The Food Train: supporting older people to eat healthily at home

Inability to go and do the weekly shopping can have a significant impact on the wellbeing of older people – apart from the inconvenience factor, it can also affect their health, as it means they may not be able to meet their nutritional requirements.

Accessibility is one of the three characteristics of food poverty – alongside affordability and education/cooking skills (click here for more information on barriers to older people meeting their nutritional requirements). Research indicates that those experiencing the greatest difficulties in food shopping are considered to be at the greatest nutritional risk (click here for more details).

To tackle this problem, The Food Train was established in 1995, with volunteers providing a grocery shopping delivery and home support service to older people to allow them to live independently at home. Created and driven by older people themselves, The Food Train began in Dumfries town but, due to the demand for its services, its expansion has been funded by the Scottish Government and local authorities, and it has since spread to Dumfries & Galloway, West Lothian, Stirling, and Dundee.

In 1995 a community survey of older people in Dumfries highlighted that many people struggled with their weekly grocery shopping. The reasons included: not being able to drive; not being able to carry shopping home; and being unable to get out due to illness or a fall. Older people in the community decided to respond and created The Food Train. The objective was to overcome the problems faced by older people with their weekly shopping through a community-capacity building approach. The Food Train was designed from the start to meet wider objectives such as enabling older people to stay in control of their lives and to remain part of the local community.

As well as helping with collecting shopping for older people, The Food Train helps people in other ways, including:

• aid for those that have difficulty writing their own shopping list due to visual or arthritis-related impairments;
• telephone ordering, with prompting for people who have memory problems;
• a variety of payment arrangements to suit differing needs;
• help with checking, and unpacking of shopping;
• help with opening tops, packets and so on if required;
• aid with returning, exchanging and getting refunds on items provided;
• signposting to other services via leaflets in shopping boxes.

When volunteers join they are asked how often they can help and what are their preferred times and days for getting involved. This helps to safeguard success, as volunteering can be tailored to each individual’s lifestyle and desired level of involvement. To ensure volunteers are well aware when they will be volunteering, so they can plan accordingly, a rota is drawn up a month in advance. 

Another method used to ensure there is open communication is through branch meetings, open to all volunteers, which are held every eight weeks. As well as disseminating news about the Food Train to volunteers, it gives an opportunity for The Food Train family to get together to discuss concerns, raise issues or share stories about how they have dealt with difficult situations and to celebrate when the service ran particularly efficiently.

The Food Train provides each customer with a blank order form so they can write out their grocery order.  Most customers have their order collected by the volunteers on a nominated day and a new blank form is left.  Customers who have difficulty writing an order have their order taken over the telephone by staff and volunteers.  Orders for the whole week are taken to the various shops and teams of volunteers will start on the orders.  In some shops the dried goods are packed the day before and fresh items added in the morning and in other stores the whole order is picked on the day of delivery.  Delivery routes are arranged for geographical efficiency and worked around the capacity of each van.  Customers received their order complete with their own till receipt and their original shopping list so it can all be checked off.  Customers pay the volunteers the cost of their own shopping plus the delivery charge either by cash or cheque.  If this is not possible for whatever reason we have a variety of different methods to resolve this.  Each local branch has a choice of shops that ‘support’ The Food Train, the customer can choose from the shops available in their local branch area.

The public sector in Scotland recognised that there was great potential in the project. A four year funding package from the Scottish Government was awarded in 2002 through the ‘Better Neighbourhood Service Fund’. This allowed one full-time staff member to be recruited initially to develop The Food Train across the region of Dumfries & Galloway (with an extra part-time member of staff in 2005). This investment ensured that by September 2005 The Food Train’s grocery delivery service was expanded from approximately 50 to around 380 customers.

Once the grocery delivery service became fully operational across Dumfries & Galloway in late 2005, the Food Train set its sights on another clear need of its members – an additional support service called The Food Train ‘EXTRA’ Service, which provides practical home support, helping the frailest with home tasks.

In 2008 a planning process to expand The Food Train to other parts of Scotland began. The Scottish Government, Community Food & Health (Scotland), and West Lothian Council provided support to ensure that The Food Train in West Lothian started in September 2010 – providing a grocery delivery service with an ‘EXTRA’ service in development. Moreover, a Food Train in Stirling, providing a grocery delivery service, began in November 2011, following support from the Scottish Government and Stirling Council. In January 2012, a Food Train Dundee, supported by the Scottish Government and Dundee City Council, was established and now provides a grocery delivery service.

Since August 2010 in Dumfries & Galloway a small pilot befriending service has been added to The Food Train to help the most socially isolated and lonely to get out and maintain and develop friendships helping them enjoy life.  Funding just awarded will now help this new service move from pilot phase to region-wide activity.

