What matters to you? Turning Passion into Practice

An overview of a community driven, bottom up initiative to meet the wellbeing needs of a large rural village the size of a town

SMART Cranleigh’s purpose is to improve community wellbeing by active relationships with providers of services; connecting, signposting and co-ordinating their accessibility for all the community

SMART Cranleigh is a citizen driven initiative for healthy living and quality of life in Cranleigh for all ages within an ageing community. SMART Cranleigh aims to promote positive local area co-ordination where people are empowered to become active and connected citizens rather than passive recipients, This will be achieved through practical initiatives that promote health and social wellbeing, interrelated with all aspects of daily community life.

Why do we need to change the status quo?

Between 2911-20011 (these dates need clarification) life expectancy has risen by 4 years (the Lancet). This means 350,000 additional people will have different types of care needs as more people live with frailty and long-term conditions. However, we must remember that most live well into old age which is cause for celebration. Councils on the other hand, due to financial constraints offer less to an increasing number of people who need help, leaving more to fend for themselves. These cuts are dehumanising care and causing long term problems. Over the next 10 years the UK population will grow by 4.4 million, equivalent to the total population of Ireland! At present, one person in twelve in our community is over 80. We have an ageing society and communities need to respond so that quality of life is good for all ages to live well together.

The need for care is rising and resources once seen as the norm are reducing. Health and care cannot continue in its present form, precepts cannot fill the gap. New paradigms for living well are needed, driven by communities themselves. Together, with the success of medicine we are now all living longer. Middle age has shifted to the 70’s and we know the first 150-year-old has been born.

Research has shown us

Nearly 1 in 5 of those aged 65 and over have no cars in their household (Surrey 18.8%)

Levels of Dementia and Depression are higher in Cranleigh than in Surrey generally, there are also higher incidences of binge drinking in adults (Dementia 0.9% (CCG average 0.7%) Depression 8.1% (CCG average 7.6%).

Residents have told us that they prefer to access help and resources from within their local community where they can be supported by their family, friends and community rather than traditional care environments and external providers.

What does this mean for us?

Effectively dealing with the identified need requires good co-ordination within communities. Doing the right thing right reduces the need for unnecessary GP and hospital visits and reduces the need for long term care. Therefore, prevention and future-proofing our community is the focus of our work. We need to join up providers of help and services in intelligent ways from the grass roots upwards.

These ideas comprise several potential outcome focused projects from social prescribing at medical practice level, initiating Time Banks, intergenerational connections and a crowd sourced shared information calendar. This is also about scoping the current assets we have, what’s going on for all ages, with signposting and support for those who need to access more help, thus providing solutions to help people and their carers remain active and engaged. Connecting people to community resources and the many small and large self-sustaining groups and initiatives are fundamental in our current fast-moving society where many people in Surrey live with loneliness, the blight of our generation. INSERT HERE PARAGRAPH ON LONELINESS

Loneliness

The silent epidemic of loneliness is dangerous for our health- it is now official. GP’s will be urged to make time to see lonely patients, who are 50% more likely to die prematurely than people with good social network. Social isolation and loneliness are akin to a chronic long-term condition in terms of the impact they have on our patients’ health and wellbeing,”

‘we should be talking to them about their weight, exercise and prescribing more medication. But really what these patients need is someone to listen to them and to find purpose in life.’

“Loneliness and social isolation are not the exclusive preserve of the elderly. They are not something that can be treated with pharmaceuticals or that can be referred for hospital treatment”. (Helen Stokes-Lampard Chair Royal College of General Practitioners).

Social networking has changed the meaning of friendships into ‘instrumental collaborations’ and less interconnected community groups. SMART Cranleigh is recommending befriending schemes for all ages, time banks and local informal groups with social prescribing within a well-coordinated local population. This is hand in glove with closely networked small initiatives, mutual co-operation and collaboration between local formal and informal groups. Much more could be done ameliorate this with unpaid citizen effort (volunteering) as an integral part of public service which is needed to fight isolation.

We also know that there has been a measurable shift in the conversations about what makes communities work and how to create compassionate communities wrapped around its residents. It does not just happen. It has to be actively encouraged and enabled at a bottom up level strategically driven by the residents for the residents. This includes how we engage people and services in building the community and demonstrating what interdependence means. There must be proper communication between the young and the old. This is in stark contrast to the current ‘individualism’ and ‘risk adverse’ culture that has taken rootwhere people appear ‘too busy to live,” “ too busy to notice” or “too busy to connect with the wider world around them. This all contributes to a deepening malaise and rising mental health problems.

Traditionally, it is people who make a difference. Often the public sector undermines change.). Partnerships are now needed between business and social entrepreneurs to keep pace and enable our communities to thrive benefiting young families, those in education, those in work or those in retirement.

