TRUSTEES REPORT: April 1997 – end March 1998

CARALINE
ANNUAL REPORT
2011-12
Registered Charity Number: 1053897
Where to find Caraline
Address:
Kline House
13 George Street West
Luton
Bedfordshire
LU1 2BJ
Helpline:
01582 457474
Fax:
01582 877219
e-mail:
caralineed@aol.com
Web-site:
www.caraline.com
Service Director:
Claire Jackson
(from September 2008)
Hon. Chairperson
John Butler
(from September 2008)
Caraline
Eating disorders counselling & support service
Annual Report
For the period:
1st April 2011 to 31st March 2012
Contents
1. Introduction
2. Service Objectives
3. Report of the Hon. Chairperson
4. Report of Service Director
5. Carers Evaluation Report
6. Report of the Trustees
7. Financial Report
Appendices
A1 Patrons, Executive Committee & Caraline Team-members
A2 Activity Report
1.0 Introduction
1.2 Charity Information
Registered Charity number: 1053897
1.1 Purpose of the service
Board of Trustees
Established in February I994, CARALINE
provides a confidential counselling and
support service for people with anorexia
nervosa, bulimia nervosa, compulsive overeating and other eating disorders.
John Butler (Hon. Chair-person)
Ann Binks (Hon. Treasurer – until May 2011)
John Jackson (Hon. Secretary)
Vince Kan (Hon. Fundraiser)
Alan Jeffs (Trustee)
Chelvanayagem Menna (Trustee)
Mark Franks (Trustee)
Brian Holmes (Hon. Treasurer – from June
2011)
Whilst direct helping services are prioritised
for the residents of Bedfordshire & Luton,
requests for counselling and support from
people with eating disorders and carers who
live outside of the county are considered in
accordance with individual need and the
practical arrangements for effecting care.
Executive Committee – other members
Claire Jackson (Service Director)
Debbie Aries (Counsellor)
Mental Health Advisor:
Emphasis is placed upon engaging people
with eating disorders within the early stages
of their illness, with an overall aim of the
service being to offer a comprehensive
support package to sufferers, their families,
and involved health-care professionals.
John Butler BSc (Jt. Hons.), RN, MSc, PGDipHE, FHEA
Where possible, people with eating disorders
are supported within the community with the
aim of minimising the need for hospital
admission, although support visits are made
to those clients of CARALINE who are
hospitalised.
Treasurer:
Brian Holmes (from June 2011)
Kline House
13 George Street West, Luton, Bedfordshire
LU1 2BJ
Registered Office:
Kline House
13 George Street West, Luton, Bedfordshire
LU1 2BJ
Independent Examiner of Accounts:
Simon Gill
Partner, Keens Shay Keens – Milton Keynes
Bankers:
HSBC (Midland) Bank PLC
63 George Street, Luton LU1 2AP
Solicitors:
Machins Solicitors
Victoria Street, Luton LU1 2BS
2.0 Service Objectives
(The Charity’s Objects)
1. The relief of those suffering from anorexia
or bulimia nervosa, in particular by the
provision of a confidential counselling and
support service within non-stigmatising
surroundings.
2. The preservation and protection of the
mental and physical health of sufferers by
the provision of an accessible alternative
to hospital-based care in order to reduce
both the necessity for admission to a
psychiatric hospital and the duration of
the length of in-patient care for those
admitted.
3. The preservation and protection of the
mental and physical health of the families
of persons suffering from anorexia or
bulimia nervosa.
4. The advancement of education amongst
sufferers, carers, professionals and the
public at large, in particular by the
provision of an education service which
offers information and skills-based
learning opportunities relating to anorexia
nervosa, bulimia nervosa and associated
mental health issues.
(Amendment to Object No. 4 was agreed
and approved by the Charity Commission
on 16-2-2000)
3.0 Report of the Honorary Chairperson
The year from April 2011 – end March 2012
proved to be another exciting year, full of
service developments.
Caraline continued to offer a number of
interventions for clients, and as ever, these
have focussed on ensuring that clients
receive an effective service by delivering
them in a collaborative and client-focused,
manner.
The summary of activity for the year (see
Appendix 2), highlights that Caraline
continued to respond to service demand in
accordance with the level of client referrals,
as well as offering new and exciting services
to carers. The following provides a summary
of activity during the financial year;
 78 clients were offered an assessment or
service by Caraline over the course of the
year;
 Three 10 session eating behaviour groups
were facilitated during the year;
 All group participants received individual
sessions for assessment and were offered
follow-up sessions;
 In addition to group intervention, 395
individual or follow-up sessions were
provided to a total of 72 clients over the
year; and,
 The self-support group was facilitated on
a monthly basis.
