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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
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ForecastSocialReturnonInvestment(SROI)ofsupportingtheCommunityMealsServiceinLeicestershire
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Social Return on Investment (SROI) is a technique that can be used to understand the return on investment and the impacts of a project, organisation or policy. This includes understanding both social impacts as well as financial cost/benefit. We have been working on a SROI evaluation of the LCC Community Meals Service by engaging with all affected stakeholders to understand what changes for them. This work aims to identify the value created by the service, who benefits and how we know. Assurance Statement This report has been submitted to an independent assurance assessment carried out by The SROI Network. The report shows a good understanding of the SROI process and complies with SROI principles. Assurance here does not include verification of stakeholder engagement, data and calculations. It is a principles-based assessment of the final report. JoelleBradlyResearchandInsightManagerResearch&InsightTeamCommunityPlanningBranchLeicestershireCountyCouncilCountyHallGlenfieldLeicesterLE38RBTel 01163055883Email joelle.bradly@leics.gov.ukProducedbytheResearchandInsightTeamatLeicestershireCountyCouncil.Whilsteveryefforthasbeenmadetoensuretheaccuracyoftheinformationcontainedwithinthisreport,neitherLeicestershireCountyCouncilnorLeicestershireTogethercanbeheldresponsibleforanyerrorsoromissionrelatingtothedatacontainedwithinthereport.
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Contents1.IntroductionAimsandobjectivesofthereportOverviewofCommunityMealsServiceScopeandcontext2.ThecontextoftheCommunityMealsServicePolicy,politicalandeconomiccontextwithinwhichthestrategysitsReviewofexistingevidence3.ThedeliveryoftheCommunityMealsServiceSummaryoftheoveralldeliverystrategy4.TheSocialReturnonInvestmentStakeholderconsultationTheoryofchangeMeasuringimpactValuingbenefitsImpactmapTheSocialReturnonInvestmentratioSensitivityanalysis5.ConclusionsandrecommendationsAppendices
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1.IntroductionAimsandobjectivesofthereportTheaimofthisreportistousetheprinciplesofSocialReturnonInvestment(SROI)toevaluatethevalueofLeicestershireCountyCouncil'scontractwiththecommunitymealsserviceinLeicestershire.SocialReturnonInvestment(SROI)isatoolthathelpsmeasurethevalueoftheimpactofaprojectorservicebyconsideringarangeofoutcomesforallstakeholdersaffectedbytheproject.Itaimstoputsamonetaryvalueonarangeofsocialoutcomes,bothintendedandunintended,sotheycanbeincludedinthevalueofaproject.Italsotakesintoaccountwhatwouldhavehappenedanywayandwhoelsemayhavecontributedtowardstheoutcomestoensurethatanactivitiescontributiontovalueisnotoverclaimed.OverviewofCommunityMealsServiceTheCommunityMealsServiceprovideshotmealstoelderlyresidentsinLeicestershire365daysayear.Sincethestartofanewcontractholderon12thDecember2010,theCommunityMealsServicehasofferedenhancementssuchasmakingadrinkandencouragingpeopletoeataspartoftheservice.Themealsareofhighnutritionalvalueandavariedmenuisoffered,promotingchoiceandflexibility.ThemealsaresubsidisedbyLeicestershireCountyCouncil(LCC);thecosttoLCCofahomedeliveredmealiscurrently4.63andthecostofalunchclubmealis4.79.Thecosttotheserviceuseris3.20.Thosewhoreceivesubsidisedmealsathomearepredominantlyclassifiedasserviceuserswithcriticalorsubstantialeligibilityneedswhichwillhavebeenestablishedthroughanadultsocialcareassessment.LCCLuncheonclubsarenotclassedasanassessedserviceandthosewhoattendalunchclubsdonothavetoundergoanyassessmentprocesstoattendandreceivemealsatthesubsidisedpricesastheserviceisregardedasearlyintervention/preventativecareduetothelongertermhealth(physicalandmental)benefitsthelunchclubsprovideandpromote.ThelunchclubsarerunbyvolunteersandsupportedbyLCCinavarietyofways;butchieflythroughtheprovisionofsubsidisedmeals.ScopeandcontextThisreportwillevaluateboththecommunitymealsserviceandlunchclubsovera12monthperiod,betweenApril2010andApril2011,withtheaimtoforecastthevalueoftheenhancedserviceusingSocialReturnonInvestment(SROI).
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2.ThecontextoftheCommunityMealsServicePolicy,politicalandeconomiccontextwithinwhichthestrategysitsBy2033anestimated23%oftheUKpopulationwillbeagedover65andafurther3.2millionagedover80.OneintenolderpeopleintheUKareatriskfrommalnutrition.Sixoutoftenolderpeopleinhospitalareatriskofbeingmalnourished,ortheirsituationgettingworse.1Thenumberofolderpeoplesufferingfrommalnutritionissettoriseevenfurtherandthereisanurgentneedtoaddresshowolderpeoplearesupportedintoolderagenowbeforetheproblemgetsworse.Therearemultiplecausesofmalnutritionthatmightpreventpeoplefromgettingtofood,suchasmobilityproblems,mentalhealth,difficultyineatinganddisease.Researchhasfoundmanyfrail,vulnerableandolderpersonsultimatelyhavetomoveintoresidentialcareandnursinghomesbecausetheybecomeillasadirectresultofmalnutritionanddehydrationwhichinevitablyislikelytocosttheUKtaxpayermorethaniftheywereabletostayintheirownhome.Goodnutritionandhydrationandenjoyablemealtimescandramaticallyimprovethehealthandwellbeingofolderpeople,aswellasincreasingtheirrecoveryfromanyillness,traumaorsurgery.Mealsandtheenjoymentofmealtimesaffectthequalityoflifeofolderandvulnerablepeople.Itisconsideredimportanttoraisetheawarenessofthelinkbetweennutritionandgoodhealthandthatmalnutritioncanbeprevented.2Arecentreportonpersonalisationandtheroleofcommunitymealsmadearecommendationtoensurethatmealsprovisionandaccesstofoodisconsideredasacorepartofsocialcare,andthatareviewofreferralcriteriaforreceivingmealsisnecessarysothatolderpeopledonotfallingthroughthegapandbecomingmalnourished3.Thereportalsocitedthestrongunderlyingeconomicargumentsforsupportingolderpeopletoremainindependentandintheirownhomes,andtheneedforacostbenefitanalysistodemonstratetheeconomiccaseofsupportingcommunitymealsservices.. 1BAPENwebsiteAvailablefrom:http://www.bapen.org.uk2DepartmentofHealth(2007)ImprovingNutritionalCare.DepartmentofHealthandtheNutritionSummitstakeholdergroup.3Wilson,L.(2010)Personalisation,NutritionandtheRoleofCommunityMealsAreportfromaroundtablediscussiononPersonalisationandCommunityMealsChairedbyBaronessGreengross.Availablefrom:http://www.ilcuk.org.uk/files/pdf_pdf_123.pdf
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ReviewofexistingevidenceMalnutritionThemostvulnerablegroupatriskofmalnutritionanddehydrationincludesthosewithchronicdiseases,theelderly,thoserecentlydischargedfromhospital,andpoororsociallyisolatedindividuals.ThisdescriptorencompassesmanyoftheLCCAdultSocialCareserviceusers.Althoughthereisnoformaleconomicevaluationofdiseaserelatedmalnutrition,itisestimatedtocarryaheavierpricetagthanthe2bnlinkedtoobesity,asmalnourishedindividualsaremorelikelytoneedalongerstayinhospital4.Malnutritionisbothacauseandconsequenceofdisease;itpredisposestoanddelaysrecoveryfromillness.Itisestimatedthatupto14%ofelderlypeoplenotinhospitalorcare5areeithermalnourishedoratriskofmalnourishment.Despitethemanagementandtreatmentofmalnutritionbeingassociatedwithimprovedoutcomesforpatientsanddecreasedcostsofcare,theproblemoftengoesunrecognisedanduntreated.
Asolderpeoplebecomemoresociallyisolated,physicalproblemspreventormakeitextremelydifficultforthemtoprepare,cookand/oreatmeals.Alackofmotivation,company,depressionandforgetfulness,alongwithproblemslinkedtodementia,couldalsocontributetothelackofeating.NACC(2010)
AnageingpopulationLifeexpectancyisrelativelyhighinLeicestershire,andinlinewithnationaltrends,thereisasubstantialprojectedincreaseinnumbersofolderpeople.The60andoveragegroupisprojectedtoincreaseby39%from2006to2021inLeicestershire,comparedtoanincreaseof23%inLeicesterCity.Inequalityinlifeexpectancyexistswiththecounty;aboyborninthemostdeprivedpartsofLeicestershireCountyandRutlandcanexpecttolivefor6.8yearslessthanaboyborninthemostaffluentareas.Forgirlsthegapis5.8years(LCR,2008).Anationalstudyfoundthat43%offemaleswereover85whentheydiedcomparedto24%ofmales.However,addressinginequalitiesshouldbemorethansimplynarrowinggapsinlifeexpectancyandratherfocusonthequalityoflifeexperiencedbytheelderlypopulations.Logicallyasthepopulationhasnowreachedlevelswheretherearemorepeopleover50yearsofagethanunder,itmakeseconomicsensetoensure 4GreenC.Existence,causesandconsequencesofdiseaserelatedmalnutritioninthehospitalandthecommunity,andclinicalandfinancialbenefitsofnutritionalintervention.ClinicalNutrition1999;18(Supplement2):328 5Gregory,J.,Foster,K.,Tyler,H.andWiseman,M.(1990)TheDietaryandNutritionalSurveyofBritishAdults.OfficeofPopulationCensusesandSurveys,HerMajesty'sStationaryOffice,London
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thatourelderlypopulationstayhealthyandwell,leadingproductiveandhappyliveswithinsocietyforaslongaspossible.
Thegoodnewsisthatduetobetterscienceandhealthcare,lifeexpectancyisdramaticallyincreasing.Weneedtowakeuptoanew29hourdayresearchshowsthatforevery24hourswelive,onaverageweaccrueanadditionalfivehourseachday.Inotherwords,UKlifeexpectanceiscurrentlyincreasingby2ormoreyearseverydecade,thekeyissueishowbestwemakethemostourlengtheninglivesbyimprovinghealthandwellbeingProfessorKirkwood,Director,InstituteforAgeing&Health,NewcastleUniversity6
WellbeingArangeofresearchonwellbeingiscurrentlybeingbuiltonanddevelopedtoimproveourunderstandingonwhatcontributestopositivewellbeing.AresearchstudyonwhatcontributestowellbeingofelderlypersonswasrecentlypublishedbytheWomen'sRoyalVoluntaryService(WRVS)7.Thestudyinvolvedtalkingto163olderpeopletogainanunderstandingofwhatwasimportanttotheirlives.Participantsidentifiedarangeoffactorsthataffecttheirwellbeing.Whileissuessuchashealth,personalcharacteristicsandfaithfeaturedprominently,themainfactorhighlightedwasrelationshipsandsocialcontactswithfamilyandfriendsandwithincommunities.Thishighlightsanimportantaspectofwellbeing.Therewasalsoastrongmessagethatwellbeingisaboutpeoplebeingabletodowhattheywanttodo.Thisfindinghighlightsthatthepromotionofindividualsenseifcontrolandindependenceisavitalcomponentinachievingandsustainingwellbeingatthelevelsoftheindividual,thecommunityandsociety.Arelatedandequallystrongmessagewasthatolderpeoplecanreallybenefitfromthatlittlebitofhelp(asopposedtomajorinterventions/assistance)toachievealevelofautonomyandindependence.Therewasalsoacallforpracticalhelpandsupportinpeoplesownhomesbyreliablecompetentandtrustworthypeople;inparticularforhelpwithsmalljobsaboutthehouseandgardenandshopping.ThestudyfoundthatpositiveaspectsoftheirlivesincludedgoodrelationshipsandprofessionalattentionfromGPs,goodhospitalservicesandtreatmentandsupportfromarangeofotherhealthservices.However,participantsidentifiedfarmorenegativeaspectsofservices,especiallysoforhealthservices.Negativeanddiscriminatoryattitudestowardsolderpeoplewithinpublicserviceswerehighlightedincludinglackofrespect,empathy,listening,compassionandaneglectfulculture.KeymessagesfromtheresearchwhichcouldbeincludedundertheheadingTreatingolderpeoplewithrespectandequalitywere: 6 www.ncl.ac.uk/about/changingage 7Voicesonwellbeing:Areportofresearchwitholderpeople,November2011,WRVS
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Improvecommunication Buildtrust Givepeoplemoretime Valuethewholeperson
JosephRowntreeFoundationsABetterLifeprogramme8reviewedthecurrentliteratureaboutwhatolderpeoplevalue,andcarriedoutindepthqualitativeinterviewswitholderpeopleinavarietyofsettings.Theyfoundthatthemostfrequentlymentionedthemesintheconversationswere:
personalrelationships; support/goodrelationshipswithcarers; selfdetermination(involvementindecisionmaking); socialinteraction; goodenvironment(home); gettingoutandabout; information; financialresources.
