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Memorandum
submitted by
1. Executive Summary ˇ Sure Start Children's Centres (SSCC) offer a range of co-ordinated services for children and families. Services are designed to meet the needs of local families and developed in partnership with other agencies, parents/carers and the local community.
ˇ SSCC are a key part of community-based networks to support children and families with a wide range of needs, including those who need intervention and support at particular times in their lives. Targeting the most vulnerable must be a priority for all Children's Centre providers.
Worcestershire County Council would like to see continued support for funding Sure Start Children's Centres with a focus on: ˇ Investment in preventative and outreach services ˇ Investment in early identification and early intervention support services for children and their families; to optimise achievement in the five Every Child Matters outcomes and prevent the escalation of emergent problems to a higher, more costly level of intervention ˇ Improved multi-agency arrangements ˇ Effective working with schools to support transition ˇ The full involvement of health professionals in centres ˇ A national marketing campaign to raise awareness of the services on offer ˇ Investment for services to meet needs in both rural and urban areas
2. 2.1 Worcestershire County Council is a diverse
county with both urban and rural areas. There are currently 29 Sure Start
Children's Centres designated across the county and by March 2010 there will be
34. The Local Authority (LA) currently manages 12 of the Centres across very
different areas which include: 2.2 A recent pilot Ofsted Inspection at Chestnut
Children's Centre in Franche (
3. How models of Children's Centres have developed as the programme spreads from the most deprived neighbourhoods; 3.1 Initially the Sure Start Local Programmes were developed in the more disadvantaged areas, but in some instances they became stigmatised. The Children's Centre initiative provides a universal programme of services/activities to every child under 5 and their family. There are clear advantages for both child outcomes and value for money in being able to offer families a variety of services from their local SSCC. These take the form of targeted services embedded within universal services. 3.2 The targeted services ensure that we are helping the children and families most in need. Every SSCC in Worcestershire provides early intervention family support, which offers personalised family support based on sustained relationships with highly trusted, skilled workers. This is generally delivered in the family home with the aim of empowering the family and building enough confidence for them to access services at the SSCC. 3.3 The family support is proving to be successful as data shows that families gain confidence and gain knowledge and support which helps to deal with their issues and achieve better outcomes. Another important aspect is the range of services that outreach workers can offer a family. Particular families who are reluctant to access services can be successfully engaged through such a personalised approach. Once engaged, the possibility arises of supporting the families into the full range of services that can support their needs, thus developing parenting capacity and enhancing childhood resilience and emotional wellbeing. Worcestershire is currently piloting two Child Poverty initiatives, which have been commissioned by the DCSF from 2009-2011: The Child Development Grant offers a cash incentive to disadvantaged families in some areas that access services for a sustained period. The Teenage Parent Supported Housing project is delivered through SSCCs to offer a package of support to teenage parents and ensure that they are living in suitable accommodation. These pilots are being independently evaluated across a number of LAs. 3.4 Assumptions are sometimes made that families with 'less complex needs' will be deterred from using services in the same physical service context as those who are coping with complex problems. Yet our experience has found that there is great positive value in integrating families with different levels of need bringing a reduction of stigmatisation of vulnerable families and an increase in shared learning from parents with different skills. 3.5 Disadvantaged areas are identified by using the multiple index of deprivation, which focuses on a range of statistical factors and breaks areas into Super Output Areas (SOAs). This identifies those SOAs in the most disadvantaged areas. Although this data helps to target the areas where families have a high level of need it is important that consideration is given to rural areas and less disadvantaged areas where some families need support. SSCCs must continue to access a range of data sources and work in collaboration with colleagues to gain local knowledge to ensure that all families receive the support they need. In Worcestershire the monitoring officer provides all SSCC with comprehensive data and information about a range of data.
3.6 Early Intervention Family Support in Worcestershire All lead organisations in Worcestershire are required, as outlined in their contract, to work within an agreed framework to provide early intervention family support. The framework has been established and agreed by all partners and covers referral processes, the qualifications and competences required by staff and outlines the threshold for 'tier 2' early intervention support services. This ensures that consistent paperwork is used across the county, which makes it easier for professionals to make referrals. It also provides consistency to families who may move and access new providers. The paperwork feeds into the Common Assessment Framework (CAF) process, should it be necessary to develop the CAF approach. There is an agreed process for referring families requiring specialist intervention.