In addition to this service, Caraline enhanced
its services beyond those established for
those experiencing an eating disorder, to
now offering a range of services to carers.
Caraline implemented this important service
and it includes the following;
 Carers support group
 Family support and mediation
 Carers support line
Staff at Caraline have demonstrated their
ability to not only keep the well established,
existing support services going, but they have
also responded to the needs of those people
involved in accessing the charity, and have
added further services in relation to this.
I will watch the progress of Caraline with
excitement over the coming financial year,
and look forward to watching it develop
further in order to improve the lives of those
accessing it.
Thanks to all staff at Caraline who work so
hard to make Caraline a success, and to the
sterling work of Brian and the Caraline
Trustees.
Carly Francis (Hon Chair & Trustee)
4.0 Report of the Service Director
At our last Annual General Meeting I
discussed the need to build on the services to
clients provided within Luton and
Bedfordshire. Interventions including our
Eating Behaviour Group were adjusted and
improved in terms of delivery to ensure the
learning outcomes were met and delivered to
effective intervention. Groups were delivered
this year providing twice weekly intervention
over a period of five weeks. Clients reported
the new way of delivery was effective in
terms of motivation and the intensity helped
make them feel safe to share experiences
with other group members.
The services of Caraline have extended
dramatically over this past year. Caraline
provides intervention and support to clients
and carers five days per week. This has been
helped by having a therapy room available to
us in Milton Keynes which saves some of our
Bedford clients having to travel to Luton. The
introduction of the Carers support group and
family support was thanks to extra funding
from NHS Luton. There is a wealth of
evidence to suggest that working with
families certainly helps in terms of treatment
outcomes. Please see Carers evaluation for
further details.
Day Centre
In February of this year, through client
consultation we opened our Day Centre in
our central Luton office on a Monday. Clients
have found this service invaluable as they are
able to access Art and Craft Works,
Relaxation, Auricular Acupuncture and have a
shared lunch with staff and other clients.
This gives clients the opportunity to talk with
others in a relaxed environment and many
have stated that eating in the group has been
helpful. Clients also reported the benefit of
having the acupuncture in terms of deep
relaxation, improved sleep and reduced
symptoms of anxiety. A good way to start
the week we think.
Fundraising
Karen and Ralph Adamson joined the
committee to raise essential funds for
Caraline. Thanks to Karen and Ralph the first
fundraising event was held in February. A
fund raising Disco at Farley Hill Luton raised
over £2,000 which was amazing. Karen and
Ralph have continued to work towards
raising money for our essential services.
Recent updates during 2011
Just to keep you updated, Caraline this year
secured funding from NHS Luton to provide
an Outreach Service to clients that were at
risk of being hospitalised. This has helped
form a closer working partnership with South
Essex University NHS Foundations Trust’s
(SEPT) Specialist Eating Disorder Team.
The Care Pathway Work started last year,
including Caraline, SEPT and the Child and
Adolescent Mental Health Team has sadly
been placed on hold due to the changes
throughout the NHS and reduction of
funding. Sadly, the effects of this currently
mean that Caraline can no longer provide
services to clients under the age of eighteen.
We do intend however to try and apply for
funds from other sources.
On a final note I wish to thank all the staff,
the Board of Trustees and Volunteers for all
their continued dedication to the Charity. I
would also like to make a special mention to
John Butler who has been involved in
Caraline since 1994 as Chair and Mental
Health Advisor. John moved up North this
summer and I along with the board of
Trustees wish him well and thank him for all
his dedication over the years. You will be
greatly missed John and we wish you the best
in your new life up North.
Claire Beeken (Service Director)
5.0 Carers Evaluation Report
Caraline Carers Support Service:
Service Delivery Report Oct 2011-end June
2012
This is a brief qualitative and quantitative
report to demonstrate the effectiveness of
the Carers Services implemented October
2011, commissioned by NHS Luton.
There is a wealth of evidence and research
that suggests the involvement of patient
carers in the treatment of the person living
with an eating disorder can certainly aid the
recovery process and therefore making the
prognosis far more optimistic
The Carers Service provided by Caraline due
to the enhancement of funds from NHS Luton
is as follows.
Carers Support Group
Meeting on the Second Wednesday of each
Month 19.00pm-20.30pm, held at the
Caraline Centre in Luton.
