One Devon Outreach COVID Vaccination Fund – end of grant evaluation report

1.0 Introduction

Living Options Devon received two rounds of funding from the One Devon COVID Vaccination Outreach Fund in November and December 2022. The grant enabled Living Options Devon to provide support to disabled people and Deaf BSL users; help to address the impact of COVID; gain insight into the barriers to COVID vaccination; and to increase confidence in the Vaccinations in these communities. Alongside this we provided Deaf awareness and disability awareness training for
vaccination centre staff with the aim of increasing understanding and knowledge to support a more inclusive, accessible service.

This report summarises the support and engagement undertaken as part of this funding. Section 2.0 focuses on support and engagement with Deaf BSL users and
section 3.0 focuses on support for disabled people.

2.0 Engagement and support for Deaf BSL users

We provided wellbeing peer support sessions (see 2.1); information and advice (see 2.2); and Deaf awareness training for vaccination centre staff (see 2.4). Through these activities, we delivered the following outcomes:

• Deaf BSL users were provided with accessible information, advice and support helping them to make informed choices.
• Deaf BSL users were provided with accessible information, advice and support regarding COVID and vaccinations, from an organisation they know and trust.
• Deaf BSL users were provided with peer support and an opportunity to share concerns, experiences and queries re COVID and vaccinations.
• We helped Deaf BSL users feel more connected to their local communities and to support, helping to address feelings of isolation and reduce the impact of the continuing inequalities and barriers Deaf people experience
• Deaf people had access to tools and guidance to support their wellbeing
• We gained insight into the barriers to vaccination in the Deaf community
• Improved Deaf awareness for vaccination centre staff to help them to provide a more inclusive service

2.1 Wellbeing Peer Support sessions

We delivered five wellbeing peer support group sessions. 21 people attended the sessions. The aim of the sessions was to provide local Deaf BSL users with peer support; a chance to share experiences; and receive information, advice and tips for maintaining wellbeing. Deaf people are often unable to access existing wellbeing services due to cultural and language barriers and their needs and challenges are in many ways different to other disabled people hence the need for these dedicated sessions.

Subjects discussed included: the 999 BSL app; health and wellbeing; talking therapies (difference between counselling and CBT); college courses; care homes for Deaf people; employment issues and poor attitudes / lack of Deaf awareness at workplaces; low mood and anxiety; and menopause.

Alongside this the sessions were an opportunity to gain insight into any barriers Deaf people experience in relation to COVID vaccinations and improve vaccination and COVID awareness in the Deaf community. We were able to share information about COVID vaccinations in an accessible way and participants had somewhere they could ask questions, share concerns and experiences with regard to COVID.

We chose to incorporate COVID discussions and information sharing as part of wider wellbeing sessions as we have found in the past that people were reluctant to engage with support or consultations which focused entirely on COVID. We felt that the sessions would offer wellbeing benefits in addition to COVID related support and engagement.

We used a combination of feedback forms and informal chats to help us evaluate the impact of the wellbeing sessions. Paperwork is often a barrier for people in the Deaf community so it can be a challenge to get many responses. The four completed feedback forms combined with additional informal feedback/ comments highlight the benefits for participants including: the chance to connect with others, share experiences and receive information and advice (COVID related information included).

In feedback forms:

• 100% found the wellbeing sessions useful.
• 100% found the wellbeing sessions supportive
• 100% felt it was ‘good to chat’ and 100% told us that it was helpful to have other people to talk to.
• 75% said the information provided at the sessions was useful and that they learned something new.

Example comments:

“I was able to share my views with others going through the same problem. glad I wasn’t the only one. I did think I was the only one with this issue.”

“Good number of people. Glad to be able to share tips and hope it helps. I don’t like topic based sessions. This was more open . I like that.”

“Being able to talk with other Deaf people. Meeting people. I have social anxiety and this was just right for me. Made me feel happy too.”

2.2 Information and advice

We offered COVID related information and advice on a one to one basis through our Deaf helpline (webcam / email support). As with the wellbeing groups, we took the view that people were less likely to contact us with a COVID related query initially but whenever people got in touch with us through this service even if it was not directly about COVID, we also took the opportunity to explore their experiences of vaccinations.

People contacted the Deaf Led Services team regarding a range of issues such as housing problems; needing support to understand and deal with personal correspondence; advice regarding benefits, support with completion of PIP forms; and information regarding assistive equipment for Deaf people.

We found that there was less contact with this service during the period covered by this funding (7 people in total), perhaps because people were making contact during the wellbeing group sessions.

2.3 COVID feedback

The majority of the Deaf BSL users (approximately 88%, n=28) we spoke with were up to date with their COVID vaccinations. Feedback from Deaf participants highlighted the following barriers.

