Evaluation Report

2015/16

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Through the Doorway to Healthy Living is a ‘virtual’ healthy living centre, founded in 2003, primarily working in Shrewsbury. We use the term ‘virtual’ because we do not have premises of our own, preferring to use a variety of community venues across the area to provide activities within communities rather than expecting people to come to one specific place.

Our aim is to reduce health inequalities (by which we mean reducing the gap between the health of different groups of people such as the well-off compared to poorer communities or people with different ethnic backgrounds), by providing free or low cost practical activities that can help people to live healthier and more fulfilled lives.

We could not do this without the support of our funders, so many thanks to the National Foundation for Youth Music for funding our mini-music sessions and Shropshire Clinical Commissioning Group which also provided some funding up until March 2016.

Our biggest thanks, as always, are reserved for the ongoing commitment of our amazing staff and most importantly of all, our users for their continuing support.

If you would like information about our work please do not hesitate to get in touch

Anne Seymour

Text/phone: 07528 700492

Email: ams.doortohealth@gmail.com

Web: www.throughthedoorway.btck.co.uk

Company No. 4746087, a Company Limited by Guarantee, registered in England and Wales

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189 adults and 89 children took part in activity sessions throughout the year

86% of participants attending our exercise sessions felt that their health had improved

82% felt they were more supple and mobile

59% felt that their balance had improved

51% felt that their breathing had improved Across all our activities

88% reported that they were having fun

70% had made friends

73% felt that it got them out

59% felt happier

We also asked about any specific benefits people had noticed. Recurrent themes included:

Reduced social isolation through getting out, meeting new people and making friends

Maintaining independence through establishing a routine of exercise and activity throughout the week, not just as part of the sessions

Relaxation and reduced anxiety/emotional problems

Improved management of existing conditions, including helping people get back into work and preparing for medical procedures

Increased confidence

Referrals Despite the significant and in some cases remarkable outcomes described in this (and previous) reports, we still find that engaging with the statutory sector in Shropshire is an uphill battle. As a small not for profit organisation, we have a limited budget for advertising and publicity, but we do make use of as many opportunities to promote our activities as possible. For example, information about our activities is available on health and social care information websites such as Shropshire Choices, Healthy Shropshire and Shropshire Council’s Community Directory. Despite this, we get very few referrals from health or social care professionals. This is frustrating for us and our clients. One participant said: “I feel spreading the word about this activity would be the most important activity. It’s sad GPs don’t refer more of their patients”. Another participant knew that there used to be an Extend session at the Lantern (not run by Through the Doorway), so was looking for an activity she could attend in which she didn’t have to stand for long. Unfortunately the Extend class was no longer running, but the receptionist mentioned the Tai Chi sessions “…. receptionist told me of this Tai Chi class (chairs if necessary). Was not told by Falls Clinic” Affordability and Sustainability In the main, our participants tend to be living on lower than average incomes, so affordability of sessions is a big issue. A significant proportion also report living with a long-term illness, health problem or disability which limits their daily activities.

Quality Triangle Low Cost

High Quality Sustainability

We can only have two of the three points of this triangle To be sustainable we could significantly increase the cost of our sessions and maintain the high quality. However, we couldn’t do this without excluding the exact people we are trying to target. In any event, doing this would be counter to our aim of reducing health inequalties and be in conflict with our organisational ethos.

To be sustainable we could reduce the quality of our activity sessions and adopt a ‘pack ‘em in and pile ‘em high’ approach to maximize income, use less experienced instructors or cut back on quality issues such as monitoring and evaluation. However, we are not prepared to do this because it would not be safe. Because so many of our participants have a long-term illness, health problem or disability, they often need more intensive support than might be usual in other exercise classes, so we cannot allow our activity sessions to become too large. To maintain a high quality service which is provided at a low cost to our participants we will always need to subsidise the cost of our activity sessions.