4. The range and effectiveness of services provided by Children's Centres 4.1 SSCCs have the potential to give children the best start in life and in many localities are embedded into the fabric of the community. While the national evaluation of the Sure Start programme in 2005 queried whether the most vulnerable and excluded were missing out, the 2008 national evaluation report revealed beneficial effects for almost all children and families living in areas with a SSCC reflecting greater experience in reaching out to the most vulnerable families. SSCCs work in partnership with a range of
professionals to plan a programme of activities to meet local need: they
include midwives, health visitors, speech and language therapists, educational
physiologists,
4.2 ˇ Relationship Counselling ˇ Early Intervention Family Support (home visiting) ˇ Citizen's Advice Bureau ˇ Stay and Play Sessions ˇ Home Start befriending services ˇ Breastfeeding support groups ˇ Baby Play and Stay and Play sessions ˇ Family Learning courses ˇ Parenting courses ˇ Speech and Language Therapist input ˇ Specific activities to engage priority groups, such as younger parents and fathers/male carers ˇ Childminding support group ˇ Family Information Service offering advice and information ; including tax credits ˇ Healthy lifestyle courses; healthy eating, quit smoking, exercise sessions Many of the Sure Start Children's Centres also offer services that include: ˇ Parents to be sessions, supported by the community midwife and health visitor ˇ Postnatal courses, covering child development ˇ Antenatal clinics, delivered by Community Midwives ˇ Bumps and baby buddies ˇ Baby Café: weigh baby, meet other parents/gain advice from professionals ˇ Job Centre Plus information and signposting to encourage returning to work ˇ Sensory Stay and Play and other activities to support children with special needs ˇ Integrated care and education supported by a qualified early year's teacher ˇ Sessions to support attachment; such as baby massage and holistic therapy ˇ Specific activities to meet local need; such as Eastern European Stay and Play activities for Gypsy, Roma, Travellers
4.3 A research project was commissioned by Action for Children in August 2009 to evaluate two SSCCs managed by Action for Children in Worcestershire. The findings showed that out of 100 service users that took part in the evaluation: ˇ 93% recognised direct benefits to their families from attending the SSCC and accessing the services. ˇ 71% stated that they noticed positive differences in their families; most commonly in social and emotional outcomes. ˇ 66% said that they were more confident to contribute to groups or discussions and felt that their opinions would be listened to.
4.4 National Indicator 92: Percentage gap between the lowest achieving 20% in the Early Years Foundation Stage Profile and the rest (PSA11). In Worcestershire the EYFSP shows that the percentage gap narrowed in 2009
4.5 Service users accessing family support are reporting that they welcome the personalised approach to their issues in order to produce personalised outcomes. ˇ Robust outreach, whereby staff make individual contact with families in their own homes in the first instance, is essential to engage some families.
4.6 Counselling services are offered at all SSCCs. A survey undertaken in June 2008 across nine of the SSCCs demonstrated that: 88% of clients, seen in the past six months, commented that they felt more in control of their lives and less anxious as a result of counselling.
5 Funding, sustainability and value for money 5.1 The Sure Start Local Programmes had a significant level of funding. Since the LA became the Accountable Body in March 2006 a funding formula has been developed for all SSCCs (including those that were formerly SSLPs). This ensures that all CCSSs run on a minimal budget and still meet the core offer and develop meaningful, effective services. This resulted in the SSLPs taking a considerable budget reduction. However, as the Children's Centre initiative developed the lead organisations cascaded services across a wider area and managed multiple Centres. This has resulted in organisations being able to operate on an 'economy of scale' model.' The LA provides financial support and advice to all SSCCs to ensure that budget planning is robust and budgets are adhered to. The formula takes into account the geographical size of the reach area (this supports the rural model), the level of disadvantage and the number of children aged under 5 years.
5.2 The LA undertakes commissioning on a central basis for several of the services, which are then delivered at all the SSCCs to ensure consistency. In some cases the SSCCs in the 30% SOA get more input from the service provider to meet need. Services include counselling, advice services, speech and language and Homestart (befriending service).
5.3 The LA has a robust tendering process to select lead body organisations and this ensures that organisations offer value for money. It also identifies organisations that have the potential to provide appropriate services for each of the reach areas in the County and enables them to demonstrate how they will meet local need through flexible service delivery.
5.4 SSCC work in partnership with other organisations and commissioners (such as Local Strategic Partnerships) and this enables them to access additional funding for activities/services that enhance the core offer and achieve local targets.
5.5 In Worcestershire high quality sustainable buildings provide high standards and low running costs. Maintenance has been kept to a minimum by replacing new windows and new roofs and installing increased insulation in refurbished buildings. Future investment to maintain the buildings will be necessary.
