The Leeds Winter Warmth Campaign: Stakeholder Evaluation

Citation: Woodward, J and White, J and Kinsella, K and Giuntoli, G and Roexe, A (2013) The Leeds Winter Warmth Campaign: Stakeholder Evaluation. Project Report. Centre for Health Promotion Research, Leeds Metropolitan University. Link to Leeds Beckett Repository record: https://eprints.leedsbeckett.ac.uk/id/eprint/846/ Document Version: Monograph (Other) The aim of the Leeds Beckett Repository is to provide open access to our research, as required by funder policies and permitted by publishers and copyright law. The Leeds Beckett repository holds a wide range of publications, each of which has been checked for copyright and the relevant embargo period has been applied by the Research Services team. We operate on a standard take-down policy. If you are the author or publisher of an output and you would like it removed from the repository, please contact us and we will investigate on a case-by-case basis. Each thesis in the repository has been cleared where necessary by the author for third party copyright. If you would like a thesis to be removed from the repository or believe there is an issue with copyright, please contact us on openaccess@leedsbeckett.ac.uk and we will investigate on a case-by-case basis. The Leeds Winter Warmth Campaign: Stakeholder Evaluation Jenny Woodward Judy Whit e Karina Kinsella Gianfranco Giunt oli Anke Roexe Oct ober 2013 Healt h Toget her Cent re for Healt h Prom ot ion Research Leeds Met ropolit an Universit y E- m ail: j .whit e@leedsm et .ac.uk Acknowledgem ent s Our t hanks go t o all t he st akeholders who agreed t o give t heir t im e and be int erviewed for t his evaluat ion. I n addit ion, we are grat eful t o Leeds Cit y Council for com m issioning t his evaluat ion and sharing det ailed knowledge about t he schem e. 1 I nt roduct ion The Leeds Wint er Warm t h cam paign aim ed t o help vulnerable resident s keep warm during t he wint er of 2012/ 13. Over £500,000 of funds were ut ilised t o reach nearly 12,000 people ( Leeds Cit y Council, 2013) . A wide range of services were provided including inst alling new heat ing syst em s, giving advice on energy bills, providing em ergency overnight accom m odat ion for hom eless people and dist ribut ing cold- weat her packs t o older people. The wint er of 2012/ 13 was longer and colder t han usual; whilst t em perat ures were average in Decem ber, it was colder t han usual from January t hrough t o May. March was t he coldest it has been for 50 years ( Met Office, 2013) . This evaluat ion focuses on t he organisat ions funded by t he Wint er Warm t h cam paign t o deliver services t o Leeds resident s. The overriding aim of t he evaluat ion was t o inform t he operat ion of possible fut ure schem es, wit h good pract ices and any issues ident ified. The views of organisat ions on t he need for t he funds and how t he cam paign was organised were ascert ained. How t hey delivered t he services, reached client s and worked wit h ot her st akeholders is explored and t heir suggest ions for im provem ent s described. This report should be read alongside t he overall cam paign report , by Leeds Cit y Council, and t he beneficiary report . 2 2 The Leeds Wint er Warm t h m odel A n e t w or k of or ga n isa t ion s was set up t o deliver t he 2012/ 13 Wint er Warm t h Cam paign ( wit h funds of over £500,000) . At t he cent re of t his net work was Leeds Cit y Council ( LCC) who co- ordinat ed t he bidding process and dist ribut ed it t o 41 organisat ions. The fund cam e from 3 m ain sources – t he Depart m ent of Healt h Warm Hom es, Healt hy People schem e, NHS Leeds ( Public Healt h) and t he Depart m ent for Energy and Clim at e Change ( DECC) Fuel Povert y Fund. Two part icipat ing organisat ions also cont ribut ed. The organisat ions and t heir role in t he net work varied great ly. The five ‘m a j or st a k e h olde r s’ r e ce ive d fun ds dir e ct ly a n d w e r e cit yw ide in t h e ir r e a ch . Som e had been involved in t he bidding process along wit h LCC. Care & Repair repaired and inst alled new hot wat er and heat ing syst em s in people’s hom es whilst Groundwork Leeds offered energy efficiency support . The t wo Cit izens Advice Bureaus helped give advice t o householders regarding t heir bills and benefit s whilst St George’s Crypt assist ed hom eless people during t he cold weat her. Leeds Federat ed Housing provided sm all- scale energy efficiency and advice t o t heir m ost vulnerable t enant s ( t hey have over 4000 propert ies) . Leeds Com m unit y Foundat ion received over £60,000 from t he Warm Hom es Healt hy People fund and, along wit h funds t hey raised direct ly, dist ribut ed t hese t o 3 5 volun t a r y a n d com m u n it y se ct or or ga n isa t ion s. Funds were allocat ed via an applicat ion and vet t ing process wit h organisat ions receiving bet ween £250 and £3000. Those t hat received funds were oft en fairly sm all organisat ions t hat t ended t o focus on a specific populat ion – t his was oft en older people but groups support ing Black & Minorit y Et hnic ( BME) people and younger people were also included ( see overall report for a full list ) . The t ype of support offered t ended t o be fairly sm all- scale, for exam ple dist ribut ing em ergency cold weat her packs, m eals, helping wit h grit t ing and social event s. 3 3 Met hods Key st akeholders of t he Wint er Warm t h cam paign were int erviewed by t elephone bet ween July and Sept em ber 2013. The int erviews were sem i- st ruct ured and last ed approxim at ely 30 m inut es. Part icipant s were select ed from a list , prepared by Leeds Cit y Council, of organisat ions who had been involved in t he cam paign. All t hose who had received m oney direct ly from t he fund were int erviewed plus t wo who received funding via t he Leeds Com m unit y Foundat ion. See Table 1 for a list of part icipat ing organisat ions. Three different int erview schedules were prepared ( see appendix 1 for an exam ple) , which one was used for each part icipant depended upon t he role of t heir organisat ion. All pot ent ial part icipant s received a Part icipant I nform at ion Sheet , not ifying t hem t hat part icipat ion was volunt ary and t he inform at ion provided was anonym ous and confident ial ( appendix 2) . I f t hey agreed t o part icipat e t heir responses were recorded ( wit h perm ission) . The int erviews were t ranscribed in full and a t hem at ic analysis conduct ed, t o draw out key findings. The Leeds Met ropolit an Universit y et hics process was followed, wit h approval given in June. Ta ble 1 : Pa r t icipa t