Response to Q1. Meals+: A New Take on An Old Classic – ‘Meals on Wheels’

What is Meals+? It’s concept that can be described as a new take on the long established ‘Meals on Wheels’ offer… defined by the DoH as: ‘Meals on wheels’ are hot, nutritional meals delivered to people who are unable to, or find it difficult to, prepare a meal for themselves. A range of meals are produced, considering people’s cultural and religious requirements, personal preferences and dietary needs.

This is an opportunity to reimagine the service in a way that aggregates many benefits to create large scale social value: a preventative caring service, embedded within the community health and care economy. The idea is the design and implementation of a new national meals on wheels service. Meals+. Meals on Wheels have almost universally been withdrawn – leaving no comparable offer suitable for older people with social care needs. There are real tangible examples of negative health impact when services are withdrawn. Limited number of existing services remain but underachieve in terms of their potential social and economic value.

The service can act as eyes and ears alert to the usually hidden signs that people may be struggling or experiencing a decline in their wellbeing, shining a light on someone’s circumstances, and proactively linking in the right support or intervention, avoiding a more detrimental outcome for that person. A summary of the achievable benefits include:

Addressing Loneliness and Social Isolation – a face to face service available 7 days a week at a pre-agreed time. Deliveries will be made by friendly, reliable people who form positive relationships and build rapport with their customers. Research has proven that the person-to-person interaction is the single most valued element of the service. Reduce demand and address capacity challenges in

Homecare services – consultation with homecare providers has revealed that between 20%-30% of the care visits they complete are for meal preparation and welfare checks, which neither activity requires a CQC regulated service provider to complete. The opportunity to replace these non-regulated care visits with a meal delivery and welfare check exists now. Linking the meals service with homecare providers will help to support their customers in a more integrated and holistic way.

Improve health outcomes and nutrition- Malnutrition (undernutrition) is characterised by low body weight or weight loss, which simply means that some older people are not eating well enough to maintain their health and well-being. It is estimated that around one in ten people over the age of 65 are malnourished or are at risk of malnutrition – over one million older people in the UK today. Malnutrition is both a cause and a consequence of ill health. It affects health and wellbeing, increasing hospital admissions, and can lead to long-term health problems for otherwise healthy and independent older people. It can also mean more visits to the GP, increased chances of being admitted to hospital and longer recovery times from illness. A nutritionally balanced daily two-course hot meal can support healthy nutrition and avoid some of these risks to health and wellbeing.

Develop links with Primary Care – the service can provide additional intelligence to GP’s and health professionals in the community, identifying red flags and making referrals to the appropriate service, enabling early intervention.

Create jobs, use Kickstart Scheme and Apprenticeships – the service will create a range of new jobs and well suited to take advantage of the governments Kickstart scheme, offering opportunities to young adults and a possible career pathway within social care. There is also the opportunity to develop apprenticeships, supporting the varied business functions.

Investment in electric vehicle fleet – the delivery of hot meals and face to face interactions with customers in their homes will require a fleet of suitable vehicles. Electric vehicles fit this bill well, because of the local nature of deliveries and opportunity to charge overnight between shifts.

Creation of new supply chains (in-country sourcing) – the setup of the service will inevitably require a supply chain. This is likely to include frozen meals, commercial catering equipment, premises, vehicles, and various support service contracts. The supply network that enables the optimisation of the service will inevitably require or provide the basis for a good degree of collaboration between public, private and non-profit sectors.

This service would also provide an opportunity to explore how support could be provided in the provision of free school meals to family homes.

Investment and financial model – with the current older population arguably being the most affluent of recent generations there is strong potential this could be a service charged to each customer e.g. £7 for a hot two course lunch meal. However, to achieve the maximum social value means testing may be a more appropriate model. There may also be an opportunity to free up some capital by making changes to the ‘Winter Fuel’ payment eligibility, for example offered only to those older people in receipt of means tested benefit. This would release some of the £2 billion currently spent annually on winter fuel payments as seed funding.




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