Shehan Perera

By Shehan Perera – Content Manager, Social Enterprise UK

Over the last year and a bit of the pandemic the nation united around its support for our health workers who are on the frontline of the coronavirus crisis. We saluted the incredible efforts made by our NHS heroes as well as all the other key-workers who kept the country going through the first and second waves of the pandemic. But did you know that when we were out clapping for carers this included thousands of people working at social enterprises?

Social enterprises form a vital part of the NHS family and are a key component in the delivery of health and social care services in the UK. Around a third of community care services are delivered by social enterprises, with those working in health and social care employing around 100,000 staff and having a collective turnover of around £1.5bn.[1]

Their greater independence has allowed social enterprises working within the health system to operate in ways which result in greater innovation as well as engagement from staff. It is little surprise that the vast majority are rated Good to Outstanding by the Care Quality Commission (CQC). Many also are able to work across different areas, integrating health and social care services and building services around the needs of patients.

When the coronavirus pandemic hit these social enterprises found themselves playing a huge role in the national effort to combat the virus – ensuring people got the care they needed, helping with testing and, over the last few months, being an important part of the vaccine rollout. This Social Enterprise Story looks at the work of one social enterprise over the last year, featuring some of the voices of workers who have been at the heart of the pandemic response.

Livewell Southwest is one of the largest health and care social enterprises in the UK, employing over 3,000 members of staff and providing integrated health and social care services for people across Plymouth, South Hams and West Devon. The social enterprise is at the forefront of integrating health and social care – bringing together health and social professionals, who previously would have worked in individual teams, to deliver the right care for people, in the right place at the right time.

Livewell was founded in 2011 as a community interest company, with all revenue being invested back into services and communities. Employee engagement is central to how the company operates and it describes itself as an ‘employee-led’ organisation, ensuring that employees voices are heard.

They also run an exemplary scholarship programme , investing in colleagues by providing fully funded learning.  Staff remain on their current salary while they go to university to obtain their degree, demonstrating the social enterprise’s commitment to the development of its staff. The scholarship has led to greater staff happiness and engagement, helping the organisation to recruit and retain their nursing and Allied Health Professional (AHP) colleagues so that they have consistently low levels of vacancies.

In a survey from earlier this year 93.8% of service users said they would recommend Livewell’s services.

Dawn Slater, Director of People and Professionalism at Livewell described setting up as an independent social enterprise as “the best thing we’ve ever done” as it allows the business to be flexible, innovative and able to “do the right stuff for the right reasons.”

Services provided by Livewell include community nursing; services for people with learning disabilities; physiotherapy; community mental health services; social work; wellbeing and health improvement services; services for children and young people and community pharmacies. Services are provided either within the person’s home, or from one of 12 locations based across the southwest.

Livewell’s community care services are designed to enable people to live independently for as long as possible – wrapping care and support around their needs. A key aim of the organisation is to support people to return home as soon as possible from hospital so Livewell provides care in patients’ homes with regular visits from nurses or occupational health to physiotherapy and even acute care at home.

The social enterprise is also directly responsible for three community hospitals with its headquarters based at Mount Gould Hospital Dawn Slater had this to say on what difference it makes to be work as an independent social enterprise:

 “Being a social enterprise gives us more freedom to flex our resources and to be as responsive to the needs of our communities and the people we care for as is needed. We are responsive and agile and can get services off the ground in a matter of days, as we did with our drive through COVID testing facility and this is one of the real benefits I think being a social enterprise brings us.”

 I am incredibly proud to work for Livewell Southwest and I am passionate about being able to do the right thing in a proactive and timely manner to ensure the people we care for and the colleagues we work with get the best from us. This has been more evident during the pandemic and its been incredible to see the impact we have made in being able to support our key partners and NHS colleagues.”

When coronavirus hit, Livewell immediately found themselves on the frontline – supporting the creation of Plymouth’s Nightingale Hospital and working with other organisations within the wider health community such as primary care providers and care homes to support people affected by the virus.

From the early days of the pandemic a key priority was to ensure that both patients and Livewell staff could get tested for COVID. Swabbing drive through facilities were set up to test people in the local community and Livewell employed a ‘Swabbing Lead’ whose responsibility it was to follow-up with people who tested positive for COVID ensuring that they had the support they needed and knew what to do. Livewell also worked to support care homes with testing and the sharing of educational material. Dawn mentioned that the key aspect of the response at this stage was “to forget boundaries and support organisations and communities get through the crisis.”

In April 2020 Livewell, alongside Plymouth City Council, worked with the New Continental Hotel in Millbay to transform it into a care hotel, offering care to people who needed extra support before they could get home. This freed up vital hospital beds during the first wave of the pandemic. Setting up the facility required working in partnership with hotel staff, who ran the practical aspect of managing the site such as catering and cleaning, and volunteers recruited through the council. The Extra Care Hotel closed its door on the 30 June after freeing up a total of 48 beds.