Otherthemesincludedculturalactivities,senseofself(selfesteem),selfdetermination(autonomyandindependence),pleasure,physicalhealth(livinginanageingbody),otherpeoplestime,goodenvironment(contactwithnature),safetyandsecurity,makingacontribution,continuity,mentalhealth(purposeinlifeandexistentialbalance),adjustingtochange/continuity,technology,humourandphysicalactivities.Theresearchfoundthatparticipantsinthestudywantedandvalueddifferentthingsintheirlives,butallexpressedcommonhumanneedsforsocial,psychologicalandphysicalwellbeing.Theyvaluedtheircloseemotionalrelationships,thoughsomeexpressedconcernsabout'imposing'onfamily.Manyhadmadenewfriendsasaresultoftheirincreasingsupportneeds.Havingcontrolovertheirliveswasimportantbutmeantdifferentthingstodifferentpeople.Adjustingwelltochangewasalsocentraltopsychologicalwellbeing,andthismightrequiresupport.Theprogrammerecommendsthatthefindingsareusedasanaidforresearchersexploringqualityoflifeissuesforolderpeoplewithhighsupportneedsandassessingtheimpactpoliciesandserviceshaveontheirwellbeing.CarersThereareapproximately5.8millioncarersagedover18intheUKandthepeakageforcaringis50to59.Morethanoneinfivepeopleaged5059(1.5millionacrosstheUK)areprovidingsomeunpaidcare.Oneinfourwomeninthisagegroupisprovidingsomecarecomparedwith18%ofmen.Thiscompareswith6%ofadults
8http://www.jrf.org.uk/publications/olderpeoplehighsupportneedsvalue
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aged1834,12.5%aged35to44,and11.5%aged65orover9.CarersUKnationalsurveyin2008highlightedthehealthrisksfacedbytheUKssixmillioncarerswithnearly21%ofcarerswhoareprovidingmorethan50hoursofcareperweekreportingthattheyarenotingoodhealthcomparedwithonly11%ofthenoncarerpopulation.Theincreasedhealthrisksarerelatedtobothphysicalandmentalhealthissues.Recentreportsalsopointtotheriskofagenerationsandwich,wherewomenaregivingbirthlaterandlivinglongersothata4550yearoldcouldbecaringforboththeirownchildrenandolderparents.
9http://www.lsronline.org/reports/leicestershire_joint_strategic_needs_assessment_jsna_2009_additional_documents
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3.ThedeliveryoftheCommunityMealsServiceSummaryoftheoveralldeliverystrategyThe2006GovernmentWhitepaper,OurHealth,OurCare,OurSay10,outlinedsevenoutcomesbasedontheindependence,wellbeingandchoiceconsultationwitharound100,000people.
1. improvedhealthandemotionalwellbeing2. improvedqualityoflife3. makingapositivecontribution4. increasedchoiceandcontrol5. freedomfromdiscriminationandharassment6. economicwellbeing7. maintainingpersonaldignityandrespect
TheCommunityMealsServicehasappliedtheseoutcomestotheirVision&Purpose.Throughtheircontractwiththemealsdeliveryprovidertheyensurethatcustomerswill:
Havechoiceandcontroloftheirmenu,includingreceivingaservicefreefromdiscriminationofferingavarietyofculturaldietchoices.
Beencouragedandsupportedinmakingapositivecontributiontotheserviceincludingthemenu.
Receiveabalancedandnutritionaldiet toenhance theirqualityof lifeandimprovehealthandwellbeing.
Receiveagoodvalueservicetoenhancetheireconomicwellbeing Receiveaservicemindfulofindividualpersonaldignityandrespect
TheLCCcorporatevisionandprioritiesalsoincludesthetargettoincreasethenumberofolderpeoplesupportedtoliveathome,whichthemealsdeliveryservicecontributestowardsthroughprovidinghotmealstopeopleintheirownhomesandfocussingonnutritionalvaluetoimprovehealthandwellbeing,sopeoplearewellenoughtostayintheirhomesforlonger.MealDeliveryBetweenApril2010andApril2011,1,416olderpeoplereceivedmealsdeliveredtotheirhomesthroughtheCommunityMealsService.Onaverage,servicesusersreceived6mealsaweek.Intotaloverthe12months,thisequatedto260,385mealsdelivered.
10Ourhealth,ourcare,oursay:anewdirectionforcommunityservices,DepartmentofHealth,2006
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Thosereceivingmealsweremorelikelytobefemale(64%)andagedover84(59%).Only1%wasfromaBMEbackground(whichreflectstheolderpopulationofthecounty).16%livedinthe10%mostdeprivedneighbourhoodsinthecountyand17%livedinthemostdeprived10%forincomedeprivationaffectingolderpeopleinthecounty(SeeAppendixA).LunchclubsThemealsdeliveryservicealsoprovidesmealstolunchclubs,whicharestaffedbyvolunteers.Therearecurrently52commissionedlunchclubsinthecounty.Lessdataisheldonlunchclubattendees,althoughthemaximumcapacityforplacesis1,416,andmostclubsareknowntobeclosetocapacity.Mappingofthecommissionedandnoncommissionedlunchclubscanidentifyhowtheymaypotentiallymeettheneedsofcommunities.
Itisconsideredimportantthatthecommissionedlunchclubsareabletoensurethatpotentialgapsinservicesarefilled,particularlyforthoselivinginthemostdeprivedareas,whereneedmaybegreater.Themapbelowdisplaysinformationfromthe
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IndicesofDeprivation(2010)onincomedeprivationaffectingolderpeople(IDOP).IDOPisclassedasadultsaged60oroverlivinginIncomeSupportorincomebasedJobseekersAllowanceorPensionCredit(Guarantee)families(CommunitiesandLocalGovernment,2011).Usingthismeasure,areaswiththehighestlevelofdeprivationarefocusedinandaroundLoughborough,Coalville,Melton,WigstonandMarketHarborough,withsomescatteredareaselsewhereinthecounty.Themapalsoshowsthelocationofcommissionedlunchclubstoillustratehowtheyaretargetedtowardsthemoredeprivedareas.Figure2.Incomedeprivationaffectingolderpeople(IDAOP)2010,CountyMap
Thefollowingmapdisplaysthenumberofpeople(50+)perpotentialluncheonclubplacewiththetop10%mostdeprivedLSOAsforincomedeprivationaffectingolderpeople.Fromthemap,wecanseethatthemostdeprivedneighbourhoodsaroundCoalvilleandLoughborougharewellservedintermsofthepotentialnumberofluncheonclubplaces,whilethemostdeprivedneighbourhoodsinHinckleyandBosworthdistricthaveaccesstoconsiderablyfewerplaces.Theseareasinparticularstandoutaspotentialproblemareasintermsofoverallcoverage,especiallytheLSOAsinEarlShiltonandBarwell.However,themapinFigure3suggeststhatthisareamaybeservedbyanoncommissionedlunchclub.
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Figure3.People(50+)perluncheonclubplacewithIDAOP2010,CountyMap
Lookingforward,themealsdeliveryservicewishestounderstandthevaluecreated(suchasimprovementstowellbeing),oravoidanceofpotentialnegativeimpacts(suchasmorecostlycare)throughLCCsupportingthemealsdeliveryserviceparticularlyinlightoffuturecommissioningstructures.Thepublicsectorcurrentlyfacesanumberofchallengeswithcutstofunding.However,populationtrendsindicatethatdemandforadultsocialcarewillrisethroughtheincreaseinthenumberofolderpeople.Evidencesuggeststhatalthoughlifeexpectancyisincreasing,theaverageyearsoflifespentinanunhealthystateisalsoincreasing.Manyelderlypeoplethatliveontheirownbecomeisolatedandafraid.PreventionandearlyinterventionPreventionandearlyinterventionarethereforekeytothefuturedeliveryofcareandsupport.Promotingtheindependenceofolderpeoplethroughastrategicshifttopreventionandearlyinterventioncanproducebetteroutcomesandgreaterefficiencyforhealthandsocialcaresystems11.TheLCCstrategicshiftisawayfrominterventionatthepointofcrisistoapreventativemodelcentredonmaintainingindependencethroughprovisionofpersonalisedresponsesfocusedonworkingwiththepersonratherthandoingforthem.Thispresentschallengesintermsoftargetingresourcesonthemostvulnerable,whilealsoprovidingsupporttothoselessneedythroughearlyintervention.Eligibilitycriteriatomanagedemandforsocial 11 ImprovingcareandsavingmoneyLearningthelessonsonpreventionandearlyinterventionforolderpeople,DepartmentofHealth,2010
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careservicesisexpectedtodrivetheneedforinterventionearly,beforepeoplereachcrisispoint.LeicestershireCountyCouncilhasrecentlyannouncedthatitwillberaisingtheFairAccesstoCareServices,(FACS)eligibilitythresholdtocriticalandsubstantial.Serviceusersassessedasmoderatewillnotbeeligibleforservices,followinganindividualreview,meaningmorepeoplemayneedsupporttopreventthedeteriorationofneeds.FollowinganalysisofthepopulationofLeicestershire,theaimsoftheEarlyInterventionandPreventionstrategywereunderstoodas:
Supportingindependencethrough:
Reducingisolation Improvingqualityoflife Increasingsafety Enablingolderpeopletoliveathome Offeringindividualschoiceandcontroloverhowtheirneedsaremet Providingtherightlevelofsupportattherighttime
And:
Reducingdemandforformalhealthandsocialcareservicesthrough: Reducingresidentialcareadmissions,includingthosewhoselffund Reducingtheneedfornursingcareservices Reducingacutehospitaladmissions Reducingtheneedforhighcostcarepackages Decreasingtheamountoftimestayingwithinhospitalorrehabilitation
services Decreasingthelongtermrelianceonhomeandcommunitycare Identifyingadvice/information/supportforcarers
TheMealsDeliveryServicefulfilsbothaimsofearlyinterventionandprovisionofservicesforthemostvulnerable,withthecommissioningoflunchclubsparticularlyaimedtowardsearlyintervention.FromApril2011,thechangeintheeligibilitythresholdforsubsidisedmealsdeliveryinpeoplesownhomesmeantthatgraduallyaspeoplescareplanswerereviewedmanyofthosepreviouslyeligibleformealsservicesfelloutofthesystembecausetheirneedswereassessedasmoderateorlow(SeeappendixBfordefinitionsofeligibilitylevels).Theyhave3optionsiftheyarenolongereligibleforsubsidisedmeals:
1. Findanotherprovider122. BuythehotmealsserviceprivatelyfromICare3. BuyafrozenservicefromICare
12howevertheonlyothersupplierscurrentlycoveringallofthecountyareforfrozenservicesexceptforsomeverysmalllocalconcernsoperationinverysmallareas
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Inpractice,aroundhalfofthepeoplewhofalloutofthesubsidisedprovisionoftentakeuptheserviceprivatelywithICareinoneformoranother.Thelunchclubscontinuetobeopentoallolderpeople,withouttheneedforassessment.ThisevaluationwascommissionedtoexplorethatvalueofsupportingtheCommunityMealsService,andunderstandwhobenefitsandhow.Itisalsoimportanttoconsiderhowthischangeintheeligibilitycriteriawillimpactonvalueandfuturecost.Thereareanumberofdifficultiesinmeasuringvalueforamealsdeliveryservice.Preventativeservicesdonotalwaysprovideaquickreturnoninvestmentmeaningthatthefinancialbenefitsofpreventativeservicesmaynotbefeltformanyyears.However,itisexpressedintheLCCpreventionstrategy13thatanypreventativeservicesshouldberootedinthecommunitysotheycanappropriatelysupportvulnerableadultswithlesscomplexneedsthatdonotneedtheinterventionofhealthorsocialcareprofessionals.TheLCCstrategyidentifiesthat,toensureservicesforolderpeopleareeffective,itisimportancetoinvolvepeopleinreceiptofservices,carers,providersandthevoluntarysector,makeefficientuseofcurrentresources,builduptheevidencebaselocallyonthecosteffectivenessofpreventativeservicestounderstandwhatkeyelementsbringbenefitsandsupportthewiderpublichealthagenda.ThisevaluationaimstounderstandthedifferencethattheservicemakesthroughforecastingvaluebasedonassumptionsaroundpreventativeinterventionsanddatafromserviceusersbetweenApril2010andApril2011.Althoughthisisanattempttoforecast,value,manyoftheexpectedoutcomescanbeinformedthroughresearchandengagementwithstakeholders.AforecastSocialReturnonInvestmentwillbeappliedtounderstandtheexpectedimpactandvalueofthecommunitymealsserviceandthereturnforLCCinvestinginthiscontact.
