The community programme at Charlton Athletic Football Club was established in 1992 and became The Charlton Athletic Community Trust in 2003. Affectionately known as CACT, it is renowned for its work in its local communities. CACT is the first Football Community Trust commissioned to run a council youth service, disability youth service and to appoint a full-time disability officer. 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. In partnership with Oxleas NHS Foundation Trust, CACT devised and delivered a 12-week pilot project, named Up & At EM. The project was for those aged 65+ with a mental health diagnosis and designed to enhance participants’ physical health and wellbeing, through activities within the community, both locally and regionally.
Highly Commended in Older People´s MH Category - #MHAwards18
From start: No
During process: Yes
In evaluation: Yes
PP Collaborative: Yes
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Carl Krauhaus - Head Of Early Help & Prevention, Charlton Athletic Community Trust
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 was established in 1992 and became The Charlton Athletic Community Trust in 2003. Affectionately known as CACT, it is renowned for its work in its local communities. CACT is the first Football Community Trust commissioned to run a council youth service, disability youth service and to appoint a full-time disability officer. 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. In partnership with Oxleas NHS Foundation Trust, CACT devised and delivered a 12-week pilot project, named Up & At EM. The project was for those aged 65+ with a mental health diagnosis and designed to enhance participants’ physical health and 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 and at Em was ‘Highly Commended’ at last year’s Positive Practice in Mental Health Awards and, having recently entered Year 2 of delivery, this impactful intervention goes from strength to strength. The schedule of activities offer a full and varied range including sporting, leisure, art and cultural based activities, and is adapted as necessary to be age appropriate. The programme is managed, scheduled and delivered by 2 members of the CACT 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 3 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. An exciting addition to the UP & AT EM project in 2018 was the UP & AWAY with EM residential trip. This provided 10 clients with a 2 night residential trip to the coast. Led by the CACT team the group took part in tours of the coast along with the chance to take in a local show in the evening. Clients reported that that had not had the opportunity to travel away over recent years due to their mental health.
What makes your service stand out from others? Please provide an example of this.
CACT use the power and reach of the Football Clubs brand and established reputation to engage with participants. CACT have been delivering mental health projects for over 12 years and we are passionate about how we can support individuals and the mental health services. The Oxleas 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 in both health and identity caused by a diagnosis of mental illness. The project supports the relationship between participants and the secondary care services. The informal delivery style provides an arena for participants to socially interact and share experiences with others who are in a similar position to them. These social bonds between participants are important as often during ill mental health informal support and peer groups fall away and people can become isolated. The group engagement and dynamics are also designed to improve connection with communities and to help people feel less lonely and isolated. 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?
The project is delivered by two full-time members of CACT staff; The Head of Early Help & Prevention and Disability & Mental Health Coordinator. Both are present at each week of Up and at Em delivery and this continuity is a big positive in engaging and building up a rapport with participants. Project delivery is also supported by an Oxleas NHS Foundation Trust band 3 support worker, who attends each week of Up and at Em delivery. The support worker liaises regularly with care coordinators and this means that, unless there is a change in presentation, care coordinators do not need to provide as much intervention as previously. Feedback from care coordinators who have had service users attend the project is that their contact with them “significantly reduced” during the timeframe of the group and led to a number of service users being discharged completely from secondary mental health.
Who is in your team?
The project has always been and continues to be delivered by the Head Of Early Help & Prevention (13 years at CACT) and the Disability & Mental Health officer (10 years CACT). Both are established members of staff with many years of delivering projects across the mental health services. CACT have a layered structure in place to manage effectively and quickly any changes in staff although none in this department are expected. CACT staff are supported in their roles by the Director of Youth and Inclusion, who in turn is supported by the CEO and a board of trustees. CACT also has a designated finance team, data protection officer, child protection and safeguarding officer amongst many other support services within the organisation.
How do you work with the wider system?
CACT delivers other programmes within the mental health services of KMPT and Oxleas. 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 2 mental health providers and is looking to grow and develop its provision into new areas in early 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 project pilot told us that people find engaging in the first week of activity a difficult barrier to overcome. Running a welcome session takes the pressure off clients and allows them to listen and engage at their own pace. We 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 fedback that them understanding the project better themselves has encouraged them to support clients to attend more. 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?
Our work with Oxleas and the UP & AT EM project is always promoted by CACT and CAFC through website stories and social media. 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 community trust programmes and other trusts are always keen to learn from the work CACT has developed. Our mental health work is no different 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?
Outcomes Two outcome measures are used to monitor and evaluate the success and impact of Up and 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 gather 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?
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 and at Em provide a strong platform for future investment. From both the pilot and Year 1 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 delivery that have helped shape Up and 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 now 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 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 and at Em participants. The most recent progression, again strengthening and evolving the programme, is the addition of a residential trip for participants who were suitable and selected. Named UP & Away with EM, this provided 10 clients with a 2 night coastal residential which involved some tours and sightseeing trips. This additional aspect provided a unique trip to clients who due to their mental health history had not spent time away from home for a considerable amount of time.
Webpage for service:
Hours the service operates *
Weekly, 10am – 3pm
Brief description of population (e.g. urban, age, socioeconomic status):
The Up and at Em project works specifically with Older People (65+) with a mental health diagnosis, from across these 3 SE London boroughs. Participants are both male and female and come from a wide range of demographics, ethnicity and socioeconomic status.
Size of population and localities covered:
CACT operate across a wide geographical area, including the South East London boroughs of Greenwich, Bexley and Bromley and across the County of Kent.
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
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