sroi community meals report final. pdf

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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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:


20

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)


21

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)


22

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)


23

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


25

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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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


27

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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30

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


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


Lunchclubattendeesdonothavetheirneedsassessed,thereforeitisdifficulttoquantifythecontributiontolivingindependently N

ReceivingamealMainobjectiveoftheservice Y Outcomeonitsown

VolunteersSatisfactioninhelpingothers

Allvolunteerstalkedaboutthesatisfactioninhelpingothersasakeyreasonforvolunteering Y

Volunteersenjoyedhelpingothersatthelunchclubsalthoughitwasdifficulttolinkthistooverallwellbeing

DriversFeeltheyaremakingadifference

Notenoughevidenceofdirectimpact N

LCCReductioninintensivesupportcosts


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


ReductioninMalnutritionscorefromassessment(PROXY:Numberswhoreceivesupporttoeattheirmeal(approx15%ofthosewhoreceive

Malnutritionassessmenttool(PROXY:Socialcaredatabase)


35

meals(1416))


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%)


Feelmoreincontrol

Numberwhostatethetheyfeelmoreincontroloftheirlivesasresultoftheservice(PROXY:No.chosenspecificneedsnotonmenu(171)andsupporttomakechoice(14))


ReceivingamealfromIcare

NumberofmealsdeliveredfromIcare Socialcaredatabase

Family

Morefreedom

Numberoffamilymemberswhostaethattheyhavemorefreedomasareasultoftheservice(PROXY:Familylessreliantondailybasisfromexpectedproportionofdailyserviceuserswhoseefamilymemberseveryday(14%))

Familysurvey(PROXY:SocialCapitalSurvey)


36

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.


37

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.


43

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


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%)


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))


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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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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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

sroi community meals report final. pdf

Documents

investment sroi

sroi principles

sroi evaluation

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sroi network

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social return

final report