The online booking process for vaccinations can be a challenge for some Deaf people. Many people told us they had to ask family or friends to help.
The face masks are a barrier as Deaf people are unable to lipread.
Lack of interpreters or even staff / volunteers who can use some basic BSL at the vaccination centres can be problematic for Deaf people. People have to rely on lip reading. Staff and volunteers have guided them but there has been no possibility of conversation, chance to ask questions etc. People were using pen and paper or mobile phones for the required questions (date of birth etc.). One person told us they tried to get interpreter support via Signhealth online while at the vaccination centre but the signal was too bad for this to work. However, some participants felt that there is no need for interpreters at the vaccination centres now that people are used to getting the vaccinations and know what to expect. For the first COVID vaccination many people felt confused and afraid so interpreter support would have made a big difference.
There were four people who had not been vaccinated (approximately 14%). They cited personal reasons for this, including fear of needles; don’t believe in vaccinations; don’t believe they will catch COVID.

2.4 Deaf awareness training at vaccination centres

We delivered two bespoke Deaf awareness training sessions to the COVID vaccination teams locally, to improve understanding of how better to meet Deaf people’s access needs and link to available support (e.g. Living Options accessible information, communication support via remote BSL interpreter services).

We asked course participants to complete training feedback forms (n=50). This includes 24 responses from participants at the two courses funded by the COVID Outreach Vaccination Fund and 3 additional courses for vaccination staff funded separately.

• 98% strongly agreed / agreed that the course had improved their knowledge and awareness of Deaf people’s communication and access needs
• 98% strongly agreed / agreed that the course improved their confidence in supporting Deaf people
• 92% strongly agreed / agreed that the course highlighted what could be done to make their service more accessible for Deaf people
• 94% strongly agreed/ agreed that as a result of the course they would make some changes to improve accessibility

Example comments:

“Thank you so much for this brilliant training course!”
“Extremely informative, beneficial and enjoyable. Learnt a great deal”
“It gave me a very useful insight into the barriers that Deaf people encounter
“Valuable insight and tips on how to support t hose we meet who are deaf or hearing impaired”
“Fabulous. All staff should attend.”
“Excellent and informative. Thank you so much – -very enjoyable two hours looking at D/deaf world”
“Informative and fun learning.”

Example comments about improvements to accessibility / inclusivity:
“Include more actions when communicating with Deaf people and not feel self conscious.”
“I would be more confident to use miming / gestures in addition to clear speech”
“Increase body / facial gestures with signing”
“Be better prepared and more confident to communicate”
“Use and maintain eye contact”
“More signage at future vaccination centres.”
“Feel more confident to use limited BSL”
“Try to be clearer with communication signs and mouthing words. Not assuming that Deaf people understand written words and subtitles.”
“Forming words more clearly. Being aware of position to enhance communication e.g. light / windows”
“Make all staff more aware of how to communicate with deaf people.”
“Ensure we have a robust system in place i.e. flashing lights for emergencies rather than just alarms.”

3.0 Engagement and support for disabled people

We provided support and information on a one-to-one basis through our Time to Talk service (see 3.1); delivered a social media campaign to share information regarding COVID and vaccinations (see 3.2); and delivered disability awareness training to vaccination centre staff (see 3.4). Through these activities, we delivered the following outcomes.

• Disabled people were provided with accessible information, advice and support helping them to make informed choices.
• Disabled people were provided with accessible information, advice and support regarding COVID and COVID vaccinations, from an organisation they know and trust.
• Disabled people had an opportunity to share concerns and queries relating to COVID and COVID vaccinations.
• We gained some insight into the barriers to vaccination in the Disabled community.
• Increased disability awareness amongst vaccination centre staff enabling them to provide a more inclusive service.

3.1 Time to Talk

We offered COVID support and information on a one-to-one basis through our Time to Talk service which is a free, confidential listening support and advice helpline, for those with a disability or long-term health condition. 37 people used the service during the period covered by this funding.

We took the view that people were less likely to contact us with a COVID related query initially but whenever people got in touch with us through this service, even if it was not directly about COVID, we also took the opportunity when appropriate to offer support and explore their experiences to help us gain insight into vaccine hesitancy in the disabled community.

We found that there is a certain amount of ‘COVID fatigue’ and whilst people are still dealing with the longer term impact of COVID there was not always a desire to speak about COVID or about COVID vaccinations. However, often the issues that we are addressing through the Time to Talk service stem from COVID related foundations – for example, someone who is lonely and isolated might feel so because they lost their networks during the pandemic or someone who is struggling with their mental health may be due to difficult experiences with a loved one during COVID etc. So whilst COVID is not always discussed overtly, the work that Time to Talk does is supporting COVID recovery in a broader capacity to help people recover from the longer term impact of the pandemic.

The majority of disabled people we spoke with were up to date with their COVID vaccinations.

• Some people were concerned about the potentially harmful ingredients of vaccines (based on previous experience). This was particularly concerning for people with sensitivities to medications. For example, one person was not because she has an egg allergy and has had bad reactions to vaccinations in the past.
• For some people transport was a barrier to getting vaccinated. Many disabled people live very independently and do not have guaranteed support from others to help them access vaccination sites or to use the national online booking system. One person highlighted the difficulties she experienced when getting two of her vaccinations. She had to travel by bus to Taunton but as a wheelchair user with respiratory problems this was not as accessible as she required. She also had to go down a road which was very muddy which was difficult with her wheelchair. She wants to see more appointments being available in Tiverton.