Exercise Evaluation 2015/16

118 adults took part in exercise sessions throughout the year

84% of participants were aged 55 or above

Over 40% of participants reported a long-term illness; health problem or disability, rising to 60% for Tai Chi

86% of participants felt that their health had improved

Our aim is reduce health inequalities and to help people adopt healthier lifestyles so that they can be as well as possible for as long as possible. This is important across all age groups, but with the age profile of our participants, we are particularly keen to help people live independently for longer through

maintaining mobility and reducing falls.

82% felt they were more supple and mobile

59% felt that their balance had improved

51% felt that their breathing had improved

Social aspects of attending our activity sessions are equally important so we seek to measure what effect our groups have on people’s well-being:

82% were having fun

74% felt that it got them out

74% had made friends

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86% of those attending Tai Chi sessions were 55 years or over with 60% reporting a long-term illness; health problem or disability. It is all the more

remarkable, therefore, that 85% reported an improvement in their health as a result. 69% reported that their balance had improved, 69% reported that their

breathing had improved and 56% felt more supple.

76% of those attending yoga sessions were 55 years or over with 38% reporting a long-term illness; health problem or disability. Significantly, 92% reported an improvement in their health as a result. 100% reported that they

were more supple, 54% said that their balance had improved, whilst 38% reported that their breathing had improved.

100% of those attending Extend sessions were 55 years or over, with 40%

being 75 or older. 75% reported an improvement in their health as a result. Of particular note physically was that 100% reported that they were more supple

and 60% reported that their balance and their breathing had improved. However, the social impact was even more marked with 100% reporting that

‘it gets me out’, 60% had made friends and 80% were having fun. This illustrates a reduction in social isolation and thus improved mental health.

80% of those attending Pilates sessions were 55 years or over, with 40% reporting a long-term illness; health problem or disability. 80% reported an

improvement in their health as a result. Again, 100% reported that they were more supple and 40% reported that their balance had improved. However,

the social impact was even more marked with 80% reporting that ‘it gets me out’, 80% had made friends and 80% were having fun.

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Through the Doorway to Healthy Living

Extend Evaluation 2015/16

When? Friday mornings, 11.00-12.00am Where? Castlefields Community Hall Number of people supported throughout the year: 12

We are keen to find out whether our activities have a wider impact on people’s lives, so asked people to make any comments about why they attended Extend and if doing so had made a difference to them. People told us:

Hope it continues

I think it is excellent for all

Enjoy company

It gets me out and about and I have met nice people

I have made good friends

We have fun and it gets me out and I would miss it (if it stopped)

The social at the end of term is helpful (allows people to get to know one another better)

When asked what they liked about Extend, people told us:

Relaxing and fun

It is fun

Gentle

Not having to stand

It’s fun and gentle to do

Everything

Company and friendship

Learning about other events

When asked what they disliked about Extend, people told us: Some people left this question blank. Those that answered said:

Nothing General comments:

Tutor is excellent

Tutor very good

Venue – could not be better

Venue – on ground as mobility problem (this refers to the good accessibility of the venue on the ground floor and with ramped access and no steps)

Would like a cup of tea every time at end of session!!

My tutor is very good and so is the venue

Julia gets us all motivated and makes it fun

The venue is suitable We all know that loneliness and social isolation in older people is harmful to health, which is why we encourage social interaction within the group, just as much as the exercise itself. Unfortunately one lady who attended the sessions had to stop for a while as she did have a fall and broke her hip. However, the other people in the group kept in touch with her to offer support which helped her recovery.