ing Or ga n isa t ion s Or ga n isa t ion N u m be r of I n t e r vie w Sch e du le I n t e r vie w s Care & Repair Groundwork 2 ( Green Doct or 1 Housing 1 Advice 1 schem e) Leeds Federat ed Version 1 – received funds direct ly Associat ion Chapelt own Cit izens Bureau Leeds Cit izens Advice Bureau 1 St George’s Crypt 1 Leeds Com m unit y Foundat ion 1 Version 2- dist ribut ed sm aller grant s Age UK 1 Version I gen 1 3 – received Com m unit y Foundat ion 4 funds via Leeds 4 Findings This sect ion will first explore t he need for t he schem e and it s perceived benefit s. I t will t hen invest igat e how t he m odel operat ed, how client s were reached and referrals bet ween organisat ions m ade. Any process issues will be explored before discussing point s t o consider and pot ent ial im provem ent s. 4 .1 W a s t h e r e a ne e d for t h e W in t e r W a r m t h sch e m e ? There was u n ive r sa l con se n su s of t he n e e d for a sch e m e t o help people in Leeds keep warm during t he wint er. Two key fact ors were driving t his; povert y, m ade worse by t he current financial clim at e, m eant m any people did not have enough m oney t o pay essent ial bills, including heat ing. Exacerbat ing t his was a lack of knowledge or know- how regarding how t o reduce t heir bills or claim benefit s t hey could be ent it led t o. The second key fact or is t he condit ion of t he housing st ock wit h m any hom es being under- insulat ed and poorly heat ed. I ndividual circum st ances were also relevant including being older, disabled or having poor healt h. One organisat ion described t he circum st ances t hat m ade t his issue part icularly pert inent in Leeds wit h it s st ock of older, solid wall houses; “ When you get people who rely on benefit s using pre- paym ent m et ers who are living in t herm al inefficient hom es, it ’s quit e a t oxic m ix.” Anot her organisat ion point ed out how subst ant ial t he issue of fuel povert y is locally am ongst older people; “ I know t here are 50,000 hom es in Leeds t hat are affect ed by fuel povert y … I also know t hat 40% of t hose are occupied by older people, and t hat ’s a lot . … Over 4 people a day die unnecessarily in Leeds from cold weat her relat ed deat hs and t hat ’s j ust unaccept able. … The ot her fact or is t hat Leeds has t he highest level of unclaim ed pension credit in t he count ry which m eans t hat a lot of older people are not claim ing t he benefit s t hey are ent it led t o … and t hey’re having t o m ake st ark choices about choosing whet her t o heat or eat and not bot h. I t ’s for t hat reason t hat we t hought it was im port ant .” A h igh le ve l of de m a n d for t h e ir se r vice s was cit ed by nearly all t he part icipant s, wit h m ost saying t hat whilst t hey had helped m any people, if t hey had m ore t im e and resources, t hey could have helped m ore; “ There were m ore people t hat needed help t hat we could get t o…. We could have carried on doing t hat work for a long t im e; I t hink t here’s at least 6 m ont hs work t here for a full t im e worker.” 5 “ The dem and t hat we had for t hat ( em ergency food packs and parcels) was m assively m ore t han we were able t o m eet from t he funding t hat was available.” “ We had a t arget , we m et t he t arget but in t erm s of t he dem and no we st ill have people on t he list … we were so inundat ed wit h referrals t hat we didn’t need t o publicise t he service anym ore.” Som e organisat ions felt t hey were offe r in g insu fficie n t h e lp given t he scale of t he need; “ The t hings t hat we did were j ust scrat ching t he surface.” “ I t helps absolut ely but it is m ore of a st icking plast er.” Only one organisat ion experienced less dem and t han expect ed. They had dist ribut ed inform at ion packs on energy bills wit h t he expect at ion t hat recipient s would t hen arrange one- t o- one advice sessions. Less had done so t han expect ed but reasons for t his were unclear – it could have been t hat t he inform at ion packs were sufficient by t hem selves or t hat a face- t o–face approach t o arrange appoint m ent s was needed. 4 .2 Ou t com e s for or ga n isa t ion s a n d clie n t s As described in t he overall report a num ber of different services were delivered by t he organisat ions involved - t he nat ure of t he benefit s experienced will t herefore be varied. This sect ion will describe som e of t he direct and indirect benefit s as perceived by part icipant s. How did t he organisat ions benefit from t he schem e?  The profile of fuel povert y was raised wit hin t he cit y.  The profile of t heir organisat ion was raised am ongst m em bers of t he public and ot her com m unit y or governm ent organisat ions in Leeds.  I t helped t he organisat ions t hem selves t o con solida t e t h e ir k now le dge on fuel povert y.  I t h e lpe d bu ild t r u st a nd im pr ove ‘r e a ch ’ by providing a reason t o int eract wit h people who m ay norm ally be difficult t o engage wit h. o A housing associat ion felt t heir relat ionship wit h t heir t enant s im proved; “ We gained from our t enant s underst anding t hat we’re t rying t o deliver and being seen t o deliver. Talk is cheap so t he fact t hat we were out t here in t he m iddle of wint er wit h snow up t o our ankles and we were t rying t o engage people, I t hink it m ade t hem realise t hat ( organisat ion nam e) do care about us and we’re t rying t o do t hings.” 6 o Anot her organisat ion said; “ it enables us t o m eet t hose people .. t hey can build t rust and realise not all services are out t o get t hem .” o An older person’s organisat ion gave an exam ple of m aking cont act wit h an older person who had not previously wished t o engage – he had asked for an em ergency cold- weat her pack and t hey were now in regular cont act helping organise daily care.  I t enabled organisat ions t o w or k m or e close ly w it h ot h e r pa r t n e r s a n d bu ild u p loca l conn e ct ion s. This had pot ent ially long- t erm effect s.  I m pr ove d sk ills a n d e m ploym e n t . The fund had led t o t wo organisat ions em ploying previously unem ployed people for a short am ount of t im e. All t hese individuals ( four in t ot al) gained paid- em ploym ent aft erwards due t o t he experience and skills t hey had gained; “ They were unem ployed init ially, t hey were volunt eers here and from t hat work t hey have m oved ont o paid em ploym ent … it skilled t hem up and also gave us good reason t o give a reference … so when t hey went t o int erviews t hey were pret t y sharp. They bot h got work from it .” How did t he client s1 benefit from t he schem e? This st akeholder evaluat ion did not direct ly com m unicat e wit h beneficiaries – please refer t o t he accom panying report for t his perspect ive. However organisat ions ident ified a num ber of perceived benefit s for t hem based on t heir experience of delivery. “W a r m e r h om e s t ha t a r e che a pe r t o h e a t ” was t he m ost com m on direct benefit but a num ber of indirect benefit s, described below, were also ident ified. I m pr ove d h e a lt h :  Less cases of people get t ing ill / being adm it t ed t o hospit al.  