13NHSLeicestershireCountyandRutlandandLeicestershireCountyCouncilAnEarlyInterventionandPreventionStrategyforOlderPeople,20112014
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4.TheSocialReturnonInvestmentSocialReturnonInvestment(SROI)isatoolthathelpsorganisationsinmeasuringsocialimpactandeconomicvaluetheyarecreating.Itcanbethoughtofasabroadapproachtocostbenefitanalysiswhichisprimarilyusedbypublicsectororganisationsindecidingwhetherornotthebenefitsresultingfromaninterventionjustifyitscosts.
TheGreenBook,HMTreasury14TheSROIprocessismadeupofthefollowingstages Talkingtostakeholderstoidentifywhatsocialvaluemeanstothem Understandinghowthatvalueiscreatedthroughasetofactivities Findingappropriateindicators,orwaysofknowingthatchangehastakenplace Puttingfinancialproxiesonthoseindicatorsthatdonotlendthemselvesto
monetisation Comparingthefinancialvalueofthesocialchangecreatedtothefinancialcostof
producingthesechangesMeasuringRealValue,nef15
StakeholderconsultationAstakeholderisanygroupthatisaffectedbytheservice.Initiallythefollowingstakeholderswereidentifiedbytheservicewith: ServiceusersMealsathome ServiceusersLunchclub Volunteers Serviceusersfamily ICareDriversStakeholderswereengagedthroughanumberofdifferentmethodsandaskedaseriesofquestionsoutlinedinAppendixC.StakeholderSamplesStakeholder Populationsize Sampleconsulted MethodMealsathome 1,416 7 Facetoface
interviewsLunchclubattendees
1,480 10 Facetofaceinterviews
Volunteers Approximately208 9 Facetofaceinterviewsorelectronic
14TheGreenBook(2003)HMTreasuryhttp://www.hmtreasury.gov.uk/data_greenbook_index.htm15MeasuringRealValue:ADIYGuidetoSocialReturnOnInvestment(2007)NewEconomicsFoundation
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surveyServiceuserfamilymembers
Unknown 6 Telephoneinterviews
Drivers 47 1 Interviewandobservation
Ideallymorestakeholderswouldhavebeeninvolvedintheconsultation.However,itwasfeltthat,althoughnumberswererelativelylow,thesameissueswerebeingrepeatedwithinstakeholdergroupsandsaturationwasreachedevenwithinthissmallsample.Theinformationgainedfromthisconsultationwasalsocollaborationfromothersources,forexamplefamilymembers,whowereabletoarticulatethebenefitstoservicerusers.AnOlderPeoplesEngagementNetworkwasalsoabletoprovidefeedbackfrom68potentialandactualserviceuserstoconfirmthefindingsandassumptions.Thisprovidedtriangulationofevidence,alongwithdiscussionswiththecontractmanager.AsaresultofthisforecastSROI,anevaluativesurveyhasnowbeensenttoalllunchclubuserstovalidatetheclaimsandprovideevidenceoftheactualimpact.ICaredriverswereinitiallyconsideredasstakeholders.Onewasinterviewedalthoughitwasdifficulttoassesstheactualdifferencetheservicemadetothemthatwouldnothavebeenaccountedforindeadweightordisplacement,i.e.thebenefitswouldhaveoccurredtotheemployeeregardlessoftheserviceastheywouldhaveworkedelsewhere,orthebenefitshavebeendisplacedfromotherpotentialemployees.Thereforeoutcomesforthedriversweredeemedtonotbematerial.Itwasnotedhoweverthatthedriverinterviewedhadpreviouslyworkedasacarerandfoundsatisfactioninbeingabletohelpothersthroughtheroleofdeliveringmealsandchattingtotheserviceusers.ServiceusersMealsathome1,416olderpeoplereceivedmealsintheirhomebetweenApril2010andApril2011.For781,theyreceivedmealseveryday.Olderpeoplewhoreceivedmealsathomewereinitiallyengagedthroughonetooneinterviewswhilemealswerebeingdelivered.Theserviceroutinelycarryoutsurveyswithusers,however,thereistraditionallyalowtakeupofresponsessoitfeltthatinformalinterviewsweremoreappropriatetogaintheirviews.Sevenserviceusesagreedtoanswerquestionsaroundtheirneedsandthevaluecreatedbytheservice.Stakeholderswereaskedwhatdifferencetheservicemadetothem:
Itsexcellent,Ihavenocomplaints,IgettochoosewhatIwantanditalwaysvaries.Theyareveryfriendly,theyaskifImalright.Thementakethetopsoffthepuddings.Iknowtheywouldhelpifsomethingwaswrong(female,age90)
Ilikethemeal.Theyareallfriendly,nicepeople(female,age88)
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Ithelpsalot,itsverygood.Ithelpsmybrothertoo.BecauseIcantgetupanymore(female,age85)
Manyoftheserviceuserstalkedaboutnotonlythedeliveryofthemealbutalsothepracticalhelptheyreceivedfromthedriversintermsofsupporttoserveupthemeal.Althoughserviceusersfounditdifficulttospecifywhattheydiddifferently,theyoftentalkedaboutthecompanytheyenjoyedfromthedriversandtheimpactthishadontheirwellbeing.Duetotheirageserviceuserswereunlikelytotakeonnewactivitiesduetotheservice,rathertheserviceenabledthemtomaintainasenseofindependencethattheymaynototherwisehave.
Thegirls[drivers]areverygood,itbreaksthedayup.IdgopottyifIdidntseeanyone.Ifracturedmypelvis12monthsagosoIcantgoout.Thegirlsattheweekendareverynice,theytalktomeabouttheirbabies.Theyareverychatty(female,age86)Wevecometoastageinourliveswhenitwouldbedangerousforustocookforourselves.Weretoooldnow.Itsnicetoseeafriendlyfacetoo(male,age95)
ThequestionwasthenaskedIftheservicedidnotexistwhatimpactwouldthishaveonyourlife?
Itmakesabigdifference.IcouldntimaginewhatIddowithoutit(female,age89)
IcantwalkorseesoIcantgetout.Iwouldhavetohaveamicrowavemealbutthisismuchbetter,itsalwaysattherighttemperatureanditsnicetohaveiteveryday(female,age86)
Iwouldntknowwhattodo(female,age88)IdontknowwhatIddowithoutit,Icouldntmakeitmyself.Idonthavetoworryaboutgettingextrasin.Itmakesabigdifference(female,age89)
Theseresponseshighlightthelackofalternativesformanypeople.However,someuserdidmentionthatwithouttheservicetheywouldinsteadrelyonfamilymemberstofillthisrole:
Mydaughterwoulddosomethingaboutit.Shelivesnotfarawayandshecomeseveryday(female,age90)
MytwodaughtersdomyshoppingandIringthedoctorifIhaveaproblem(female,88)
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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
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Serviceuserswereaskediftheyfeltanyoneelsebenefitedfromtheservicetoensurethatallthestakeholderscouldbeincluded,andtogiveanideaoftherelativevaluetothesestakeholdersasperceivedbyserviceusers:
MydaughterhasMSandshelivesinahomeinTwycross,soIdontgettoseehermuch,onlywhensomeonetakesme.IhaveagrandsonwholivesinSystonwhosometimesvisits,hesveryhappywiththeservice,itmeanshedoesnthavetoworry(female,age89)Itmeansmydaughterdoesnthavetoworry.Itgivesherabreak(female,age90)
Apointthatwasalsoidentifiedinpreviousresearchwasthatalthoughserviceusersappreciatedthecompanyoftheirfamily,theyalsodidntwanttobecomeaburdenonthem.
Ihaveadaughterwhocomestoseemeonceortwiceaweekbutshesverybusyatthemoment.Shesanurseatthehospital,shesdonereallywell.Shesveryintelligent(female,age88)
Whilesomeuserswereabletocitethebenefitstofamilywhowerestillinvolvedintheircare,othersstatedthattheydidnothaveanyfamilyinvolvement,meaningthattheycouldbequitelonely.Somehadalreadylostchildrenaswellaspartners.
IlostmydaughtertocancerandIhavetwosonswholiveinMarketHarborough,butnoonecomestoseemeexceptacareratweekends(female,age86)
Overallthethemesthatemergedfromtalkingtoserviceuserswerearoundpracticalhelpsotheycouldremaintobeindependentandmaketheirownchoices.Thesocialcontactwitharegulardriverwasalsoimportant,particularlyforthosewhodidnotregularlyseefamily.FamilymembersItwashardertogaincontactwithfamilymembers,astheyarenotroutinelyconsultedwithonservicesforolderpeople.However,ICarewereabletopassoncontactdetailsof6familymemberswhomtheyhadcontactwith.Theyweretheninterviewedoverthephonetounderstandtheimpactthecommunitymealshadonthemintheircaringrole.Theinterviewshighlightedtheirimportanceintermsoftheimpacttheservicehadonthem.Thesestakeholderswerealsoaskedwhatdifferencetheservicemadetothem:
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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
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Theyhaverangmewhenmumsfallen.Anyproblemstheyringmeormybrothertheyhaveallournumbers.TheyhaverangmeacoupleoftimeswhenshesbeenillandIvegoneround.Ivegotnoworries(Daughter)HewentfromfendingforhimselftonotbeingabletofendforhimselfWelivetoofarawaytodoanythingonaregularbasis.Icantbetheretoputfoodinthecupboard.[Sincehestartedreceivingmeals]Iworrylessbecausefirstly,someoneisseeinghimeveryday,forsure,andsecondlybecauseheisgettingfoodeveryday,forsure.Hesbeentohospitalbeforewhenhesbeendehydratedbuthessworntomehehastwodrinksaday,andIdgoroundandhehasnoteainsoIknowhehasnt.Hedsayanythingifyouask.Itsabigbenefitjusttoknowforsure.(Son,age64)
Weknowheshavingahotmealaday.Theressomeonecheckingonhim.Iftheycantgetholdofhimtheyringme.(Son,age46)Theburdenistakenaway,Iusedtospendweekendsjustdoingalltheirfoodfortheweek.Itsabigrelief.Ittakesthepressureoff.Mygranddaddidntknowwhathewasdoing,hedidntevenknowifthingsweredefrostedornot,hismindisgoing.Gettingoldpeopletoadapttochangeisabigissue,theywanttocopeanditsreallyhardforthemtoaccepthelp.Buthelovesgettingthemealsnow(Granddaughter)ItmeansmyDadat92canhaveahotmealeverydayandthenhecangethimselfasandwichintheeveningandthatsok.Imrelievedthathestillhasahotmeal.Iamreassuredthathesgettingahotmealeverydaythatstheword,reassured(Daughter,aged64)IpushedfortheMealsonWheelsreallybecausewewantedtoknowshewasgettingahotmealeveryday.Itsreallygivenuspeaceofmind.Itsthesameforherson.Shespartiallysightedtocantdothingsforherself.HerconditionisdeterioratingbutinherselfsheskeepingwellandIattributethattotheservicesthatcomein;MealsonWheelsispartofthat.(Daughterinlaw)
Familymemberswereaskedwhattheydiddifferentlyasaresultoftheservice
IvegonetoFosseparkanddonesomeshoppingtodayIwouldntbeabletodothatifitwasntfortheserviceitwouldbeabigworry(Daughter)Hersoncanspendmorequalitytimewithhernow,hegoesoverandplaystheflute,andhedoesnthavetobethereatacertaintime.Providingshesgettingamealeverydaywedonthavetoworry(Daughterinlaw)
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Familymemberswerethenaskedwhattheywoulddoiftheservicedidntexist: "WithoutitIdontknowwhatIddo.Imfullofarthritisandmybrotherworks.Itsnot2minutesdowntheround,itsa20minutejourneyinthecar,about5or6miles.Itsnotlikeitsjustroundthecorner.Itshardwhentheweathergetsbad.Sometimesshegoesthroughastageofnoteating"(Daughter) Wedbescratchingourheads,hedbeinahome,buthedoesntwantthatandwehavenodesiretoputhiminahome,especiallywhenhedoesntwantthat,itwouldbeawful.Havingareliablefoodserviceisessential.Freezerfoodwouldntdothejob.Hewouldntthinkaboutit.HesbadonhislegsandIdontthinkhedbeabletoputfoodinthemircrowave.(Son,aged64)
