Be Active Life Long

This is one of seven case studies that celebrates what ‘community social work’ is and has to offer.

It demonstrates how working closely and in partnership with communities makes the best use of resources, generates new capacity and greater agency, builds resilience, and supports preventative approaches that make a real difference to people’s lives. It also has much to offer at a time of reduced public spending and pressure on services.

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Twenty-two active ageing groups in Moray, run by and for older people (with support and advice as required), help over 700 people a week stay active and connected to their community.

BALL (Be Active Life Long) groups are unique to Moray. They were created in 2005 out of the need to improve mental and physical activity among the over 60s, keeping them connected to their communities and preventing, reducing or delaying the need for formal care services. BALL groups are a collaboration of the Older People's Development Team (OPDT), NHS Physiotherapy and Community Support Unit, led by Irene Weedon from Moray Council’s OPDT.

Supporting the BALL group activities gave me a sense of purpose, which has helped my confidence to grow... What has BALL changed for me? Just my whole life!

Dot
BALL group member and fitness instructor

BALL groups operate within communities, attracting members from surrounding localities. Hopeman, a small coastal village, was the first to set up a group that targeted existing community groups with messages about improving health through physical and mental activities, and increased opportunities to socialise. It involves an hour of physical activity (e.g. yoga, dancing, walking), a tea break followed by a ‘seated’ activity such as a craft session, a talk or a quiz. Members pay on average £2.50 per week and group sizes vary from 7 to over 70. The smaller groups value group cohesion, while the larger groups value the ability to focus on their own hobbies with like-minded individuals. Both are seen by their members as ‘the best’ way to do it.

The initial results from Hopeman showed promise, reporting a decrease in isolation, along with higher levels of activity and improvements in confidence and general wellbeing. As the first group thrived, BALL was rolled out across Moray, beginning with Elgin and Tomintoul. By the close of 2017, the Community Wellbeing Development Team (CWDT), led by Carmen Gillies, supported Moray’s 22 BALL groups, as well as over 30 other older people's groups. The CWDT and BALL are now recognised and trusted brands within Moray.

We act as that conduit between keeping people fit, healthy and active as a preventative approach for health and social care. But then there’s the whole aspect of continuous learning, the community learning and development side of what BALL delivers. And then we have micro providers, many of them retired people with skills they can share, who are paid for providing sessions, so BALL supports a whole range of different areas

Carmen Gillies
Community Wellbeing Development Officer
Health and Social Care Moray

How it works

The Community Wellbeing Development Team initiates the development of each group. Over the course of the first 12-week sessions a new group has its initial programme of activities provided, along with advertising and promotional material. Gradually organisation is handed over to the group members.

As well as teaching them games and skills to run activity sessions, the CWDT teach the members to be ‘canny’ with their BALL finances, making the most of the seed fund that each group is awarded and the income they generate. Some groups also choose to apply for grant funding.

Each group is encouraged to draw on the skills and interests of members as part of their programmed activities, rather than paying external specialists for everything. As the group’s capabilities and confidence grow, the CWDT gradually hands over responsibility, but maintains a light-touch relationship as link workers who can signpost to appropriate services and provide relevant information into the group.

The group develops its own (informal) management committee, taking responsibility for the finances and arranging the activity programme. In addition, there is an overall Governing Board that offers guidance to the groups and covers insurances. The Board meets quarterly and each group is invited to send a representative along to share ideas, best practice and discuss any challenges.

The gradual handover of day-to-day management from the small CWDT to the group members usually takes nine to twelve months.

The programme now forms part of Moray’s strategic plan, which reflects its effectiveness.

Results

BALL Groups help to delay, prevent or reduce the need for long-term care for older people by supporting them to make new connections, friends and networks within their community while staying mentally and physically active.

They are so supportive of each other. If anyone is ill they are all in touch to see how they are doing - it’s like a wee community within their own group.

Ann Hay
CDWT

In addition to the BALL Groups, the CWDT support a further 30+ groups including Men’s Shed, lunch groups, social groups and the University of the Third Age.