The need to take more responsibility for our own health is NOW. How can we be creative with our existing assets? What are they? Who can use them? Where are they? Who do they belong to? How can we make better use of our open spaces? Making space available with easy access such as parks, hills and natural environments to enjoy will form an important part of this?

How can a community be persuaded to focus on the residents and their quality of life rather than just looking at the available pot of money as the driver for everything? The answer is that we must work together more co-operatively and collaboratively to achieve these objectives.

Communities need to work together in a new and different way as the burden of care is rising and the traditional resources are reducing, leaving many gaps unplugged. Lack of leadership, short term political expediency and vested interests have all resulted in preventing local people from coming up with their own solutions. ‘Same old’ approaches to problems, a lack of ideas and the general political drift have contributed to these with too much focus on fairness and equality and not enough on practicality.

The Vision

It is suggested that a longer-term vision focusing on enterprise, interest and community commitment which is what SMART Cranleigh seeks to deliver. This involves the integration of health and wellbeing, education, housing, environment, joining business and social enterprise and the arts with a single point of access and a joined-up response to the key issues (list or diagram here)

The focus must be innovation and joining up, with the resident’s wellbeing at the core. “Learning on the job” initiatives, with experimentation will require getting hands dirty in carrying out of projects, which is the best way to learn what works:

The underlying principles of success for inclusion in and formulation of local plans:

· Devolving power to all in the community must be shaped by individuals, families and neighbourhoods.

· We need to use the many assets, strengths and resources of older people with high support needs through recognising and creating opportunities for them to both give and receive support.

· Organic growth based on quality relationships, honesty and a sense of belonging, working with local leaders as agents of change

· Real change is not a soft option and takes time. People want quick fixes but they tend to fizzle out without constant attention.

· Practical results come from local people being involved in the process of change, and shaping the learning about what works

· Focus on individuals with identifiable tasks they are responsible for

· Local people have the power to transform the lives of people with practical project work based in identified needs and focusing on the detail around the results of what is working

· Work with a coalition of the willing, bringing private enterprise and the social sector together. It is vital to be open to radical and innovative approaches

· Breaking down “silo” working by forming shared projects involving different groups

· A single source of crowd sourced information across the community groups such as an online calendar

· Encouraging philanthropy of wealthy individuals to fund directly projects rather than a faceless charity

· Don’t involve people with a limited view on the world who don’t know what they don’t know

· An effort must be made to see and hear the individual behind the label “helping people to understand the increasing diversity of older people as a demographic group” Rampant ageism and negativity from younger and older people alike must be prevented.

· All support must be founded in, and reflect, meaningful and rewarding relationships.

· Connecting with others is a fundamental human need whatever our age or support needs.

· Everyone must be treated as equal citizens with both rights and responsibilities, not just as passive recipients of care. There must be clarity on what can reasonably be expected from publicly-funded services and what will need to be dealt with individually for ourselves.

· The individual and collective voices of people with high support needs should be heard and given power.

· Consideration must be given to how, often simple, changes can improve lives within existing models.

New ways or working:

A recent Voluntary Action South West Surrey Conference highlighted how the world in which we live is changing. This is especially relevant here in Cranleigh and the surrounding villages, (a growing community in a semi-rural location on the outskirts of Surrey with limited transport infrastructure). In light of the proposed new housing developments and the future impact of Waverley’s Neighbourhood Plan, it has become even more important to use the unprecedented opportunity for increasing community action in response to the wider and growing health and wellbeing needs of our community. This means using the immense collective resources in a truly coordinated way to take back control at a local level.

To give this some context, the conference heard about changes in the charity world over the last decade (in large part due to government policy) and the instigation of the ‘Big Society’ movement. In the future, a new way of working locally would be needed,, comprising mutuals, cooperatives and social enterprises working closely with voluntary organisations. This will include working with local government, where their traditionally more cohesive, regulatory and process-driven teams have been disrupted by new councillors who may not be so prepared to knuckle down to the ‘old rules’ and protocols.

The structures pursued in local government will have to change to accommodate a new generation of citizen, and their more fluid approach to living and working, for the benefit of all our communities.

What is needed is a reframing and restructuring of the flows of power at all levels of local government. This would prevent authorities from becoming disconnected from the people they serve. A more forward-thinking approach would be the creation of a resident-centred development plan focused on not only infrastructure needs but also health, wellbeing and social experience that engages with real people’s real needs.

What does it look like?

Outdoor amenities must be designed around those who may not be as able to access them without help and support to stay in the mainstream of life. The design must take into account the ideas and requirements of all parts of the community.

The rising numbers of people living with dementia will need well planned, safe, outdoor spaces to enjoy with signposting and ways of finding such areas.

