Meals on wheels celebrates its 60th anniversary this year. Tom Vaughan followed one of Southwark council's meal delivery vans for a day to see how the service is adapting to the demands of the 21st century
"It's not bad for only £2.20," says Len. "The only thing I have to moan about is her." With this he emits an age-defying cockney cackle and nudges the meals on wheels worker as she deposits the hot Somerset lamb and cider dumpling lunch on his kitchen table. Following us to the door, he sticks his head outside. "Look after her," he bellows. "I'm looking forward to chatting to her tomorrow."
A meals on wheels customer for four years now - "I started when my wife first got ill" - Len would have been a young man when the service started 60 years ago.
Founded by the Women's Royal Voluntary Service in 1947, following the destruction of the Blitz, it originally ran from soup kitchens, providing meals for the housebound and elderly.
Operations evolved over the next 40 years - but not by much. Until the early 1980s, freshly cooked meals were still being loaded into vans equipped with charcoal burners. By the time the lunches reached their destinations they were somewhat overcooked. The burners worked on a first-in-last-out principle, and the final meal was usually completely incinerated.
In the 1980s the Conservative Government introduced compulsory competitive tendering - an attempt to bring greater efficiency to local government and health services through the use of competition - prompting an evolution of the service.
For Len's local borough - Southwark, in south-east London - the change was slow to come. Like most other local authorities, Southwark council merely formed a separate arm - the Direct Services Organisation - to which it awarded the contract.
Slowly, frozen meals began to replace the charcoal fires and burnt offerings of former days. When the contract came up for renewal in 1996, the council reassessed the best and cheapest way to deliver the service. It then became the first London borough to award its annual £1.2m meals on wheels contract to an outside company, Westminster Meal Service, which set up a deal with Apetito to provide frozen meals on a cost-per-volume basis. The company still holds the contract to this day.
Jackie Hibbs, welfare catering contract manager at Southwark council, has witnessed the changes that the contract has brought. While frozen meals were established as the norm before Apetito took over, the company expanded the choice from one set meal to eight, including ethnic meals.
The diversity of the borough's population has been embraced over this time. As well as three standard meal choices, such as breaded fish and chips or chicken and mushroom pie, Apetito offers a salad, Afro-Caribbean, halal, Asian vegetarian, English vegetarian and kosher options.
The service has also been streamlined. Since taking over, Apetito has properly databased the operation. Beforehand, 400 of the 900 recipients were, in Hibbs's words, "non-existent", while the rest received two meals daily. The service also managed to shave £1m off expenditure in the first year in unnecessary management fees.
The service is fairly simple in operation. Elderly people are referred by their doctors to social workers, who then assess whether they qualify for the meals on wheels service. If approved, the service can be at their door the next day, sometimes the same day.
Recipients pay £2.20 per meal, the rest is subsidised by the council, the amount depending on which meals are chosen and the cost-per-volume agreement. Menus are handed out a week in advance, and a selection is made for the following week.
All except the Afro-Caribbean option are held in the freezer of the service's offices in Southwark. At 10am, staff start loading the meals into ovens fitted in the eight vans. These heat the dishes to the required temperature, and then hold them at that heat.
The Afro-Caribbean cooking is outsourced to a local restaurant, which prepares and delivers meals to the offices every morning to be held at the right temperature in the vans' ovens. The company is looking to outsource other ethnic offerings, and is currently in trials to bring in a Somali option from a local restaurant.
Each of the eight vans delivers 40-50 meals, covering a customer base of 400 around the borough. The company also delivers 400 meals to day centres and clubs that can no longer afford the time and expense of manning kitchens in-house.
Unlike many boroughs, Southwark employs two drivers per van, partly for safety reasons in the rougher neighbourhoods, but also so that if a driver finds a client in need of help or medical attention, the other can carry on the shift.
Behind this reasoning lies the ulterior motive of meals on wheels. It's not just a means of feeding the elderly and impaired, but a daily contact for those who don't qualify for care. Procedures are in place for an "empty response at point of delivery", and if no contact can be made by the office by the end of the day, then the police are notified. For people like Len it can be the only visit they receive on a daily basis.
The contract is up for tender again in 2008, and Hibbs is in no doubt that there will be more bidders as the field gets increasingly competitive. What would she like to see changed? "I'd like more flexibility," she says. "Maybe two or three meals a day, or for mealtimes to be wrapped around some of the clients' hospital appointments, as otherwise they miss out."
Sixty years might seem like a long time, but it pales in comparison with the age of some of the current clients. Grace, a Bermondsey girl since birth, is 108 this year. She's just returned to the service after a short hiatus, explains Hibbs. "She cancelled briefly for about six months. ‘I think I'll have a go at doing it myself,' she said."
A typical daily menu
- Lamb hotpot
- Sausages in onion gravy
- Fish fingers
- Salad of the day
- Pasta with mushroom and leek sauce
- BBQ chicken with herb-roasted potato
- Plum crumble
- Raspberry trifle
National Meals on Wheels Week is running from 1-7 October