The Centre for Health and Social Care at University of Bristol have received funding for a two year project exploring day centres, day clubs and activities for older people. Local authority budget cuts, increased use of personal budgets and a view of day centres as outdated have contributed to a shift away from collective provision of social care including the closure of day centres. Increased recognition of the issue of loneliness and social isolation, highlighted further during the COVID-19 pandemic, provide an opportunity to re-consider the role of collective services. Our project will explore innovative examples of collective day services for older people including their role in promoting wellbeing.  

Day centres have been a part of the social care landscape since the 1948 National Assistance Act. They can be difficult to define but generally are building-based services that provide activities, opportunities to connect with others, preventative services and respite for carers (Orellana et al, 2018). Day services for older people, such as day centres and lunch clubs, are often overlooked in debates about the need to ‘fix social care’ (Bottery, 2019), which tend to focus on the provision of residential care and home care. Social care policy development over the past 30 years has been driven by the prioritisation of individual choice and personalisation, contributing to a view of collective provision such as day centres as outdated and many day centres have been closed (Needham, 2012). However, there is growing recognition that many older people value collective services (Orellana et al, 2020) and would welcome the opportunity to choose collective forms of care (Age UK, 2011), and that they have the potential to address the needs of some older people more appropriately, for example those experiencing isolation or living with complex, multiple health conditions. Collective day services can support mental and physical health, continued independence and rehabilitation (Orellana et al, 2018), however, there is a need for services to be more inclusive of the needs and aspirations of all older people. 

During the COVID-19 pandemic, many of us have thought more than usual about connection, community, wellbeing, isolation and loneliness. Concerns have been raised about the impact closure of services and requirement to shield have had on the wellbeing of older people including increased depression and loneliness (Steptoe and Steel, 2020). Loneliness and isolation were a growing policy concern before the pandemic. The government’s loneliness strategy recognises the importance of collective services for wellbeing and highlights the potential for social prescribing, where GPs refer people to community activities such as art groups and clubs, to improve wellbeing and mitigate loneliness and social isolation, alongside investment in community spaces (Department for Digital, Culture, Media & Sport, 2018). A recent report from Kings College London (Green et al, 2021) mapped day centres in four boroughs in South London and highlighted the importance of up to date information to enable individuals, as well as those referring as part of social prescribing, to choose and access services. Their report further highlights the lack of information, research and evidence about collective forms of day provision. For example, little is known about who attends day services, how they are perceived by those who attend them or by those who are involved in commissioning them, and the impact of attendance including for different groups of users.  

Our research will explore the current role, and potential role, of collective day services including day centres, clubs and activities for older people (65+) in England. It is a two year study funded by the National Institute for Health Research, School for Social Care Research and will be led by Professor Ailsa Cameron and researchers at the University of Bristol School for Policy Studies, along with local community partners. The study will have two elements: an analysis of trends in provision and uptake over time and in-depth qualitative research to explore different models of day service provision, including their impact on health and wellbeing outcomes for service users, as well as a costing exercise. We are particularly interested in examples of innovative day service provision, such as intergenerational day services, skills exchange, wellbeing hubs, integrated health and social care services, and those with a focus on inclusive practice.  

We’re in the very early stages of this work and grappling with the challenges of COVID-19. But our early exploration of innovative day services for older people have led us to understand the huge variety of services on offer, as well as how services are innovating and responding to peoples’ needs. Innovative examples include transforming the traditional adult day care centres to a network of activity hubs bringing a range of activities to older people. Others provide a range of groups and social opportunities to connect LGBTQ+ people over 50. Not to mention, the ways in which day centres have adapted during the pandemic. Many day centres have been operating remotely or ‘Virtual Day Centres’ as well as offering alternative community-based services such as hot meal deliveries, welfare calls or essential item deliveries. One day club for older people brought in pets for service users who were missing human touch during the pandemic.  

Starting this work when many day centres and services have been closed as a result of COVID-19 is going to be a challenge, but as services begin to welcome people back, it may be the right time for some ambitious conversation, debate and evidence about what collective day services for older people could look like.  

Please get in touch if you would like to know more or know of an innovative example that we should exploreL.bennett@bristol.ac.uk  

To find out more please visit our website: https://reimaginingdayservices.blogs.bristol.ac.uk/  

References: 

Age UK (2011) Effectiveness of day services. London: Age UK  

Bottery, S. (2019). What’s your problem, social care? The eight key areas for reform. London: The King’s Fund. Retrieved from: https://www.kingsfund.org.uk/publications/whats-your-problem-social-care  

Department for Digital, Culture, Media & Sport (2018) A connected society: A Strategy for tackling loneliness – laying the foundations for change. Retrieved from: https://www.gov.uk/government/publications/a-connected-society-a-strategy-for-tackling-loneliness 

Green, C., Orellana, K., Manthorpe, J., & Samsi, K. (2021). Caring in company: a preCovid snapshot of day centres in south London: Report of a mapping exercise of publicly available information from four south London boroughs. London: NIHR Applied Research Collaboration South London. Retrieved from: https://kclpure.kcl.ac.uk/portal/files/152782395/Caring_in_company_May2021.pdf 

Needham, C. (2012) What is happening to day centres services? Voices from frontline staff. Birmingham: University of Birmingham/UNISON  

Orellana, K., Manthorpe, J., Tinker, A. (2018) Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived. Ageing & Society. 40(1)73-104. 

Orellana, K., Manthorpe, J., & Tinker, A. (2020). Choice, control and person-centredness in day centres for older people. Journal of Social Work. 

Steptoe, A. and Steel, N. (2020). The experience of older people instructed to shield or self-isolate during the COVID-19 pandemic. Retrieved from: https://www.elsa-project.ac.uk/covid-19-reports