The aim of the group is to encourage carers
to talk to trained professionals and seek
support from their peers. So often, the
carers feel frightened and alone and are at a
loss as how to help their loved one. The
support group also offers education around
eating disorders, it gives carers pointers
around certain problematic behaviours their
loved one is engaged in and how to deal with
these behaviours effectively.
Individual Carers Support
This service is available to all carers,
however, what we have noticed is that the
uptake of this service is generally from new
client referrals and the age range of the
client is between 14-18yrs. There is no
restriction in terms of how many times a
carer can access an individual appointment
but in general it averages out to six sessions
per carer. The service encourages Carers to
talk openly about their loved ones treatment
and carers are given tools to support this
without breaking client confidentiality.
Family Support and Mediation
Prior to a client attending the Eating
Behaviour Group or Individual programme,
they are required to go onto an eating plan
that is designed to meet the need of the
individual client. Caraline recognises the
importance of the main carer attending this
meeting to alleviate anxiety both for the
client and their carer. Meal times generally
are a battle ground and it impacts the whole
of the family. Carers attending this session
will be part of the programme which in turn
makes them feel empowered to helping their
loved one. For the client, it offers a sense of
relief in terms of knowing exactly what is
expected from them in terms of their meal
plan as well as knowing they will get the
support from home.
Mediation is offered to clients and carers
who have a block in communication in fear of
upsetting their loved one. These sessions are
offered to provide a safe place with a
qualified professional for them to air their
concerns and find solutions to particular
problems.
Carers support Line
Carers have access to both the telephone
helpline and Caraline mobile number should
they have any concerns or anxieties.
Generally this service is used if the carer is
having a particular difficult mealtime or need
to ask questions about their loved ones
behaviour. We would encourage the client
and carer to make a joint appointment to
discuss any difficulties they may be having.
Caraline has offered a carers service to 16
Luton based cares from the period Oct 2011June 2012. To demonstrate the effectiveness
and the importance of this service it is
noteworthy that is 64% of carers from our
Luton client case load of 25, for this reporting
period.
Carers
Support
Group
Number of
sessions
15 sessions
(16 carers)
Individual
Family
Support
Support
Number
of Number
Sessions
Sessions
36 Sessions
(12 carers)
10 sessions
(10 carers)
of
Carers Evaluation
Caraline recognises the importance of
evaluating its service to both clients and
carers. To ensure the quality of service
Caraline gave a Carers Survey to all sixteen
carer service users. Caraline received 12
completed surveys back from the sixteen
issued. A summary of findings is a follows:
When contacting Caraline for the first time,
by telephone or email, was the person who
contacted
you
professional
and
approachable in Manner?
12/12 carers reported yes.
From your first point of contact with
Caraline how quickly were you offered and
initial appointment?
9/12 carers 1 week
3/12 carers 2 weeks
Which of the following services do you use?
SERVICE
Carers
support
group
Individual
Carers
support
Helpline
Support
Family
Support
Most
frequent
12
Next
frequent
12
12
10
Least
frequent
If you needed to, how likely would you be to
use these services in the future?
SERVICE
Carers
support
group
Individual
Carers
Support
Family
Support
Helpline
Support
Very
Likely
Likely
Not
Very
Likely
“Without the support of Caraline I dread to
think where we would be now.”
Never
12
12
10
12
SERVICE
Excellent
V.Good
Good
Fair
Poor
Carers
12
support
group
Individual 12
Carers
support
Helpline
9
2
support
Family
10
support
NB: all 12 carer comments were positive in
nature.
Describe the relationship you have with you
counsellor (by placing a tick by the following
scales)
How long have you used any of the Carers
service Caraline Provide?
DURATION
Less
than
three
months
3-6 months
7-12 months
Less than 1 year
Less than 2 years
RESPONSE
5
4
3
0
0
0-10 Scale
I feel comfortable (10)
Rating (out of 10)
(10) 12/12
I do not (0)
I Feel safe (10)
(10) 12/12
I do not (0)
I feel able to raise
Personal issues (10)
(10) 12/12
Do you feel that the services of Caraline
which you have used have been of help to
you? ( a selection of responses)
I do not (10)
I
do
not
intimidated (10)
“Caraline make the experience a personal
experience. Other services can feel clinical.”
I do feel intimidated
(0)
“They have helped me and my daughter
enormously. We haven’t been judged, we
have been listened to and they understood
and gave the right information and care.”
