Further afield

Establishing
and meeting the support needs of people in sparsely populated areas requires an
innovative approach. Here, project co-ordinator Antoinette Ward describes a
Cumbria project at the cutting edge of service provision.

Amajor
stumbling block for anyone aiming to research social services and carry out
social work in rural areas is finding the people. They do not live in defined
or concentrated areas and are not inclined to advertise the difficulties of
their situation. And where vulnerable people are socially isolated and live
alongside others who appear to be thriving, it is hard for professionals to
gain their confidence and enable them to have a voice in service development.
This means social workers tend to overlook their needs.

The Northern Fells Rural Project is based in
seven "super-sparse population" parishes in north Cumbria, and is
piloting methods for developing services in rural areas, using health care as
an entry point. This means identifying health and social needs, and the causes
of social exclusion; mapping the provision of existing support services and
identifying gaps; then implementing action to meet those needs. The project is
being evaluated and the findings will be disseminated for others in rural
areas.

It is one of three projects within The Prince
of Wales’ rural revival initiative. Funders include the North Cumbria Health
Action Zone and a charitable trust. The project also receives some EU funding,
and is supported by Voluntary Action Cumbria and an external research
consultant. There is a near full-time project co-ordinator, a part-time
transport co-ordinator and a part-time youth development worker.

Our major challenge was to find and talk with
the residents in vulnerable situations. These include older people, disabled
people, carers, young people, people without transport, parents of disabled
children, and unemployed people and those on low incomes. We aimed to work with
them on possible solutions. Some, such as older pensioners on low incomes and
disabled pensioners, could be identified and accessed using health care as an
entry point. This group was reached via health checks for the over-75s at GPsurgeries
and about 230 people were sent a benefits awareness leaflet with a reminder of
the health check. The project helped many with benefits claims, netting more
than £19,000 so far in attendance allowance, income support, and council tax
benefit.

Also, as a practice nurse seconded part-time
from a local surgery, I was able to "piggyback" interviews with 23 of
those who came in for health checks. When we asked them what facilities or
services would make life easier, they cited lunch clubs, help in their gardens
and domestic help.

The project responded by flagging up the
lunch club issue locally, and there are now four parish-based lunch groups for
older people, with a fifth under development. We’re also developing a database
of local gardeners and domestic helpers.

Carers are another priority. We advertised in
parish magazines for carers, and asked local surgeries and social services to
contact carers. We received no contacts via the statutory services, but four
carers responded to the magazines. Carers identified their key needs as
accessible practical help, respite care at home rather than at an institution,
information in advance of problems arising, and the chance to talk about their
problems.

Subsequently, we offered a pilot scheme of
support via local surgeries. We want to find out if we can reach more rural
"hidden" carers, and ask them whether the support offered is useful.
Initially, we are focusing on checking carers’ entitlement to services and
benefits and acting as an advocate for them in accessing support.

It is often hard for voluntary and social
services agencies to access support services in rural areas such as this. It
covers the rural edges of two district authorities and is often overlooked by
statutory and voluntary services and funding. There are also transport
barriers, and the few support services that do reach us often have exclusive
criteria, such as age or a particular disability.

Consequently, we arranged a meeting to
discuss the development of a practical inclusive support scheme, and from this
arose a handyman and domestic/personal support scheme. Through mapping local
needs we have also reached and supported people without transport, young
people, and parents of disabled children.

This work has shown the way in which many
rural social and health care needs are invisible to statutory and voluntary
agencies, and that careful local development work is necessary to place the
needs of such areas onto policy and service agendas.

Antoinette
Ward is project co-ordinator at the Northern Fells Rural Project and is a fully
qualified practice nurse. The project can be contacted at www.btinternet.com/~nfrp