We didn’t risk assess for this!

On Friday 26th March we held the second in our series of monthly UK Meeting Centres Support Programme webinars, in lieu of a face-to-face conference. This time the focus was the impact of the Covid-19 pandemic on how Meeting Centres have been able to operate. A key aspect of Meeting Centres is regular face-to-face contact, but the pandemic meant there was a need to rapidly implement innovative ways to support members and families at home.

After a welcome and introduction by Professor Dawn Brooker MBE, representatives from the four demo site Meeting Centres were invited to join a conversation about the challenges and risks they have faced in the past year, and how they hope to move forward. They were:

What happened during first lockdown?

Phillipa began by acknowledging the huge amount of time and effort put in by those working at Leominster Meeting Centre to continue to provide support through the first lockdown. While initial concerns centred on wanting to provide protection for members and their families as well as staff, the financial stability of Leominster Meeting Centre was also an issue as it is funded through a combination of grants, local fundraising and membership fees, all of which could be affected by lockdown.

Everyone wanted to continue to support the members and carers and prevent further social isolation, so alternative options for providing support were considered. The team started by using WhatsApp and Facetime to contact people, with garden catch-ups where possible. Zoom sessions were also set up for group activities, and while these appeared to be the most effective method, they could also be difficult for some members to engage with. The frequency of existing newsletters increased, focusing on providing ideas of things to do, and the Meeting Centre also subscribed to the Daily Sparkle. It was acknowledged that this package of support was not necessarily an adequate substitute for the Meeting Centre, but reflected what the team was able to put in place at the time. Positive staff attitudes and their willingness to continue providing as much support as they could were key to Leominster Meeting Centre operating in any format during the first lockdown.

Graham reflected that Kirrie Connections had made the decision to close its doors before start of the first lockdown due to concerns about it being too late, so had a bit more time to plan ahead for remote delivery before restrictions came into force. They were able to carry out a technology audit to see what devices families had and the types of platform they were comfortable using. Additional funding was also secured to provide devices for those that needed them, and also to support the printing of hard copies of newsletters to match people’s needs and preferences. Graham and his team explored the suitability of different types of device for different members depending on their abilities and the support available to help them use the device in their own homes. He also praised his staff team for the huge amount of effort that they put in.

How have you managed to support people’s social engagement?

Like Graham, Deborah and her team also took the decision to close their Meeting Centres earlier than the official lockdown, but maintained social engagement by setting up regular ‘buddy’ phone calls between members and staff. They also set up a weekly virtual Meeting Centre, with the first session being held on 26th March 2020. One year on, it is still going strong. In Powys they have been learning from their members and carers, recognising that they have to adjust to a whole variety of changes on a daily basis. They were surprised how unflappable the members and carers were as they just ‘rolled with it’, so took their lead from them. Further efforts to maintain social connections included garden visits when possible. Their approach is to try to incorporate the principles of the ‘Adjusting to Change’ model (on which Meeting Centres are based) into all of the interactions that they are able to have with their members and families.

How have you supported people practically?

Jude presented a slightly more mixed picture from Droitwich Spa Meeting Centre, as some of their staff were furloughed while others continued to support their members and carers. They have not provided virtual support, but have been carrying out ‘well-check’ calls and garden visits, as well as providing activity packs. They were able to reopen between September and December 2020, and are looking forward to opening again in April. They have remained in regular contact with carers throughout, and recognise that reopening will be yet another change that their members and carers will have to contend with.

What has been the impact on members and carers?

Everyone at Leominster Meeting Centre has missed social contact, and it’s been seen that carers and family members have found lockdown particularly difficult as all caring responsibilities have fallen on them. Their normal options to obtain even a brief relief from caring have not been available. However, Leominster Meeting Centre has been able to reopen with limited numbers since the end of the first lockdown and has remained open ever since. In some respects it has been slightly easier as they have their own premises so are in full control of the cleaning and other safety measures. They have also received funding to support them opening 5 days per week, but even with the extra day people are still not able to come as often as they would like. It has also not been possible to allow carers to come to the Meeting Centre due to restrictions on numbers, with the focus being on members attending instead. The inclusion of and engagement with carers is one of the Meeting Centre’s strengths, so they have had to look at alternative ways of providing that support. It has also been recognised that even after restrictions are lifted, some people won’t be returning to the Meeting Centre as their dementia has progressed, in some cases more rapidly that would have expected in ‘normal’ times.