I m proved safet y from servicing of appliances such as boilers and gas heat ers. Less chance of carbon m onoxide poisoning.  Reduced st ress and anxiet y; “ We t ook t hat st ress and pressure away from t hem and t hey’re going int o t his wint er now knowing t hat t heir appliances are safe and t heir propert ies are going t o be warm .”  People feeling t hey are support ed; “ t hat act ually som eone’s willing t o help t hem wit h t his.” I m pr ove d socia l a spe ct s:  Children being warm er at hom e so t hey can do t heir hom ework and engage bet t er at school.  Fam ilies not having t o m ove due t o reasons of affordabilit y. 1 The terms clients and beneficiaries are used inter-changeably in this report 7  Helping older people get out of t heir hom es and m eet ot hers; “ if you speak t o t hose older people t hat m ay be t he only t im e t hey get out of t heir own hom e or get t o see som ebody else and we would never underest im at e t he im pact t hat social cont act can have on som ebody t hat doesn’t get it ot herwise.” I m pr ove d fina n ce s:  Aft er being given advice client s im proved t heir incom e eit her by swit ching energy providers or claim ing benefit s t hey were ent it led t o. One advice bureau saw over 150 client s in t he t im e period, wit h an average im provem ent of incom e of £34 per week. The fact t hat organisat ions co- or din a t e d t he w or k on behalf of client s was im port ant ; “ t hey didn’t have t he hassle of t rying t o find a cont ract or, being unsure whet her t his cont ract or was legit im at e.” Organisat ions t hanked t he providers of t he fund; “ What a difference it ’s m ade t o t he lives of older, disabled and people on low incom e and people wit h healt h condit ions t hat m aybe ot herwise would have been unable t o do t hat work t hem selves. Financially t hey wouldn’t have been able t o finance t he work and som e of t hem , physically wouldn’t have had t he knowledge, t he st rengt h t o go t hrough t hat process on t heir own.” 4 .3 Be n e fit s a n d pot e n t ia l dow n side s of t h e m ode l u se d What were t he benefit s of t his approach? A key benefit of using exist ing organisat ions m eant t hey were r e a dy t o pr oce e d ope r a t iona lly a t sh or t n ot ice . Once funds were agreed t hey could provide services quickly due t o t heir exist ing infrast ruct ure, cont act s and expert ise. “ We are a well- est ablished organisat ion t hat has all t he m ain m echanics in place t o be able t o spend t hat kind of funding and we’ve got t he right cont act s and t he right t ype of client ele. We’re able t o publicise quickly, provide our services and any new services t hat com e around.” As t he organisat ions had exist ing links in t he com m unit y and expert ise in working wit h t he t arget populat ion t he schem e could r a pidly r e a ch pot e n t ia lly vu lne r a ble pe ople ( see 4.4 for m ore det ail) . They were already known t o people “ an est ablished brand” and organisat ions were able t o incorporat e it int o t heir norm al work as part of t heir “ regular conversat ion” ; “ A num ber of our services have got regular cont act wit h older people so we’re oft en in cont act wit h people. … We had an alert syst em where all of t he st aff were briefed t o be looking out for older people t hat m ay be experiencing hardship during colder weat her.” Organisat ions were confident t hat t hey could deliver, m any em phasised t hat t his work was a ‘good fit ’ wit h what t hey already do; “ I t ’s what we do, it ’s in our charit able obj ect ives and it really is our business.” 8 St akeholders em phasised t hat t hey had a good r e pu t a t ion and t here were high le ve ls of t r u st bot h bet ween t hem selves, t he ot her part ners and LCC –t hey were t herefore able t o work t oget her in a posit ive, const ruct ive way; “ I t hink we have a good reput at ion. We’ve got a long hist ory of delivering all sort s of proj ect s and in t his area we had a really fine exam ple of work t hat we’d done on fuel povert y before.” “ I also have a relat ionship wit h ( LCC) t hat t hey t rust what we’re saying and t hink act ually t hese guys can do t his.” The fact t hey had already worked wit h t he ot her part ners ( e.g. during energy saving week) , m eant t hey were a ble t o co- or dina t e t he ir a ct ivit ie s a nd r e fe r clie n t s bet ween t hem selves for ext ra help or support . One organisat ion described how t he m aj or st akeholders had discussed t he need t o work t oget her m ore closely in t he fut ure and refer client s bet ween t hem selves for appropriat e help; “ That was a benefit of knowing each ot her and being relat ively sm all.” Are t here any downsides t o t his approach? Ut ilising a net work of exist ing organisat ions does raise t he possibilit y of t here eit her being gaps in provision or duplicat ion of services. How easy it is for m em bers of t he public t o underst and t he roles of t he different organisat ions involved also needs considerat ion. Pot e n t ia l ga ps in pr ovision ident ified by part icipant s were:  Regist ered social landlords ( ot her t han t he one part icipant ) .  