All aboard as the train with a brain takes the strain

Tuesday 27 November 2012

So what does the term "personalised services" conjure up for you?

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Ruth Wishart

A new world order in which you choose from an extensive menu of care options tailored to your needs? A large cheque to be disbursed in dollops to your preferred professional back up? Dream on.

The onward march of austerity has already stretched care budgets beyond their natural elasticity, which can only get worse when the cuts bite in earnest next spring. The common experience is real difficulty accessing much-needed services, and, even where they can be found, the deliverers have too many clients and too little time to do more than the basics. Not that the core concept is to be despised. The notion that top-down social service provision should be re-balanced to give more power to the recipients and less to the administrators is entirely welcome. As the Christie Commission urged, new patterns of service have to be built "around people and their communities, their needs, aspirations, capacities and skills, and work to build up their autonomy and resilience". Yet there are stumbling blocks to wholesale fulfilment of that aspiration. Some people in need of care, either through age or incapacities, are not in a position to beef up their autonomy and resilience. And for people in these constituencies, organising their own services is not so much a golden opportunity to take control of their lives, as an added layer of anxiety. Yet there are good role models out there, examples of responding to need in the kind of empathetic way which rarely features in official guidelines with their inevitable checklists, timetables and myriad warnings about health and safety. This week the Food Train charity starts interviewing for staff as it plans to expand its operation into south-east Glasgow. They started up in Dumfries 12 years ago, where a partnership of local shops and volunteers began doing shopping trips for people who were elderly and partially housebound. But, as is the way of these things, the volunteers themselves tended to be getting on a bit. So, says Food Train chief executive Michelle McCrindle, the organisation was put on a more businesslike footing with the help of a board and funds from a variety of sources including the local council, and the then Scottish Executive. She herself was recruited from a background in psychiatric nursing, but wanted a new challenge which specifically involved care of the elderly. Critical to the project, she says, is getting the right breed of committed, sympathetic volunteers. But the fact that the Food Train workers get immediate and positive feedback from the people whose houses they visit, makes it a very satisfying brand of community service. The basic deal was that it was set up as a club where all the elderly folk were described as members. Volunteers would call round on a Monday to pick up the shopping list for the week, then do deliveries over the next three days. The delivery charge is £3, but the shoppers will go to the store of your choice, and buy the brands of your choice, all the while checking for offers which might make savings the following week. And this isn't a hit-and-run service. While they are in the houses, the volunteers will pick up on any odd jobs needing done, and someone will pop round again on the Friday to sort it out. Within a few years it went region wide in Dumfries and Galloway and has grown again there into a befriending service where, for £10 a year, the members will also get visits and phone calls and the chance to be taken out and about – a real example of a virtuous community circle and a way of dealing with those other scourges of getting to an age and stage which restricts mobility: loneliness and isolation. The Food Train then took its brand of provision into West Lothian, Stirling and Dundee where, in the latter two cases, they have been successful enough to replace the council's in-house services. When they get up and running in south-east Glasgow they hope similarly to prove to their council and housing association funders that they can give a more cost-effective and popular service than the current one. But, in essence, for the people who access the Food Train, it's not so much about who is the provider but the quality of what's on offer. And this model in many ways exemplifies what a real personalised service should be in that it pledges to be entirely driven by what its members demand. The befriending service, which, for many folk I suspect, is at least as important as the shopping one, came directly out of feedback when members were asked what could make the existing provision better. Having someone they can trust popping in on another day to sort out that inaccessible light bulb or dodgy door lock is another common-sense addition, not least because it's likely to involve a cuppa and a blether as well as practical assistance. And it's worry free too, since the Food Train pays for essential insurance cover. It's just one model, of course, and there is no shortage of ingenuity in the voluntary sector. After all, they've been in the business of getting the biggest bang for a buck for a very long time. But the Food Train is not so much a political slogan, more a big-hearted society in action.

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All aboard as the train with a brain takes the strain

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