Wewoulddoitbutitwouldbedifficult.Hewasonaboutcancelingthemandwesaidnodont!Itdoesfreeusupbutifwehadtowewoulddoit.Theonusisonus.Itwouldbeuptoustosortitout.Hedoesstruggle.Weprovidehimwithfoodattheweekendbutwewouldhavetodoiteveryday.(Son,46)OhGod,Nightmare!Itwouldbeanabsolutenightmare.Itwouldhaveabigimpactonmylife.Iwouldhavetogoupeverydaydayandphysicallymakethemsomething,theycantusethemicrowavesoIdhavetodoiteveryday(Granddaughter)GollyIdontknow,hewouldntcopewellatall.Hestriedcookingacoupleoftimesanditsbeenadisaster,hehadtoringmeandaskofsomethingwasstillfrozen.AndIwouldntbeabletogoeveryday,someonewouldhavetogoin,hewouldgetinarightmuddle.Safetyisreallyimportant.Hedoesnthavetoputtheovenonthatssoimportant.Hisneighbourhasfrozenfooddeliveredandonedayheputamealonandthenhewentintoacoma.Ifhewasfound20minuteslaterthehousewouldhavebeenonfire.Itsnotsafeforolderpeopletoheatuptheirownfood.Icanttellyouhowimportantitis.IfeelmyDadhassuchasadvantageoverhisneighbour.Allhehastodoistakethetopsoff.Andifanythinghappenedtheywouldnoticethathewasntwellbecausesomeoneiscomingeverydayandthereisntthatriskoffire.Theygetdementiaandtheythinktheyregreat.Theysaytheyknowwhattheyredoingbuttheydont!(Daughter,aged64)Withouttheserviceitwouldbedevastatingtoallofus,becausewewouldhavetoprovidethemeals.AndIdontknowhowweddoit.SomeonewouldhavetogoinanddoitforherbecauseIcouldntvisiteveryday,wehavetofindabalanceandMealsonWheelshelpusfindthatbalance.(Daughterinlaw)
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Familymemberswerealsoaskedwhatthemostimportantthingabouttheservicewas,togainanunderstandingofhowtheyvaluedifferentaspectsoftheservice:
Itgivesyoufreedomandpeaceofmind.Itspeaceofmindtoknowtheyllgetintouchwithme.Ineedtohavepeaceofmindthatshessafe.Withouttheserviceourlifewouldbequitemiserable(Daughter)Peaceofmindisthemainthing.Nothavingtoworry(Son,aged64)Myhealthisntgood,Icanstruggletogetabout,IvegotarthritisandIminandoutofhospitalandoncrutches.Itsjustnice,theresthatcontact.Weknowthathesalright(Son,aged46)Justtoknowtheyaregettinghotfoodeveryday.Icouldnttrustthem[grandparents]otherwise.Theycantuseagascooker,itstoodangerous.Wehadtotakeitaway,hedoesntknowwhathesdoing.Itsthesatisfactionofknowingtheyareok.Itspeaceofmindthatsmostimportant.(Granddaughter) Itspeaceofmindreallyforme.AlthoughImnotthereitsreallyimportant.IlivealongwayawayfromDad,70miles.Ittakesanhourandahalftodrive.Ihavehighbloodpressureandcholesterolproblems.ImonmyownbutImdoingmybestformeandmyDad.Itsonlymenow.Thepeoplearoundhimareoldthemselvessotheyhavetheirownproblems.MealsonWheelsisalifesaver.Inthecoldweatheritsahotmealandinthesummerthathotmealstillgivesthemenergythattheyneed.(Daughter,aged64) Thepeaceofmindiswortheverything.Ilivefurtheraway,itshalfanhourdrive,itsnotpossibleformetogoeveryday.(Daughterinlaw)
Responseswerealsoexploredtoidentifyanynegativeorunintendedoutcomes:
Thereusedtobesomeoneshedidntlike;amanwhowassnappyanddidnthavetime.Hewasquiterudebuthesgonenow(Daughter)
ItwouldbeniceiftheycouldstayafewminutesmorebutIknowtheyrepushedfortime.Theyhavetogetto4or5differentvillages(Daughter)
Familymemberswereaskedifanyoneelsebenefitedservices.Theirresponsesoftenincludedotherfamilymembersaswellastheserviceuserthemselves.
Mywifebenefitstoo.Shewashavingsleeplessnightsworryingabouthimatonestage.Mywifehasserioushealthproblemsandbackproblems,shecantreallytravel150miles.Ihavesomelimitationstoo.Drivingisaproblem.Ineedtohaverestdays(Son,aged64)
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MeandmyDadbothbenefit[fromtheservice].AndmyGrandparentslookbetternowtoo.Theylookhealthiernowtheyaregettingproperfood,muchbetterthanwhattheywerehaving(Granddaughter)Youknowwhatitslikewitholderpeople,theymissafewmealsandtheygetusedtoit.Theystopeating.WithMealsonWheelstheyhavethatroutine.Shelooksverywell,shesveryalert.Itsthatroutineofeatingandenjoyingameal.Shelooksbetternowthanshedidin2009.Shetooksomepersuadingatfirstbutnowshelovesit.Ihavehealthproblemsandsodoesherson.Hes72.Wereallgettingonabitbutwehavetostayhealthy.(Daughterinlaw)
Somefamilymembersalsotalkedabouttherelationshipwithcommunitymealsstaffandtheimportanceoftrust:
Theyareveryapproachable.Ifthereareanyproblemstheyarestraightontoit.Theyarefriendlyandapproachable,justlittlethings,likeonhisbirthdayIwasntabletogooverasitwasintheweekandhesaiddontrisktheroads,andherangmetotellmethedriverhadsaidhappybirthdaytohim.Sometimesthatfriendlycontactisimportant.Thatlittlebitofoutsidecontactorbitsofinformation.WhenIveseenthemtheyarealwaysniceandbrightandcheerful.(Daughter,aged64)Theyarenotlikesocialservicesatall.IvehadsomanyproblemswithsocialservicesnotdoingwhatIveasked,notgettingbacktome.[WithIcare]Youvegotthattrust.Thereisalwayssomeoneyouknowtospeakto.Youknowthemandtheyunderstandwhereyourecomingfromstraightaway.(Granddaughter)Theyareveryobliging;shesgotspecificlikesanddislikes.Oldpeoplegetlikethatastheygetolder,shesveryfinickybuttheyareverygood.Iliaisewiththemtomakesurethatshegetswhatshelikes.Theydocartwheelstoensurethemealgetstheresomehow.Weknowwecanrelyonthem,andalsoitsanotherpersoncallinginsoifanythingiseverwrongtheyhaverungusup.Theyhavemynumber,itspeaceofmindtoknowshesgettingagoodmeal.Thedriversdogoaboveandbeyond(Daughterinlaw)
Theresponsesfromtheinterviewswithfamilymembershighlighttheimportanceofinvolvingfamilymembersinevaluatingservices.Thoseinterviewedhadstrongviewsaboutservicesandfeltthatwhereaserviceishavingapositivebenefittotheserviceuser,thisalsohasasignificantimpactonfamilymembersintermsofboththeirfreedomandpeaceofmind.LunchClubattendees
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LCCcommission52lunchclubs.Mostofthesearecurrentlyatcapacitysuggestingthatclosetoapproximately1,450placesarefilled16.Lunchclubattendeeswereengagedthroughofnumberofsmallfocusgroups.Thisalloweduserstodiscussvariousaspectsoftheservice.Intotal10peoplewereinvolvedinansweringquestionsaroundthevalueoftheservice.Stakeholderswerefirstaskedwhatdifferencetheservicemadetothem:
Thecompany,amealisreadyforyou,itsaniceplace.Youfeelwellcaredfor(female,age85)
Itbringsyououtforanhour.IenjoytalkingtopeoplethatIdont[normally]see(female,age90)Youmeetpeopleyouwouldntnormallyseeandyoucanhaveagoodmoan.Welive4doorsawayfromeachotherbutweonlyseeeachotherhere!(female,age94)Youmeetotherfriendswholiveinthevillage(female,72)
Yourewithothers,youhaveagoodlaugh.Thebuspicksusup,Irecentlyhurtmyfootsocantgetaround(female,age70)
Lunchclubattendeeswereaskedwhattheydiddifferentlyasaresultoftheservice:
WhenmyhusbanddiedIstartedcomingandIvejoinedoneortwomorethingsliketheladiesevening.Theyareveryfriendly(female,age79)
Itssomethingtotalkabouttoyourfamilyathome(female,age90)Imakecakesfortheothers(female,age94)
Lunchclubattendeeswerealsoaskedwhattheywoulddoiftheservicedidnotexist:
Idgetmyownmeal.Myfamilydomyshopping(female,age85)
Iwouldntseeanyoneatall.IhavenofamilyhereTheyliveinCoventryandIhardlyeverseeotherpeople(female,age90)
Again,thereweresomewhowouldrelyonfamiliesmoreheavilywithouttheservice,whereasforotherswithouttheservicetheywouldhaveverylittlecontactwithotherpeople. 16Numberswerenotgivenfor4lunchclubssoafigureof20(justunderaverage)wasused
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Lunchclubattendeeswerealsoaskedwhatthemostimportantthingabouttheservicewas,togainanunderstandingofhowtheyvaluedifferentaspectsoftheservice;
Friendship,beingwithothersandmixingwithpeople.Weveallgotfamiliesbuttheyhavebusylives,theyhavetheirownlives.Theyknowwhereweareandwhen(female,age79)
ThecompanybecauseImonmyown(female,age90)
Agoodgossip,sociable.Youmeetsomenicepeopleeveryweek.Itsnicerthangoingtoarestaurant.Itssomethingdifferent.Youseeallthesedifferentgroups,andthepicturesonthewallthatthechildrenhavedoneItsalwayschanging.Itsnicetofeelpartofit(female,age71)Meetingupwitholdfriends.Andthemealsarealwaysnice(female,age90)
Lunchclubattendeeswereaskediftheyfeltanyoneelsebenefitedfromtheservice:
Yourfamilyknowwhereyouregoingthatsimportanttothem(female,age94)Thefamilyringandsaywhereareyougoingtoday?(female,age79)
Myfamilypersuadedmetocome.Itsgivenmydaughteradayoff.(female,age90)Ivestoppedbeingabletogetaroundsomydaughterfetchesthingsinforme.ShecheckstoseeifImalright(female,age90)
Thepeoplethatruntheservice.Therearenomiserablepeople.Asmileisimportant.Ifyousmileatsomeone,theysmileback.(female,age71)
Thelunchclubattendeesoftentalkedaboutthevillagetheylivedin,highlightingtheimportanceofthatconnection,bothintermsofknowingwhatwashappeninginthecommunityandkeepingintouchwitholdfriendsandneighbours.Theyoftentalkedaboutthefuntheyhadattheclubwhichcontributedtotheirpositivewellbeing.Intermsofotherstakeholders,thelunchclubattendeesagainmentionedtheirfamily,aswellasthevolunteerswhohelpedruntheservice.Volunteers
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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
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Eachlunchclubreliesonaminimumof4volunteerstohelpruntheclubs.Thisequatesto208volunteers.LunchclubvolunteersaresupportedbyLCCandarefromarangeofbackgrounds.LCCprovidealuncheonclubguidepublicationtoassistvolunteerstoruntheirclubsandofferfreefoodhygienetrainingtoallaffiliated.LCCalsosendoutnewsletterstoallvolunteersandguidanceandwarningsabouttradingstandardsissues.9Volunteerswereinterviewedforthisreportaboutthevalueofvolunteering.8wereLCCemployeesand1wasassociatedthroughthechurch.Stakeholderswerefirstaskedwhytheydecidedtovolunteer:
"IdecidedtovolunteerbasedonmyworkexperienceIdidwithschool,IactuallyworkedinahospitalandthatmademerealisethatIreallyenjoyhelpingtheelderlytosocialiseetc,sowhenthisopportunitycameup,itwasperfectforme.Ihavealwayswantedtovolunteer,howeverIhavesomanyoutofworkcommitmentsitshardtofindthetime,sowhenthiscameupitwasperfectasIcoulddothevolunteeringthatIhavealwayswantedtodoandduringtheworkingday"(Volunteer)"IvolunteeredbecauseIhavealwayswantedtodosomevoluntarywork,mainlywitholderpeople,butIdifficulttofindthetimeasIamasingleparentandIhaveoldparentstolookaftertoo"(Volunteer)
"Achancetoputsomethingbackintothecommunityandhelpavulnerablegroupinsociety"(Volunteer)
Mostvolunteersdecidedtogetinvolvedbecausetheywantedtodosomethingdifferentandgivesomethingback.ThesupportfromLCCallowedthemtheflexibilitytodothis.Formost,thiswastheonlyvolunteeringtheydid.Volunteerswerethenaskedwhatdifferencevolunteeringmadetothem:
Themainbenefitsofthelunchclubforme,isseeingtheladiesenjoyingthemselvesandhavingacatchupwithothersintheirvillage,theladiesarealwayshappytoseeusandseemtoalwaysenjoythemselves(Volunteer)"Idoenjoythetimethereasitachievestheobjectofgivingsomethingtothecommunityandmoreimportantlywitnessingwhatitdoesforthepeopleinvolvedwhoattendthelunchclubandwhatitmeanstothem.Itactuallyhelpsseeingrealpeopletoo,weoftenjustworkwithnamesonscreens.Itactuallymakesyoufeelgoodtoo"(Volunteer)"Forme,realisingthattherearerealpeopleouttherethatneedperhapsasenseofsometimesaroutine,orsomethingtolookforwardtoandawelcomechangefromaclinicalautomatedhelpdeskapproachthatistoo