Lockdown has highlighted just how reliant members and carers have become on the support provided by Kirrie Connections Meeting Centre, so when that wasn’t available it led to faster decline in people’s conditions. This also had a knock-on impact on carers. However, Graham has seen a positive impact as a result of their remote working. They have been carrying out 1-1 work with people who do not like or may not cope well with group sessions, or get along with different technology. This way of working, together with the carer support groups they’ve been running, have made it possible to get to know carers on a deeper level than previously. When the Meeting Centre was physically open, many carers used it as a form of respite and did not necessarily engage with the staff and activities as much as hoped. The relationships that have been built during the pandemic, even with carers and families that the staff have not actually met in person yet, will hopefully result in a different dynamic and everyone is looking forward to attend the Meeting Centre when they are able.

How will the pandemic impact on the sustainability of Meeting Centres?

In Powys, their main funding for Meeting Centre delivery has been from the National Lottery. They were reassured to find that they could still use that funding to deliver support in other ways when face-to-face sessions were not possible. Due to numbers and amount charged, Powys does not generate enough money through their membership fees for their Meeting Centres to be sustainable, so they are still looking at applying for grants from multiple funding sources. When they do return to face-to-face delivery there is an option to increase membership fees, but it may still not be enough to become sustainable.

What have been biggest risks and how have you managed them?

When it briefly reopened, and ahead of reopening in April, Droitwich Spa Meeting Centre has been following all relevant government guidance, but has been having a lot of discussions about risks, in particular the need to balance the risks of opening against the risks of not opening. One of the benefits about being based at the rugby club is that the room they use is a large open space with plenty of windows, and access to outdoor spaces. They’ve done the necessary health and safety assessments and put a variety of measures in place. For example, there are temperature checks for everyone coming into the building, and procedures have been developed in case anyone is found to have Covid. Luckily, during its period of reopening, these procedures were not required. Staff wear masks and members are encourage to where possible, with visors being offered as alternatives. The team has been great at exploring alternative options for activities to limit contact. Social distancing is maintained by having members at separate tables with their own craft packs to minimise cross-contamination, but it was acknowledged that it has been difficult as this does not fit with the Meeting Centre ethos. It has not been the same as the normal Meeting Centre, but was better than expected.

What are going to be the main challenges over the next few months?

For Leominster, one challenge will be around rebuilding member numbers. Funding applications are also underway. There is a lot of uncertainty about the future, such as the possibility of another lockdown, so plans are being developed to cope with further restrictions. There will also be a challenge around getting people used to the idea of getting out and about and engaging with others. Overall, the main focus will be on re-establishing, moving forward, and getting back to the Meeting Centre ethos.

Kirrie Connections Meeting Centre has moved to a different premises in the past year, so they plan to carry out some building work on their new premises before reopening. However, it is hoped that face-to-face work can start relatively soon. In the meantime, they are just about to start running a weekly health walk which will help to get people back outside and engaging with others. Financially, they have decided not to include membership fees and fundraising in their budget as they are so unpredictable, so will be focusing on grant funding instead. They had hoped to become self-sustaining, but recognise that it’s not possible at present.

Powys has seen a change in membership during the past year, losing some but also gaining new ones. They have engaged with a wider range of people during lockdown as more people have been seeking some form of support, but a concern is how previous members will transition back to face-to-face interactions. They will be providing 1-1 support from befrienders to help people feel more comfortable being out and about again, for example going with them to a shop, just to get them used to being around people. An important factor is keeping everyone informed about what is going on and what any plans for activities or reopening will be. However, the main concerns relate to the financial situation.

Droitwich Spa Meeting Centre receives 50% of its funding from membership fees, but it is expected that numbers will be reduced when they reopen, so they have to work out how that will balance. There is also uncertainty about whether they will be able to get back to previous member levels. Unsurprisingly they are also considering different options around funding and sustainability.

After hearing from the four Meeting Centres, there was discussion about a couple of points arising from the conversation. One was around the different types of device available, with examples shared including:

A second discussion topic was around whether the lack of people being diagnosed with dementia during the past year could have an impact on Meeting Centres. Initially there may be smaller numbers of people able to access Meeting Centres due to the need for a diagnosis, followed by a potential influx which might overwhelm capacity. It was an interesting discussion and no real answer as we need to see how things pan out, but if the past year has shown us anything, it’s that Meeting Centres are flexible and adaptable. However, any additional staff required to support extra members would require suitable funding. As with most things, funding is an issue.

Thanks to everyone for sharing their views during this webinar, and we hope you found it interesting and inspirational.

A recording of the webinar is also available.

The next webinar will take place on Friday 30th April at 12noon. ‘You’ve come to the right place’ will be looking at different locations for Meeting Centres and different approaches to make them ‘dementia friendly’. You can register to attend for free on our website.

Author: Association for Dementia Studies

We are a multi-professional group of educationalists, researchers and practitioners who are expert in the field of person-centred dementia care and support. Our aim is to make a substantial contribution to building evidence-based practical ways of working with people living with dementia and their families that enables them to live well. We do this primarily through research, education and consultancy.

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