? The Family Health Services Authority had some money to encourage health promotion based on General Practices. The Senior Community Physiotherapist's priority was to set up an exercise club for those physically disabled people who get forgotten - the ones who are neither very young nor very old. This would bring a "physio" into the village for rather more than half a day a week. The GP was keen to support this club too, but where could they hold it? In the Community College , of course. The Judo Club might be prepared to save them money by lending their mats, and CARESCO would find volunteers to help. So the village got more physiotherapy time,the swimming therapy volunteers had professional support when they needed it, and the Community College hosted another club for people who might otherwise be housebound. (Furthermore the Community Physiotherapist formed an alliance with the Development Manager of the FHSA to repeat the process elsewhere with other GP Practices.) from Community Education NETWORK , November 1991 THE NEW SWIMMING POOL. In 1987/8 the District Council agreed to invest in upgrading the Sawtry Sports facilities and taking on the running costs of the Swimming Pool which had been previously borne by the school, (County Council.) The Swimming Club and CARESCO had for years postponed planned improvements to the changing rooms and heating of the pool for able and disabled swimmers because they were waiting to learn the details of what the District Council could do. Sadly, after inviting the Community to give them a "Shopping List" of the facilities they would like, (predictably long,) the District Council weighed up the total costs and decided what they felt was necessary and could be afforded, without coming back to the villagers. The pools, which had been built and run by members of the community, were declared to be sub-standard, and filled in. Sawtry now has one smart and hygienic new pool (smaller than the two old ones,) run by highly qualified District Council Staff. The participation and goodwill of many volunteers who contributed to and used the old pool has, however, been lost, and CARESCO cannot afford to run Swimming Therapy because of - 4 - CARESCO History - Theme Five - Partnership the high charges in the school holidays. CARESCO had hoped that the District Council would do more to encourage the use of the new pool by disabled swimmers, perhaps by having special public sessions for the disabled and their families, as happens in many other pools. In this case, the initiative for inter-agency partnership seems to have been lost now that the statutory body has taken over from the volunteers. WORKING WITH THE SAWTRY GP's PRACTICE CARESCO staff were particularly pleased that this Partnership marked an increasing confidence in our position on the part of the staff at Sawtry Surgery. From the beginning, we had hoped that one of the GPs could be a regular member of our Committee, but pressure on their time prevented this. Unfortunately this meant that sometimes one of the Surgery Team made a formal complaint to CARESCO (or worse, criticised us to someone else,) instead of raising the matter personally as between equals. The CARESCO organisers felt at a slight disadvantage partly because the Doctors knew us, through our medical records, far better than we knew them, and also because we always hesitated to trouble the Surgery, knowing they were so busy. We were often uncertain whom we should contact if we were worried about one of our Club members, and on some occasions we reacted inappropriately to some new person who had been referred to us, because we did not know their background. Over the years CARESCO worked with the Sawtry Practice on a number of projects which brought us closer together. a. The attempt to persuade Huntingdon Health Authority to fund the "Hospital at Home Scheme" in Sawtry. (See Theme Two. We had benefitted from this innovative scheme started in Peterborough before the Health Authority boundaries were redrawn.) b. Meetings of the Parish Council's Health Committee. (See Theme Two p ) Dr. Hackman attended, and supported the Council's attempt to lobby for the provision of Housing Association "Very Sheltered" accommodation in the village. (The nearest Residential Home was eight miles away.) This was another example of a rural community losing out to towns which could offer "economies of scale". c. "Questions Women Ask - a Meeting about Health Issues for women of all ages." Dr. Hackman of Sawtry and Dr. Davies of Yaxley took the lead in this well-supported meeting organised by CARESCO with the help of Shelagh Palmer of the Huntingdon Health Promotion Team. d. Sawtry Carers' Group. This is one of several projects which failed when it was first tried, and had to be abandoned, but was reborn later. Age Concern Cambridgeshire had a very successful Carers' Support Scheme and Sit-In Service, which we visited for ideas. But the scheme didn't really take off in Sawtry until the Huntingdon Health Promotion Team - 5 - CARESCO History - Theme Five - Partnership involved Kathy Jones, CARESCO's Organiser, in the production of a Handbook of information "Caring for the Carers". The Doctors and Surgery Staff supported the establishment of a local Carers' Group which meets at the Surgery once a month, convened by Kathy. (See p...) The group's members