Charting a new course for day centres in Central Bedfordshire

TLAP, in conversation with practitioners at Central Bedfordshire Council, looks at what's changed in relation to day opportunities as a result of the coronavirus pandemic and what has been learnt. This article expands on the case study first described in the recentTLAP report, The 3Rs of Social Care Reform

Pre-pandemic, the day centres operated by Central Bedfordshire Council were in a long-term transition. They were gradually shifting from a traditional day care offer, informed by engagement with regular attendees, unpaid carers and council staff, towards a more flexible, person-centred offer, less dependent on building-based services.  In recent years, fewer younger adults were attending day centres in Central Bedfordshire and much less frequently, seeking instead opportunities more in keeping with a purposeful life enriched with a variety and diversity of activity.  However, some people remained dependent on the day service.

The transition has been difficult to progress, not least because of the uncertainty of stepping away from the security offered by a familiar and reliable service. What might change mean to the person in their mid 40s that has spent much of their adult life in a day care setting? To parents, now in their 70s, worrying about the future of their son or daughter? To the staff who work there, many of whom have supported people to build relationships, acquire new skills and confidence over many years?

Covid-19 forced an overnight change

As the pandemic forced a suspension to services overnight, a rapid response from the council was necessary. The council was concerned that the closure of these services meant that there were people and unpaid carers receiving no support. Using a cohort of re-deployed staff, an alternative outreach service was quickly mobilised, which still continues. Feedback from the service was very positive, with personalised, weekly 1-2-1 visits to people’s homes being well received.

However, there was still concern that this outreach was only weekly, where some people would have accessed day provision more frequently. In order to provide additional support for people, and for unpaid carers - considered to be at most risk of breakdown without regular respite support - and in line with national guidance, the council decided to re-open some day care provision. This followed an extensive risk assessment of each building and putting measures in place to keep people safe.

For other people, a virtual day centre was started, both for older people and people with learning disabilities, providing a total of 21 hours activity per week. The online sessions were set up by the council, in response to a survey carried out during the first lockdown, when nearly a third of people said they would welcome the opportunity to participate in online activities. The online programme caters for adults of all ages and disability and offers a wide range of activities - whether it’s movement to music, joining in a cook along session, interactive storytelling or listening to an educational talk. The sessions proved to be really popular, both for the content and for building and maintaining friendship groups. Over time the council has seen people gain more confidence in their IT skills, motivation and their ability to participate in running some of the online sessions. 

The conditions enabled a measure of co-production; people ran programmes with staff, for example, hosting song requests and delivering a talk on Ramadan. Despite the physical distance of Zoom calls, a more supportive community has emerged with participants supporting and encouraging their peers to be more comfortable in using technology and celebrating successes. 

The learning from the pandemic is helping to shape thinking around the future of day centre provision at the council 

Questions that need to be resolved include; whether the virtual support should be rolled out more widely; how best to respond to challenges as people come out of lockdown with changing needs, particularly from unpaid carers who have previously relied on day-long services for their own well-being.  It is anticipated that this will lead to a mixture of both face-to-face and online support, building on feedback from those that have been involved over this period. The aim is to shift away from day care towards personalised choices, to make better use of the diversity of life opportunities outside the walls of a traditional day centre.

“We’ve been thinking, what’s the offer? Covid was a chance to throw it up in the air” Stuart Tripcony, Operations Manager, Central Bedfordshire Council

The council’s ability to lead change is in not waiting for the next emergency before tackling the tough stuff. Those drawing on care and support don’t have time to wait for systems, culture and behaviours to shift. Collectively, people who draw on social care need to direct their own solutions, properly supported by those in enabling roles across the public, private, voluntary and community sectors.