The schedule of activities on offer through Up & At ‘Em are extremely varied, engaging and age appropriate. These activities can include a multitude of sports based activities such as soft tennis, cricket and boccia, leisure activities such as the Emirates cable car, visiting Herne Bay and visiting Hythe & Dymchurch railway station and finally, art and cultural based activities such as pottery creation / painting and a theatre trip to central London. The programme is managed, scheduled and delivered by two members of the CACT Early Help & Prevention team with support from a designated member of staff from Oxleas. Transport for the activities is also provided by CACT and has proved a crucial part of the programmes’ success, removing a key barrier to participant involvement.
Hours the service operates 11am - 4pm every Friday for Up & At 'Em (The EH&P strand delivers other MH projects 6 to 7 days a week, at various times) www.cact.org.uk
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
The community programme at Charlton Athletic Football Club (CACT) was established in 1992 and became The Charlton Athletic Community Trust in 2003. The main geographical areas of delivery for CACT programmes are Greenwich, Bexley, Bromley and Kent across 7 main strands: Early Help & Prevention, Equality & Diversity, Health Improvement, Social Action & Enterprise, Youth Services, Football & Sports Development and Education. Since 2006, CACT’s Early Help & Prevention team have been delivering consistent, innovative and empowering projects surrounding the topic of mental health across multiple boroughs in South East London and Kent. In partnership with Oxleas NHS Foundation Trust, CACT’s Early Help & Prevention team devised and delivered a 12-week pilot project, named Up & At ‘Em in 2017. The pilot was for those aged 65+ with a mental health diagnosis, designed to help reduce social isolation and to enhance participants’ physical health and mental wellbeing through activities within the community, both locally and regionally. Following this very successful pilot and subsequent evaluation Oxleas conducted a comprehensive invest to save exercise and confirmed 3 years of project funding, taking delivery up to 2020.
Up & At ‘Em was ‘Highly Commended’ at last year’s Positive Practise in Mental Health Awards and having recently entered Year 3 of delivery, this impactful intervention goes from strength to strength. The schedule of activities on offer through Up & At ‘Em are extremely varied, engaging and age appropriate. These activities can include a multitude of sports based activities such as soft tennis, cricket and boccia, leisure activities such as the Emirates cable car, visiting Herne Bay and visiting Hythe & Dymchurch railway station and finally, art and cultural based activities such as pottery creation / painting and a theatre trip to central London. The programme is managed, scheduled and delivered by two members of the CACT Early Help & Prevention team with support from a designated member of staff from Oxleas. Transport for the activities is also provided by CACT and has proved a crucial part of the programmes’ success, removing a key barrier to participant involvement. Delivery spans the three South East London boroughs of Greenwich, Bexley and Bromley and Year 1 saw a comprehensive 10 week programme delivered in each of these areas, with a cohort of up to 16 participants per programme.
What makes your service stand out from others? Please provide an example of this.
CACT utilise the unique relationship with Charlton Athletic Football Club, using their strong branding and established reputation to assist in engaging with a multitude of participants across our delivery areas. Football Community Trust’s can also find themselves in an exclusive position of having an existing fanbase for the football club or football as a sport, which can assist in engagement with individuals who are interested in the sport or sport in general. CACT’s relationship with Oxleas NHS can also be considered unique in term of a partnership between a Football Community Trust and an NHS service. As stated earlier, CACT have been delivering mental health projects for over twelve years and we are passionate about how we can support issues surrounding mental health on a micro and macro scale, from individual success stories to supporting the NHS and other mental health services. The Up & At ‘Em project which we are putting forward for this award is our latest addition to what is now a comprehensive programme of delivery across our regional mental health services. The project is delivered by non-clinical staff in non-clinical settings. The programme provides a sense of normality during a time of crisis and instability in both health and identity caused by a diagnosis of mental illness.
The project also supports the relationship between participants and the secondary care services. The informal delivery style provides an area for participants to socially interact and share experiences with others who were in a similar position to themselves. These social bonds between participants are vital to the participants as often during ill mental health, informal support and peer groups fall away, leaving individuals at risk of becoming socially isolated. The group engagement and dynamics were also designed to improve connections with their local communities, in order to help people feel more confident in engaging with their local communities and reduce the feeling of loneliness and isolation. Participants report that the variety of activities are a platform and backdrop to a deeper level of support that the project provides which increases the more they engage with the project and other participants.
How do you ensure an effective, safe, compassionate and sustainable workforce?
There are various structures that are in place at CACT to ensure that our workforce is effective, safe compassionate and sustainable. Due to the general nature of work that our Early Help & Prevention do, there is almost always a need for a specific certificate or qualifications in order to be effective and compliant within a role. An example of these needs being met was our most recent sequence of Buccal training for our casual and part / full time staff, giving them the necessary qualifications to support children who have seizures by administering medicine etc. This helps CACT by having skilled employees but it also benefits the individual by having a recognised qualifications which could aid in future employment.