care for husbands, wives, parents and children. One of the oldest carers in the country - aged 97 - lives in Sawtry and attends the Day Centre with her 76- year old daughter, who has been disabled since birth. The youngest member of the group is in her early forties and cares for a son who has had learning disabilities since birth. Ex-Carers are welcome to continue coming to the group and are often able to provide emotional support to the others. d. Rural Transport. This is a universal rural problem. Sawtry started a Car Scheme in 1981 - the Year of the Disabled, and CARESCO took over the running of it in 1984. Until 1988 a team of volunteers did regular runs within the village and occasional trips further afield. But the success of the scheme depended on the energy and drive of the voluntary Coordinator, Chris Kempton, who took the requests on her own home phone, and often found herself drawn into more than she had bargained for. CARSHARE .... or LIFESHARE? It was really a horror story of what can happen if you start up a Car Share Scheme. But Chris told it in such a casual (... no - caring - ) way that you ended up feeling that journeys like this made the job worth while. That is, if you could stand the pace! A trip to the dentist? Sure - No problem. That's what we're here for - to help people who could not otherwise make these journeys. It was only when they arrived that it turned out that she had no appointment. Emergency? "No, but they'll have to see me now I've arrived. I'll tell them my Social Worker has brought me in..." Fortunately the dentist could see her, in about an hour's time. "Then perhaps you could take me to the optician, while we wait?" That seemed logical. But she had no appointment with the optician either. However, the same charm worked. Only this time they said come back in TWO hours time! As our community is situated ten miles from these services and the dear lady could not easily get in on her own, what could Chris do but agree? "While we wait, perhaps you could take me to the bank?" It turned out that she wanted to go there to deposit most of the contents from under her mattress. So onto the bank's counter she poured out a huge unsorted collection of coins, cheques and odd papers. " Could you help me sort it all out?" she said. Chris hesitated, but the bank clerk seemed unperturbed and took over. In our passenger's estimation we are all "social workers", even the banks. (Chris noted that, having deposited this large sum, she took nothing out.) It was lunch time now and they repaired to the Wimpy. Guess who paid! "I'd rather have gone to the hotel over the road,"she said. By now it was clear that they were not going to be back by the end of school, so Chris had to ring and make arrangements for her child to be met from Junior School. Her only "perk" of the day was to snatch a few minutes to try on some jeans. "You go on . Don't bother about me. I haven't enjoyed a day out so much for years.!" When eventually they got home, Chris got out the Car Share receipt book to acknowledge her payment (- a bargain at 15p a mile.) No money. "Pay you next week!" Article from CAMBRIDGESHIRE CARES - a news sheet for caring groups. 1987 When Chris left the village it was difficult to find anyone with the time available to succeed her. Attempts to take requests through the CARESCO office were not satisfactory, and we failed to obtain a grant to employ a Coordinator who would build up a fuller "Transport Project". Individual drivers helped to bring members to the Sawtry Thursday Day Centre, - 6 - CARESCO History - Theme Five - Partnership but as these members became more frail it was difficult for volunteers who were themselves elderly to help them in and out of a car. Now the Day Centre hires a specially adapted bus from Social Services. Some Lunch Club members are still brought in by volunteers, (and one 93 year-old drives herself in along the quiet back roads from Gidding four miles away!) But there is no scheme for medical, shopping or social trips. Volunteers are soon lost when they discover that their passenger has a family member available with a car, or is capable of getting by bus to the supermarket ten miles away! We have concluded that a succesful Voluntary Car Scheme really needs a dedicated regular Coordinator who is prepared to encourage and praise the Drivers, and be firm with those using the scheme to ensure that they do not abuse the goodwill of the volunteers. It may be necessary to pay for this. CARESCO had already begun to share in the use of the Village College Minibus. Three volunteers obtained County Council "Green Cards" qualifying them to drive it, taking the Lunch Club members on outings and the Play Scheme on trips. Help the Aged gave a grant for steps and a hand-rail so that the elderly could more easily use the bus, and we dreamed of eventually persuading the College to buy a bus with a tail lift! The Doctors' Surgery had referred many people to the Car Scheme, and eventually it was through the Health Promotion Department that a Rural Transport Initiative came to Sawtry. POSTMAN PAT? The HUNTS RURAL TRANSPORT INITIATIVE Kathy Jones, a member of the Steering Group, writes:- With the decline in Public Services in rural areas, the need for transport is a continual problem for individuals and voluntary organisations alike. With so many people