It is also notable that by bringing people together they share information about other groups, services and activities, which further reduces their social isolation. In response to the comment about meeting socially after each session, we will look at introducing a tea session after the sessions. This will be in addition to the monthly social event where the group meets at the end of each month to have lunch in the pub next door, as well as a Christmas meal in mid-December. For individuals completing the evaluation questionnaire and who chose to answer: Age breakdown: 55-64 20% 65-74 40% 75-84 40% Ethnicity: White British 100% Gender: Male 20%

Female 80%

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Through the Doorway to Healthy Living

Pilates Evaluation 2015/16

When? Friday mornings in term time, 9.30-10.45am Where? Grange Youth Centre, Harlescott Number of individuals reached: 18

80% of people reported that their health had improved since coming to the sessions

This figure is particularly noteworthy considering the age breakdown of this group. 80% were over 55 years of age and 40% reported a long-term illness, health problem or disability. We are keen to find out whether our activities have a wider impact on people’s lives, so asked people to make any comments about why they attended Pilates and if doing so had made a difference to them. People told us:

I enjoy the classes – they keep me supple and improve my core strength

Our teacher is excellent – she makes us work hard and is encouraging

Please do not stop the classes

It gets me out of the house and meet people

To keep fit and help the ageing body!

No classes that would be sad!

This and the yoga class on a Monday gives structure to my week and the chance to make new friends as I am relatively new to the area, as well as the health benefits.

Helps to loosen limbs, stretch and has helped me prepare for my hip replacement operation

Helped to re-establish a home routine of stretching and exercises When asked what they liked about Pilates, people told us:

It’s good exercise and keeps me fit

It keeps me fit and healthy

A new type of exercise

I enjoy the structure of the class and the positive impact it has on my health i.e. improved posture and strength

Helps establish a discipline and reinforces good routine of stretching When asked what they disliked about Pilates, people told us:

Nothing x 4

Nothing (only that it stops through the school holidays) General comments:

Tutor is excellent

Venue is good x 2

Great tutor and venue

Good tutor

I find Helen a very approachable and excellent tutor and enjoy her class very much

Helen is very encouraging and helpful in tuition.

Case studies WM had had to stop work because of ill health and was experiencing a range of emotions such as anger, frustration and low mood. Being in constant pain, her condition was not only affecting her, but also her family – she couldn’t attend a grandchild’s sports’ event because she couldn’t cope with sitting on the low benches. WM attends two Through the Doorway to Healthy Living exercise sessions each week and reports that they help her maintain her mobility as well as being good for her mental and emotional health, giving her the chance to take some ‘time out’ for herself and meeting with a group of like-minded people. EK has always been a regular walker and recently moved to the area. She had been feeling low because her mobility had worsened and she needed a hip replacement operation. Having spoken to a neighbour, who she noticed going out with a yoga mat on Fridays, she started to attend Pilates too. As a result her mobility has improved, she is doing more exercise at home, feels strengthened in preparation for her operation and has got to know her neighbour better. The tutor also reports that the participants definitely became more chatty as they got to know one another through the shared activity. Of those who disclosed the information: 40% of respondents reported a long-term illness, health problem or disability which limited their daily activities or the work that they did. Age breakdown: 35-44 20%

55-64 40% 65-74 40%

Ethnicity: White British 100%

Gender: Female 100%

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Through the Doorway to Healthy Living

Tai Chi Evaluation 2015/16 When? Tuesday mornings 10.30-11.30am Where? Castlefields Community Hall When? Thursday mornings 10.00-11.00am Where? The Lantern, Sundorne Number of people supported throughout the year: 48

Other reported comments:

Blood pressure lowered

I feel calmer – reduced anxiety

It prevents my anxiety problems

Coping with genes

85% of people reported that their health had improved since coming to the sessions, even though of those who chose to tell us, 60% reported a long-term illness, health problem or disability. The person whose health had deteriorated noted that the class ‘has still helped’

and the person whose health was unchanged noted that ‘blood pressure lowered’.

We are keen to find out whether our activities have a wider impact on people’s lives, so asked people to make any comments about why they attended Tai Chi and if doing so had made a difference to them. People told us:

Because I enjoy it

Devastated if it stopped

The class helps me with the discipline of doing something to benefit my health

I would feel disappointed if I could not attend

A great crowd of people

If it stopped I’d be sad

If I had not known that at one time there had been armchair exercises at the Lantern. These were no longer but receptionist told me of this Tai Chi class (chairs if necessary). Was not told by Falls Clinic.