CACT also run multiple continued professional development days over the calendar year, to give all staff members perspective of their role, the roles of others, the role of the Trust in general which allows staff to have a deeper level of understanding and identifying skill / knowledge gaps within their department. There are also a variety of free online training courses made available through the Royal Borough of Greenwich that CACT staff can access. Many of these sessions are mandatory, such as GDPR and information sharing to ensure best practice within the Trust. It is also important to state that all of CACT’s staff members are required to have a DBS for employment. CACT are keen in expanding our workforce strategically and sustainably. CACT have a proven track record of promoting within the Trust at a variety of staffing levels. A positive example would be the appointment of our new Early Help & Prevention Officer, who initially engaged with many of our programmes as a participant, became a casual member of staff later on in life and now is a full time member of the Early Help & Prevention team. CACT have also invested in bringing in fresh talent, with many individuals being kept on over the years after successful placements / internships.
The staffing structure (please see attached) provides multi-tiered support for our Early Help & Prevention team and all of our other delivery teams. Delivery teams are supported by the Director team, which in turn is supported by our CEO and trustees. This provides all staff members with an appropriate network of experienced colleagues who can support throughout the implementation of our provisions. Our HR Coordinator also sends out a weekly HR update, highlighting the Employee Assistant Programme through Workplace Options that we currently offer. This service provides free, confidential access to professional consultants, expert referrals to counselling and a range of online resources covering work / life balance. CACT also have a yearly appraisal method for every member of staff with their line manager, allowing them to assess their targets over the year, set attainable targets for next year and discuss their continuous professional development within the Trust. This reflective method gives staff members a clear set of objectives to work towards, keeping them motivated and efficient.
Who is in your team?
The project has always been and continues to be delivered by the Head of Early Help & Prevention and the Disability & Mental Health Officer who have amassed a collective 25 years of experience at Charlton Athletic Community Trust in their respective roles. Both of these staff members are extremely established and experienced in their field and they coordinate / deliver a plethora of mental health, disability and early intervention programmes that support a variety of people, seven days a week. The Early Help & Prevention team are also supported in their roles by various structures of support departments such as Fundraising & Development, Finance and Research & Monitoring to name a few. These departments allow the Early Help & Prevention team more time to plan effective and engaging projects for our beneficiaries. CACT also have a dedicated Safeguarding and Health & Safety Officer, who supports staff and participants throughout project delivery and ensures all projects are in compliance with various regulations around working with vulnerable individuals. The Early Help & Prevention team report into the Director of Youth, Health & Inclusion, who supports the team in their coordination and delivery. In turn, the director is supported by our CEO, who is supported by our board of trustees, effectively displaying the sturdiness our staffing structure. It is also important to state that Up & At ‘Em is supported by an Oxleas NHS Foundation Trust Band 3 support worker, who attends each week of delivery and acts as a liaison between the care coordinators, CACT’s delivery team and the participants.
How do you work with the wider system?
CACT delivers other programmes within the mental health services of Oxleas and KMPT. A similar but adapted version of this project is also delivered across the Early Intervention in Psychosis teams under both Oxleas and KMPT NHS trusts. CACT also has activity projects within secure and forensic setting under both KMPT and Oxleas services. CACT also hold a place on the board of governors at Oxleas and contributes and supports their services as a whole. CACT has been approached by other services under the two mental health providers and is looking to grow and develop its provision into new areas in late 2019.
Do you use co-production approaches?
At the start of every 10 week block, CACT and Oxleas hold a welcome session for all clients and their carers. Evaluation from the pilot of Up & At ‘Em told us that people find engaging in the first week of activity a difficult barrier to overcome therefore running a welcome session takes the pressure off clients and allows them to listen and engage at their own pace. We also find that the majority of clients will engage with others at some stage of this more relaxed session allowing for a more confident approach to the first programme activity. Carers have also given feedback to CACT, discussing that the carers understanding the project better themselves has encouraged them to support clients to attend more. The variety of activities has always been positively received by participants, but by having the initial welcome sessions benefits the service as participants feel relaxed and more at ease, which in turn allows the participants to open up, show their true selves and enjoy socialising and participating in exciting activities. Feedback is recorded from all clients on every activity with the information used to help shape and design the next blocks of activity. Staff from CACT and Oxleas evaluate each block of activities from a staff perspective and implement any changes they agree will improve the service and enable it to evolve.
Do you share your work with others? If so, please tell us how.