working away from the village or hamlet where they live, it is easy to see how the young mother, elderly person and disabled may become socially isolated. However neighbourly people may be at the weekend, during the week it is not uncommon for the person at home to see no neighbours for days on end. The mobile worker leaves home in the morning and returns for dinner in the evening. The family with a car needs the car for the breadwinner to travel to work. Endless surveys and conferences on life in rural areas all put transport at the top of their list of needs. It was against this background that a village G.P. requested help in bringing elderly patients to his surgery. The Hunts Rural Transport Review was set up to review existing local transport and to assess potential needs. CARESCO was asked to join the Steering Group. Eventually not one but three rural G.P. practices (including Sawtry,) took part in the Transport Project. Voluntary organisations from the West Huntingdonshire area worked together, funded by the (then) Cambridgeshire Family Health Services Authority, Cambridgeshire County Council and the Rural Development Commission, with help in kind by the Health Promotion Service. The Steering Group focussed on transport and mobility needs, Particularly those of the elderly and disabled requiring health care. Over a thirty-day period at each of the G.P. surgeries - 7 - CARESCO History - Theme Five - Partnership involved, a questionnaire was issued to each patient who visited the surgery or who received a visit. Questions were asked on access and journey times to hospitals, G.P. surgeries, opticians and dentists, and, perhaps more importantly, on the ability of people to reach their destination without personal transport or hospital transport. Additional questionnaires were prepared for people receiving Day Care or direct support in some way. CARESCO Lunch Clubs and Day Centre members all took part. Perhaps one of the most interesting answers was to the question "Do you get help from Volunteers?" The most frequent answer was "NO." However, to the next question "Do you get help from friends?" EVERYONE answered "Yes!" Volunteers were invariably seen as friends, which is a much more dignified form of help. The Group made certain recommendations directly concerning people in our area:- 1. Bus passes should be available from local Post Offices. 2. Bus should be sheltered, and could be raised to improve access to buses. One village planned to erect a bus shelter, but decided not to - because it vould be vandalised! 3. Children's bus fares after school should not be at the full passenger rate. 4. Local residents should receive the same level of concessionary bus fares across Cambridgeshire. 5. Late bus services from Sawtry to local towns should be improved. An additional contract bus was run from Sawtry, but because it was not well publicised, it was not used! 6. Footpaths in villages should be improved and maintained. 7. There should be a review of local traffic accidents involving young people. 8. Multi-occupied seats on buses cause concern and should be reconsidered. As a result of the Survey, a Post Bus was started between Kimbolton (one of the three G.P. surgery towns,) and St. Neots, the bus from Sawtry to St. Neots on Market Day, (Thursday,) was re-routed through some of the small villages, and an in-depth survey of every house in Conington, (another small village,) led to two gentlemen attending the Sawtry Day Centre and becoming friends there. In 1995 Sir George Young, then Secretary of State for Transport, was Keynote Speaker at a Conference organised at Sawtry Community College by the Hunts Rural Transport Initiative, "Postman Pat: a Rural Reality? Alternative solutions to Rural Transport Needs." PARTNERSHIP IN PLANNING In 1997 it is now generally recognised that "users and carers" ought to be consulted on the nature of the services to be provided for them through the Health and Social Services as part of "Care in the Community". Effective consultation is, however, extremely difficult to achieve. This is particularly true in rural areas. Surveys by the National Council for Voluntary Organisations show that very few Counties explicitly recognised the problems - 8 - CARESCO History - Theme Five - Partnership faced by rural areas in their early Community Care Plans. (Gould - Not Just Fine Tuning , and - Still Just a Sideshow!) Cambridgeshire's Community Care Plan for 1997/8 highlights a RURAL STRATEGY, which has been adopted by the County Council to "bring together all organisations which have an interest in improving lives and livelihoods in rural Cambridgeshire and to fully understand and agree measures to bring about considered improvements." Cambridgeshire ACRE is leading the voluntary contribution to this Strategy, and encouraging community appraisals at Parish level. The Policy is to consist of "an active rolling programme," including an "annual Rural Forum to cover three key issues per year." "The central theme is on partnership working to maximise resources and expertise in identifying and resolving rural issues and in targeting service delivery and resources to meet actual demands. The strategy would also further the aim of local governance in stimulation local initiatives and solutions..." Cambridgeshire Social Services - Developing the Cambridgeshire