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prevalentthesedays.Peopleingeneralliketoseepeopleandtalktopeople"(Volunteer)
Volunteerswereaskedwhattheydiddifferentlyasaresultofvolunteering
I'mprobablyabetterpersonbecauseofit,itmakesmereflectonissuesoutsideofmynormaldaytodaywork(Volunteer) "IhavethoughtifinthefutureIamnotworking,Iwoulddosomethinglikethat"(Volunteer)"Notreally,butIwouldconsidervolunteeringforanotherservice"(Volunteer)
Volunteerswerealsoaskedwhatthemostimportantthingaboutvolunteeringwas,togainanunderstandingofhowtheyvaluedifferentaspectsoftheservice;
Itsnicetofeellikeyouremakingadifferenceandhelpingtoprovideaservicethatisenjoyedbyothers(Volunteer)"Theenjoymentandfunofmeetingupandhelpingothers.Itisalsosomethingdifferenttodoandgetsusoutofourownofficeenvironmentforawhileandsoisrefreshing"(Volunteer)
Volunteerswereaskediftheyfeltanyoneelsebenefitedfromtheservice:
Theirfamiliesbenefitfromknowingtheirlovedonesarehavingahealthymealandsocialisingwithfriends,whichalsogivesthemabreak(Volunteer)
Thevolunteerswerealsoabletocitecaseswheretheyhadseenspecificunintendedbenefitstoserviceusersasaresultofthelunchclubs:
OnedrivercamebackandsaidyouknowMavisshousedoesnthavealockonthedoor,thecouncilcantrepairittillnextyear.SoIrangthenieceandshesaidthatdidntsoundright.Youhavetocheckitout(Volunteer)Afewyearsagowehadtomakeenquiriesandintheendwerangthepolicebecauseonlythepolicecanbreakin.Shewillstillalivebutshedfallenagainstthedoorshewasntunconsciousbutshecouldntmakeanyonehearhertilllaterinthedaywhenthepolicewentround.Itsourresponsibility,wellyoufeelresponsibleforthem.Soyoutryandfindoutwhytheyrenothere.(Volunteer)
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Responseswerealsoexploredtoidentifyanynegativeoutcomes
Thisisanopportunitytomeetpeopleoftheirownclassandage.Wehadtwocouplesheretheywerenttherightsortofpeople,notverysociable.Afteraperiodoftimetheysaidtheysharntbecomingagain(Volunteer)
Thevolunteersgenerallyfeltthattherewasabenefittothempersonallyinvolunteeringatthelunchclubsontopofthebenefittotheusers.Noadditionalstakeholderswerementioned.TheoryofchangeTheengagementwithstakeholderscanbeusedtodevelopatheoryofchangeforallstakeholdergroupstomapouttheshort,mediumandlongtermoutcomesoftheservice.Atheoryofchangeshouldalsoincludeanynegativeorunintendedoutcomes.However,theexplorationfornegativeoutcomestendedtoidentifyareaswherevaluecouldbeincreasedratherthantherebeinganactualnegativeimpact.Manyofthestakeholdersalsoidentifiedchangesforotherstakeholdergroupswhichcaninformandsupportthetheoriesofchange.
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MaterialityToensurethatonlymaterialoutcomesareincluded,atthisstageitisimportanttoidentifytheoutcomesthatconsideredrelevanttotheservice.MaterialityisdefinedasInformationismaterialifitsomissionhasthepotentialtoaffectthereadersorstakeholdersdecisions.AccordingtoSROIGuidanceonMateriality,testingforrelevanceinvolvesidentifyingwhethertheoutcomeisrelevantbecausethereare:
policiesthatrequireitorperverselyblockitandtheinterventioncandeliverit;
stakeholderswhoexpressneedforitandtheinterventioncandeliverit; peerswhodoitalreadyandhavedemonstratedthevalueofitandthe
interventioncandeliverit; socialnormsthatdemanditandtheinterventioncandeliverit;and financialimpactsthatmakeitdesirableandtheinterventioncandeliver
it.
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Theoutcomesinthetheoryofchangecanbetestedforrelevancebyjudgingeachoutcomeagainstthecriteriaformateriality.Fromthetheoriesofchange,thefollowingoutcomeswereidentifiedasbeingpotentiallyrelevantimpactsoftheCommunityMealsservice:
Stakeholders Outcome Relevance Relevant?Longer/shorterterm
outcomes?
CommunityMeals
(MealsonWheels)users
Reductioninthoseatriskofmalnutrition/dehydration
Keyaimoftheservice Y
Researchsuggeststhatsupporttoeatnutritionalmealsdoeshaveanimpactonmalnutrition
Supporttoliveindependently
Keyaimoftheservice Y
Researchsuggestthatalittlebitofhelpdoescontributetowardsindependence
Friendlysocialcontactonadailybasis
Olderpeoplefrequentlycitedtheimportanceofcompany Y
Thiscontactisadirectimpactoftheservice.Futuremonitoringcanalsotestforlongertermoutcomes
Feelmoreincontrol
Olderpeoplesaidthattheyweresupportedtomakechoices.Thisimportanceisreiteratedinresearch Y
Researchsuggeststhatsupporttomakechoiceshelpsolderpeoplefeelmoreincontrol
ReceivingamealMainobjectiveoftheservice Y Outcomeonitsown
Family
Morefreedom
Aswellasthisbeingcitedbyfamilymembers,serviceusersalsoacknowledgedtheincreasedfreedomforfamilymembers Y
Theservicedirectlygavefamilymembersmoretime,howevernotenoughevidencewasavailabletomakethefurtherlinktowellbeing
Peaceofmind
Aswellasthisbeingcitedbyfamilymembers,serviceusersalsoacknowledgedthedecreasedworryforfamilymembers Y
Theservicedirectlyreducedtheworryforfamilymembers,howevernotenoughevidencewasavailabletomakethefurtherlinktowellbeing
Lunchclubattendees Feelpartofcommunity
Manyoftheattendeestalkedaboutlinkstothecommunityasakeyreasonforattending Y
Thisengagementwithcommunityisadirectimpactoftheservice.Futuremonitoringcanalsotestforlongertermoutcomes
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Havefun
Manyoftheattendeestalkedaboutenjoyingthemselvesandhavingfunasakeyreasonforattending Y
Whiletheattendeesclearlyenjoyedthelunchclubsitwasdifficulttolinkthistooverallwellbeing
Supporttoliveindependently
Lunchclubattendeesdonothavetheirneedsassessed,thereforeitisdifficulttoquantifythecontributiontolivingindependently N
ReceivingamealMainobjectiveoftheservice Y Outcomeonitsown
VolunteersSatisfactioninhelpingothers
Allvolunteerstalkedaboutthesatisfactioninhelpingothersasakeyreasonforvolunteering Y
Volunteersenjoyedhelpingothersatthelunchclubsalthoughitwasdifficulttolinkthistooverallwellbeing
DriversFeeltheyaremakingadifference
Notenoughevidenceofdirectimpact N
LCCReductioninintensivesupportcosts
Keyaimoftheservice Y
Researchsuggeststhatalittlebitofhelpdoescontributetowardsindependence
NHS
Reductioninthoseatriskof
malnutrition/dehydrationorpotentialhospital
admissionsKeyaimofthe
service Y
Researchsuggeststhatsupporttoeat
nutritionalmealsdoeshaveanimpacton
malnutritionThe following outcomes were therefore identified as relevant at this stage:
Stakeholders Outcome
CommunityMeals(MealsonWheels)users
Reductioninthoseatriskofmalnutrition/dehydrationSupporttoliveindependentlyFriendlysocialcontactonadailybasisFeelmoreincontrol
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ReceiveamealfromIcareFamily Morefreedom
Peaceofmind
LunchclubattendeesFeelpartofcommunityHavefunReceiveamealfromIcare
Volunteers SatisfactioninhelpingothersLCC Reductioninintensivesupportcosts
NHSReductioninthoseatriskofmalnutrition/dehydrationorpotentialhospitaladmissions
MeasuringimpactSignificancewillneedtobeconsideredateachofthenextstages.Significancemeansthattherealorpotentialscaleoftheoutcomehaspassedathresholdthatmeansitcanpotentiallyinfluencedecisionsandactions.Wherequantitiesofchangeorvaluesarelow,orifdeadweightorattributionarehigh,thentheoutcomesmaynotbesignificanttothesupportingfunctionofthemealsdeliveryservice.Significancecanbeconsideredafterquantitiesofchange,values,deadweightandattributionhavebeendetermined.EvidencingoutcomesDatawasexploredandanalysedfromarangeofsourcestocalculatetheactualchangeinoutcomes.Anindicatorisapieceofinformationthathelpsdeterminewhetherornotchangehastakenplaceitallowsperformancetobemeasured.Theindicatorsarethewaysofknowingsomethinghashappenedorchanged.Thereareoftendifferentwaysofknowingachangehastakenplace.Avarietyofsourceswereusedtoestimatebaselineandimpact.Theseincluded:
Stakeholderinterviews SocialCaredatabase(2010/2011) SocialCapitalSurvey(2007)17(Forprofiling)(SeeAppendixD) Quarterlysurveywiththosereceivingmealsathome(2011)(SeeAppendixD)
TheSocialCaredatabasekeeprecordsofserviceuserswithdetailsoftheirneedsintermsofpersonalinformationandmealspecifications.Notesrecordedwillincludeinstructionsfordriverssuchaswhethertheyneedhelptotakelidsoff/serveupfoodetc,orotherregulartaskssuchastakingbinsout.Theserecordscanprovide 17 http://www.lsr-online.org/reports/social_capital_survey_2007
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informationonwhoisreceivinganenhancedserviceandthetypeofadditionalsupporttheyreceive.TheSocialCapitalSurveywascarriedoutin2007within20neighbourhoodsinthecounty,representingdifferentlevelsifdeprivation.Volunteersfromavarietyoforganisationsweretrainedandcarriedoutthehousetohousesurveysin12oftheseneighbourhoods.Therewere2,296interviewsintotal,359(15.6%)ofwhomwereover75.Thesurveycanbeusedtoestimatethefrequencythatolderpeopleseefriends,familyandneighbourstogiveanindicationoflevelsofisolationforserviceusers.Astheresearchsuggestedthatsocialcontactwasofhighimportancetoolderpeopleitisnecessarytosplitthestakeholdersintogroupstomeasureandunderstandthedifferentimpactsofincreasedsocialcontact.Thethreegroupswere:
thosewhosocialisewithfriendsandfamilylessthanonceamonth thosewhosocialisemorethanonceamonthbutlessthanonceaweek thosewhosocialisewithfriendsandfamilymorethanonceaweek.
Thesocialcaredatabasecanbeusedtoextractthenumberofserviceuserswhoreceivedmeals(andthereforehadsocialcontact)sevendaysaweek,andestimatetheamountofsocialcontacttheywouldhavehadwithoutICare,basedonthesocialcapitalsurveyproportions.ThisprovidesanestimateofthechangeduetoICare.Thetotalnumberreceivingmealsthroughouttheyearwas1416.Thetotalnumberreceivingmeals7daysaweekwas781.Foroutcomesaroundincreasedsocialcontactonlythosereceivingdailymealswillbeconsidered.Forotheroutcomesthetotalnumberofserviceuserswillbeconsidered.ThequarterlymealsathomesurveyisdisruptedbyICareStaffwiththosereceivingmealsathome.ThetakeupisfrequentlylowandsupportfromtheICaredriverisoftenrequiredtocompletethesurveysotheresultsshouldbetreatedwithcaution.However,itcanprovideanindicationofgeneralsatisfactionlevelsforserviceusersaswellaspickuponanyissues.AsthisisaforecastSROI,someoftheoutcomesareestimatedbasedonresearchonimpactsfromoutputs,ratherthanbeingabletoactuallymeasuretheoutcome.ForanevaluativeSROItheactualoutcomeswouldneedtomeasuredtobeconfidentthatthevaluewasachieved.Fromtheavailableinformation,proxyindicatorscanbeidentifiedtoforecastoutcomes,aswellastheactualindicatorsthatwouldbeusedtoshowchangeStakeholders Outcome Indicator Source
whatchanges?(basedonhowstakeholderswoulddescribethechange) Howwouldwemeasureit?