Fam ilies wit h young children – it was agreed t hat older people are especially vulnerable and do need t he m aj orit y of assist ance but fam ilies could also require help; “ I f you look at t he list of organisat ions funded t hen t he m aj orit y is t owards older people groups so t here could be an argum ent t o say t here’s perhaps an area t hat wasn’t t apped int o as m uch as m ay have been possible around t he fam ilies and young children…” Pot e n t ia l du plica t ion of se r vice s. This issue was not raised direct ly by part icipant s but advice on benefit s and bills was provided by m ore t han one of t he m aj or st akeholders –t he CABs specialised in t his area but ot hers also carried out checks when t hey first m et client s. Leeds Com m unit y Foundat ion had recognised t his as a pot ent ial area of overlap so sm all grant s were not available for advice giving via t heir program m e. A num ber of local organisat ions provided em ergency warm weat her equipm ent so again, t here is a pot ent ial for overlap, but t his could have been avoided due t o t he fact t hat t hey t ended t o cover discreet geographical areas or com m unit ies. One part icipant raised t he possibilit y t hat m em bers of t he public m ay get confused as t o what each st akeholder did – however, how significant t his is can only be ascert ained by asking client s direct ly; 9 “ I t hink for a client t o m aybe go t hrough t he whole schem e as it were on m aybe one cent ral referral form would be really good … t hey could m aybe t hen t ap int o help from t he ot her organisat ions m ore seam lessly.” A final point t o m ake is t hat t his research only int erviewed organisat ions who had successfully received som e level of funding. Many em phasised t heir posit ive relat ionship bot h wit h LCC and t he ot her part ners and how t his helped m ake t he process work very sm oot hly. As one part icipant put it ; “ I would say well it was easy for m e but if I hadn’t got t hose relat ionships t hen I m ight be singing a different t une.” A pot ent ial downside of t his is t hat new organisat ions, t hose who are unaware of t he schem e or wit hout exist ing relat ionships m ay find it m ore difficult t o becom e involved as a m aj or st akeholder. One solut ion t o t his was t he provision of sm aller grant s publicised and m anaged by t he Leeds Com m unit y Foundat ion – t his was open t o organisat ions across t he cit y. A Poin t t o Con side r :  How t o ensure new organisat ions can get involved in t he schem e, whilst m aint aining t he posit ive working relat ionship bet ween part ners. Too m any key st akeholders m ay result in t he part nership becom ing m ore difficult t o m anage, t oo few and coverage m ay be reduced. 4 .4 Re a ch in g clie n t s How did t he st akeholders reach m em bers of t he public? Organisat ions used e x ist in g con t a ct s a n d st r u ct u r e s t o reach client s – nearly all said t his was a relat ively easily process and som et hing t hey were used t o doing. Exam ples include; t he Cit izen Advice Bureaus having offices cit ywide, t he older people associat ion having t eam s visit ing vulnerable resident s and t he housing associat ion who have 4000 t enant s in t he region. Many of t he sm aller organisat ions run groups or drop- in cent res for vulnerable people. Exam ples of pr o- a ct ive ou t r e a ch w or k em erged. One organisat ion visit ed GP services and children’s cent res and ut ilised t heir m ent al healt h out reach t eam . Anot her organisat ion had a part icularly successful approach involving visit ing prim ary schools t o t arget parent s and carers – t hey worked closely wit h t he fam ily support workers t o ident ify vulnerable households; “ We t hink t hat schools, especially schools in areas of high econom ic deprivat ion, are probably hubs of fam ilies where we can go t o t he schools and t alk t o t he fam ily support workers or even t he t eachers, t hey will direct t he referrals t o us. I t ’s basically easy pickings, it ’s not difficult t o get t he work and we were quit e right in t hat .” 10 Their only not e of caut ion was t o ensure t hat t he hierarchy of t he school were involved at t he st art t o avoid any pot ent ial t ension – in one school an awkward sit uat ion developed as t he head- t eacher had not been fully consult ed. Lin k in g w it h ot he r com m u n it y or n e ighbou r h ood or ga n isa t ion s worked well. I n t he exam ple above fam ily support workers knew who t he vulnerable fam ilies were and were t rust ed by t hem , m aking cont act easier and m ore fruit ful. Ot her exam ples include working wit h neighbourhood net works and Healt h Cham pions. The rough sleepers’ hub had benefit ed from t he st reet out reach t eam direct ing people t o t hem . Were vulnerable m em bers of t he public reached? Defining vulnerabilit y is challenging – people could be vulnerable t o cold weat her due t o t heir age, t heir housing sit uat ion, t heir incom e or ot her personal circum st ances; “ t o us … it ’s im port ant t hat t here’s a wider definit ion of who’s vulnerable rat her t han j ust on age” . Running t hrough t his m odel is a desire t o t arget t hose adversely affect ed by cold weat her – how explicit ly t his is st at ed and applied however varies. Som e organisat ions used spe cific e n t it le m e n t cr it e r ia . These included t he key st akeholders who t ended t o be delivering t he m ost subst ant ial support i.e. inst alling new heat ing syst em s or insulat ion. “ Well obviously t he m ain t arget group is poor people in fuel povert y so we t end t o work wit h and t ry t o t arget t he m ost vulnerable groups so people t hat are elderly, people wit h young children, people wit h disabilit ies or long t erm healt h condit ions and people on low- incom es … below £21,000.” “ We work wit h older, disabled people and people on low incom es, t hat ’s our client group.” There was som e desire t o allow people wit h som e savings t o cont ribut e t o t he work and t hus free up t he process of ensuring ent it lem ent . Sim ilarly, t he Leeds Com m unit y Foundat ion asked organisat ions applying for funding ( sm all VCSO) t o define which vulnerable populat ions t hey would be working wit h and what work t hey would be doing. Who received funding was agreed by a panel consist ing of t hem selves, t he NHS and LCC. The housing associat ion priorit ised people living in t he worst propert ies “ t he m ost t herm ally inefficient .” Ta r ge t e d ou t r e a ch was used by ot her organisat ions t o reach vulnerable people. Their crit eria for which people t o help were less explicit but by t he nat ure of where t hey were based and t he com m unit ies t hey int eract ed wit h, vulnerable people were reached. The support offered t ended t o be sm aller scale. One organisat ion, for exam ple, t arget ed t heir out reach work in t he m ost deprived areas; 11 “ By t he nat ure of our client base, we will have reached a lot of low incom e deprived backgrounds.” Sim ilarly, m any of t he sm all grant recipient s worked wit h com m unit ies likely t o be vulnerable e.g. older people, BME com m unit ies who do not speak English or even wom en asylum seekers. Only one organisat ion accept ed all- com ers during t he cold weat her - t his was t he rough sleepers’ hub. Given t heir rem it it is likely t hat all client s were vulnerable; “ The crit eria at t hat t im e of year is basically anyone who t urns up, when it ’s a severe weat her prot ocol we