Bereaved members we talked to described a downward trajectory following their loss. Loneliness leads to decreased confidence, which leads to a decline in socialising. This, in turn, can mean less physical activity and less mental stimulation. The BALL groups have helped turn this around, providing activities, mental stimulation and a wider circle of friends for members. As Ann says, 'they take an interest in each other’s wellbeing and provide support to one another'. This includes helping with travel to and from the groups. They are also extremely welcoming of new members. The hardest part is often making the decision to try the group.

Twenty-two BALL groups are now active across Moray, supporting over 700 individuals a week in staying mentally and physically active. The support they provide equates to around 1400 hours of care per week.

Mapping the development and influences

Olga, Janet and Stella’s story

Olga joined Duffus BALL group after meeting a group member on the bus. She had always been a keen walker, but joint issues and operations meant she was no longer able to participate as she had previously.  With family living away she was beginning to feel isolated. The BALL group was an interesting option, although she had some reservations. 'I’d never done this sort of thing before, apart from walking Groups.' Her local group had a waiting list but she was able to join another in nearby Duffus where she also met Stella and Janet. 'Within ten minutes I thought, ‘Hey, I like this!’ I just think this is the best.' Olga talks enthusiastically about the group and events such as the ‘daytime nightclub’ that the BALL groups across Moray organised in a local Elgin nightclub.

Janet organises the programme for the group, providing a wide variety of activities. It’s a role that she wouldn't have taken on a few years ago. One of the activities she organised was sharing things that people had written. Some chose to write about what BALL means to them and one member, also called Janet who had been reluctant to go along to start with, wrote a moving poem about the difference the group has made to her life (a copy can be found in the Appendix).

The Duffus group has around 30 members and runs during term time, with meet-ups for coffee in between the blocks. There is a Treasurer post, but no formal committee. The group has given all of them new opportunities, new friends and greater variety in their lives. For this group, a limited size is seen as a benefit, as is the democratic approach to running and organising it. The central ‘tea break’ is a small but vital part of the BALL day, 'We do nothing but eat!' Stella jokes. It’s a chance to come together, get to know people and have a catch up with friends. Crucially, they also see their participation in BALL as being a help and support to others, not just for their own benefit.

Duffus BALL group has developed some informal ‘interest’ spin-offs, such as a walking group and a curry lunch group. They share ideas with other groups, building bridges to other local communities in the process. All three talk warmly of the support within the group for those going through personal difficulties, be that ill health, bereavement or day-to-day challenges.

Their recommendations to anyone setting up a group are:

• Make the most of the support from the council to build capability and confidence
• Find out and build on the strengths already present within the group’s membership

One of the reasons the BALL group works so well is the amount of time that the team put into setting us up and coming along all the sessions. And then after a wee while we decided we could become independent, which we did.

Stella
Duffus BALL group

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If somebody had said to me I’d be doing Tai Chi and yoga and stuff, and organising a group like this, I wouldn’t have believed it. It opens your mind to different things.

Janet
Duffus BALL group

Dot’s story

Dot is sprightly and engaging. Her enthusiasm for life and pragmatism are far more apparent than her limited vision and hearing difficulties. Four years ago, at the age of 75, Dot qualified as a fitness instructor. A year later she took a further qualification in providing chair-based exercise. 'What has BALL changed for me? Just my whole life!'

In 2002, on Mother’s Day, Dot stopped smoking. To keep her hands busy, she took up the harmonica. Keen to play along with others, she started a band. Although short-lived in itself, this led to the development of a dance group, the Hip Bumpers, that performed across the region and encouraged participation from audiences in care homes and community groups. A chance meeting with Irene Weedon at a BALL taster Salsa class led to Dot taking her community dance to six BALL groups initially and then expanding further.

She sees the strength of BALL in the confidence it breeds, by facilitating and encouraging people to try new activities in a safe space, with an emphasis on fun.

When you’re getting older, you tend to lose your confidence and you lose your standing, you lose your status a bit. The children are all grown up and they no longer need you and with that the lack of confidence can creep in. The BALL groups have given me my confidence back. I would never have believed I could walk into a room and get a hundred people on the floor to dance!