Wheredidwegettheinformationfrom?
CommunityMeals(MealsonWheels)users
Reductioninthoseatriskofmalnutrition/dehydration
ReductioninMalnutritionscorefromassessment(PROXY:Numberswhoreceivesupporttoeattheirmeal(approx15%ofthosewhoreceive
Malnutritionassessmenttool(PROXY:Socialcaredatabase)
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meals(1416))
Supporttoliveindependently
Numberwholiveintheirownhomeforlongerthanexpected(baseline)andfeelmoresupportedtoliveindependently(PROXY:Numberreceivingadditionalpracticalhelp(supportnonmealrelatede.g.binstakenout)(1%)
SocialcaredatabaseandSurvey(PROXY:socialcaredatabase)
Friendlysocialcontactonadailybasis
Numberofthosewhowerepreviously'quiteisolated'whostatethattheyaremorelikelytoseepeopleregularlyasaresultofservice(PROXY:Numberreceivingdailymealsandstatethatdriverisfriendly(781)fromexpectedproportionofover75whoseefriendsorfamilylessthanonceaweek(19%)
Survey(PROXY:Socialcaredatabase/SocialCapitalSurvey
Numberofthosewhowerepreviously'veryisolated'whostatethattheyaremorelikelytoseepeopleregularlyasaresultofservice(PROXY:receivingdailymealsandstatethatdriverisfriendly(781)fromexpectedproportionofover75swhoseefriendsorfamilylessthanonceamonth(16%)
Survey(PROXY:Socialcaredatabase/SocialCapitalSurvey
Feelmoreincontrol
Numberwhostatethetheyfeelmoreincontroloftheirlivesasresultoftheservice(PROXY:No.chosenspecificneedsnotonmenu(171)andsupporttomakechoice(14))
Survey(PROXY:Socialcaredatabase/SocialCapitalSurvey
ReceivingamealfromIcare
NumberofmealsdeliveredfromIcare Socialcaredatabase
Family
Morefreedom
Numberoffamilymemberswhostaethattheyhavemorefreedomasareasultoftheservice(PROXY:Familylessreliantondailybasisfromexpectedproportionofdailyserviceuserswhoseefamilymemberseveryday(14%))
Familysurvey(PROXY:SocialCapitalSurvey)
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Peaceofmind
Numberoffamilymemberswhostatethattheyhaveorepeacseofmindasarsultoftheservice(PROXY:Lessstressfromexpectedproportionofdailyserviceuserswhoseefamilymembersatleastonceamonth(62%))
Familysurvey(PROXY:SocialCapitalSurvey)
Lunchclubattendees
Feelpartofcommunity
Numberwhostatethattheyfeelmorepartoftheircommunity(PROXY:Feelingmoreapartoflocalareafromexpectedproportionofover75sseeneighbourslessthanonceamonth(51%))
Survey(PROXY:SocialCapitalSurvey)
Havefun
Numberwhostatethattheyhavemorefunasaresultofattendingthelunchclub(PROXY:Estimationthatallattendastheyareenjoyingthemsleves
Survey(PROXY:stakeholderengagement)
ReceivingamealfromIcare MealdeliveredfromICare Socialcaredatabase
VolunteersSatisfactioninhelpingothers
Numberofvolunteerswhofeeltheyaremakingadifference(PROXY:Estimate=Minimumof4perclub)
VolunteersSurvey(PROXY:Stakeholderengagement)
LCCReductioninintensivesupportcosts
Reductioninprovisionofotheradultsocialcareservice(PROXY:Numbersreceivingadditionalpracticalhelp) SocialCaredatabase
NHS
Reductioninthoseatriskofmalnutrition/dehydrationorpotentialhospitaladmissions
Reductioninadmissionsduetomalnutition(PROXY:Numberswhoreceivesupporttoeattheirmeal(15%))
NHSdata(PROXY:SocialCareDatabase)
Valuingbenefits
ConsideringsignificanceThequantityofchangeinvolvedinsomeoftheoutcomes,suchassupporttoliveindependentlyandreductioninintensivesupportcosts,islowcomparedtootheroutcomes.However,theseoutcomescontributedtosomeofthekeyaimsoftheservice,therefore,ajudgementcanbemadetoretaintheseoutcomesatthisstage.
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Toassessthepotentialvalueofoutcomesalloftheindicatorsneedtobemonetised,orexpressedinfinancialterms.Whendataisunavailableordifficulttoobtain,proxiescanbeused.Aproxyisavaluethatisdeemedtobeclosetothedesiredindicator,forwhichdatamaybeunavailable.Proxiesshouldnotbeseenasconveyingahardandfastvalueonthatoutcomebutasawayofexpressingitinfinancialtermsthatensuresitcanbeincludedintheanalysis.Therearethreemaintypesoffinancialproxies:
Approximationsofrealtransactionsorchangesinmoney,forexamplewhereanoutcomeproducesachangeinincomeorexpenditurefortherelevantstakeholder.
Approximationsofvaluebasedonpotentialchangesinmoneyfortherelevantstakeholder.Forexample,wheretheoutcomemayresultinaloweruseofresourcesbutthisisinsufficienttoactuallyaffectthebudget,theseareoftenvaluedusingunitcosts.
Approximationsofvaluebasedonwhatarelatedmarketrevealsaboutpreferencefortheoutcome(revealedpreference),orwhicharebasedonsurveysofstakeholderspreferencesfortheoutcome(statedpreference).Thisapproachisoftenrequiredtovalueoutcomesforgroupsofstakeholdersthatarenotorganisations,suchasserviceusers,familiesandothermembersofthecommunity.18
Thissectionwilllisttheoutcomesidentifiedfromthetheoryofchangeandthevaluesattached.Themainsourcesofevidenceusedinthisstageare:
o Voicesonwellbeing:Areportofresearchwitholderpeople,WRVS,November2011
o PuttingaPriceTagonFriends,Relatives,andNeighbours:UsingSurveysofLifeSatisfactiontoValueSocialRelationships,Powdphavee(2007)(SeeAppendixE)
Stakeholdergroup:MealsathomeReducedriskofmalnutrition15%(207)ofthosewhoreceivemealsathomealsoreceivesupporttoeattheirmealsuchasremovinglids,cuttingfoodorbeingpromptedorremindedtoeatordrink.Withoutthissupporttheseusersarelikelytobemorevulnerabletomalnutrition.16%offemalesreceivedthisadditionalsupportcomparedto12%ofmales.Theseuserstendtobebetweenage75and85andareslightlymorelikelytohavementalhealthdisabilitythanphysicaldisabilityhighlightingtheissuesofmotivationandemotionalfactorsthatplaceolderpeopleatriskofmalnutrition.Thereducedriskof 18AguidetoCommissioningforMaximumValue,LGA,2011
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malnutritioncanimprovequalityoflifeQALY(QualityAdjustedLifeYears)isatoolusedtomeasureimpactstoqualityoflifetoassesswhethertreatmentsarecosteffective.Astudyofthevalueofreducingtheriskofmalnutritionfromhightolowfoundthatqualityoflifeimprovedby13%formalesand4%forfemales19(SeeAppendixF).NICErecommendthatbetween20,000and30,000isequivalenttooneQALY(fullqualityoflifeyear)forcostbenefitpurposes,givingaminimumvalueof1,450formalesand800forfemalesforreducingtheriskofmalnutritionfromhightolow.Givingtheproportionoffemalesreceivingthisservice(71%)theaveragevalueperpersonisaminimumof1,330.Thisvalue,andthenumberaffected,islikelytobeanunderestimateasmanymoreserviceusers,notreceivingadditionalsupporttoeat,mayalsobeatriskofmalnutrition.AdditionallythevalueofaQALY(20,000to30,000)doesnotrepresentthevalueofqualityoflifefromapatientsperspective.Furtherresearchhassuggestedthatthismaybeasmuchas70,00020.Supporttoliveindependently1%ofthosewhoreceivemealsathomealsoreceivepracticalhelpthatisnotmealrelatedthisincludestakingbinsout,bringinginpost,takingoutrefuseorchecksthattheyarewearingtheirlifelinependant.Whilethesetasksmayappearminimal,suchhelpcanmakeabigdifferencetoretainingasenseofindependenceandenableserviceusersremainintheirownhome.Mealsdriversarenotexpectedtoreplacethesupportoftrainedcarerswhoundertakeskilled,personal,caretaskssuchasbathing.However,smalltaskssuchasemptyingbinsareimportanttoandvaluedbyolderpeople.ThisisevidencedintheVCRSresearchwhichhighlightsalittlebitofhelpasanimportantcontributortoolderpeopleswellbeing.Thisvaluemaybeequivalenttothemarketvalueofonehouraweekhomehelp(1,040ayear).FriendlysocialcontactonadailybasisTheVCRSresearchfoundthatsocialcontactisthemostimportantdriverofpositivewellbeingforolderpeople.Thisfindingissupportedbymostresearchintowellbeing.Whenengagingwithstakeholdersitwasfoundthatformanyolderpeopleitgavethemsomethingtolookforwardtoeachday.Thequalityofthisinteractionisthereforecrucialtomaximizingthevalueofthemealsdeliveryservice.TheSocialCapitalsurvey21in2007asked2,296residentsinLeicestershirehowoftentheysawfriendsorfamily.Forthoseagedover75(359)10%statedthattheyneversawanyfriendsorfamilyandafurther6%saidtheysaweitherfriendsorfamilylessthanonceamonth.19%sawfriendsorfamilymoreoftenbutlessthanonceaweek.Afurther45%sawfriendsorfamilyatleastonceaweekbutnoteveryday.ResearchbyPowdphaveelookedatthevalueofsocialcontactanditscontributiontowellbeingtocalculatetheextraincomerequiredtocompensateforthosewhoseetheirfriendsorrelativesonlyonceortwiceaweek. 19 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075394/ 20ThesocialvalueofaQALY:raisingthebarorbarringtheraise?http://ukpmc.ac.uk/articles/PMC3023672/21SocialCapitalSurvey2007http://www.lsronline.org/reports/social_capital_survey_2007
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Inorderforthosewhousuallyseefriendsorfamilyonceortwiceaweektohavethesameleveloflifesatisfactionasthosewhoseetheirfriendsorarelativeonmostdays,theadditionalincomerequiredis15,000perannum.Forthosewhoseefriendsorfamilylessthanonceamonth85,000ayearisrequiredtoreachthesamelevelofwellbeingasthosewhoseetheirfriendsandrelativesonmostdays.Inthelatestquarterlysurveywithserviceusers100%ofservicesusersstatethatthedriverisfriendlysuggestingthatthisisapositiveaspectoftheservice.Ifthiscontactisdaily(781receivesmealseveryday)thenitmayberealistictoassumethatsuchapersoncouldberegardedasafriend.Ininterviewsstakeholderstalkedaboutchattingwiththedriversabouttheirlivesinsimilarwaytohowfriendsmayengagewitheachother.However,forthisvaluetoberealiseditmaybethatmoretimespentwithserviceusersisrequiredtoformbondsthathaveequivalentvaluestofriends.Insomeinterviewswithrelativesissueswereraisedaboutpreviousnegativeexperiencesofthissocialcontact,suchasdrivernottakingtimetochecktheyarealright.Asystemtorecordsuchcomplaintsshouldbeclearandmonitored.Feelmoreincontrol12%(171)ofthosewhoreceivemealsathomeexpressedaspecificchoiceovertheirmealsuchasstatingwhichfoodtheydontlikeorcannoteat.14ofthesearealsoassistedtomakechoices,forexample,assistancetocompletethemenucardduetovisualimpairment.Thissuggeststhattheserviceencouragesserviceuserstobeincontroloverdecisionsthataffectthem.Iftheservicedidnotexistthentheymaybemorerestrictedintheirabilitytomakesuchchoices.Itisoftenimportanttoolderpeoplethattheyfeeltheystillsomecontrolovertheirservicesandcareastheygetolder.TheSROIdatabaserecommendsusingthewageforfeitofbecomingselfemployedasthevalueofmakingonesownchoices(1,900ayear)22.ReceivingamealfromIcareAstheserviceusersarepayingforamealat3.20,thiscanbeconsideredthevalueofthemealtoserviceusers.Stakeholdergroup:FamilymembersMorefreedomFamilymembersoftenplayabigpartinthelivesofelderlypeople.Stakeholdersspokeaboutthefreedomtheservicegavefamilymembersbecausetheywerenotreliedupontosuchalargeextent.Theservicemayfreeupapproximatelyanhouradayoftheirtimewhichtheycanuseelsewhere.Thesocialcapitalsurveyfoundthat61%ofover75sawtheirfamilyatleastonceamonthsuggestingthatfor61%ofserviceusersafamilymemberbenefitsfromonaverage6hoursaweekor312
22 SurveyofPersonalIncome,annuallyundertakenbyHMRevenue&Customs,EarnedIncome