don’t really ask t he sam e sort s of quest ions about whet her t hey’ve got a t em perat ure or anyt hing like. We j ust t ake whoever com es t o t he door.” Organisat ions t herefore clearly t arget ed t hose t hey perceived as vulnerable or in need. Most were reluct ant t o say t hat t hey were t he ‘m ost needy’ or t hat t hey had reached everybody but all felt t hat t hose t hey accessed were in need of help or advice at t hat t im e. “ I wouldn’t say t hat we m et everybody in need because in t rut h you’ll never do t hat .” I n sum m a r y, t h e pe ople r e a che d w e r e a ll vu ln e r a ble . H ow e ve r , t h a t doe s n ot m e a n a ll vu ln e r a ble pe ople w e r e r e a ch e d. Were t here any barriers t o reaching m em bers of t he public? Barriers t o reaching som e com m unit ies em erged for t wo organisat ions. The housing associat ion init ially found it difficu lt t o e nga ge wit h t heir t enant s; “ I t was very hard, even for us, t o act ually get t he appoint m ent s and get t ing t hrough people’s doors. … I t was very difficult t o get it going, it sort of got word of m out h and it developed from t here. ( I t was) really, really hard work.” They felt t his barrier was part ly due t o t he t ype of com m unit ies t hey were t rying t o engage wit h, wit h m ore affluent populat ions som et im es being m ore recept ive. The organisat ion who dist ribut ed t he inform at ion packs reflect ed t hat som e client s m ay la ck t h e sk ills t o be able t o use t hem on t heir own – som e st ruggled wit h lit eracy, ot hers did not speak English; “ I t ( t he inform at ion pack) was really clear and well writ t en but t hen it kind of assum ed t hat t hey were able t o use t he inform at ion in t hat t o m ake t heir sit uat ion bet t er t hem selves. We know t hrough all t he proj ect s and advice we give here t here’s a proport ion of client s who would st ruggle wit h t hat . … A lot of t hose client s t end t o be eit her not speaking English or t heir English isn’t so good.” Fact ors for successfully reaching com m unit ies were ident ified as:  En su r ing a cce ssible in for m a t ion for people who m ay have difficult y wit h lit eracy, num eracy or speaking English.  En ga ging w it h pe ople fa ce t o fa ce , in preference t o social or m arket ing m edia; 12 “ I t ’s not about using social m edia, it ’s not about m ail shot s, it ’s not about SMS t ext ing. What it ’s about is get t ing out t here, knocking on doors and t alking t o people.”  Or ga n isa t iona l com m it m e n t ; “ what m ade it work well was t he com m it m ent from ( t he organisat ion) t o get out t here and m ake it work.” A Poin t t o Con side r :  How t o ensure all vulnerable people are reached – part icularly if t hey m ay not be in t ouch wit h t he volunt ary and com m unit y sect or. Can ot her LCC organisat ions, such as schools, be ut ilised? 4 .5 Re fe r r in g be n e ficia r ie s Were client s referred bet ween organisat ions? I t was recognised by m any key st akeholders t hat referring bet ween organisat ions was vit al in order t o ensure t he best out com es for client s; “ What ’s t he point of m e or m y st aff m aking sure everybody has got as m uch benefit as t hey’re ent it led t o, if t hat m oney is going out of t he window via t he heat because t hat hom e is not insulat ed properly.” Re fe r r in g be t w e e n pa r t ne r s was in evidence from all part icipant s; “ Because t hey were part ners in t he proj ect we were alert t o what t hey could offer as well so point ed people in t heir direct ion and m ade referrals where necessary.” “ There’s a bit of a part nership going on in t erm s of referrals which is what we aim ed it t o be.” St akeholders bot h r e fe r r e d w it h in t h e ir ow n or ga n isa t ion s ( e.g. t he advice bureaus would refer t o t heir debt advice t eam ) if appropriat e and t o ot h e r e x t e r n a l pa r t ie s such as Wrap Up Leeds, energy com panies, t he benefit s agency and t he fire service. One part icipant felt t hat even great er part nership work should be welcom ed. They felt referrals needed t o be a m ore st rat egic part of t he schem e and pot ent ially include a web- based appoint m ent s syst em . Just giving a num ber for people t o call was felt t o be insufficient ; “ Som et hing t ight er t han giving som ebody a num ber and expect ing t hem t o ring, it ’s quit e difficult for people t o m ake t hat st ep som et im es even if t he know it ’s going t o benefit t hem .” A Poin t t o Con side r :  How t o ensure client s are aware of all t he services available t o t hem , wit hout confusing t hem or reducing t he num ber of ent ry point s int o t he schem e. 13 4 .6 Pr oce ss a n d logist ics How well did t he process work? As key part ners, som e st akeholders had been involved in t he bidding process along wit h LCC. Everyone involved in t he schem e felt it was a sim ple process wit h clear obj ect ives - feedback was generally very posit ive. Part icipant s felt it t ied int o what t hey did anyhow allowing t hem t o use t heir expert ise posit ively; “ I t hink for us it was a relat ively easy process … t he support we got from t he council and t he NHS was very helpful … t hey were very flexible in t erm s of sit t ing down and going t hrough t he applicat ions … and m aking it as efficient as we could do.” Were t here any issues? The m ain issue raised by nearly all t he part icipant s was t hat of t im ing – confirm at ion of t he fund arrived lat e causing increased st ress and pressure plus it t ook longer t o deliver services t o client s; “ I t was quit e a t ight t im e- scale in t erm s of t he am ount of work we had t o do… it was a bit of a st ruggle and in t he end we needed t o get m ore cont ract ors in because we act ually got m ore funding t his year.” “ We were j ust absolut ely run off our feet .” “ ( I t ) t akes a t oll on m anagem ent and supervision t im e which act ually we hadn’t budget ed for.” One organisat ion felt t he t im ing was im proved from t he previous year but st ill agreed t hat bringing it forward would be advant ageous. Many part icipant s were clearly frust rat ed and called for great er forward planning – t hey acknowledged it was not t he fault of LCC but t he m ain funding bodies; “ I f you’re going t o do t his, plan it properly, st art t he planning in t he spring … t hen we can hit t he ground in Oct ober when it st art s t o get colder and people st art t hinking of fuel. … We said we should be ready for it t his t im e .. ” “ I don’t t hink t he council could have done anyt hing bet t er, I t hink NHS England 2 could