Dot adds that self-management of the groups gives the members standing in their communities, which some feel they lose in retirement. What Dot gets from BALL is seeing others develop and feeling good in herself. She chooses to donate the payment she gets for her classes to a charity each year.

Dot’s advice to anyone thinking of starting a group or going along  'Just do it! Start small and then let it grow.' Dot would like to see more of the groups in smaller places and emphasises that it doesn’t have to be ‘big and brash’ – small is beautiful!

It’s just wonderful – you see them coming in kind of timid and shrunken and after three or four weeks they’re striding along. You wouldn’t believe the difference it makes and it can spread into all areas of their life. It’s as though someone has lit a light inside them.

Dot
BALL group member and fitness instructor

The growth of Archiestown group

Archiestown’s BALL group was first proposed to the village council. The village has fewer than 100 homes with about 500 residents. Through posters, the village newsletter and word of mouth, a BALL group was launched around four years ago with six members, aged from 60 to 90. Its members cite word-of-mouth as a particularly effective way of garnering interest.

Ann Hay from the CWDT ran the group for them initially - attending every week, organising the programme of events, taking responsibility for the group’s finances and organising the venue. The group’s activity programme was shared in advance, with the emphasis on group participation, whether it looked like ‘their sort of thing’ or not. (NB Some groups now choose to keep their activities unpublished, so that no one pre-judges the activities and misses an opportunity to try something new).

In line with the BALL model, gradually the group was encouraged to take charge of its own management. Jim, one of the earliest members, described how ‘ambition has grown from their successes’. 'Every now and again you hear a little comment from someone and you think – Yes! – It’s working!' and their confidence to run things for themselves has blossomed. They set up a bank account for the group and some members began to step into specific roles, such as treasurer, programme organiser or running activity sessions. The group’s management is informal, with loose ‘business meetings’ to help them plan future activities. Programmes are planned 12 weeks ahead.

Jean joined the group a little time after Jim. 'It was a time just after my husband died and I had withdrawn into myself. The longer I was indoors the harder it was for me to get out and I was getting lonelier; I felt I had cut myself off.' Jenny, one of the original members, said, ‘You really ought to come along.’ 'I was walking with two sticks at the time, really sorry for myself, but she thought it would do me good.' Although she found the courage to go, the first visit didn’t quite hit the mark for her. 'When I first went along I hobbled in only to find they were doing Latin American dancing! She was very good, showing me how to join in sitting down, but I felt I didn’t know anybody and after the first visit I thought it wasn’t for me.'

However, on the second attempt she felt a host of opportunities had opened up. 'I gave it a second go, we did something different and I went home with a different attitude. Ever since then I’ve got more and more involved.'

BALL not only helped Jean regain her mobility, but led her to become the programme organiser for the Archiestown group as her confidence grew. Jean has also taken on further challenges. 'It has brought me out, made my brain work again, I’ve got a wider group of people I socialise with – it’s made me a slightly different person, so much so that this last year I did a course with Citizens’ Advice Bureau and now I’m a fully fledged adviser. I thoroughly enjoyed it. I feel that because of BALL, because of what it did for me I’m now giving something back to somebody else. I come home mentally exhausted but the wellbeing has made a difference. That’s all down to the BALL group, there’s no two ways about it. There’s no way I would have been doing it otherwise.'

An openness to trying new things is at the heart of the BALL programme – Jim and Jean both try activities there that they wouldn’t have considered previously, whether it's yoga, line dancing, craft activities or geology talks. They have also taken on group challenges, like using pedometers to track their cumulative progress as they walked the distance of a full round trip of the UK and Northern Ireland. This has encouraged them to walk more and they are planning touring all the capital cities in Europe as their next virtual walking tour.

The group is inspired and delighted by the difference it sees in it and each other, especially in terms of mobility, confidence, capability, support and sociability.

Archiestown now has around 26 regular attendees, which is substantial given the size of the village. As its developed, the group has built bridges with other BALL groups, widening its social networks, sharing ideas and engaging in the University of the Third Age. 

