How Hertfordshire Community Meals provides social value

Meals on Wheels services exist in most local authorities in the UK and elsewhere in Europe but often do not have a great reputation in terms of value for money for the public purse or quality of service and food. However, it does not have to be like this. The social enterprise Hertfordshire Community Meals (HCM), based in the county of Hertfordshire, north of London, proves that it is possible to deliver good value meals, and a wide range of caring welfare services, appreciated by clients and commissioners alike. Through ‘Social Return On Investment’ research, HCM has gathered evidence of the social value provided by the meal service and related support services.

Why Hertfordshire Community Meals was set up as a social enterprise

HCM was set up as an Industrial Provident Society (IPS) in 2007 by HCC and a number of borough and district councils in Hertfordshire to deliver Meals on Wheels (MoWs) to disabled, elderly, and vulnerable people across Hertfordshire. As an IPS, HCM is regulated by the Financial Services Authority, issues shares to members who comprise the Board, and is run primarily for the benefit of people who are not members, in the interests of the community. HCM was set up with two charitable objectives: (1) The relief of poverty, sickness, and disability by the provision of meals and services to people who are elderly, frail, ill, disabled or otherwise in need and (2) the relief of unemployment.

The provision of MoWs is a statutory responsibility for Local Authorities under the Chronically Sick and Disabled Persons Act 1970. Prior to 2007, in a somewhat disparate approach, HCC’s statutory responsibility was met by a combination of borough councils, district councils, and Voluntary and Community Sector (VCS) organisations delivering highly variable MoWs services across the county.

This approach was ineffective for a variety of reasons: (1) It was expensive; (2) it was financially inefficient as economies of scale could not be realised; (3) it was inconsistent in terms of quality; (4) it was difficult to manage contractually; and (5) it was difficult to co-ordinate strategically. As such, in 2002 the Hertfordshire Meal Providers Group (HMPG) was established in order to bring together officers from several of the authorities in Hertfordshire to identify opportunities for joint working to generate efficiencies and to look at potential solutions to the problems identified with existing provision. As a result of the work of HMPG, HCC successfully secured a grant of £76,000 from the Norfolk Centre of Excellence in Procurement to work with the borough and district councils to assess the feasibility of a ‘community enterprise model’ for MoWs delivery. A consultancy firm called Mutual Advantage was commissioned to carry out the feasibility study.

The final report from Mutual Advantage considered three options for a social enterprise: (1) A production unit only, with the management and organisation of the service and delivery of meals remaining with the individual District Councils; (2) integrated management and delivery, with meals bought frozen or chilled from a commercial or non-commercial provider or contract and (3) an integrated holistic food production and delivery service.

Key objectives of ‘Meals and Wheels’ services in Hertfordshire

Of the three options suggested in the Mutual Advantage report, Option 2 was subsequently chosen by the HPMG because it was argued that the option could meet four key objectives:

1. Improved quality of service for clients
2. Financial efficiencies for local authorities
3. County-wide consistency of provision
4. Improved social benefits for Hertfordshire’s communities

Subsequently in October 2007 commissioners from HCC’s Adult Care Services (now Health and Community Services) set up Hertfordshire Community Meals (HCM) to commence service delivery in North Hertfordshire with a view to providing for Hertfordshire’s remaining nine districts on the expiry of existing contracts.

HCM has six values which underline the expectations of all of its members of staff: caring, community, conscientiousness, creativity, communication, and cost-efficiency (see www.hertscommunitymeals.co.uk). The purpose of these values is to help reinforce HCM’s community-focussed culture both internally and externally.

Arguably this is an important part of HCM’s success, particularly in terms of recruiting other caring like-minded individuals, advertising the service to lonely clients, building relationships with stakeholders, and establishing an attractive ‘brand’. For example, in HCM’s 2011 Annual Survey, 58% of clients agreed that because of HCM’s service they now ‘feel part of a community’. 

Diversification
HCM is constantly looking to improve its service offerings, often through working in partnership with other organisations. For example, Operation Sponge Pudding is a safety project, which involves police, fire, and trading standards officers accompanying drivers on their rounds in order to carry out safety checks of vulnerable clients’ homes. Not only does this make clients feel more secure, but also allows Hertfordshire Constabulary and Fire and Rescue Service to prevent certain crimes against older people, such as distraction burglaries, and to install equipment that will help to prevent fires.

HCM is far from being just a meals provider, and provides a range of welfare checks to all of its clients: meals are not just delivered to the door – drivers often have to plate meals, prepare a drink, or speak to relatives on behalf of clients. This means that HCM can provide a much more holistic service which has a hugely positive impact not just on the clients, but also their carers and family members too.

Indeed, as HCM has grown so quickly (in 2007 it had 7 staff and 2 vehicles, in 2014 it has 185 staff and 62 vehicles), it now has a considerable resource base that can be used for a wide range of other purposes: pilots are currently being run in day services for clients with early-onset dementia, non-personal homecare, and telecare installations.

Forward-thinking leadership
HCM is fortunate in the sense that it has an extremely dedicated Chief Executive and a committed, qualified, and well-rounded Board of Members that collectively contribute to the effective governance, management, and leadership of the organisation. This cannot be underestimated, particularly in times of difficulty, such as organisational restructures, when strong leadership is absolutely essential to organisational success. 