have.” One organisat ion discussed pot ent ially planning in advance as a part nership; “ Perhaps we can plan it ourselves, we don’t need t o be prom pt ed by t he NHS cent rally, and we should know t hat m oney m ight be com ing. Alt hough we m ight not know how m uch, but we should have an idea of how we want t o spend it and what we can do wit h it before t he act ual form s com e out .” Suggest ions regarding t he ideal t im ings varied. Som e felt t he fund should be available all year round as t hat would enable bet t er planning and result in less confusion for client s; “ it get s very confusing for client s because one m inut e t he 2 The Department of Health 14 service is here and t he next m inut e you’re having t o t ell people t hat it ’s all spent up” . Ot hers felt it should all be agreed by early Decem ber for delivery t o st art by Christ m as. One part icipant felt t he fund should run int o t he spring as t his is when bills from t he wint er arrived. A second, less universal, issue raised was ca sh- flow . A few organisat ions m ent ioned t hat having t o invoice t he council and t hen wait for paym ent could cause difficult ies; “ There was som e issue wit h get t ing t he funding as a lot of t he organisat ions involved including ours are charit ies so we need t o get t he funding upfront .” A Poin t t o Con side r :  How t o prepare for a new schem e – wit hout knowing t he size or t im ing of t he fund. 4 .7 Fu t u r e im pr ove m e n t s Should t he schem e be cont inued? All part icipant s were adam ant t hat t he schem e should be cont inued in t he fut ure – it was felt t hat t he need for assist ance would rem ain and t hat t he schem e had been an effect ive way of help Leeds people. “ Cert ainly t here’s a need t here and t hat need is unlikely t o have disappeared. I n fact , wit h t he changes t hat are happening in t he benefit s syst em and j ust generally econom ically, t here’s likely t o be m ore people perhaps who need t hat t ype of support .” “ I t hink it ’s so im port ant t hat we have som et hing like t his and congrat ulat ions t o Leeds Cit y Council and t he healt hcare t rust for t hinking of it . I t really is im port ant and it ’s not a problem t hat ’s going t o go quickly. We’re going t o have high bills, poor insulat ion in cert ain houses and t hings like t hat so it ’s going t o cont inue. So, I t hink we do need it again and we’d been cert ainly ent husiast ic t o be part of it again, I ’m quit e sure of t hat .” What im provem ent s were suggest ed? Three key areas of im provem ent s were suggest ed, as follows: Ex t e nding t h e sch e m e t o t he following organisat ions:  More landlords – specifically social housing and ALMO’s.  Those working wit h children and young people.  More local organisat ions t hat work on t he ground. 15 I m pr ove d co- or dina t ion bet ween part ners. A way of ‘j oining t oget her’ t he needs of a client so if t hey, for exam ple, at t ended for benefit s advice, t heir needs for ot her services e.g. insulat ion, was checked and t hey were referred for an appoint m ent . A cent ral hub was suggest ed by one part icipant . Finally, w ide r disse m in a t ion of t h e r e su lt s of t he schem e was suggest ed; “ The final report perhaps could have m ade bigger news, I t hink it was a really good proj ect and it could have m ade bigger news. I t hink it j ust went t o t he affordable Warm t h Part nership and t he councillor in charge of environm ent and t he depart m ent of healt h and I j ust t hought it m ay have been wort h a press release, som e news around it .” 16 5 Conclusions and Recom m endat ions This evaluat ion, conduct ed by Healt h Toget her at Leeds Met ropolit an Universit y, involved int erviewing t en st akeholders from t he Leeds Wint er Warm t h Cam paign 2012/ 13. There was universal consensus of t he need for such a schem e due t o povert y, low incom e and a st ock of fuel inefficient houses. A high level of dem and for t he services provided was experienced - given great er t im e and resources m ore people could have been helped. Organisat ions benefit ed by t he profile of fuel povert y being raised wit hin t he cit y, it helped t hem m ake cont act wit h m em bers of t he public, im proved t heir relat ionships wit h ot her part ners and led t o increased skills and em ploym ent . Organisat ions felt t hat client s gained from im proved healt h, safet y and reduced st ress and anxiet y. I m proved st abilit y for children and fam ilies was not ed and older people gained social cont act . The Leeds Wint er Warm t h Cam paign for 2012/ 13 ut ilised a relat ively com plex m odel of delivery involving a wide variet y of volunt ary and com m unit y sect or organisat ions. Som e were cit ywide in t heir delivery, ot hers very localised. Som e had very explicit crit eria, ot hers less so. The support offered varied from relat ively cost ly, e.g. inst alling a new heat ing syst em t o m ore sm all- scale help such as grit t ing an older person’s pat h. This m odel had m any advant ages – it t apped int o exist ing expert ise, m eaning services could be delivered rapidly wit h lit t le st art up t im e. Most im port ant ly however it ensured t hat t he cam paign reached m any vulnerable people by working wit h organisat ions who had cont act s in t heir com m unit ies and were t rust ed by t hem . Pot ent ial downsides include gaps or overlap in provision. Vulnerable m em bers of t he public were reached by organisat ions using exist ing cont act s and infrast ruct ure and doing pro- act ive out reach work. Working wit h ot her personnel and organisat ions e.g. healt h cham pions, neighbourhood net works and fam ily support workers in schools was part icularly successful. Face t o face cont act and using accessible language were im port ant . Whilst all t he people reached were felt t o be vulnerable in som e way, not all vulnerable people were necessarily reached. Referring client s bet ween part icipat ing organisat ions was ident ified as crit ical in ensuring t hey received t he m ost appropriat e support – organisat ions referred int ernally, bet ween part ners and t o ext ernal bodies. Making t his m ore int egral t o 17 t he m odel and m ore co- ordinat ed was ident ified as a pot ent ial area for im provem ent . Process- wise t he schem e operat ed very sm oot hly and received m uch posit ive feedback. The key area for im provem ent was a longer t im e t o prepare for t he wint er m ont hs. Support for a fut ure sim ilar schem e was universal. Recom m endat ions St r a t e gic Le ve l  Funds t o enable sim ilar schem es t o t ake place in fort hcom ing wint ers, across England, should be m ade available.  