The Food Train supports members of the community to live more independently through being able to stay in control of their lives and to enjoy a healthy diet. This helps to prevent malnutrition – reducing the likelihood of hospital admissions, and allows older people to remain in the comfort of their own homes within their community – greatly improving their quality of life.

The Food Train also provides unobtrusive advice for individuals about referral agencies in case individuals begin to have additional problems – helping individuals to manage their own conditions more effectively.

Community Food & Health (Scotland) commissioned an evaluation of The Food Train in 2008 to shed some light on its overall social benefits. This involved a customer survey on the perceived benefits of the services. The five key outcomes of The Food Train included:

• Independence 76%
• Health 50%
• Tackling Isolation 35%
• Wellbeing 27%
• Safety 21%

The evaluation concluded that:

‘The Food Train provides a well targeted, effective and flexible service that is highly acceptable to customers, with low cost inputs primarily as a result of its volunteer workforce. It generates high value outcomes for customers and fulfils a critical role in supporting them in their desire to retain their independence and to remain in the comfort of their own homes and within their own communities. Its economic value in delaying the onset of higher-cost packages of care is highly significant, and is in line with current UK and Scottish Government policies on meeting the challenge of an ageing population which is living longer though unhealthier lives.’

The Food Train’s work also has a beneficial impact on volunteers taking part. Volunteers have improved their mental and physical well-being because the project involves:

• working and doing things outside;
• increased social contact;
• getting a feel good factor from helping others;
• enabling volunteers to build upon their skills, increasing their employability.

Social cohesion is bolstered by creating contacts amongst volunteers and customers, amongst volunteers, and between local enterprises and the community.  This process also creates a culture of active citizenship. The Food Train has a positive economic impact for local shops, supermarkets and garages, enabling them to retain and attract new customers.

The Food Train also contributes to the Dumfries & Galloway’s Local Outcomes Framework, including:

• Improving employment and business opportunities (1.1)
• Maximising household income (1.4)
• Caring for vulnerable people (2.2)
• Reducing inequalities in health (2.4)
• Leading healthier lifestyles (2.5)
• Improving community safety (3.1)
• Supporting communities (3.2)
• Encouraging people to be responsible citizens (4.4).

The quality of the work that The Food Train provides has resulted in many awards such as:

• Queens Golden Jubilee Award (2004)
• Guardian Society Award (2004)
• Best Practice in Volunteering (2005)
• Age Concern Scotland Group of the Year (2005)
• UK Charity Awards – Highly Commended (2007)
• Healthy Working Lives (Bronze 2008 and Silver 2009)
• The Herald Society Awards – Commended (2008)

The economic evaluation calculated the direct costs of delivering The Food Train’s services in 2008/09 were just over £211,000. This consisted of:

• Staff costs of £81, 900
• Central running costs of £77,900
• Delivery of shopping & EXTRA services of £51,500

This allowed for over 15,000 grocery deliveries, and 1,000 EXTRA home support visits. This generated £31,000 in service charges to customers. Grants and donations were levered into the service equivalent to over £193,000.

The importance of volunteers to The Food Train is demonstrated by an estimate made by an evaluation of the Food Train’s economic value. It was estimated that the  total unpaid time invested for the year 2008/09 was 27,500 hours. This works out as invested time equivalent to £277,000 (using an average hourly rate for volunteers of £10.10) .

The Food Train's customers benefit financially from not having to use transport to get to enterprises. Moreover, the delivery service has lower costs and higher quality service than alternatives. The same is true for customers of the EXTRA service. The Food Train's customers spent £434,302 in 2008/09. There was a consensus amongst retail partners that The Food Train had a positive economic effect. Garages have benefited from the sale of diesel to tune of approximately £11,000.

By creating a good relationship with local enterprises the service is able to provide choice for customers, establish a guaranteed source of provision, and have access to fresh and affordable food.

Partnership with the local community: The Food Train has developed a strong network within the community, allowing referrals for individuals needing assistance to be easily made from local agencies, groups, clubs or individuals who believe an older person may be in need of help. Its partnership with the community involves all services being delivered by local volunteers and coordinated by local staff.

The service’s partnership with its members ensures that it listens and learns in order to provide members with what they need, when they need it, and ensure it is affordable. Members are especially able to shape the Food Train by voting at the AGM.

The Food Train has created a mutually beneficial partnership with its funders, which allows it to diversify and increase its range, whilst providing funders with a strong return on investment, and allowing local needs to be met, alongside wider benefits such as enabling a stronger, healthier community.

The Food Train website - http://www.thefoodtrain.co.uk/

Community Food and Health (Scotland) Website - http://www.communityfoodandhealth.org.uk/

Article by the Guardian on the Food Train - http://www.guardian.co.uk/society/2004/oct/13/charityawards.voluntarysector3