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Memorandum submitted by Ormiston Children & Families Trust 1. Introduction to Ormiston Children's Centres 1.1 Ormiston Children & Families Trust manages 11 Sure Start children's centres, in the East of Our children's centres provide a one stop shop for under 5s services, which brings convenience, familiarity and belonging, thereby promoting community cohesion and integration. We also choose to take our work out into communities, into schools, prisons, homes, with the aim of providing support free of stigma and to create a sense of ownership within the community. 4.2 Children's centres provide universal services that are stigma-freeOur children's centres provide a range of services both targeted and universal, with staff building confidence skills for the whole family either in their home and/or supporting them to access the centres. Our children's centres have developed to provide a good model for social care services engagement. Children's centres provide preventative intervention, with an emphasis on non-labelling, so there are no issues with stigma attached to attending certain groups or receiving particular services and you do not have to have a problem to access the services. 4.3 Quick referral and crucial early interventionBoth parents and professionals have identified that the referral route for support can happen quicker and more effectively through children's centres. Routinely having professionals i.e. health, speech therapists, qualified teachers present in the centres, prompting the early identification of development delay, providing parenting support without waiting nor having to access clinical settings, helps parents to feel more at ease with the "professional". Support is needs-led from where the individual family has identified issues. 4.4 Parents very involved in developing services to fit their needsIt is important to ensure that parents and children play a part by having a say on what their centres should look like and provide. We have parent representation on our advisory boards and make sure the language and rhetoric used does not exclude them from participating in decision-making and understanding how their children's centre works for them. Our expertise allows us to recognise where we might overlook or alienate the most vulnerable, perhaps because of literacy or language differences, and ensure we include and involve them. We do not believe all Early Years-focused local authority controlled children's centres will necessarily have this experience of working with vulnerable families. 5. Our comments on funding, sustainability and value for money;5.1 Benefits of working together Added value of multi-agency, multi-disciplinary approach to working with communities. This element of participation and volunteering breeds sustainability and ownership and creates a sense of community responsibility. 5.2 Shared resources among professionals also helps reduce barriers to access for the most vulnerable.Resources can be pooled and health care and education professionals can work from the children's centres and use equipment, and in turn the families receive the support needed i.e health clinics taking place within the centres. This obviously also reduces the travelling and other inconveniences which might prevent a family from accessing vital health care services. 6. Our comments on staffing, governance, management and strategic planning;
6.1 A need for sensitive consistency without uniformity Having one umbrella organisation overseeing the children's centre agenda development (Together for Children), with prescriptive structures i.e. partnership boards, advisory board, lead agencies etc, should promote consistency. This appears fluid and dependent on local political priorities. Early Years staff should be complimented by social care staff at all times in order to provide the preventative early intervention family support packages. 7. Our comments on how well Children's Centres work with other partners and services, especially schools and health services; 7.1 Reduce competitive commissioningNot all delivering partners engage in the same way across the board, making partnership working patchy and ineffective in some areas. Commissioning of these services could be self-defeating as partners become competitive and not necessarily want to share resources. Also with commissioning, the commissioners appear not to look at quality most of the time choosing to go with more for less which then compromises achievement of the intended outcomes. Because we work with four different local authorities we can see that the level of support and success of children's centres, working in partnership with other services, varies from one local authority to the next. 7.2 It takes time to build relationships that workWork is in place in promoting the work of children's centres, but it takes time to build relationships with partners and other services. Multi-agency work is still very new. Trust and respect of all professional heritage has to be established. For example midwives and health visitors need to learn to know and understand the full breadth of services within the children's centres to understand the benefits of encouraging families to take part. Where our children's centres are well established we can see this is clearly working very well. However, it has taken time and effort. 7.3 School links are essentialSuccessful children's centres need really good links with schools, with a range of activities also taking place in schools. Head teachers should access advisory boards, which have representation from services supporting families in the community, including parents-representation. This is a way for agencies to get to know about each others work and to identify partnership working and gaps in delivery. 7.4 Other agencies need to refer to children's centres as early as possibleEarly intervention is essential and referral to children's centres should be done quickly. Midwives can pick up vulnerable adults at 'booking in' stage and the Health Visitor role to be more as it used to be, with home visits being made on a regular basis to enable early identification and intervention.
7.5 Believe in the holistic approach Holistic approach working with whole family is often a way to see improved outcomes. Services need to learn that working in isolation is not always the best option. Staff also need to be adequately trained and experienced to take on the family support role. The Ormiston Children's Centre model here works well. Families can move seamlessly through from family support to the children's centre services or other way round and we have seen more of the vulnerable families access the universal services through this system.