All ages need to be encouraged to get outside and enjoy the local countryside with a range of amenities that promote this. The development of new park involving the community in what is to be incorporated will include activity equipment (for the young and old) and play areas that can bring younger and older people together through physical activity.

Access to outdoor nursery schools together with well-designed safe paths, easy to navigate in a local park will promote better access to the countryside for young children, older people and those with either mobility or cognitive needs.

Even and wide pavements with well positioned regular stopping places with seating will encourage more people to get out and about.

Care workers need bespoke housing solutions over-and-above ‘affordable’ housing to ensure we have the capacity of carers to keep people living well in their homes for longer in an expensive place such as Cranleigh.

Dementia friendly housing and life-

time homes should be part of the planning conditions for many (if not all) of the new developments.

Local area co-ordination with a community connector/village agent/co-ordinator role will enable more people to access purposeful activity and stay in the mainstream

Loneliness, frailty and dementia need imaginative amenities, supported by social prescribing with reablement help, self-management and health-promoting learning opportunities. The implementation of these measures in the local community will result in a reduction in the numbers people at risk of “falling between two stools”.

The case for local area co-ordination

There is a need for co-ordination across Cranleigh. The use of social prescriptions underpinned by a whole system approach to supporting all people to get out more easily and the undertaking of a wide range of enjoyable exercise outdoors will provide a healthier life for all the community. It will result in fewer medical problems and will reduce the overall burden on the community. For healthy lifestyles to be fully encouraged, a further joining up of organisations working closer together will help everyone to be more self-sufficient and inclusive. This will mean:-

· coordinating social and physical activity,

· using technology more effectively with an interactive crowd sourced community calendar, local co-ordinators/ community connectors,

· improved transport, and learning opportunities for the wider community in self-management.

Local area co-ordination can bind communities together and help to ensure that amenities are better utilized thus allowing those at risk to stay in the mainstream of life.

Cranleigh Cares- working together towards a compassionate community

A local co-ordinator role will link people with places, amenities and services. There is now an unprecedented opportunity for increasing community action in response to the wider health and wellbeing needs of our community. Using the community’s immense collective resources in a truly coordinated way control can be taken back at a local level, maximising community participation with other joined up and co-ordinated services.

Great things can be achieved by the few who collaborate, co-ordinate and co-operate together. Cranleigh can be a place where it is good for the young and old and where the old can live in dignity.

Aristotle suggested that other people are the critical ingredient for supreme happiness in other people. Reciprocity across the generations has been a hallmark of human history until 20th century when these relationships were supplanted by individualism and a sense of rootlessness and pursuit of self-fulfilment.

Intergenerational connectivity

Intergenerational connectivity is important for young people too. Older adults tend to have a more positive outlook, a greater sense of wellbeing, more patience and can bring a balanced perspective. The wisdom of age means that older people are a resource and not a drain or recipient of intergenerational transfer. The Generation Gap Group (GGG) is a new project with toddlers and residents from a local care home facilitated by active community members.

With all the new developments in the area, there will be many new neighbours joining the community soon. They will need to find their feet in the community and get to know their neighbours. Those who are coping less well out there might be our neighbours. It is essential that they form part of the integrated community and made to feel that they “belong”.

A challenge to old politics:

Political imperatives should now focus almost entirely on the greater public good, rather than enabling personal gain for politicians. A more reciprocal approach is needed with. citizens caring and contributing to each other’s care, creating social enterprises around needs with churches and voluntary groups acting as effective co-ordinated, outward facing and networking organisations.

Public services are currently based on an outdated model that is intricately linked to hierarchical systems of tax and funding. It’s too rigid and paternalistic and has the bureaucrats and professionals acting as if they always know best whereas individuals need to be in control of their own lives.

There needs to be an effective re balancing of the engagement with community. A response with new ways with more entrepreneurism is the only sensible way to make it work. The barrier of ‘immunity to change’ keeps the status quo. Change-makers need resilience and emotional stamina- be persistent and flexible, aligning actions collaboratively, to spot opportunities and act!

Citizens need to be empowered to co create and be problem solvers not just passive recipients. Reliance on public services is too slow and new approaches are needed to address these challenges. Institutions now need to act as a catalyst – supporting local communities to meet their needs where citizens are.

Ref

We have also drawn on conclusions from the “Hidden Surrey’ research of Community Foundation Surrey and Hazelhurst Trust which are applicable to the Cranleigh area.

Public Health SCC 2017

Cacioippa J et al (2017) Lonely Planet, RSA and other contributions from Gus O’Donnell, Ian Bainbridge and Dr Richard Davies from the RSA

Joseph Rowntree (2013) Valuing our Later Years

Davies R (2017) Scaling up Voluntary and Community Services: who to create health and care that focuses on caring towns and villages, Royal Society of Arts

BBC 1 The Age of Loneliness

The Guardian newspaper 12th October 2017