Any further comment on your counsellor? ( a
selection of comments)
feel (10) 12/12
“They are very easy for me to talk to, I feel
like I have known them years and engage
with you like real human beings”
presented at the end of the reporting
financial year March 2013.
Claire Beeken
“The counsellors are caring and make you
feel like you want to have an appointment”
“The counsellors have so much knowledge
they really understand your concerns and
help you deal with them by giving excellent
advise.”
NB All twelve comments were of a positive
nature.
After and individual session, have you felt
that your anxieties were not approached or
were not managed in a satisfactory
manner?
Always
Sometimes
Never
Yes
12/12
Are there any elements of the carers service
you believe could improve? (selection of
comments)
“I think the service is excellent, I would not
change anything.”
“I think it needs to be publicised more I have
learnt so much since coming here. My GP
and other health professionals have not
supported our family at all. At Caraline care
is given to everyone.”
6.0 Report of the Trustees
6.1 Status
CARALINE became a registered Charity on
19th March I996 as an unincorporated
association governed by a constitution.
6.2 Provision of Services
CARALINE has continued to provide services
from its Centre in central Luton, having
secured these premises with the help of a
capital funding grant from the National
Lottery Charities Board. The Centre’s facilities
have been widely complemented by staff,
professionals and clients alike.
Individual work has continued to be based
upon an assessment of the client’s specific
problem areas, with a focused programme of
individual or group intervention sessions
being offered in the first instance.
Individual counselling sessions continue to be
based upon one or more recognised
therapeutic approaches, and principally the
cognitive-behavioural and person-centred
approaches.
All individual sessions / programmes have
been offered by counsellors or therapists
who are trained to at least diploma level, and
each has received formal supervision on a
regular basis.
“You can phone, you can have an
appointment, you can attend a group. I can’t
see how you can improve on that!”
6.3 Fund Confirmation
In the opinion of the Trustees, the Charity’s
assets are sufficient to fulfil the current
obligations of the Charity for the coming
year.
This concludes the Carers evaluation for Oct
11-end June 2012. A full evaluation will be
Most grants that have been received relate
to specific projects, restricting the use of
such funds to the project rather than for
meeting the costs of Caraline’s overheads
(revenue costs), and meeting these costs
remain a challenge.
In this respect, Caraline is indebted to the
local NHS Primary Care Trusts (NHS
Bedfordshire, NHS Luton) for their continued
financial support in accordance with a Service
Level Agreement, which is re-negotiated
annually. Withdrawal of this grant aid would
have a major impact upon the services that
could be provided.
Acknowledgements
Caraline would like to thank all our members
and volunteers who have helped us
financially and practically over the past
twelve months.
Prepared for, and on behalf of, CARALINE
Trustees by:
Carly Francis (Hon. Chairperson & Trustee)
& Brian Holmes (Hon. Treasurer & Trustee)
Signed:
……………………………………....................………
Trustee
……………………………………………....................
Trustee
5.4 Trustee Matters
The current Trustee Board seek applicants
from any section of the community and new
Trustees can be elected at any time.
If you believe you can make a contribution to
Caraline’s Objectives, please do get in touch.
7.0 Financial Report – Please see over.
We particularly need the time, experience
and skills of newly-retired business
professionals.
Appendix 1:
Patrons, Executive Committee & Caraline Team-members
PATRONS:
Cleo Laine DBE
Dr. Roger Hood TD, BSc, PhD
Derek Prag Hon. MEP, D.Litt
Diane Youdale Dip.F&E, RSA
Billy Schwer (appointed in March 2001)
THE EXECUTIVE COMMITTEE:
John Butler (Hon Chair & Trustee)
Brian Holmes (Hon Treasurer & Trustee)
John Jackson (Hon Secretary & Trustee)
Alan Jeffs (Trustee)
Chelvanayagem Menna (Trustee)
Mark Franks (Trustee)
Claire Jackson (Service Director)
Debbie Aries (Counsellor)
CO-OPTED MEMBERS:
John Butler BSc (Jt. Hons.), RN, MSc, PGDip HE, FHEA
Mental Health Advisor
CLINICAL SUPERVISOR:
Carrie Roberts – Counselling Supervisor
CARALINE TEAM MEMBERS (P/T):
Claire Jackson
Service Director
Carly Francis
Treatment Manager
(Eating Behaviour Group)
Debbie Aries
Counsellor & Group Facilitator
Imelda Flanagan
Counsellor
Cate Lynch
Group Facilitator
Gawaine Aries
Group Co-facilitator
Elaine Jackson
Team Administrator
Appendix 2:
Activity Report: April 2011 to end March 2012
The Caraline client-based activity quality monitoring criteria have been agreed as follows, several
of which are considered in providing a review of activity for the period from April 2011 to end
March 2012:
o
Age Group
o
Gender
o
Ethnicity
o
Geographical Location (Bedfordshire & Luton practice-based consortia areas)
o
Source of Referral (including whether referred or self-referring)
o
Waiting Time (from referral to assessment)
o
Presenting Problem
o
Session DNAs and Cancellations
o
Outcome, if not accepted following assessment
o
Contracted Number of Sessions / Attendances
o
Length of Time of Client Engagement with Service
o
Total Number of Sessions Attended
o
Closure Outcome (including number completing)
o
Number of Follow-Up Sessions (offered and attended)
o
Waiting List
Referrals: Caraline offered assessment appointments to 78 new client referrals between April
2011 and end March 2012, of whom 59 clients had been referred since April 2011.
