Organisational Structures
Formal Care in the Home and Community
access points (referral, counselling, one-stop-shops)
COUNTRY / LOCATION: Netherlands
Keywords: independence, integration, local community, empowerment
Keywords: independence, integration, local community, empowerment
'Living comfortably in Menterwolde': Integration of health and social services in the local community for people who need care
Summary
The number of people who need care but wish to live as independent as possible is increasing. To encourage this independent living for people who need long-term care, the government in the Netherlands developed several financial regulations like the “Woonzorgstimuleringsregeling” in 2000 and the "Beleidsregel zorginfrastructuur” in 2006. Also European grants are used for developing innovations, for example technology services which enable independent living.
The project ‘Comfortabel Wonen Menterwolde’ (Living comfortably in Menterwolde) aims to provide enough opportunities for contact and support to vulnerable local citizens. The strength of the project is the cooperation between health and social services which not only focus on care facilities but especially try to find solutions for living independent in a nice way. These solutions are found in several health and social services like activities to meet, a restaurant, day care for people with disabilities, 24 hours care, technology services etc. All these services and facilities are provided in or from the multifunctional (meeting) centre ‘De Gilde’ and support people in the apartments of the Gilde and people in the neighbourhood in their own houses.
The key question is what do vulnerable people (older people and people with disabilities) need to enjoy living (or staying) independent. Good cooperation between health and social services is crucial.
The integration of people with and without disabilities is a secondary goal of the project.
What is the main benefit for people in need of care and/or carers?
The main benefits of the project ‘Comfortabel Wonen Menterwolde’ is that older people and people with disabilities who have a need for care can stay independent in their own neighbourhood in a meaningful way. Empowerment of vulnerable people is an important part of the project. The other benefit is the integration of people with disabilities in their community.
People experience care close to their homes, they have opportunities to meet each other. Also feelings of safety play an important role. When someone is in need of care, the carer is able to respond at short notice because the care organisation is nearby.
What is the main message for practice and/or policy in relation to this sub-theme?
The main message for practice and/or policy is to develop more integrated health and social services in the local community. By using opportunities for welfare activities and cooperation with informal carers the need for care as well as nursing home admission can be postponed or even prevented.
People wish to stay independent as long as possible but to prevent social isolation and to guarantee safety, organisations need to provide integrated services which offer care and welfare opportunities in local communities near people.
This means a good cooperation between the several disciplines is needed to offer the diversity of services which can be helpful for vulnerable people to live independently.
Why was this example implemented?
With the help of different financing regulations many good initiatives started in the local community, where health and social services are brought together. The example of Menterwolde was started in 2003 when a location of one of the organisations became vacant. Citizens and organisations wanted a new destination for this location. The first project phase was focussed on the ‘hardware’: financing the location and dividing the different rooms. The project was funded through European and national regulations. Different healthcare and welfare organisations were involved and also the housing corporation. In 2008 a project leader was assigned for organising the care and welfare services. The project leader brought the organisations together at the practical level and they started making plans.
Living comfortably in Menterwolde was implemented to meet the wishes of people with care needs to stay in their own neighbourhood as long as possible and another goal of the project was for people with a disability to participate in the community, for example in voluntary work.
Description
Living comfortably in Menterwolde is an infrastructure in the local community which provides several public health and social services. The building ‘De Gilde’ is a multifunctional meeting centre which contains 18 apartments for older people from which 70% have a need for care. There are also 26 studios for people with a learning disability. In the meeting centre several organisations provide their services like home care, a playground for children, activities for older people and people with a learning disability. But also a restaurant and activities for the citizens in the neighbourhood is available. Examples of these activities are computer courses and cooking. The activities focus especially on social interaction. The health and social services which are provided in ‘De Gilde’ support people who live in the apartments but also vulnerable people in the neighbourhood who live in their own houses.
Several care and welfare organisations cooperate to provide the health and social services. The organisations involved are the housing corporation, welfare organisation, care organisation for older people and two services for people with a learning disability. In the meetings end-users are also involved.
Another part of the project is the technology services which are offered in the apartments for older people and people with a learning disability.
In Menterwolde most people are self reliant. The project leader (from the health care organisation) initiated different services but especially asks users to be involved in arranging activities.
Supporting empowerment of vulnerable local citizens is another purpose of the project. People who are in need of care become more independent, empowered and integrated into the community.
The project is funded through different financial European and national regulations. With the help of these regulations the building can be financed. To get the costs of the services covered, organisations cooperate efficiently (e.g. night shifts) and a lot of volunteers are involved.
The project leader will stop in January 2012, which means the project will cease. Organisations have to make plans on how to continue the health and social services at the meeting centre ‘De Gilde’. All partners are willing to organise a sustainable structure, which is promising for the future.
What are/were the effects?
There are several project effects:
- People in need of care can stay independently in their own neighbourhood for longer because of the apartments and services. Without these facilities they would have to move to another village.
- People with disabilities are able to participate in activities or as a volunteer. Participation gives them self esteem and they integrate in their own neighbourhood.
- There is also a positive effect for the neighbourhood. A lot of services are provided nearby which has a positive dynamic; people feel more involved in their neighbourhood which improves social cohesion. For example the Christmas market is visited by 500 people from the area. This development can be a tool to prevent decreasing rural populations; citizens see more reason to stay in Menterwolde.
- Research has shown that the quality of life of the older people in the apartments improved significantly. The services and activities also prevent people from becoming isolated.
- Professional carers feel the additional value of cooperating with different organisations. They are trained in this cooperation as a T-shaped professional: the vertical bar on the T represents the depth of related skills as expertise in his/her own field, whereas the horizontal bar is the ability to cooperate across disciplines with experts in other areas, and to apply knowledge in areas of expertise other than their own.
- The integration of health and social services has a positive effect on the way professionals reflect on their work.
What are the strengths and limitations?
The strengths of this project are especially focused on the cooperation between the different organisations. In the beginning, the project leader had to invest a considerable amount in this cooperation but it created good communication and a lot of enthusiasm.
Another strength of the project is the support within all the cooperating organisations. On every level in the organisation there was a lot of enthusiasm for the project and so every organisation involved was willing to invest time and energy
The project leader divided different portfolios (like technology or welfare services) to the organisations so they became portfolio managers, responsible for their portfolios. This was a strength of the project. Organisations became more involved and felt obliged to make their portfolio a success.
The weaknesses and threats of the project were also evident within the cooperation between the different organisations. When organisations have internal challenges there is limited time and energy to invest in the project. Another threat for the project is a lot of staff movements. The involvement of staff is crucial.
Political interests are also a threat. After four years the political climate may change which means different interests and investments from the local authorities.
Credits
Author: Tessa Overmars-Marx (Vilans, centre of expertise for Long-term Care)Reviewer 1: Jenny Billings
Reviewer 2:
Verified by:
