Creative Home Delivery Service 2025

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PSU’s professional team of creative facilitators visit the individuals in their home and engage in creative activities such as visual arts, creative writing, storytelling, pottery, wire work, music, movement and singing. Artists and staff are offered fortnightly check-ins with a Wellbeing Coach to support group reflection and wellbeing.

Referrals come through Social Prescribers, Age Cymru Dyfed, Connecting Carmarthenshire admiral nurses and through the community. 

585 visits were completed with a total of 100 participants.

Evaluation Methodology

The evaluation was led by external project consultant Dave Horton alongside Ali Franks, who facilitated the MSC ‘themes and emergent questions’ workshop, People Speak Up CEO Eleanor Shaw and Project Co-ordinator Carys Phillips, who led project monitoring activities.  A number of methods were used to measure the impact of the project and to provide opportunities for learning and improvement, including:

●    Use of a Wellbeing Numerical Rating Scale (WB NRS) at the beginning and end of each session to measure improvements in participant wellbeing.
●    Initial and end of project calls to assess participants’ experiences of the support provided.
●    A reflection session reviewing outcomes and learning with project artists and facilitators.
●    A Most Significant Change (MSC) evaluation.

The MSC evaluation involved gathering, discussing and selecting stories of personal change to understand the project’s impact and inform future developments. In keeping with previous uses of this approach, three written stories were collected from participants and carers.  For the first time the project also made use of three recorded spoken stories (allowing evaluators to hear the tone and emotion of the storyteller) and three pieces of visual art (enabling evaluators to engage directly with participants’ creative output).

On Thursday 12th March 2026 a panel of 18 people (including People Speak Up staff, project participants, funders and partners) met to discuss these ‘stories’ of change.  Starting in three groups, each group reviewed one written story, one spoken testimony and one piece of visual art, asking for each: what can be learned from the ‘story’? What emotions does it evoke? and what insights does it provide for the project’s future?  Each group was encouraged to choose a ‘most significant story’ (or  artwork) and to present this back to the whole gathering.

Finally, a creative workshop was used to identify the key themes that resonate across all the narratives and to generate forward-looking ‘emergent’ questions under each theme.  This was aimed at ensuring the evaluation is not just a summary of past success but a tool to support future planning.

The entire session was recorded and transcribed, and was captured visually by illustrator Dom Tsoi.  

The panel discussions identified a number of significant outcomes for participants, their carers, and healthcare partners:The project successfully breaks the "shell of isolation" for those living alone or housebound.
●    Restoration of Identity and Value: The sessions help participants rediscover a sense of value that may have "gone to sleep" due to illness or age. By engaging with their "whole history," the project moves them from feeling like an "insignificant person" to a valued individual with a rich life story.
●    Joy and "Just Being": A major outcome is the shift from "survival mode" to a state of "acceptance and joy". Participants describe a physical "glow" and a "sparkle" returning after sessions, viewing "just feeling better" as a valid and transformative result.
●    The "News Path": The project provides participants with "news" or new experiences to share, which builds their confidence in conversation and allows them to engage more meaningfully with their families.
●    Physical and Mental Health: Outcomes include improved mobility, weight loss, and effective pain management, with one participant noting that being in the "creative zone" allowed her to temporarily lose the sensation of chronic arthritic pain.

The panels emphasised that the project supports the entire household, not just the referred individual.
●    Peace of Mind and Relief: Carers experience a significant "relief" and "peace of mind," knowing their loved ones are safe, happy, and engaging in meaningful activity.
●    Meaningful Breaks: The sessions provide carers with a "meaningful break" and a space to "offload" their own stresses.
●    Relationship Transformation: In households dealing with dementia, the intervention has been described as creating a "kinder place," reducing frustration and improving communication between partners.

The project has become an essential asset for the local healthcare and social prescribing systems.
●    A Trusted "Lifeline": Social prescribers describe the service as a "lifesaver" and a "massive huge asset," providing a reliable referral route for vulnerable patients who do not fit into traditional clinical boxes.
●    Filling the "Massive Void": The service addresses social isolation in rural areas where few other non-clinical options exist, helping to prevent the escalation of problems into statutory services.
●    Empowering Practitioners: The project supports the professional development and wellbeing of its creative team, providing a "tight" and supportive structure that helps prevent "burnout" while working with highly isolated individuals.

●    Transition to Community: A key outcome for some housebound participants is the transition from home visits to attending community groups at centers like the Living Well Center.
●    Reignited Creativity: Participants have moved from having "no creative left in me" to completing unique, multi-layered art projects, such as "maps of life" or junk journals, which they view with immense pride and ownership.
●    Restoring Roles: One participant regained her identity as a "hostess" by preparing tea and cakes for the facilitators, reclaiming a social role that had been lost.

The following conclusions and recommendations are made in order to maximise the benefits of the learning from this project in future iterations of CHDS (and other PSU projects):

●    The risk of stress and burnout for staff, facilitators and artists is always present.  PSU should continue to maintain a tight team structure with regular meetings and coaching made available to the team.  

●    The service is described as a "lifesaver" in rural areas where statutory services are scarce. Expansion should specifically target "the north of the county" and other rural locations where isolation is most acute.

●    PSU should make use of the identified ‘emergent questions’ when designing future projects.  Project proposals and funding applications should be framed as responses to these questions and opportunities to explore and respond to them further.

●    In particular, there is an identified need to create a ‘language of joy’ that resonates with funders, advocating for ‘just feeling better’’ as a valid, fundable outcome that prevents more costly clinical interventions. PSU should continue to explore creative methodologies for measuring and valuing Joy (including MSC).

●    In addition, there are emerging questions related to how participants can be enabled to access communal experiences, even when housebound and unable to attend group sessions (see, for example, the emergent question: ‘How to nurture genuine connection across everyone involved?’)  PSU should explore new and innovative ways of connecting isolated participants, including by supporting the creation of collaborative art works and/or enabling online connection.

●    The experiment with using artwork as "most significant change" stories was highly successful and should be a standard part of future evaluations to capture histories that ‘cannot be answered in a paragraph’. Indeed, other creative methods of expression should be embraced as potential ‘story-telling vehicles’ including: photography, poetry, drama and song. There are opportunities to make use of the communal nature of some of these methods to explore shared needs and experiences collaboratively (placing the story of the individual within a wider shared community).

●    The final creative themes and emergent questions workshop, held with the MSC panel, was highly effective as a participatory method of identifying key themes and orienting the evaluation towards future action.  This approach should be embedded in future MSC evaluations and PSU (with the consultants) should explore how this approach could be developed further to target and strengthen the future planning element.

●    Panels noted a ‘goodwill economy’ where social prescribers refer patients to the project, but the project itself operates at capacity without dedicated systemic funding. PSU and partners should continue to advocate for consistent and sustainable funding from health and social care budgets that recognises the preventative and transformative nature of this provision.