Of this group of clients, 46 (59% of all clients) were residents of Bedfordshire, 32 (41% of all
clients) were residents of Luton.
The socio-demographic and clinical characteristics of this group of 78 clients attending
assessment / offered a service by Caraline during the period from April 2011 to end of March
2012, are summarised in the following Tables.
AGE Group
14-18
19-25
Bedfordshire
9
11
Clients
Luton
4
7
Clients
Other
0
0
Clients
GENDER
Bedfordshire Clients
Luton Clients
Other Clients
26-35
11
36-45
13
46-55
2
56-65
0
65+
0
9
9
3
0
0
0
0
0
0
0
Males
5
3
0
Females
41
29
0
ETHNICITY
White British
Irish
Any Other White
White & Black Caribbean
Pakistani
Indian
Any Other Asian
Any Other Mixed
Bedfordshire
Clients
44
1
1
0
0
0
0
0
GEOGRAPHICAL LOCATION
Luton
Bedford
Leighton Buzzard
Dunstable (inc. Houghton Regis)
West Mid Bedfordshire
East Mid Bedfordshire
Other
SOURCE of REFERRAL
Luton
Clients
27
0
1
0
4
0
0
0
Other
Clients
0
0
0
0
0
0
0
0
No. of Clients
32
8
11
13
13
1
0
Self-Referral
GP
Other
Bedfordshire
Clients
30
9
7
Luton
Clients
23
3
6
Other
Clients
0
0
0
WAITING TIME
(Referral to Assessment)
1 week
2 weeks
3 – 4 weeks
5 – 6 weeks
7 – 8 weeks
Bedfordshire
Clients
19
17
10
0
0
Luton
Clients
13
8
10
1
0
Other
Clients
0
0
0
0
0
PRESENTING PROBLEM
Bedfordshire
Clients
21
17
3
Luton
Clients
11
14
2
Other
Clients
0
0
0
Anorexia Nervosa
Bulimia Nervosa
Mixed Presentation
Compulsive Over-Eating
Obesity
Other / Not Confirmed
5
0
0
5
0
0
0
0
0
Outcome following Assessment: of this group of 78 clients, 65 were accepted and offered one or
more services by Caraline during 2011-12. Of the remaining referred clients, 10 had either failed to
attend for assessment or were continuing to move through the assessment process at the year
end. A further 3 clients were not accepted / did not accept a service offered by Caraline (2 of
which were not accepted due to hospital admission).
Session Attendance:
o Individual Sessions: 43 Bedfordshire clients attended a total of 227 sessions; 29 Luton clients
attended a total of 129 sessions;
o Facilitated Peer Support Group: 19 Bedfordshire clients attended a total of 65 sessions; 9 Luton
clients attended a total of 32 sessions
o Eating Behaviour Group: 16 of the Bedfordshire clients and 14 of the Luton clients have
attended this group since being referred to Caraline (seven of these clients attended the Eating
Behaviour Group that commenced during the previous year)
o Follow-Up Sessions: 11 Bedfordshire clients attended a total of 26 sessions; 8 Luton clients
attended a total of 13 sessions;
Information on session ‘Did Not Attend’ and ‘Cancellations’: 27/78 of those referred either did
not attend or cancelled between one and three offered / planned sessions over the course of the
year; a total of 28 individual appointments were either cancelled or not attended.
Waiting List: Caraline does not currently operate a waiting list.