Rural Strategy 1997 Not many Parish Councils have the nerve to enter into systematic planning for Health needs. Sawtry considered doing so, and set up a Health Committee in 1986. (See Theme Two p ) Barnes and Gould, in another NCVO publication, sum up the difficulties facing statutory authorities which try to involve grassroots communities in the consultation process:- "Authorities which had begun to get to grips with these issues commonly perceived the following challenges: -Lack of quality information about unmet needs and existing services and opportunities. -Lack of appropriate indicators of need , to measure rural deprivation and allocate funds fairly. -The high costs per head of serving clients scattered over a wide area - specialist local provision is non- viable and individual home care expensive. -Poor infrastructure on which to build - low level of local services, no ready-made rural network to consult and an under-resourced voluntary sector. - The problem of measuring 'quality' of rural service provision. -The variety of local communities, each requiring an approach to suit its own particular needs - and some looking to services in towns outside the county. These issues and problems are experienced by every agency involved in provision of health and care services in rural areas. Nowhere is effective collaboration more crucial." Barnes & Gould - Strategies for Success in Rural Care - a practical guide. INFRASTRUCTURE - NETWORKS FOR CONSULTATION Apart from the variety of local services which CARESCO has been able to develop, it has been important in establishing, together with the Parish Councils of the Community College catchment area, a strong infrastructure through which needs can be identified, and a lively network for consultation. Its first Organiser had contacts with the WRVS county-wide, and through these, was elected to the Committee of the Cambridgeshire Community Council (now Cambridgeshire ACRE.) Michael Bond, Director of the Community Council, was responsible for organising elections of representatives from the Voluntary organisations to both the Huntingdon Community Health Council, and the Huntingdon Joint Consultative Committee. It was not long before CARESCO sought to be represented on these two - 9 - CARESCO History - Theme Five - Partnership influential bodies. (No one else spoke for North West Huntingdonshire, especially as the designated "Rural Development Area" in Huntingdon District only covers a tiny part of the catchment area of the Village College - and does not include the village of Sawtry itself.) Michael Bond of the Community Council played an important part in training and supporting the voluntary representatives on the Joint Consultative Council, briefing them and organising Forums where they could keep in contact with their "electorate". He helped them to win funding from the Huntingdon Health Authority to set up "Hunts Forum" - an association of caring groups in Huntingdonshire, who met regularly to discuss the issues of Community Care with which the JCC was dealing. The regular meetings of Hunts Forum exemplify the strength of the voluntary groups in Huntingdonshire, who do not compete (for funding or volunteers,) but share their ideas and experiences and support each other's caring work. INFORMATION ABOUT UNMET NEEDS Sawtry Parish Council's Health Committee and Special Housing Provision. With these District and County-wide contacts, CARESCO's staff were able to urge the Parish Council to clarify locally unmet needs and lobby for provision to meet them. In 1986 Sawtry Parish Council appointed a Health Committee, chaired by a Councillor who was also Coordinator of the Car Scheme and active on the CARESCO Committee. The Health Committee looked into:- "1. The provision of a Home for the frail and elderly within the village. (The nearest home of this kind is ten miles away.) One Sawtry couple had been married for 60 years. Worn out by caring for her husband, the wife had a spell in hospital. When she got home, her husband agreed to "give her a break" by spending a week in residential care himself. But the Home was eleven miles away and she had no transport. He soon phoned her saying "I'm so lonely because you can't visit me". 2. Looking into ways of creating a support network using statutory and voluntary help. (Helping elderly and disabled people to remain in their own homes, should they wish to do so.) (A comparable scheme had been set up by the Parish Council at Haslingfield, in South Cambridgeshire, where a "Village Warden" kept an eye on residents, not only in District Council accommodation but those in privately owned houses.) 