Dissem inat e t he m odel ut ilised in Leeds as a way of effect ively reaching a wide range of vulnerable people and rapidly delivering int ervent ions.  Em brace a wide definit ion of who is vulnerable t o being cold in wint er – including t he elderly, t hose wit h healt h concerns, t hose on a low incom e ( including fam ilies) and t hose who m ay not be able t o access inform at ion.  Link int o ot her healt h and wellbeing and social- care agendas, part icularly for older people. Wint er warm t h int ervent ions can pot ent ially help prevent social isolat ion, accident s and m alnut rit ion. Loca l / Or ga n isa t ion a l Le ve l  A concert ed effort t o repeat a sim ilar schem e in fort hcom ing wint ers should be m ade. The Model / Net work of Organisat ions  Ut ilise a sim ilar delivery m odel consist ing of a net work of local organisat ions– t his helps ensure t here is reach int o a variet y of com m unit ies, can be m obilised rapidly and aids referrals.  There needs t o be scope for new, or less known, organisat ions t o becom e involved t hat m ay be able t o offer access t o different com m unit ies t o services.  Maint ain m ult iple ent ry point s int o t he schem e via t he net work of sm aller organisat ions. This helps ensure m axim um reach.  Build in m ore planning t im e – t his will ensure organisat ions are able t o m anage and operat e t he schem e m ore effect ively, it will also result in less confusion for m em bers of t he public. Reaching vulnerable people  Ensure vulnerable groups or individuals, organisat ions, and are also reached. not represent ed by exist ing  Allow t here t o be professional j udgem ent from organisat ions on who fit s t he crit eria. 18  Use face t o face cont act and accessible language t o reduce barriers t o ent ry – pot ent ially alongside ot her m et hods including social m edia.  Consider involving organisat ions such as schools, t he healt h service ( prim ary and secondary care) and ot hers.  Consider a cent ral way for client s t o access t he range of services – but as a supplem ent , not a replacem ent t o t he use of t he VCSO. I m proving referrals  Encourage close working bet ween part ners.  Ensure organisat ions are aware of every part ner’s offer so client s receive a package of care – not j ust one elem ent .  Make referrals ont o ot her part ners or agencies a cent ral part of service delivery am ongst t he ‘people on t he ground.’ 19 Appendix 1 I n t e r vie w Sch e du le V1 : Pr oj e ct s w ho r e ce ive d fu nds dir e ct ly fr om LCC Pr e pa r a t ion Researcher t o read report prepared by LCC so aware of what organisat ions spent t heir allocat ed m oney on Pr e - a m ble Hi, m y nam e’s ( nam e) . I ’m a researcher from t he CHPR at Leeds Met ropolit an Universit y and we’ve been asked by Leeds Cit y Council t o evaluat e t he Leeds Warm Hom es Healt hy People Fund. We’re current ly int erviewing organisat ions t hat received m oney from t his fund in order t o find out t heir opinion of t he schem e and how it m ight be im proved. Check:  Part icipant s have received an inform at ion sheet – t hat t hey’ve read it and underst ood it and are happy t o proceed  Go t hrough t he consent form wit h t hem  Okay being recorded Capt ure:  Nam e of int erviewee and t heir posit ion in t he organisat ion Se ct ion A: M ot iva t ion for a pplyin g a n d pr oce ss First I ’d like t o find out a lit t le bit m ore about your organisat ion and how you got involved in t he WHHP fund. A1. ( keep t erm s of…  What  What  What t his brief! ) Could you t ell m e a lit t le bit about your organisat ion in your aim s are? area you cover? groups of people you m ainly work wit h? A2 . H ow did you r or ga n isa t ion ge t involve d w it h t he W H H P fun d?  Was your organisat ion involved in shaping how t he ‘bid’ was delivered? A3 . W h y did you t h ink you r or ga n isa t ion w a s a suit a ble ca n dida t e for t he fu nd? A4 . W a s t he pr oce ss of r e ce iving t h e fu nds fa ir ly st r a ight for w a r d or n ot ?  Could it have been im proved at all? A5. Did you receive enough t raining and inform at ion?  I f no, what would you have liked t o receive? Se ct ion B: Act ivit ie s D e live r e d I ’m now going t o ask about how t he fund m onies was spent by your organisat ion B1 . W h a t a ct ivit ie s w e r e you a ble t o de live r ba se d on r e ce ivin g t h e fund?  Was t his a new program m e or expanding an exist ing one? B2. How did you organise t he delivery of t he act ivit ies? 20 B3 . D id you r e fe r t o ot h e r a ge ncie s a t a ll?  I f yes, why? How responsive were t hey?  I f no, what were t he barriers for referring on? B4 . D id a ny issu e s a r ise w h e n de live r in g t h e a ssist a n ce ?  I f yes, what were t hese? B5. Did everyt hing go as planned or did you have t o m ake any changes during im plem ent at ion?  I f changes had t o be m ade - why and what were t hey? Se ct ion C: Re cipie n t s C1 . H ow did you se le ct w ho r e ce ive d a ssist a n ce ?  W e r e t h e r e a ny se le ct ion cr it e r ia ?  W a s t h e r e a pr oce ss pe ople h a d t o follow ? C2 . W e r e m ost r e cipie n t s k now n t o you a lr e a dy or did you m a k e a n y ne w cont a ct s?  I f yes, how did you do t his? C3 . Look ing ba ck , do you t h in k t h e pe ople w ho m ost n e e de d h e lp w e r e r e a che d?  W e r e t h e r e a ny gr ou ps of pe ople t h a t n e e de d h e lp bu t did n ot r e ce ive it ? I f so, w hy? C4. Was your organisat ion able t o m eet dem and?  I f no, why not ? Unprom pt ed first t hen - Lack of funds? Lack of capacit y t o deliver? C5. Looking back would you change anyt hing in t erm s of how your organisat ion delivered t he fund or how recipient s were select ed? Se ct ion D : I m pa ct / Ou t com e s for t h e or ga n isa t ion I ’m now going t o ask you about t he benefit s of being involved wit h t he WHHP fund. D 1 . W ha t do you t h in k t h e pe ople you a ssist e d ga in e d fr om t h e W H H P fu nd?  Unprom pt ed – in general  Prom pt ed - in t erm s of healt h and wellbeing D2. Do you t hink t he people who received help were sat isfied or not wit h t he service t hey received?  Did anyone raise any issues or concerns? D 3 . W ha t h a s your or ga n isa t ion ga in e d fr om r e ce ivin g t h e funds?  Has it helped develop any fut ure work/ st rengt hened part nerships?  