Co-production in social care: What it is and how to do it
Practice example: The Healthy Living Club
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About the project
The Healthy Living Club in Lambeth, South London, is a self-directed, dementia-centred club based in, but independent of, an extra-care housing association. The club comprises people with dementia and their carers from across the borough, some of the residents from the building, volunteers and a part-time coordinator. They meet twice a week to take part in activities of their own choosing.
There is regular one-to-one contact between participants. This ensures that members' changing needs and preferences continuously influence what happens and are fed into the frequent meetings of the committee. This is an elected group of trustees, including people with dementia, carers, volunteers and some external people.
The club used to be a dementia café funded by the local primary care trust. The money ran out and it looked like the café would have to close. But the café's weekly meetings had been providing its 'users' with a strong sense of belonging to a community of which – they felt – they shared ownership. So they decided they would continue to meet and were supported by the coordinator, who agreed to work without pay until funding could be secured. So the community outlived the closure of the service.
It is now a vibrant place with everyone contributing to running the club and to all the decisions about how it is run, to the extent that they are able and willing to do so.
What has co-production meant to the project?
When those involved in the club heard about 'co-production', they realised that the term described exactly what they had been doing all along – with non-disabled people and people with dementia running the club together.
They have discovered that between them they have a range of talents and skills - from bid-writing for grants, to keeping the books, to information technology skills, to active listening, to music making, to planning meals – all of which can be used in running the club and its activities.
The club has actively built relationships with local and London organisations which are developing innovations in dementia. This has enabled them to pilot and develop their offerings at the club, which has benefited both parties. The club makes use of outreach activities from cultural bodies including the National Gallery, Royal Albert Hall and the Gardening Museum.Most recently a local person has volunteered to run a monthly ‘Crafternoon’ on Sundays, further extending the club’s activity into the quiet and often-lonely weekends.
What has helped in implementing a co-production approach?
When the club started, its only resource was its members, so working together was the only route to survival for former ‘staff’ and former ‘users’ alike.
Good contacts built in the wider local community have really helped too. A local professional who works as an Admiral nurse and as a trainer for Dementia UK is a regular volunteer and a Trustee. The Paxton Green Time Bank registers, checks and insures the volunteers, saving the club time and money.The most important factor, though, has been the enthusiasm and hard work of club members who have been determined to keep it going.
What difficulties have there been in implementing co-production?
At the beginning there was 'nothing' – no money to run the club and no legal status or organisation to raise the money. Members, although they wanted to continue, were surrounded by pessimism. Public officials and other potential sources of support were sceptical that a group of vulnerable adults and non-professionals could self-manage, and seemed reluctant to invest in supporting a project that – they felt – would be likely to run out of steam and fail.
These difficulties were overcome by establishing the club as a legal entity and as a registered charity. It has also been important to promote the work of the club to the wider community by various means – through social media in particular. This really helped the club gain credibility as a viable organisation in itself and as a model of co-production.The club has been very good at attracting small grants for new activities and its strategic aim now is to build up regular income to support its coordinator and core costs.
What are the main strengths of the approach that has been taken?
The club's main strength is that, being directed by the people who are also benefiting from it, it meets their needs very closely and can change as needs change.
Unlike services led by professionals, it provides people with dementia, their carers and other members of the community with more than just opportunities for active participation as either 'service users' or as volunteers. It provides them with an opportunity to self-determine, and even act as commissioners of the services they need.The high quality of the club’s output reflects the high calibre and regular commitment of a strong core of volunteers. Some were already skilled and experienced when they started working with the club, while others have developed within the club and through training provided.
What have been the main outcomes of the project?
The two main outcomes are:
- The strong sense among members of belonging to a community, one in which dementia is normal, rather than the isolation which many would otherwise experience.
- The club has become a community hub, bringing together extra-care residents with vulnerable adults who live alone or in other settings in Lambeth. It brings life to the setting and enables friendships to develop.
There have been two evaluations of the club. A specialist consultant looked at outcomes for individuals using a ‘dementia mapping’ methodology. This involved a systematic recording of individuals’ mood, behaviour and responses during their participation at the club. They reported: ‘…never before have I witnessed so many people living with dementia have such levels of mood and engagement for such sustained period of time, while in a group session together’.The Health Innovation Network South London evaluated the social return on investment (SROI) of our Wednesday Club in comparison with dementia peer-support projects in two other boroughs. The authors concluded that the £30,784 of funding that the club receives each year translates to £506,094 in annual ‘social value’.
How has the project worked to engage all sections of the community?
Lambeth is very mixed in terms of social class, ethnicity and cultures and this diversity is reflected in the club's membership, and in the sharing of experiences and memories from around the world.
Cooperative working relationships with other charities has resulted in local young people becoming involved in intergenerational projects and as volunteers.
What advice would the project give to others?
- Take advantage of the assets and resources of everyone taking part, then everyone will rightly feel they are making a contribution.
- Make purposeful links with professional and community groups.
- Share the knowledge and experience of co-production with other groups.
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- Co-production in social care: What it is and how to do it
- Co-production in social care: What it is and how to do it - easy read