3. Talking to the Health Authority and the Sainsbury Trust about the possibilities of regaining the Hospital-at-Home service, (lost to us when Health Authority boundaries changed,) which enabled some patients to be treated in their own homes rather than taking a hospital bed." Sawtry Parish Council Annual Report 1986/7. John Major, our M.P., was very sympathetic when he met members of the Health Committee in February 1987, but there had been no progress towards shifting the log-jam of departmental interests by March 1988, when the following letter outlined the situation to the - 10 - CARESCO History - Theme Five - Partnership Chairman of the County Social Services Committee, Councillor Maggie Scott. She had told us about similar schemes which had been established at Fulbourn, a village near Cambridge. "...The joint project for accommodation and day care at Fulbourn sounds very much the sort of thing that Sawtry Parish Council have suggested to meet some of the needs of Sawtry. These are (a) "Part 2" Accommodation. While we have excellent District Council provision in mobility bungalows and warden-controlled flats, anyone who is unable to look after him or herself has to go ten miles out of the village, leaving behind the whole support network of family and friends. (b) A base for the new Social Services patch team. Up till now the Team Leader has used an office in the Doctors' surgery, coming out once a week. I understand that it is intended to make more of the resources directly accessible to the community - and that, ultimately, this should mean an office in Sawtry. (c) A base for the "localised" Health Team. (d) A base for a Village Warden" on the lines of Haslingfield's, who would act as Good Neighbour to elderly people in their own homes, mobilising both statutory and voluntary help to enable them to stay there as long as possible. It has seemed to us that a complex of the kind you describe at Fulbourn would make possible all these things and more. The Health Authority is helping us prepare a survey which we hope will produce more detailed evidence of what the residents would like. The Nene and Muir Housing Associations are fully in support of what we suggest, and have been in touch with both Social and Health Services for several years. The stumbling block is land. Three sites are possible.....(each had drawbacks). All other suitable land in the village is owned by developers, who look to raise full building rates on it, especially with the limit placed by the Structure Plan on further housing in Sawtry. Can you suggest any means by which we can shift the log-jam?" The survey referred to had been carefully prepared over 16 months,with help from the Health Authority and the Social Services Department, and was authorised by the outgoing Parish Council in Spring 1988. "It was intended that this survey would not only clarify our needs but should be useful as a pilot scheme for other communities....The Annual Meeting approved the Report... But the Survey was rejected by the newly elected Council largely on the grounds that it was beyond their brief." Sawtry Parish Council Annual Report 1988/89 Nine years later, the dream has not been realised. Various individuals submitted unsuccessful plans. A private Residential Home has opened in Sawtry and the District Council has built some more specially-designed houses, but improvements have been fragmented. The Parish Council's Health and Emergency Committees are now combined. They produce an impressive EMERGENCY PLAN, designed to " improve the emergency preparedness of Sawtry by making arrangements to provide local voluntary assistance to the Local Authorities and Emergency Services in a Major emergency." Not surprisingly, the Supervisors for Emergency Feeding, Information and Welfare are all active workers in CARESCO. There is, however, still a perceived need for a Centre to give a focus to the welfare services provided in the community and improve the ability of volunteers to deliver them. It is hoped that funds will be found, from the Lottery or elsewhere, to build such a Centre. - 11 - CARESCO History - Theme Five - Partnership Healthy Alliances are now, in the 90s, encouraged by Government policy, and partnerships similar to CARESCO's are quoted in a Practical Guide to Rural Care published by NCVO. A particularly successful scheme was the Healthy Village Project in Brockenhurst - a village of 3,500 in Hampshire. The local GP and his partners adapted his experience of the African Community Health model, aiming - to help people of all ages improve their health and well-being by making use of existing community facilities and - to develop networks of care, to back up the work of the primary health care team. The Brockenhurst Project was funded by the Health Commission and the Regional Health Authority and the steering group included GPs, the Health Commission, Social Services, District Council, and the Parish Council with support from Hampshire Education Authority and Brockenhurst College. The part-time Co-ordinator lived in Brockenhurst and "helped individuals access local resources and resolve any remaining problems through follow-up visits." Hampshire's Rural Health and Community Care Project Worker commented:- " The Co-ordinator was what every village needs, working with individuals, taking the load off the GP's plate." Barnes & Gould - Strategies for Success in Rural Care - a practical guide. This prize-winning project, funded for two years, has much in common with CARESCO's aims and achievements. We have worked with the equivalents of almost all the bodies who were involved in Brockenhurst, but, as their experience shows, there comes a point where the weight of a statutory body is necessary to shift log-jams. So far Sawtry and CARESCO have been unable to mobilise that weight. Statutory bodies are only moved by massive lobbying from the grass roots. CARESCO's failure to achieve the housing complex of which we dreamed demonstrates the sad fact that pioneers can get nowhere without persuading a great many people. - 12 -