Hoping to improve my balance and strengthen my back

Feeling relaxed after session

Would be ‘annoyed’ if it stopped

It inspires me

I would miss the companionship and James’ good explanations (if it stopped)

It is a good discipline to help cope with life’s demands by getting the best from your body

For health benefits

Meeting people in local area

Relaxation

I have something to do

It’s nice to meet new people

I’m having fun whilst learning

I keep coming to keep learning so I can practice at home – keeps me motivated

James is a fantastic, supportive teacher

I would feel really bad if these classes ended!

It gives me get up and go and also relaxes my mind as I am fighting anxiety problem often

If it were to stop I would be devastated as I so enjoy it

Try and do exercise every day so this forms a valuable part of my programme

I feel it would be a disaster should the class close not only personally but for the whole group

When asked what they liked about Tai Chi, people told us:

Friendship and enjoyment

Focused, gentle workout

It’s marvellous

No pain – elsewhere ethos is no gain without pain

Slow and controlled – relaxing

Slow, measured movements

Gets me out of the home

Relaxation

It’s made me more supple

I’ve learnt new skills

It’s fun

It’s relaxing

Helps my breathing

Feel I have worked out although it seems so gentle

Keeps my brain working

It improves my balance and stretches my body so it feels more agile

It keeps me supple and improves my concentration

Walking in and floating out When asked what they disliked about Tai Chi, people told us: Some people left this question blank. Those that answered said:

Nothing (x6)

Nothing, it’s lovely

Not long enough General comments:

I feel spreading the word about this activity would be the most important activity. It’s sad GPs don’t refer more of their patients.

All good

Very inclusive

Very relaxed – makes for an enjoyable class

It is just perfect for me

Re the venue: o Is ideal o Lovely o Floor clean o Local to me o Free parking o Very convenient for me o Whilst venue has been redecorated, it’s rather institutional and needs

something to brighten it up

Re the tutor: o Is brilliant o Is great o He is so aware of people’s limitations and accepts them so your failure is

never a problem o James is very caring o James explains the basis of Tai Chi exercises and how it benefits the

individual very well, stressing to do it at our own pace o Very welcoming and knowledgeable o He makes us feel very welcome o He’s easy to follow o James makes it easy to follow new patterns o James is very helpful! o James is an excellent tutor o He explains this in great detail

Of those who disclosed the information: 60% reported a long-term illness, health problem or disability. Age breakdown: 35-44 7%

45-54 7% 55-64 26% 65-74 40% 75-84 20%

Ethnicity: White British 97% Other White 3% Gender: Male 19% Female 81%

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Through the Doorway to Healthy Living

Yoga Evaluation 2015/16

When? Monday mornings in term time, 10.00 – 11.15am and 11.30 – 12.45pm Where? Castlefields Community Hall Number of individuals reached: 44

92% of people reported that their health had improved since coming to the sessions

We are keen to find out whether our activities have a wider impact on people’s lives, so asked people to make any comments about why they attended Yoga and if doing so had made a difference to them. People told us:

Very sad (if the class stopped)

We know it makes us feel better and more flexible and is good for our health

We would miss the class if it finished

Improves my posture and health

Enjoy the social side

Is affordable for me

Feel more supple and energized

Would miss friendship and encouragement to stay active (if stopped)

I love the exercise and the social side

To keep fit and the company

Julia and the group are friendly people and I feel comfortable with them

I have been able to make friends which was particularly important to me as I was new to Shropshire. The social part is as relevant as the exercise

It’s friendly, very relaxed, fun and we have a laugh

I enjoy the lovely company and would be very upset if the class stopped

It gets me out of the house and meeting people

I originally came because I had suffered a neck injury. However, I enjoy the class and would be upset if it were to close

The fun

I enjoy the sequences and exercises – thanks

Excellent sequences really helped loosen up my body

A very big thank you for last year’s yoga. I thoroughly enjoyed your class and it has given me the skills and confidence to carry on by myself over the summer holidays

I’m signed up for the Through the Doorway Friday class for next year and I’m really pleased that I can continue yoga at a price I can afford (from a participant with specific difficulties which improved over the year and is now back at work).