7.6 Embrace expertise Ormiston's own work with children affected by imprisonment, children of Gypsy and Traveller communities and children at risk of emotional and physical harm informs our community work. Accessing this level of expertise of working with these groups means our children's centres provide a greater level of support. Understanding the unique issues affecting these groups enables us to provide them with the appropriate support and signposting. We are also able to help other partner professionals to understand the unique needs of some within these groups. 8. Our comments on whether services are being accessed by those most in need and how effective they are for the most vulnerable;8.1 A Case Study: A vulnerable family - Jane, Steve and their three children, Ben, Sam and Max
8.2 Suffolk Children and Young People Service requested support from Ormiston Children's Centre for a young and vulnerable family, struggling to cope with a range of issues. Jane, the mother was finding it difficult to cope with her youngest son Max, who was violent and aggressive towards her and other children. Her eldest son Ben is autistic, her middle son, Sam, is quiet and withdrawn and Max, the youngest had already been referred to Child and Adolescence Mental Health Service (CAMHS) because of his hyperactive behaviour. Jane had been in a previously violent relationship and Steve, her husband, had recently returned to the family home, after a three month separation following a domestic incident.
8.3 At the children's centre, Jane joined the Freedom Programme, a 12-week course to support women affected by domestic violence. Through this she was able to learn new skills to keep herself and her children safe. Her middle son Sam joined our Wishes and Feeling support programme to help him understand the mix of feelings of anger and frustration he was feeling. This was provided through one to one sessions at school as this is where staff felt Sam could feel safe in expressing his feelings. Jane joined our Incredible Years Parenting (Webster Stratton) programme to help her understand how to encourage, support and set effective boundaries for behaviour for all three of her children. These sessions were delivered to Jane at her home, to help her model new ways to deal with her children's challenging behaviours.
8.4 This was a family at risk. By providing support within the physical environment of the children's centre, as well as at home and at school where appropriate, we were able to treat the challenges facing the family holistically and work effectively in collaboration with the appropriate statutory support services. The children's behaviour and the family's problems cannot be changed overnight, but with the support of their children's centre, they are finding new ways to cope and learning quickly to minimise the risks and dangers to the children. Our work with this family will continue beyond the age limit of five years. (*names and some minor details have been changed to respect the confidentiality of our service users.) 8.5 Identifying the most vulnerableThe support we can offer in the home is vital to enable us to build confidence and trust, this can only happen if agencies know where we are and how to refer. In our experience it is not until we can establish the partnerships with agencies and they let us know where the families are that it will work. Children's centres are relatively new so it will take time. Where inter-agency relationships - at an individual level - are good, then vulnerable families have been identified and supported. 8.6 Proving that children's centres are being accessed by the most vulnerable.The designated data collection system E-start does not collect the necessary demographic data to prove the reach and scope of children's centres and does not identify those considered to be most vulnerable. A lack of standardised evaluation methods - different local authorities capture different information - therefore makes it difficult to quantify and evaluate the success of accessibility and efficacy of outreach.
9. Our recommendations to the Committee
9.1 Replace E-start with a system which will collect the right statistics to prove outreach
E-Start, the chosen method of capturing data to prove the efficacy of children's centres is destined to fail. It cannot provide the necessary data because it is not capable of collecting the appropriate information. A new standardised system of data collection which can analyse the inter-relationships between children's centres and the most isolated and vulnerable families will be necessary to prove children's centres do reach out.
9.2 Results aren't instant - allow time for children's centres to become part of their communities
It takes years to embed a system of support in the heart of the
community. To create a stigma-free place with a sense of belonging within a
neighbourhood, to engage with health care and education professionals and with
generations of local people, we know that this cannot happen instantly. We can
see that after almost three decades, our children's centre in
9.3 See children's centres as crucial to a holistic approach to helping the most vulnerable. Children's centres are uniquely placed for early intervention and could save lives and money
Early intervention is crucial and children's centres are uniquely placed to identify families or individuals who may be struggling, long before their problems become a crisis. Early intervention can save lives and will save public money in the long run.
9.4 Continuing family support is essential - we need to be there for children beyond the age of five and make the most of the links children's centres have already forged with the most vulnerable
Family support should not end once a child reaches five. The nominated system of passing over support to Extended Schools is not working because of limited resources and a lack of universal application. For some of the most vulnerable families we work with, schools are not even aware of their problems, for example children of prisoners, or children who do not attend school such as Gypsy and Traveller children. If children's centres such as ours have made contact with these isolated communities they are best placed to continue that support, within schools, communities, prisons and homes, according to an individually tailored support assessment.
9.5 Ensure family support is always appropriate, universally available, needs-led and stigma-free
Extended schools are also not always the best place to provide a stigma
free environment for supporting the most vulnerable families. For example we
can provide a support programme for women affected by domestic abuse within our
children's centres during the afternoon, this could not happen through the
9.6 Ensure training and expertise so staff can recognise and help the most vulnerable
Children's centres, where staff have received the appropriate training and have the knowledge and expertise, can reach out into the community and can find those most isolated and at risk. Our staff work in homes, schools, communities and prisons as well as within the physical building of the children's centre. There should be an emphasis on training children's centre staff to build this expertise and understand the issues surrounding some of the most vulnerable within our communities.
October 2009
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