Jean and Jim’s advice for anyone setting up a new BALL group is:

• Be realistic about what you want to achieve at the start
• Start slowly, give it time to bed-in and develop
• Identify the audience and engage with them through activities they will find interesting
• Be persistent and don’t take it personally if people don’t engage - it may not be for them or they may not be ready yet
• Have a programme
• Make the facility a friendly, welcoming place to be
• Seek help and advice

Through various network meetings, as long as you have people who are active and prepared to learn and share, the whole network will continue to grow, and that can only improve the problems you’ve got with loneliness and isolation.

Jim
Archiestown BALL group

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You can do it, you don’t have to sit alone at home – there is somewhere out there that can help you and encourage you.
Jean
Archiestown BALL group

What worked well and why

The model is self-sustaining, so after the initial set-up the need for practitioner (CWDT) input is greatly reduced in terms of time. There remains a vital role for them, however, in terms of advice, link visits and crisis management. By being fast to respond to any queries, the CWDT maintains the trust of the groups, which, in turn, means that any issues are likely to be raised and are resolved early.

Part of the appeal to members, and the secret of the group cohesion, is knowing they are helping others. The increased mental stimulation also breeds further curiosity and a willingness to learn. Members report surprising themselves with what they have been able to achieve since getting involved.

While BALL groups have worked effectively in almost every area, there is one place where there has been insufficient numbers to make a viable group. In this instance the interested individuals have gone on to meet weekly at each other’s homes.

This demonstrates a real strength of the way BALL groups are run – the CWDT are given the freedom to respond to changes, without being tied to a restrictive mandate. The outcomes are clear to see at an individual and group level, even though it is difficult to measure what the demand on care and health services would have been without BALL.

The CWDT also work alongside health and social care services to provide support to individuals. The trust they have built over time for the BALL brand among individuals and service providers allows them to be an effective facilitator between all parties concerned, and to receive referrals into BALL groups through the social work group and GPs.

While the programme was outsourced to a third sector provider for a period, the trust and reputation of the CWDT proved to be a major factor in the ability of BALL groups to grow and prosper. As a result, the decision was taken to bring it back into the council. This trust is reflected at a membership level; word-of-mouth is the main recruitment method for BALL groups.

What would they do differently

There is a need to ensure that the groups are clearly promoted as inclusive. In some communities, for example, men got the impression that they were aimed at women given the activities such as dancing. However, the brand is strong. There is a broad and improving understanding of what it involves (once the preconceptions about dance classes are overcome). BALL has good standing with both participants and professional service providers alike.

Challenges

This initiative has a long-term pay-off as older people, with increasing life expectancy, are supported to help themselves to live more enjoyable, more mobile lives for longer. A challenge is the reliance on centralised funding.

Although the individual groups could in theory continue if this was withdrawn, the programme would gradually fade as the lack of ‘below the radar’ support that the central team provides to the existing groups would become a barrier.

Future plans

The CWDT is building a programme for those unable to take part in BALL due to decreasing mobility. With the same ethos as BALL, they have developed SET Groups (Singing, Exercise and Tea) for those who no longer have the mobility to participate in the BALL activities. SET provides the same socialisation and stimulation, but in a quieter environment and with activities requiring less mobility or dexterity. The first three groups are now in operation. As with the whole BALL programme, there are no ‘hard’ breaks, so members are often choosing to gradually move into SET, possibly attending both groups for a period as they transition from one to the other.
The first Pow Wow workshops were introduced in February 2018.These are for group members who want to develop their technical abilities, providing more formal training sessions on the types of skills they need to run the groups. As part of these sessions they will capture and share best practice, increasing community learning and community resilience.

The team also has ambitions to expand the programme beyond Moray and would be happy to discuss this with any interested regions.

Wider benefits

Through involvement in BALL groups, individuals are also finding the confidence and uncovering abilities that are helping them to go on to develop new skills and take on new challenges within their communities. Examples include Dot who took fitness instructor training at the age of 75 so that she could lead sessions for BALL groups and others, going on to take a qualification in leading seated exercise for less mobile participants the following year. Jim has also learned how to make effective grant applications. Jean had just completed her Citizen’s Advice Bureau training at almost 80.