After reviewing very similar positive results from the 2011 Annual Survey (in a context of local authority financial pressures, widespread closures of MoWs services around the United Kingdom, and political uncertainty), the management of HCM decided to embark on a Social Return On Investment (SROI) study in order to prove the value of the service to its key stakeholders. The study was carried out by an SROI practitioner in collaboration with Anglia Ruskin University and was subsequently approved by the assurance process of the SROI Network.

After going through a detailed process of analysis the study found that, on average, for every £1 invested in HCM, £5.28 of value was created for stakeholders (44% of the value for clients, 36% for public organisations such as the local authority, and 20% for carers and/or family members.

Therefore, the statistical evidence suggests that HCM generates considerable value for its stakeholders. In addition to quantitative evidence, HCM gathered a significant amount of qualitative evidence, particularly from clients and their carers, which indicates the value that the service provides. For example, a large number of clients reported that because of the service provided to them by HCM, they are happier, healthier, and have greater peace of mind (see the results from the annual client surveys at https://hertsindependentliving.org/client-survey/).  Clients and their carers also told HCM that they felt more independent, their lives are easier, and that they are now able to work full-time as a result of not having to take time off from work to feed their relatives, as can be see from the following comments:

“I am healthier and more relaxed, as I know I won’t be hungry.”

“Since having meals 7 days a week, mother has been in better health and has gained weight! She was 6½ stone and now she’s 9½. She is brighter and much more with it.”

“The service helped my recovery from hospital since my hip replacement.”

“I used to keep hurting myself when cooking”

“I have security in knowing someone is checking-in on me”

Not only are the results extremely positive; they also indicate that the services provided by HCM offer considerable benefits to a whole range of stakeholders in Hertfordshire’s communities. In question eight (“I visit my GP less”), for example, response revealed that 30.1% of clients ‘agree strongly’ that they visit their GP less, and a further 36.8% ‘agree somewhat’ that they visit their GP less. This is significant, as it is therefore very likely that HCM is indirectly reducing the strain on GPs (and perhaps other health services) around Hertfordshire.

Clearly, Hertfordshire Community Meals is not just a provider of meals. The SROI study revealed that HCM has a hugely positive indirect impact on a wide range of stakeholders. Perhaps most importantly, this impact translates into tangible savings for public sector organisations. Indeed, the SROI study argued that from a total investment of around £2.3m (in 2011/2012), HCM generated approximately £12.3m in wider social value. 

As a publicly-subsidised service, HCM is absolutely committed to reducing costs in order to realise savings for HCC. For example, to name but a few initiatives, last year HCM re-negotiated all of its utilities contracts, changed its I.T. provider, and transformed its vehicle fleet, all of which will realise considerable savings which will in turn be passed on to HCC. HCM is very aware of the financial pressures faced by local authorities, and as such often pre-empts rounds of funding cuts by seeking savings through challenging and transforming its own operation.  

HCM’s SROI study is particularly significant for other MoWs services around the United Kingdom, which appear to have been victims of short-sighted cuts by local authorities. The study suggests that MoWs services can have a huge impact on local areas, and although they are often seen as ‘just a meal’, they can actually provide a wide range of indirect benefits to numerous types of stakeholders, which otherwise may go unevidenced. The study also highlights the usefulness of SROI and, given that local authorities are now obliged by the Social Value Bill to look at ‘wider social value’ as part of the commissioning process, it is very likely that providers of other services may be tempted to carry out such studies to demonstrate the importance of their own services. 

Re-visiting the original objectives

As stated previously, there were four objectives to establishing HCM:

1. Improved quality of service for clients
2. Financial efficiencies for local authorities
3. County-wide consistency of provision
4. Improved social benefits for Hertfordshire’s communities

First, the results from HCM’s annual surveys suggest that clients are much happier with a wide range of aspects of the service (including menu range, driver service, timeliness of delivery etc.) – see https://hertsindependentliving.org/client-survey/.

Second, the combined cost of the previous approach to MoWs in Hertfordshire was costing local authorities around £3m every year. HCC now spends less than £1m per annum on commissioning HCM. Indeed, HCM is committed to reducing its unit cost and thus lessen its impact on the public purse. 

Third, it is clear that Hertfordshire now has a vastly more consistent service: pre-2007, some rural areas did not have access to MoWs, some districts did not operate on week-ends, and clients in some districts did not have access to special dietary requirements.

Fourth, it is clear from HCM’s SROI study that the organisation has a hugely positive social impact on Hertfordshire’s communities, not just through its core delivery service, but through other initiatives, such as its employment initiatives with the Probation Service and Offender Management teams, security projects with Hertfordshire Constabulary, and fire safety initiatives with Hertfordshire Fire and Rescue.

The future

Interestingly, HCM is now looking at a range of diversification opportunities including homecare, community transport, and community alarms, as part of expanding its core operations to provide a more holistic service offering to its clients, while at the time hoping to achieve further savings for local authorities. HCM is able to do this through utilising its relatively under-used resource base which includes four sites, 62 vehicles, and I.T. infrastructure, all of which is dispersed around Hertfordshire in four key locations (Hemel Hempstead, Letchworth, St Albans, and Ware).

Since this case study was written, Hertfordshire Community Meals has changed its name to Hertfordshire Independent Living, which now provides a wide range of services to help older and vulnerable people stay happy, healthy and independent – see https://hertsindependentliving.org/

For more information on conducting a SROI study please visit: http://www.thesroinetwork.org/