Back problems have reduced

The friendship and company are important

Emotional difficulties have reduced

Was very stiff after gardening, but feel much better after this yoga class

I use the breathing techniques to calm me down and relax. When asked what they liked about Yoga, people told us:

Everything (x2)

It is relaxing

Improves health

Feeling relaxed

Keeps me supple

Love it

Time allocated just for myself.

The whole session is enjoyable.

I like the background music

The stretching and breathing is good for me

All the stretches and the relaxation too!

It keeps me fitter

I enjoy the easy going atmosphere

The exercise

The relaxed atmosphere

Great fun

Lovely routines

Wonderful – thank you When asked what they disliked about Yoga, people told us: Some people left this question blank. Those that answered said:

I sometimes get too hot

N/A or Nothing (x6)

No after term meal

The breathing meditation

Cold floor

I sometimes find it frustrating when new people start and the exercises sometimes have to be simplified for them

General comments:

Very calming, welcoming and helpful

Excellent tutors

The tutors are great

Julia is a very good tutor and thoughtful of each person’s requirement

Everything is great

Julia continues to run a lovely yoga class, she is so lovely and friendly

Great tutor and venue – would like more dates and times

Julia is a great tutor!

The venue is not that pleasant but fits the purpose Of those who disclosed the information: 38% of respondents reported a long-term illness, health problem or disability which limited their daily activities or the work that they did. Age breakdown: 25-34 8%

35-44 8% 45-54 8% 55-64 23% 65-74 38% 75-84 15%

Ethnicity: White British 100%

Gender: Female 92% Male 8%

Children’s Activities Evaluation 2015/16

Headline figures:

71 families were supported throughout the year

89 children took part in our children’s activities

Although the sessions are specifically targeted at children, 81% of parents/carers reported an improvement in the way they felt as a result of

attending.

100% of parents/carers reported that both they and their children were having fun.

Parents/carers reported significant improvements in aspects of their children’s

behaviour which should enhance their learning and readiness for school – listening to people more, mixing with other children better and having more

confidence.

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Through the Doorway to Healthy Living

Mini-music Evaluation 2015/16 When? Wednesday mornings in term-time – 9.30-10.00am, 10.15-10.45am and 11.00- 11.30am Where? Castlefields Community Hall Number of families supported throughout the year: 71 Number of children supported throughout the year: 89

Firstly, we asked parents whether they felt they had benefited from attending mini-music.

81% of people reported that they felt better as a result of attending Mini-music We then asked about their children

When asked what they liked about Mini-music, people told us:

Interactivity

Sarah has so much energy and radiates joy each week which the children respond so well to

Fun and interactive. Great way of spending quality time with my children

Brilliant fun

Educational

Lots of fun – very energetic ½ hour

Everything!

It’s so much fun and X really learns so much

Sarah’ energy! It’s been so lovely to see my boy involved

Love all the songs and actions. Sarah is so full of energy.

It’s a nice safe space where parents can sit down

Morning activity out of the house.

Time concentrated on my daughter

Sarah’s skills in teaching and having instruments available for the children they otherwise might not have a chance to use

Everything – mostly just Sarah and her enthusiasm and positivity – she’s amazing

It’s fun and enjoyable

Socialising, learning new music

The children have fun and mix with other children

Interaction, movement, sounds, meeting people

Friendly atmosphere – inclusive – no pressure When asked what difference (if any) attending Mini-music had made to them or their children, people told us:

Lots of fun and musical instruments

We know what claves are now!!

My daughters have learnt to interact with other children at an earlier age, as they haven’t/won’t start nursery until age three

It’s a Wednesday landmark for my girls!