When events took a turn for the worse at the start of this year and the country entered the second wave of COVID-19, Livewell set up a new care hotel at the Hearts Together Hospital, to again support people recover and free up beds. This facility was stood down on 31 March as the numbers of people needing support reduced.

In December, once the national vaccination rollout began, Livewell played an essential part in supporting people to get vaccinated, working with the acute trust to create a vaccination centre initially for those in high priority groups. Over the course of the last few months they have been rolling out the vaccine across all eligible cohorts.

Beyond jointly running a vaccination centre, Livewell have been supporting local primary care networks and care-homes to ensure that vulnerable patients are vaccinated. As well as delivering the vaccine they have been supporting people to better understand the need to get vaccinated, listening to patients worries and helping them make their own decisions as to whether they want to get the jab.

Their learning disabilities team, for example, worked with vaccinators to ensure that they were present when their patients were vaccinated as well as offering guidance and support to make sure they were willing to be vaccinated. Dawn describes this as Livewell using their staff to “walk alongside” the people they care for to make sure they are supported.

Shona Cornish is the Community Modern Matron at Livewell and has been working at the social enterprise since its conception.  She’s been one of many Livewell staff who’ve played a huge role in supporting communities through the course of the pandemic and told us about what it’s been like working to get the local population vaccinated and being part of this huge effort:

“I am extremely proud to have been given the opportunity to contribute, support and develop Livewell’s offer for the mass vaccination programme. The support and flexibility from Livewell and my colleagues has enabled us all to truly consider where the need to meet outcomes is required and make real time suggestions as to how we support this. Working collaboratively as a social enterprise with our acute partners and partners within primary care has given us an opportunity to demonstrate our skills and expertise.

Personally I have been humbled by the offer and support of everyone pulling together to work towards one goal. It makes us united. Working together to support our communities in the vaccination programme means we have been able to truly provide a personalised service for everyone attending the vaccination centre.”

Shona Livewell Southwest Social Enterprise UK Stories
Shona Cornish – Community Modern Matron at Livewell Southwest

Helen Mills is a Community Team Manager (and Queen’s Nurse) at Livewell had this to say looking back at the work her colleagues and herself undertook and continue to undertake to support and care for communities as we start to get past the worst of the pandemic:

“I’m conscious of the massive impact COVID has had on our patients. It’s been wonderful what’s been achieved so quickly. We need to pull together and encourage as many people as we can to have the vaccine and start moving back towards normal life.

“Although COVID has had such a negative impact, for me it’s about all about how we came together as a health and care system, pulled together at a time of need. It’s good and exciting to be part of it all.”

Showing the innovative spirit so characteristic of the social enterprise sector, Livewell made it their goal to identify hard to reach groups within their patch to help them access the vaccine.

Staff from the complex needs team and the physical health outreach team helped support the vaccination of people who may be homeless or transient, or living in insecure accommodation. The effort to reach these groups involved a significant multi-agency, multi-disciplinary approach to delivering healthcare involving a range of specialised health workers.

Beyond just providing vaccinations, staff from Livewell’s dental services were on hand as well as sexual health services, hepatology with dry blood spot testing for Blood Bourne Viruses (BBV) and practice nurses from the health for homeless services. All these groups came together at a “one-stop health event” which was so successful that Livewell are looking at how it can be reproduced in the future.

Livewell Southwest have used the key tenants of being a successful social enterprise – innovation, collaboration, adaptability and a commitment to serving the communities they work in to deliver services in the most difficult of conditions, easing the burden on acute care, supporting people through all stages of the pandemic and doing all they can to ensure patients have the care they need.

Vaccinators Livewell Southwest Social Enterprise Stories
some of the vaccination team

Social enterprises are an important part of the fabric of our health and social care system – showing pioneering methods of integrating health and social care and working across silos so patients get the best care possible. Work such as that carried out by Livewell in the South West is happening across the country with social enterprises breaking down barriers to care and showing innovative ways of working, from running garden centres employing people who need mental health care support, such as Navigo do in Grimsby, to running primary care services for people who are homeless, refugees and asylum seekers. It is vital that proposed changes to the running of the health service, which could see more services brought ‘in-house’, do not forget the huge contributions social enterprises are making to deliver quality services.

As the situation starts to get brighter with cases falling dramatically and things starting to open up again the immense contribution made by social enterprises to support those affected and get the nation vaccinated can’t be forgotten. As Donna Ozanne, a frailty nurse at Livewell told us – “It’s something that I’ll tell my grandchildren one day, that their grandmother was on the front line.”