5.6 Every effort has been made to re-shape services where efficiencies can be made. Health professionals attend both ante-natal and post-natal courses, whereby they see several participants rather than having to see people individually; unless necessary. Early identification of developmental delay (such as speech) and appropriate intervention supports better outcomes and avoids more costly involvement at a later stage.
6 Staffing, governance, management and strategic planning 6.1 The introduction of the NPQICL (National Professional Qualification in Integrated Centre Leadership) supports SSCC managers in their continued professional development. 6.2 Local Authorities have a vital role in supporting and challenging lead organisations to ensure that services are quality assured and measured for impact and outcomes effectively. 6.3 The advisory boards support each SSCCs to develop the Self Evaluation Form (SEF) to demonstrate a comprehensive needs analysis and ensure attainment gaps are narrowed. Provision is effectively reviewed and evaluated. Parent's forums are established to give parents a say in the development of each Centre. 6.4 From April 2010 Ofsted will inspect all SSCCs and this will support a cross campus approach where SSCC are located on school sites. 6.5 All SSCCs have robust policies and procedures, which have been scrutinised and ratified by the LA. This includes safeguarding.
7 How well Children's Centres work with other partners and services, especially schools and health services 7.1 Linking Children's Centres with schools can yield significant benefits by ensuring a smoother transition to school life for children. Regular joint activities and planning meetings with school staff all generate better inter agency collaboration and co-operation. 7.2 In Worcestershire a team of Early Intervention Family Support Workers support all school age children. The workers link to the schools and the SSCCs (for those families who also have children aged under 5). This project has resulted from the success of the SSCCs early intervention family support programme and schools identifying that a preventative approach supports better outcomes. 7.3 Links with health are improving and the majority of SSCCs have input from health professionals, as outlined above. 7.4 The LA has worked with the PCT, Acute Trust and NCT (National Childbirth Trust) to produce a DVD, which is given to every pregnant woman in Worcestershire via their midwife. The DVD promotes healthy choices during pregnancy, outlines the story of birth and labour, outlines the benefits of breast feeding, and promotes Children's Centres and the Family Information Service. Much of the filming took place at various SSCCs and shows parents accessing a range of activities. The DVD will be translated into a range of languages. 7.5 All SSCCs are signed up to undertake the UNICEF Baby Friendly Initiative and a joint post between the PCT and SSCC has been developed to support this initiative. 7.6 Health, the fire service and the local SSCCs have worked together to develop a programme called 'Heart Smart Homes' that supports families to have healthy lifestyles, safe and smoke free homes. 7.7 The PCT have funded a post that supports all SSCC to achieve Health Early Years Status (HEYS). 7.8 The centres also deliver a range of services to support the promotion of attachment and infant mental health. There is commitment to delivering the Children's Centre as a universal service where all families can access a range of services, but where targeted interventions are available to those who need them. The Early Intervention Family Support Workers (EIFSW) can support families in individual areas including breastfeeding, support with children's behaviour, post natal depression etc.
8 Whether services are being accessed by those most in need and how effective they are for the most vulnerable 8.1 SSCCs pro-actively offer an inclusive, engaging, integrated and effective service to meet the differing needs of children and families. This approach often involves working with other local organisations and community groups. Partnership working enables the SSCCs to identify families in the most need. 8.2 SSCCs work pro-actively to identify those
families in need. For example close links with 8.3 Close links are maintained with Health Visitors who make the highest number of referrals to the SSCCs. They identify families who need support and are often less likely to access a SSCC without encouragement. The EIFSW provide a package of support and if the family wants further support in the home a referral can be made to Homestart who provide a befriending service. A trained volunteer is matched to the family and visits on a regular basis to offer ongoing support. 8.4 All SSCC develop specific activities to target and attract specific groups, such as dads groups on a Saturday morning and sensory play for children with disabilities.. 8.5 All Centres populate a data base called E-start, which informs them how many people attended each activity and their ethnicity, gender, date of birth and where they live. This enables each centre to monitor take-up and plan strategically to engage all priority groups from across the reach area. 8.6 Consultation with service users is ongoing to ensure that services are meeting need and leading to better outcomes. 8.7 A consultation with very young children has
recently been undertaken, using the 'Mosaic Approach', developed by 8.8 Marketing of the SSCCs has been developed with diversity in mind and a range of methods has been deployed to target all families. Not all families are aware of the services offered by the Centres and now they are available at a universal level a National Campaign should be developed using a range of mediums.
October 2009
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