Made a difference to my child’s confidence in large group situations

Boosted my child’s confidence and social skills

Have exposure to music

Both girls adore mini-music. They love coming and enjoy the music

Enjoys meetings friends and sings songs from mini-music at home

A lovely social morning!

Confidence

Follow instructions and play musical instruments, singing with the group

Learnt lots of songs

Made lots of friends and become more sociable

Loves dancing and interaction

Structured knows what to expect

Children are learning songs, counting, confidence in ways I wouldn’t think of helping them

Watching my children grow and join in

Better listening skills

More confident – joining in, improved listening – timing instrument

They’re excited to attend and look forward to it

Loves singing more

We have fun and have met new people

We love music and dancing

My daughter enjoys the singing, dancing and musical instruments and I enjoy watching and meeting people.

Confidence and good routine When asked what they disliked about mini-music, people told us: Some people left this section blank. Those that completed it said:

Nothing (x6)

Nothing other than sometimes very crowded

n/a (x2)

It’s too short!!

I wish it was a bit longer

The sessions could be longer

It’s not on in the holidays!

Sometimes too busy.

Wish it was available at a place with better parking or different days as well (more sessions)

General comments:

I have been coming here for 9 years with my 4 children. Sarah is an inspiration and it has been a fundamentally important fixture of all their childhoods.

Sarah is an enthusiastic and excellent leader

Tutor is excellent – welcoming, friendly and makes music fun!

Sarah is great at keeping the children engaged. She is great fun and does a fantastic job at what she does

She (the tutor) is amazing

(The tutor is) always welcoming. She’s very personable

(The tutor) very good and energetic. All children really like her

Very welcoming

We really enjoy music and will miss it greatly!

Sarah is just brilliant! We love seeing her every week – so joyful!

Sarah’s so lovely. It’s the right length of the class. Thank you xx

Very welcome by teacher and other parents

Sarah is fantastic and my daughters really enjoy coming to see her

Sarah is brilliant, enthusiastic and brilliant

Always welcome

Sarah is a great teacher who really engages the children

Sarah is great at keeping the children’s attention and coming up with new ideas

Sarah is always fab. Long may she continue!

Responding to this feedback We are delighted by the overwhelmingly positive comments we have received about mini-music and what a positive impact it is having on children and families. We are keen, however, to address the aspects of our service that some felt were less than ideal. The number of children attending each session can be hard to manage as we try to have an open-access policy as far as possible. However, we are encouraging parents to ‘spread out’ across the three sessions and to limit each session to 6 children rather than the previous policy of 10. This responds to parents’ feedback, but also the tutor’s observation that numbers above 6 children are harder to manage, can be less safe and reduce the learning opportunities for individual children. A comment we receive most years is that people wish there were more sessions and on different days. More recently a lack of parking has become a problem for those not walking and we have been told that Wednesdays can be difficult for parents who go back to work part-time as many work either Monday to Wednesday or Wednesday to Friday. To respond to this we intend to seek funding to run 2 sessions on Mondays and reduce the number of sessions on Wednesdays from 3 to 2. Session length and working through school holidays are aspects we do not feel would benefit from a change. The half-hour sessions are designed for a wide age-range as we do not run age-related sessions (we tried that in the past and it was not successful); whilst older children might benefit from a longer session, any longer than half and hour would be too long for the younger ones. In the past we have tried to run our activities during school holidays, but uptake was poor and we found that it simply wasn’t cost-effective. Of those who disclosed this information: Parental/carer age breakdown: 25-34 31% 35-44 63% 45-54 6% Children’s ages: 1year 14 % 2 years 36% 3 years + 50% Children’s gender: Girls 82% Boys 18% Parent/Carer Ethnicity: White British 88% Non White British 6% Prefer not to say 6% Please note that although we collect ethnicity data in the standard format, I have grouped together all non White British ethnicities into one category. This is because ethnic diversity in Shropshire is limited and it is possible that individuals could be identified if specific categories were reported.