Can a new day centre dawn?

    For such an innocuous concept, day centres can be quite
    divisive. For some social care professionals and service users
    alike, day centres offer the ideal opportunity to provide targeted
    services to clients in a safe, stable environment. But others
    regard them as outdated and patronising, a service firmly stuck in
    the last century. So is the debate over day centres that
    clear-cut?

    When day centres opened their doors in the 1960s they were aimed
    at people with learning difficulties, who often attended five days
    a week. They offered a relief to this group – and their parents –
    as no services had preceded them. However, the centres were little
    more than institutions, with users isolated from their local
    communities and not involved in meaningful activities.

    Nowadays a range of service users, including older people and
    those who are homeless or have mental health problems, use centres
    as part of their care package.

    For the past six years, Sheila Bell, day services co-ordinator
    for Suffolk Council, has been based at the Stradbroke Court day
    centre for older people in Lowestoft. It offers 30 places a day and
    106 clients attend on average twice a week from Monday to
    Friday).

    Bell says day centres for older people in particular have
    progressed significantly in the past 10 years, due partly to
    changing demographics: “The sorts of people who were in residential
    care in 1992 now attend day centres. They are much frailer and
    older and need specialised transport to get them there.” She says
    the centre gives back to older people the social aspect of their
    lives that they lose when they are “sitting at home alone, looking
    at four walls”.

    Last year Stradbroke Court became involved in the New Look
    Project, operated by arts and inclusion agency Suffolk Artlink. The
    basis of the pilot was to involve older people in art workshops,
    but with a difference: the usual fare of Easter bonnets and
    Christmas cards was out; instead, in came four practising artists
    and a writer to lead a series of workshops.

    Clearly some day centres run effectively, but there is often
    another side to the story. Andrew McCulloch, chief executive of the
    Mental Health Foundation, says the concept put the cart before the
    horse: “Day centres are an estate-centred approach, not a
    person-centred one.” He says the quality of service in day centres
    for people with mental health problems varies widely because there
    is little guidance for service providers. “A lot of clients are
    treated like couch potatoes,” McCulloch says. “They sit there and
    drink coffee.”

    Day centres are an inadequate way to meet people’s support
    needs, agrees Roy Webb, the National Centre for Independent
    Living’s head of policy. “The trouble is that most day centres are
    limited in the type of support they can and do offer. People go
    there because they don’t have the practical support available to
    them otherwise.”

    Although some day centres have transformed themselves into
    supporting independent living for their users, Webb says most lack
    the resources to make the change. Instead, they “play safe” and
    continue as they always have done.

    But if this is the case, how is it that when a day centre is
    threatened with closure users band together to protest? Many a
    placard has been waved declaring that such centres are much valued
    and how wrong a local authority is to contemplate closing it.

    Barbara McIntosh, co-director of the Foundation for People with
    Learning Disabilities, says parents of day centre users often fear
    that the quality of a service will fall if it is redesigned. She
    says: “We have seen examples of people receiving a lesser service
    rather than a better one.”

    Webb says some local authorities fail to spend enough time
    preparing to change their day centres into positive alternatives
    and if they did this then clients would not resist the change.

    So what makes a good day centre? It might simply be one run by a
    positive team that listens to its clients and provides an
    imaginative variety of activities. Bell says: “You have to be
    needs-led. What you do has to reflect those users.”

    No matter how much day centres strive to improve, for some users
    and social care professionals they are simply not the answer. But
    unless there is wholesale revolution, day centres seem set to
    stay.

    Convert to the cause

    When Dora Welch, 88,  was advised to go to a day centre five
    years ago she was unimpressed. Having always been active – she took
    up sequence dancing at the age of 61 – she wasn’t ready to slow
    down. Eventually, continuing problems with her heart led doctors to
    recommend Welch attend a day centre and employ carers.  She
    recalls: “I thought ‘I’m not ready for that’ because in my mind I
    thought day centres were about people being slumped in chairs.” Her
    negative view stemmed from when her aunt was in a home where all
    the residents spent their days sitting in their chairs. Welch
    decided to give it a go anyway and began to attend Stradbroke Court
    once a week. After her first visit she decided it was “ok” and on
    the eve of her third visit Welch admits she was looking forward to
    going.  She now attends every Monday and Thursday and takes part in
    a mixture of activities ranging from bingo and quizzes to going out
    for meal and boat trips. What does she say to those who believe day
    centres fail to provide their users with enough stimulating
    activities? “I don’t know what people expect if they think a day
    centre is boring – you have to take part. The staff try their
    hardest to get people to join in and I wouldn’t have the patience
    to do that. “I’m definitely going to come here until they chuck me
    out. In fact, I’d come every day but I don’t think they’d have
    me.”

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