Our work with Oxleas and the Up & At ‘Em project alongside a whole host of provision provided by ACCT is always promoted by CACT and CAFC through website stories and social media through our Marketing & Communication team. Oxleas also promote the project heavily through their internal and external channels. CACT also hold a place on the board of governors at Oxleas and have presented the project to all governors including visiting governors from other NHS trusts. CACT’s community programme is highly regarded with the Trust receiving the English Football League Community Club of the Year Award in 2016 and London Regional Club of the Year in 2018. Our work programme is widely recognised as one of the country’s leading football Community Trust programmes and other trusts are always keen to learn from the work CACT has developed. CACT’s annual Impact Report highlights and presents a multitude of qualitative and quantitative data to the wider public, showcasing the positive work we do within the community. It breaks down all seven strands social return on investment and highlights these figures with statistical evidence and case studies, which other organisations are free to access, strengthening the overall community offer available to residents. Our mental health work is no different to our other strands / projects and is well respected and valued by partners, with whom we regularly share our best practise. This is highlighted by long term relationships and financial commitment with Oxleas (8 yrs) & Kent and Medway NHS Trust (12 years)
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
Two outcome measures were used as part of the pilot of Up & At ‘Em – Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and Core 10. WEMWBS is a measure of mental wellbeing and looks at how people are interacting with others, their confidence and self-esteem. Core 10 is a generic measure of distress and helps to measure anxiety, depression, risk and functioning. WEMWBS: 76% of group members demonstrated improvement on the mental wellbeing rating scale. Three people showed a decline on the WEMWBS. These three service users were the most unwell of the group so their presentation may have affected the results. CORE10: Over two thirds showed an improvement on the Core 10 scale. For some people there was quite a dramatic reduction in feelings of distress as a result of attending the group. For those who had an increase, this was generally by a small percentage and could be due to increased awareness of symptoms as a result of attending a group with other service users with mental health conditions. We also gathered qualitative feedback: • “The different experiences have been amazing” • “Every minute has been lovely – I never expected it to be so good” • “The company has been great” • “Very uplifting is all I can say” • “I appreciate all the care and support shown to me” • “Thanks for all the hard work put into the groups. They were varied, interesting and fun” • “Thank you for Up & At ‘Em. I appreciated every minute”
Has your service been evaluated (by peer or academic review)?
How will you ensure that your service continues to deliver good mental health care?
Our partnership work with Oxleas remains strong and is a crucial element to ensuring sustainability of the programme. The continued success and positive outcomes of Up & At ‘Em provide a strong platform for future investment. From the pilot and Year 1 & 2 of delivery we have been able to demonstrate the benefits of collaborative working and been able to offer our service users a different, innovative treatment programme. The projects encompass the ethos of recovery – supporting people to look forward, set new goals, participate in activities and develop meaningful relationships. There is strong evidence to support the claim that social inclusion plays a key role in recovery and highlights the importance of individuals regaining a place in their community and taking part in mainstream activities and opportunities. Evaluation and further evidencing the project’s value will develop over the next two years. With funding confirmed to 2020 this will give us a healthy run it to ensure funding is committed beyond that point. This has included positive conversations with each of the relevant Local Authorities, who also recognise the significant outcomes and value for money this project represents. CACT recognises that key to sustainability is ensuring wider recognition in the form of awards such as these.
What aspects of your service would you share with people who want to learn from you?
There has been key learning from both the pilot and Year 1 and 2 of the delivery that have helped shape Up & At ‘Em, with feedback from participants, carers and our own reflections crucial to evolving the programme. A challenge during the pilot project was transport, with the journey to activities often proving daunting and a barrier to attendance. To remove this barrier, CACT provide all transport to and from activities from a set and sensible central meeting point within the participants’ borough. Participants feel safer and more secure with this arrangement and the social element has been a huge positive, with conversations on the mini bus improving interaction and enjoyment. Key learning from Year 1 and 2 focussed on the need for continued engagement; within the programme, with other participants and with local services beyond the 10 week intervention. CACT reacted promptly to this demand for longer term support by scheduling monthly meet ups, for cohorts to stay in touch and continue to benefit long term. In addition to this, our established partnerships across the community have enabled us to link individuals into befriending groups, community facilities, leisure providers and local services to further support Up & At ‘Em participants.
How many people do you see?
How do people access the service?
Referred through Oxleas.
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England): Oxleas NHS Foundation Trust
Provided by (e.g. name of NHS trust) or your organisation:
Charlton Athletic Community Trust
Brief description of population (e.g. urban, age, socioeconomic status):
CACT operate within the entirety of Greenwich, Bexley, Bromley and Kent over seven different delivery strands, working with a variety of people of different ages, ethnicity, gender, socioeconomic backgrounds etc
Size of population and localities covered:
Greenwich: Population estimate – 290,000 (entire borough) / Bexley: Population estimate – 267,000 (entire borough) / Bromley: Population estimate – 330,000 (entire borough)
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