There was an average score of 4.8 on service user feedback forms, in response to the question ‘how helpful did you find our service on a scale of 1 to 5 with 1 being not at all helpful and 5 being extremely helpful and 100% would recommend the service to others.

• 100% strongly agreed or agreed that it was helpful having someone to talk to
• 100% strongly agreed or agreed that they felt listened to and understood.
• 91% strongly agreed or agreed that the service made them feel less on their own and 82% felt less lonely / isolated.
• 82% strongly agreed or agreed that the service helped them to make choices about support or services they need.
• 82% felt the service would help them access the services or support they need.

Example comments

“You have helped me through the virus and other things in my life and every time I said goodbye on the phone I felt much happier I loved talking to time to talk so I really appreciate that.”

“Time to Talk makes me feel less alone and knowing they help all kinds of people with various problems it also feels being a part of a group where we can all relate to each other in some way.

“Keep going as it will be very disappointing to me and others if the service goes as we all need that someone to talk to and be listened to”

3.2 Social media campaign

We used our social media platforms to share information regarding Covid and vaccinations to help increase confidence in the vaccination in the disabled community by providing a consistent message. We reached 365 people.

We put out nine COVID vaccination posts in total across Facebook, Twitter and LinkedIn. This included a mixture of information regarding COVID vaccinations; signposting to accessible resources; and hints and tips to counteract some of the vaccine hesitancy feedback we are aware of amongst some people with disabilities.

To plan effective posts, we incorporated the feedback from the vaccine hesitancy engagement work LOD undertook in March/April 22. Our posts addressed some of the barriers to getting vaccinated that were raised through our engagement activities (see appendix 1 for further details of social media campaign).

• The location of the vaccination sites was a significant barrier for many due to transport issues. Many were unable to drive and/or struggle / cannot manage public transport. We included a social media post focusing on community transport access
• Unfamiliar settings, no knowledge of what the environment would be like, was a huge barrier for respondents did not know how well staff would interact with or understand them, particularly for autistic people.
• We included a post about our trainers providing disability awareness training for vaccination centre staff.
• The environment at vaccination centres can be a challenge as busy and noisy
• We included a post about going at quieter times if busy environments are difficult or people find queuing hard.
• A lack of understanding among medical staff about autism. There are problems regarding staff not knowing how to communicate, staff inflexibility around reasonable adjustments and a willingness to make them.
• We included a post about our trainers providing disability awareness training for vaccination centre staff.
• Not knowing rights as a disabled person meant that people did not know they could ask for reasonable adjustments, what reasonable adjustments they could have, or other information relating to this.
• We included a post about disabled people’s right to ask for reasonable adjustments.
• Carers or a companion not being allowed in
• We included a post about taking a friend, relative or support worker to your appointment.
• A lack of accessible information was reported by multiple people.
• We included a social media post suggesting people ask for jargon free, simple language / easy read information. We highlighted that people can still access easy read information and BSL information resources about the COVID vaccination including boosters. This included a link to Gov resources for easy read info / BSL.

3.3 Disability awareness training

We delivered two sessions of disability awareness training to the vaccination centre staff to improve confidence and awareness, so staff better understand how to meet access needs. 31 people attended these sessions.

• We asked course participants to complete training feedback forms (n=19).
• 100% strongly agreed / agreed that the course had improved their awareness of the needs of people with disabilities.
• 84% strongly agreed / agreed that the course raised their awareness of the laws which support the rights of people with disabilities.
• 100% strongly agreed / agreed that the course improved their confidence in supporting, welcoming and assisting disabled people.
• 89% strongly agreed / agreed that the course highlighted what could be done to make their service more accessible for disabled people
• 79% strongly agreed/ agreed that as a result of the course they would make some changes to improve accessibility

Example comments:
“Very informative and enjoyable.”
“Very eye opening and relevant.”
“Excellent and relevant to my work.”
“Really informative and thought provoking.”

Example comments about improvements to accessibility / inclusivity:
“We are moving into new offices and will consider the accessibility issues through a new lens.”
“Think ahead and ask how can I help. Remember there are hidden disabilities.”
“This has reaffirmed that as a team we are supporting people with disabilities well but can make changes e.g. better signage, info.”
“Better signage and watching body language.”
“Be braver!”
“I will be more aware of people waiting for a vaccination and make a reasonable adjustment where necessary.”

4.0 Summary

The funding enabled Living Options to provide valuable support to disabled people and Deaf BSL users, addressing the ongoing longer term impacts of COVID. Whilst we experienced a degree of COVID fatigue we were able to gain some insights into existing barriers to vaccination uptake. Our disability awareness and Deaf awareness training will help to address some of the barriers and feedback suggested that staff and volunteers would make changes to their practice to improve accessibility.