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hoursayearinfreeduptime.Thiscanbevaluedatapprox6anhour(1,874ayear).PeaceofmindThestakeholderengagementfoundthat,aswellasfreedom,theserviceprovidedpeaceofmindforfamilymemberswhowereworriedabouttheirelderlyrelativeswellbeing.Thiswasoftenconsideredmoreimportantthantimeandprovidedaconstantreassurancethattheirrelativewasbeingcheckedupon.As61%ofover75sseetheirfamilyatleastonceamonththenitcanbeestimatedthatfor61%ofserviceusersafamilymemberbenefitsfromincreasedpeaceofmind.Toachievetheequivalentoutcomeofpeaceofmindsomeonemaybepreparedtopayforanhouraweekcounselling.Themarketvalueofthisis2,08523.ThisvalueisslightlyabovethepreviousoutcomeofMoreFreedomwhichreinforcesthecommentsfromfamilymemberswhostatedthatpeaceofmindwasthemostimportantthingtothem.Stakeholdergroup:LunchclubusersFeelpartofcommunityThestakeholderengagementfoundthatmanylunchclubuserssaidtheclubenabledthemtomeetupwithothersinthevillageandfeelasenseofcommunityinasettingthatwasalsopartofthecommunity.Meetingupwithpeoplewasoftencitedasthemostimportantaspectofthelunchclubforthosewhouseitwithmanystatingthatitgavethemsomethingtolookforwardto(agoodgossip)andthentalkaboutafterwards.TheSocialCapitalSurveyandPowdphaveesresearchonthevalueofseeingneighbourscanagainbeusedheretoestimatethevalueofincreasedcontactwiththoseintheircommunity.51%ofover75sseeneighbourslessthanonceamonth.Forthosewhoseeneighbourslessthanonceamonth,inorderforthemtohavethesameleveloflifesatisfactionasthosewhoseeneighboursonceaweektheywouldneedhaveanadditionalincomeof22,000perannum.HavefunInterviewsatlunchclubsfoundthatmanyolderpeoplewereabletoattendandhavefun.EventssuchasChristmaspartiesalsoprovidedtheopportunitytoenjoythemselves.Thefriendlinessofvolunteershelpeduserstofeelwelcomeandrelaxed.Thevalueoffuncanbeequivalenttoanannualspendongamesandhobbies(93ayear)24.ReceivingamealfromIcare 23Frominternetsearchesconductedforthisdatabase,thecostsofindividualpsychotherapyandcounsellingareconsistentat40perhour.24FamilySpending2009Areportonthe2008LivingCostsandFoodSurvey2008
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Astheserviceusersarepayingforamealat3.20,thiscanbeconsideredthevalueofthemealtoserviceusers.Stakeholdergroup:VolunteersSatisfactioninhelpingothersInthestakeholderengagement,volunteersstatedthatthefeelingofhelpingothersgavethempersonalsatisfaction.Thetimetheygaveupcanbeaccountedforintheinputs,althoughvolunteersalsogainasenseofpositivewellbeingfrombeinginvolved.Thevalueusedistheaveragevaluegiventocharityayearforeachvolunteer(110ayear)ascalculatedinapollbyInvestecPrivateBank25.ReductioninintensivesupportcostsThetheoryofearlyinterventionisthatolderpeoplearesupportedtostayintheirhomesforlongerdelayingtheneedforexpensivecare.Althoughthewishesofolderpeoplevarymanydoprefertostayintheirownhomeratherthanmoveintoresidentialcare(JSNA).Thedatashowsthatonly6serviceusersstoppedreceivingmealsoverthe12monthsbecausetheyweremovingtoresidentialcare(lessthan1%ofallterminatedcontracts).However,itisdifficulttoknowhowmanywouldhavemovedtoresidentialcarewithoutthemealsdeliveryserviceandthereforehowmuchmoneyissaved.Theoutcomeofthosereceivingadditionalsupportnotrelatedtomeals(above1%)canbeusedtoestimatethecostsavingofnotneedingtoprovidesuchcarethroughsocialservices(5,824ayear).26LessneedingtreatmentformalnutritionTheoutcomeofreductioninriskofmalnutritionismentionedabove.ThecostsavingtotheNHSisequivalenttotheadditionalcostoftreatingapatientwithmalnutrition(1,000over6months)27DiscussiononvaluesThevaluesforsocialcontactusedhereistakenfromPowdphaveesresearchintohowmuchadditionalincomeisrequiredtobeashappyassomeonewiththoserelationships.AlthoughthemostconservativevalueswereusedtheyaremuchhigherthanpreviousmarketvaluesusedinSROIsforactivitiessuchasjoiningasocialclubormoneyspentofsocialactivities.Whicharetypicallyaround520a
25 http://www.thirdsector.co.uk/news/977447/?DCMP=EMC-FundraisingBulletin 26Averagehoursofcareperpersonprovidedbysocialserviceswas7.Averagecostperweekdayhouris16from'UnitCostsofHealthandSocialCare'2009,PSSRU27Guest,J.F.etal(2011)HealtheconomicimpactofmanagingpatientsfollowingacommunitybaseddiagnosisofmalnutritionintheUK.ClinicalNutrition,doi:10.1016/j.clnu.2011.02.002
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year(Averagespendonsocialactivitiesinayear)28ratherthan15,000+.ThiswillthereforehaveasignificantimpactontheSROIratio.ApplyingvaluesfromthePowdphaveesresearchshouldperhapsbeviewedasthepotentialvalueifrelationshipsbetweenserviceusersarestaffandconsideredasimportanttowellbeingasrelationshipswithfriends,Similarly,applyingPowdphaveesresearchonthevalueoftalkingtoneighboursforthoseattendingalunchclubconsiderablyinflatesthevaluewhencomparedtousingthefamilyspendingsurveycostofsocialactivities,suggestingthatthecontributionoftalkingtoneighbourstowellbeingshouldbeviewedasthepotentialvalue.ByusingPowdphaveesvalues,theSROIsignificantlyinflatesthevalueofsocialcontactcomparedtootheroutcomes.Althoughthishighlightsthepotentialimportanceofconsideringincreasedvalueofsocialcontactforthosewhodonotnormallyseeanyfriendsorfamilyitmaynotberealistictousethesefigureswithouttheconfidencethatwellbeingisdirectlyaffectedtotheextentimplied.However,wecanusetheresearchtoapplyweightingstodifferenttypesofincreasedcontact.AccordingtoPowdphavee,thevalueofdailysocialcontactforthosewhopreviouslysawfriendsandfamilylessthanonceamonthis5.7timesthevalueofdailysocialcontactforthosewhopreviouslysawfriendsandfamilymorefrequently(morethanonceamonthbutlessthanonceaweek).Ifthevalueof520(averagespendonsocialactivitiesinayear)remainsforthelatergroup(wherethereislikelytobelessimpactofdailycontact)thanavalueof2,912maybemorerealisticforthemoreisolatedgroupwhousuallyseefriendsandfamilylessthanonceamonth.Applyingthissamelogic,thevalueofseeingneighboursmaybe764.Basedontheengagementwithstakeholdersthesevaluesappeartobemoreappropriate.Theoutcomealsoassumesthatolderpeoplereceivingmealsathomearesimilartotheover75sformtheSocialCapitalSurvey.AnecdotalevidencefromICarestaffsuggestthatmanyserviceusersarelikelytohavelesscontactwithfamilythanexpectedattheirage,hencetheneedfortheservice.Theyestimatethatonlyathirdareinregularcontactwithfamilyorfriends(atleastonceaweek).Afurtherthirdseefamilylessthanonceamonthandtheremainingthirdseefamilylessthanonceaweekbitmorethanonceamonth.Thesefigurescanbeappliedinthesensitivityanalysis. 28FamilySpending2009Areportonthe2008LivingCostsandFoodSurvey2008
ConsideringsignificanceThevalueforoutcomessuchashavingfun,andfeelingtheyaremakingadifferencearelowincomparisontoothervalues.However,thenumbersinvolvedindicatethattheycouldpotentiallyprovematerial.Bydeterminingtheactualimpact,thesignificanceoftheseoutcomescanbereconsidered.
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NotoverclaimingTheSROIprocessalsoinvolvesassessinghowmuchoftheoutcomesisaresultoftheactualprojectorservice.Todothis,deadweightdisplacement,attributionanddropoffratesneedtobetakenintoaccount.Theseratescanbeagreedwiththoseworkingontheproject,basedontheirexperiences,theneedsofserviceusersandwiderresearch.DeadweightDeadweightconsiderswhatwouldhavehappenedanywayiftheservicedidnotexist.Sincetheeligibilitythresholdhasbeenreduced,somepeoplewhohavenolongerbeeneligibleforsubsidedmealshavecontinuedtouseICareprivately.ICareestimatethatthisappliestoaround50%.However,itisworthnotingthatthehighereligibilityserviceusersarelikelytofinditmoredifficulttopayforthemealwithoutasubsidy.Thecostofprivatemealscanbeequivalenttooverhalfanolderpersonspension.Subsidisedmealscost3.20*7=22.40aweekPrivatenonsubsidisedmeals4.63*7=32.41+VAT=38.89,anincreaseof16.54perweekAsthecostofthemealtotheserviceuserisincludedintheinputcosts,ifserviceusersweretousetheserviceprivatelyitwouldaffectwhowasinputtingtotheservicebutnottheoverallvaluetoeachindividual.DeadweightshouldthereforeconsiderwhethertheoutcomeswouldbeachievedwithoutICare.Itisalsounderstoodthatforthosereceivingmealsathome,withouttheLCCcontract,ICarewouldnotbeabletoprovidetheserviceinthearea.Theonlyothersupplierscurrentlycoveringallofthecountyareforfrozenservicesexceptforsomeverysmalllocalconcernsoperationinverysmallareas.Itisthereforereasonabletoassumethatthemajorityoftheoutcomesarounddailycontact,supporttoeat,practicalhelpandchoicewouldnotberealisedthroughalternativemealsprovision.Asmalldeadweightof5%canthenbeusedtotakeaccountofthosewhomaybeabletoobtainthesameoutcomesthroughlocalprovisionorfamilymembers.Forthelunchclubs,therearearound50noncommissionedlunchclubsinLeicestershire,suggestingthatifLCCwithdrewtheircommissionofclubstheremaybesimilaralternativesthatwouldachievesimilaroutcomes.However,thecommissionedlunchclubsaremoretargetedtowardsdeprivedareasandattendeesmaynotbeabletotravelfurthertolunchclubs.Theoutcomesaroundbelongingtotheircommunitiesmayalsodependontheclubbeingwithintheirvillagetoretainestablishedlinkswithfriendsandneighbours.ItispossiblethatlunchclubscouldsetupinnewdeprivedareasalthoughitwouldbedifficulttoinfluencethiswithoutLCC
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support.Adeadweightofaround20%wasagreedwiththeFoodandNutritionmanager.Astheserviceuserswerepayingthesubsidisedcostof3.20foramealfromIcarethedeadweightfortheoutcomeofreceivingamealswasgivenavalueof0%astheywouldnotreceiveamealfromIcarewithouttheservice.Inreality,manywouldstillbelikelytoeatameal,perhapsfromsomewhereelse,ifIcaredidnotexistbutastheirpaymentstoIcarewereincludedintheinputcostswecanspecifythattheoutcomeistoreceivemealsfromthisprovider.Asthemajorityofvolunteersintervieweddidnotfeelthattheywouldhavevolunteeredwithoutthisopportunity,adeadweightof10%wasagreed.DisplacementDisplacementoccurswhentheprojectbenefitsareattheexpenseofothers(e.g.benefitsaredisplacedfromelsewhere).Itisunlikelythatanydisplacementoccursthroughthecommunitymealsserviceasitiswelltargetedtowardsthosewhoneeditmost,withnonegativeimpactonothersAttributionAttributionconsiderswhatshareofanoutcomeisattributableto,orresultsfrom,thoseoutsideoftheservicebeingevaluated.ThisconsiderstheproportionoftheoutcomethatcanbeattributedtoLCCsupportandtheproportionthatshouldbeattributedelsewhere,forexamplefamilymembers.ManyofthefamilymemberswhowereconsultedlivedalongdistanceawayfromtheserviceusersocouldnotusuallydirectlyhelptowardstheoutcomesalthoughtheywereofteninfrequentcontactwithICare.AllthefamilymembersconsultedfeltthatICarewerebothcompetentandreliable,unlikeotherservicestheyhaddealtwith.TheyfeltthattheycouldringICareifsomethingneededchangingandthatitwasquickandeasytodo.Afewfamilymembersstilllikedtobearoundwhenthemealwasdeliveredandensurethattheywereok.Theattributionforserviceusersoutcomesweregivenwasestimatedtobe15%asICarewerefelttobeprimarilyresponsiblefortheseoutcomesbutthefamilywereoftenstillinvolved.Thisisbeingtestedthroughthecurrentsurveywhichasksforeachoutcomewhetheranyoneelseishelpingthemwiththischange.Theattributionforfamilymemberswasgivena5%attributionastheyoftenfelttheywerealoneindealingwiththeworryorresponsibilityofcaring.Againthiscanbetestedthroughthecurrentsurveywhichasksforeachoutcomewhetheranyoneelseishelpingthemwiththischange.