In addition to BALL, members have gone on to become involved in lunch and social groups that they organise themselves and CWDT-introduced groups, including:

• SET Groups - Singing, Exercise & Tea (Groups for fall prevention and support after a fall, providing rehabilitation in the community)
• Men’s Shed (a national programme being introduced to Moray by CWDT, which brings groups of men 50+ together to ‘potter’ in a communal shed, socialising, constructing and sharing skills)
• University of the Third Age (U3A - continuing education, with an emphasis on sharing knowledge for people who have passed the stage of working full time and caring for children)

There are also examples of cross-generational work, for example, the Archiestown Group has been collaborating with and sponsoring a local athletics group.

Sharing the model

The model is relatively low-cost to implement and run. It has the potential to provide substantial savings in NHS and social care requirements as a result of the improvements to the lives of those participating. The design of the model makes it feasible to replicate it across other regions. The coordinating team, however, would need to be given the authority and flexibility to respond to the needs of their local population within the overall model.

Key points

• Individuals can experience life-changing improvements in wellbeing through shared physical and mental activities
• The benefits of the groups extend beyond the individual to the wider community and ease pressure on formal support services
• Use existing contacts and word-of-mouth to promote the concept
• Provide support with a gradual handover of control in a managed and measured way
• Provide reliable and responsive support to the groups
• A small central team can support a large number of individuals through a well-planned, staggered rollout of the programme

Further information about BALL and additional services for the over 60s in Moray

Remote video URL

Appendix

When One Door Closes
When my family finally flew the nest,
For quite some time I felt really bereft,
Oh! what’s the point of moping and crying?
I could find me a job,
Well at least it’s worth trying,
The thought’s quite daunting after such a long break,
A lot of courage it doth take.
So now I embark on yet an another new life phase,
Working full time to fill in the days,
Life becomes the other extreme,
No time now to sit and daydream.
Then all too soon the years have flown,
It’s time to retire and I’m once more alone.
What to do now that I’m back in that place?
I don’t feel quite ready to sit at home and ‘make lace’.
Then one day in the local shop,
I honestly didn’t mean to eaves drop,
They’re discussing something to do with a ball,
Ah! It’s a new Group that’s forming down in the hall.
It seems to be for people of a certain age,
Well, well, well just watch this page.
But then I have always been quite shy,
Should I, dare I give it a try?
So I pluck up the courage and venture along,
There’s no harm in just finding out what’s going on,
And do you know what it’s one of the best things I’ve done.
Meeting new people and enjoying much fun,
Be it dancing with Dot or simply having a natter,
But it’s the import things that really matter.

The most important thing of all,
Is the friendship I have found down in the hall.
For that I say ‘thank you’ friends, one and all,
I can truthfully say ‘I am now having a ball’.

Poem written by Janet reflecting on how being a member of her local BALL Group has impacted upon her life.

Acknowledgements and thanks

Thanks to everyone who contributed to this research project. With particular thanks to Carmen Gillies and Ann Hay from Moray Council’s Community Wellbeing Development Team and to Jim, Jean, Dot, Olga, Stella and Janet who were kind enough to share their experiences.

This document has been prepared for Iriss by Fay Purves CMRS of Creative Art Works CIC, a Community Interest Company. Unless otherwise stated, design and photography is by Lindsay Snedden LBIPP of Creative Art Works CIC.

We would also like to thank the Community Social Work Advisory Group members for their valuable input to this work: Trisha Hall (Scottish Association of Social Work), Stuart Hashagen (independent), Andrew Gillies (Social Work Scotland), Graham McPheat (University of Strathclyde), Keith Moore-Milne (Glasgow City Council), Kerry Musselbrook (Chair & Project Lead, Iriss), Liz Timms (SASW member), Colin Turbett (social work author and activist).

For more information about this work contact Project Lead: kerry.musselbrook@iriss.org.uk