Are you working different ly? D4. Did your organisat ion achieve what you originally hoped? Se ct ion E: Ge n e r a l com m e n t s on t h e m ode l a nd r e com m e nda t ion s E1 . D o you t h in k t h is m ode l of de live r in g t h e fu n d w a s e ffe ct ive ? o I f yes, what m ade it work well? o I f no, why was t hat ? E2 . D id t he su ppor t com e a t t he r igh t t im e ? 21 E3 . Th ink in g cit y- w ide , do you t h in k t h e fu n d r e a ch e d t he r igh t or ga n isa t ion s a n d t he r igh t pe ople ?  Probe – were t here any ‘gaps’ in support ? Any organisat ions who should also have received support ? E5. Do you t hink t he fund should be repeat ed in t he fut ure? E6. I s t here anyt hing t o do wit h t he fund t hat could have been im proved or you’d like t o feedback t o Leeds Cit y Council? 22 Appendix 2 Eva lua t ion of t h e Le e ds W a r m H om e s, H e a lt hy Pe ople Fun d Pa r t icipa nt I n for m a t ion Sh e e t Please read t his leaflet carefully. Please ask if you do not underst and or would like any m ore inform at ion. Lead I nvest igat or: Judy Whit e, Cent re for Healt h Prom ot ion Research, Leeds Met ropolit an Universit y. You are being invit ed t o t ake part in a t elephone int erview as part of an evaluat ion of t he Leeds Warm Hom es Healt hy People Fund t hat was dist ribut ed during t he last wint er. This is being carried out by researchers from Healt h Toget her at Leeds Met ropolit an Universit y. Before you decide, it is im port ant for you t o underst and why t he research is being done and what it will involve. Please t ake t im e t o read t he following inform at ion carefully. Ask us if t here is anyt hing t hat is not clear or if you would like m ore inform at ion. Take t im e t o decide whet her or not you wish t o t ake part . What is t he purpose of t he evaluat ion? The Warm Hom es Healt hy People fund aim ed t o assist vulnerable people during t he 2012- 13 wint er. Leeds Cit y Council dist ribut ed t he fund t o a range of organisat ions wit h links t o vulnerable people and t he capacit y t o deliver a variet y of int ervent ions. As part of an overall evaluat ion we are aim ing t o int erview 10 m anagers of organisat ions t hat were involved in t he delivery of t he WHHP fund t o ascert ain t heir opinions of t he schem e. Specific obj ect ives are t o: 1) explore t he process of applying for and receiving t he fund 2) det erm ine how well t he fund worked in pract ice 3) invest igat e perceived im pact on client s and t heir sat isfact ion wit h t he schem e 4) seek t he organisat ions’ views on possible im provem ent s t o t he schem e 23 W h y ha ve I be e n ch ose n ? You are being invit ed t o t ake part in t he evaluat ion because t he organisat ion you work for was involved in delivering int ervent ions funded by t he Warm Hom es Healt hy People fund. The Leeds Cit y Council proj ect leader suggest ed you would be able t o cont ribut e t o t he evaluat ion. Do I have t o t ake part ? No - it is up t o you t o decide whet her or not t o t ake part . I f you do decide t o t ake part you will be given t his inform at ion sheet t o keep and be asked t o give your consent verbally. You will have t he chance t o t alk t o one of t he research t eam before you m ake up your m ind. You are st ill free t o wit hdraw up unt il t he end of August 2013 wit hout giving a reason – you will j ust need t o cont act one of t he researchers list ed in t his leaflet . What will happen if I t ake part ? The research involves t aking part in a t elephone int erview bet ween in July 2013. The int erview will follow a schedule and be led by one of t he research t eam who will be in a privat e room t o ensure confident ialit y. The researcher will ask open quest ions about your involvem ent and experiences of t he WHHP fund. The int erviews will be recorded as ot herwise it is difficult for t he researcher t o t ake det ailed not es - you m ay refuse perm ission for t his. The int erview will norm ally t ake around 30m ins t o 45 m inut es and will be held at a convenient t im e for you. What will happen t o t he inform at ion I provide? Aft er t he int erview, inform at ion will be st ored securely in accordance wit h t he Dat a Prot ect ion Act and only t he research t eam at t he Universit y will have access t o it . Anyt hing you t ell us will be kept st rict ly confident ial - t his m eans t hat your nam e will not be used at any point in writ t en report s or in any feedback t o t he proj ect . Whilst t he organisat ions who part icipat ed will be nam ed in t he report t he findings will be anonym ised so t hey cannot be at t ribut ed t o any part icular proj ect . However, if you divulge inform at ion t hat we feel could pot ent ially put you or anyone else at risk, we will have t o inform t he appropriat e aut horit y. This is in line wit h t he universit y policy. 24 What are t he possible disadvant ages and risks of t aking part ? There should be no risk from t aking part in t his st udy t o you personally. We hope t hat being int erviewed does not raise any concerns wit h you, but if it does t hen please get in cont act wit h eit her m yself or m y colleagues – our det ails are below, or speak t o your proj ect leader. What are t he possible benefit s of t aking part ? You will be m aking a valued cont ribut ion t o t he developm ent of knowledge in t his field of work but t here are no personal benefit s. What will happen t o t he result s of t he evaluat ion? The result s of t he st udy will be used in a report for Leeds Cit y Council. The result s m ay be shared wit h ot her researchers and professionals t hrough j ournal art icles and conferences. You will not be ident ified in any report or publicat ion about t he evaluat ion. Everyone t aking part in t he evaluat ion will receive a sum m ary of t he result s. I f you have a concern about any aspect of t his evaluat ion you should ask t o speak t o t he researchers who will do t heir best t o answer your quest ions. I f you rem ain unhappy and wish t o speak t o som eone independent from t he st udy, you can do t his t hrough Diane Lowcock ( Senior Lect urer) , Facult y of Healt h & Social Sciences Tel: 0113 812 4409 Em ail: d.lowcock@leedsm et .ac.uk. Cont act us The t eam m em bers are: Jenny Woodward, Research Fellow Tel: 0113 812 5856 E- m ail: J.L.Woodward@leedsm et .ac.uk Judy Whit e, Direct or of Healt h Toget her Cont act Tel: 0113 812 4479 E- m ail address: j .whit e@leedsm et .ac.uk I f you have any quest ions please call or em ail a m em ber of t he evaluat ion t eam above. Or writ e t o us at t he address below: Cent re for Healt h Prom ot ion Research Facult y of Healt h & Social Sciences Leeds Met ropolit an Universit y Queen Square House Leeds LS2 8NU Thank you for reading t his inform at ion 25