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Thosereceivingmealsathometendedtobemoreindependentandlessreliantoffamilymembers.Theattributionwasestimatedtobearound5%.Theoutcomesforvolunteerswasgivenahigherattributionof20%asitwasfelttobemorereliantonothers(suchasthecurrentemployer)tosupportthevolunteering.DropoffDropoffreferstothedeteriorationofanoutcomeobjectiveovertime,suchasthenumberofparticipantseachyearwholosetheconfidencegainedasaresultoftheproject.DuetothevulnerabilityandageoftheserviceusersadurationofjustoneyearwasusedbecausetheactivitywouldneedtobesustainedtoseeanylongertermsbenefitsProjectingfuturebenefitsWhenprojectingbenefitsintothefuture,itisstandardSROIpracticetodiscount29thevalueofanyfuturebenefits.TheHMTreasurydiscountrateof3.5percentwasappliedtoallfuturebenefitsinthemodel.
29 DiscountingisdefinedasTheextenttowhichthevalueofabenefitaccruedinthefutureisreduced,toreflectboththesocialandeconomicpreferencesforreceivingasumofmoneynow,ratherthanreceivingthesamesumofmoneyinthefuture.
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ImpactMapStage1 Stage2 Stage3Stakeholders
Intended/unintendedchanges Outputs
Deadweight%
Displacement%
Attribution%
Dropoff%
Impact
Description Indicator Source Quantity Duration Financial Proxy Value Source
whatchanges?(basedonhowstakeholderswould
Howwouldwemeasurei t? Wheredidwegettheinformationfrom?
Howmuchchangewill there
Howlongwill itlast?
Whatproxydidweusetovaluethechange?
Whatis thevalueofthe
Wheredidwegettheinformationfrom?
Thoseatriskofmalnutritionaresupportedtoeatnutritiousmeals costofmeals 833,225.60
Reductioninthoseatriskofmalnutrition/dehydration
ReductioninMalnutritionscorefromassessment(PROXY:Numbers whoreceivesupporttoeattheirmeal (approx15%ofall thosewhoreceivemeals(1416))
Malnutritionassessmenttool (PROXY:Social caredatabase) 207 1 IncreaseinQALY 1330
QualityofLiferesearch 5% 0% 15% 0% 222,312.83
Olderpeoplehavesomeonetocarryoutbasictaskstohelpthemliveindependently
TotalNumberwhoreceivemeals=1416
Supporttol iveindependently
Numberwhol iveintheirownhomeforlongerthanexpected(basel ine)andfeel moresupportedtol iveindependently(PROXY:Numberreceivingadditional practical help(supportnonmeal relatede.g.binstakenout)(1%)
Social caredatabaseandSurvey(PROXY:social caredatabase) 9 1
Costofhomehelpe.g.cleanerfor1hraweek(20)overayear 1040 Estimate 5% 0% 15% 0% 7,558.20
Olderpeoplehavesomeonevisitregularlytoincreasetheirsocialcontact
Numbersreceivingdailymeals=781
Numberofthosewhowerepreviously'quiteisolated'whostatethattheyaremorel ikelytoseepeopleregularlyasaresultofservice(PROXY:Numberreceivingdailymealsandstatethatdriveris friendly(781)fromexpectedproportionofover75whoseefriends orfamilyless thanonceaweek(19%)
Survey(PROXY:Social caredatabase/Social Capital Survey 148 1
Valueofseeingfriendsorfamily/contributiontowellbeing 520
FamilyspendingsurveyandPowdphaveeresearch 5% 0% 15% 0% 62,145.20
Numberofthosewhowerepreviously'veryisolated'whostatethattheyaremorel ikelytoseepeopleregularlyasaresultofservice(PROXY:receivingdailymealsandstatethatdriveris friendly(781)fromexpectedproportionofover75s whoseefriendsorfamilylessthanonceamonth(16%)
Survey(PROXY:Social caredatabase/Social Capital Survey 125 1
Valueofseeingfriendsorfamily/contributiontowellbeing 2912
FamilyspendingsurveyandPowdphaveeresearch 5% 0% 15% 0% 293,930.00
Olderpeoplearesupportedtomakechoicesovertheirmealtohelpthemfeelmoreincontrol Feel moreincontrol
Numberwhostatethetheyfeel moreincontrol oftheirl ives asresultoftheservice(PROXY:No.chosenspecificneedsnotonmenu(171)andsupporttomakechoice(14))
Survey(PROXY:Social caredatabase/Social Capital Survey 14 1
Valueofautonomy(reducedwages ofselfemployed) 1900
SurveyofPersonal Income 5% 0% 15% 0% 21,479.50
Receivingameal fromIcare NumberofmealsdeliveredfromIcare Social caredatabase 260383 1
Costofmeal toservcieuser 3.20
CommunityMeals 0% 0% 15% 0% 708,241.76
Supportfromcommunitymealsallowsfamilymemberstohavemorefreetimefromcaring Morefreedom
Numberoffamilymemberswhostaethattheyhavemorefreedomasareasultoftheservice(PROXY:Familylessreliantondailybasisfromexpectedproportionofdailyserviceuserswhoseefamilymemberseveryday(14%))
Familysurvey(PROXY:Social Capital Survey) 109 1 Valueoftime 1872
Minimumwage(6ahr) 5% 0% 5% 0% 184,153.32
Supportfromcommunitymealstohavepeaceofmind Peaceofmind
Numberoffamilymemberswhostatethattheyhaveorepeacseofmindas arsultoftheservice(PROXY:Lessstressfromexpectedproportionofdailyserviceuserswhoseefamilymembersatleastonceamonth(62%))
Familysurvey(PROXY:Social Capital Survey) 482 1
Onehouraweekcounselingoverayear 2085 Internetsearches 5% 0% 5% 0% 906,985.43
Olderpeopleattendlunchclubsintheirneighbourhoodandfeelmorepartoftheircommunity
Lunchclubs=52 Feel partofcommunity
Numberwhostatethattheyfeel morepartoftheircommunity(PROXY:Feel ingmoreapartoflocal areafromexpectedproportionofover75s seeneighboursless thanonceamonth(51%))
Survey(PROXY:Social Capital Survey)
728 1Valueoftalkingtoneighbours/contributiontowellbeing
764
FamilyspendingsurveyandPowdphaveeresearch
20% 0% 5% 0% 422,705.92
Olderpeopleattendlunchclubsintheirneighbourhoodandhavefun costofmeals 173,171.20 Havefun
Numberwhostatethattheyhavemorefunasaresultofattendingthelunchclub(PROXY:Estimationthatall attendastheyareenjoyingthemsleves
Survey(PROXY:stakeholderengagement) 1450 1
Averagespendongamesandhobbiesperannum 93
y p g2009Areportonthe2008LivingCostsandFoodSurvey2008 20% 0% 5% 0% 102,486.00
Receivingameal fromIcare Meal deliveredfromICare Social caredatabase 54116 1
Costofmeal tolunchclubattendee 3.20
CommunityMeals 0% 0% 5% 0% 164,512.64
Volunteers
Volunteersfeelthattheyarecontributingtotheserviceandhaveincreasedsatisfactioninheplingothers Minimumwagefor1h 64,895
Satisfactioninhelpingothers
Numberofvolunteerswhofeel theyaremakingadifference(PROXY:Estimate=Minimumof4perclub)
Volunteers Survey(PROXY:Stakeholderengagement) 208 1
Averageamountpeoplegivetocharityayear 110
InvestecPrivateBank 10% 0% 20% 0% 16,473.60
LeicestershireCountyCouncil
LCCpayforthecontracttoallowandsuppporttheservicetobeofferedatasubstidisedpriceleadingtoareductioninlongtermcarecosts
Contract,supportandsubsidy 497,145.17
Reductioninintensivesupportcosts
Reductioninprovisionofotheradultsocial careservice(PROXY:Numbers receivingadditional practical help) Social Caredatabase 9 1
Annual costofprovidinghomecare 5824
UnitCostsofHealthandSocial Care'2009,PSSRU 5% 0% 15% 0% 42,325.92
NHS
Theserviceimprovesthehealthofolder
peoplereducingcoststotheNHS
Reductioninthoseatriskofmalnutrition/dehydrationorpotential hospital admissions
Reductioninadmissions duetomalnutition(PROXY:Numberswhoreceivesupporttoeattheirmeal (15%))
NHSdata(PROXY:Social CareDatabase) 207 1
Additioncostoftreatingpatientswithmalnutri tion 1000
Guest,J.F.etal (2011)Healtheconomicimpactofmanagingpatientsfollowinga 5% 0% 15% 0% 167,152.50
1,568,436.97 3,322,462.81
CommunityMeals
(MealsonWheels)users
Lunchclubattendees
Stage4
Inputs TheOutcomes(whatchanges)
Friendlysocial contactonadailybasis
Family
Whatwouldhavehappenedwithout
Whatactivitywouldwedisplace?
Whoelsewouldcontributetothechange?
Wil l theoutcomedropoffinfutureyears?
Quantitytimes financial proxy,lessdeadweight,displacementandattribution
Whowill wehaveaneffecton?Whowill havean
Whatdowethinkwill changeforthem?
Whatwill theyinvest? Value Summaryofactivityinnumbers
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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
47
TheSocialReturnonInvestmentratioThissectionwillinclude:
Costofdelivery Afigurefortotalvalue,andthesocialreturnoninvestment
CostofdeliveryThecostofmanagementandadmintomanagetheserviceoverayearisapproximately42,000.Thecostofsubsidingmealsisapproximately260,000x1.43fordeliveredmealsand54,000x1.53forlunchclubmealstotallingapproximately458,000.Fig4.Inputscosts unitcost No.in10/11 TotalcostMealsdeliverysubsidy 1.43 260,383 372,347.69Lunchclubsubsidy 1.53 54,116 82,797.48Managerandadmin 42000 1 42,000.00Mealsathomeserviceusers 3.20 260383 833,225.60Lunchclubattendees 3.20 54116 173,171.20Volunteertime 6 10816 64,896 1,568,438
Thisgivesatotalinputofjustover1,500,000ayear.
ConsideringSignificanceTheimpactofsupporttoliveindependentlyiscomparablylow.Thisisperhapsexpectedastheprovidingpeoplewithpracticalhelpisnotconsideredtobeakeyofferofthemealsservice,anditisalsolikelythatsimplyprovidingmealshelpspeopletostayindependent.However,thereporthastakencarenottooverclaimimpactsoonlythosereceivingadditionalpracticalhelphavebeencountedasbeingmorelikelytoliveindependentlyduetotheservice.Researchdoessuggestthatlittlethingsliketakingbinsoutcanbeveryvaluabletoolderpeoplewantingtoretainindependenceintheirownhome,suggestingifthistypeofsupportwasofferedandrecordedmoreformallyaspartofthemealsdeliveryserviceitcouldpotentiallymaximisevalue.
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ForecastSROIofsupportingtheCommunityMealsServiceinLeicestershire
48
TotalvalueandsocialreturnoninvestmentTotalPresentValue(PV)
3,210,109.00
NetPresentValue(PVminustheinvestment)
1,641,672.03
SocialReturnper 2.05ThisgivesaSocialReturnof2.05forevery1investedinsupportingcommunitymeals.34%ofthevalueisachievedthroughoutcomesassociatedwithfamilymembers,21%forlunchclubusersand41%forthosereceivingmealsStakeholder TOTALValue(beforediscounting) %CommunityMeals(MealsonWheels)users
1,315,667.49 41
Family 1,091,138.75 34Lunchclubattendees
689,704.56 21
Volunteers 16,473.60 0.5LCC 42,325.92 1.3NHS 167,152.50 5.2
Theoutcomesthatcreatedthemostvalue(>100,000)were:
1. Receivingamealforserviceusers2. Peaceofmindforthefamily3. Feelingpartofthecommunityforlunchclubattendees4. Dailycontactforthos