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Memorandum
submitted by the
1. Executive summary · This submission outlines the London Borough of Newham's approach to the delivery of children's centres and tackles the Committee's questions around whether the model is effective · The submission describes how the multiple challenges faced by Newham's residents have shaped the way services are enabled and developed in a collaborative, targeted and cost effective way. Newham is keen to explain the collaborative targeted early intervention good practice and value for money established locally in our children's centres. We agree, however, that the way forward is to ensure more joined up working through complementary services. · Brief general context information is followed by a series of challenges or myths answered by evidence based responses setting out Newham's position. These include tackling challenges around the use of children's centres by middle class parents rather than vulnerable families or ethnic minority communities; whether centres are value for money; whether centres can show impact and focus; whether centres undermine the role of parents. · A series of recommendations for action, based on the responses and evidence, including proposals to recognise the potential effectiveness of early intervention and the role of children's centres in tackling deprivation and joining up partners to address child safety. Further recommendations include a focus on outcomes and impact rather than outputs and process and the introduction of cross professional challenge to consultation and policy setting. 2. Brief introduction to the submitter This submission is being made by the London Borough of Newham. Newham delivers and enables the provision of 24 children's centres and associated services with a range of local partners. In 2005, Newham was one of four local authorities nationally to achieve Beacon status for 'Early Years and Childcare - the Sure Start Agenda' for it's mainstreaming of Sure Start local programmes into a borough wide service. We have subsequently developed our locality model to link in related services such as extended schools, parenting and play to achieve the maximum from our resources to effectively support families in Newham. 3. Factual information 3.1 Newham is classed as an outer · Youngest population under one nationally and very high child poverty rates · High levels of ethnic and cultural diversity but also high levels of community cohesion · Very high family mobility levels challenge overall continuity and impact of services 3.2 Newham has 20 children's centres and 4 children's centre outreach centres. Our 20 centres are required to include childcare as the whole borough is in the 30% most disadvantaged areas of the country. We use our DCSF funding to run these 20 designated centres and provide additional value in providing an additional 4 centres which provide the whole core offer except full time childcare and a range of framework services to ensure that the centres are well supported in delivering good quality services. Without ongoing funding, achievements are likely to be compromised. 3.3 The accompanying service targeting and performance management data in appendices to this submission show the high levels of child poverty in Newham, the dense population of very young children, the wide ethnic diversity of our families and the multiple challenges many of our residents face. 3.4 These multiple challenges require us to deliver and enable services in a way that meets the wide range of requirements of our residents. This challenge provides a good base for integrated and outcome focused work, using families' needs to design services. Children's centres and a core offer of related and graduated services to support families where appropriate within a universal framework provide the best approach to collaborative and potentially cost effective models of local delivery that currently exists in the public sector. This provision could be linked far more effectively than is currently possible with other services at a locality level to create a more cost effective holistic set of collaborative services that address need and deprivation. 3.5 Accompanying case studies show how joined up working can really make an impact on children's lives in a cost effective way which minimises crisis intervention and maximises opportunities. 4. Proposition 4.1 Children's centre services are used only or mainly by middle class parents, effectively subsidising families who do not require additional help. Poor and vulnerable families do not access children's centres. Evidence in Newham 4.2 Nearly all children in Newham using children's centres and related outreach services are in the most deprived 20% of children nationally. 4.3 Children's centres enable parents -including the vulnerable - to tackle a diversity of needs through one approachable access point. Those who are hardest to engage are visited at home or pulled in to access services by targeted outreach, providing the lowest levels of intervention appropriate to the situation. 4.4 89% of Newham's children's centre service users are in the 20% most deprived super output areas nationally. 4.5 We have a reliable local data system underpinning this information. These children represent real and current users of services, not survey based statistics. 4.6 Our heat maps in the appendix show actual numbers of registered children in different areas of the borough, allowing us to target increased numbers of children of a particular age, focus on specific identified needs or vary our planned offer to meet the requirements of different communities. 5. Proposition 5.1 Children's centres have failed ethnic minorities. Evidence in Newham 5.2 Children's centres in Newham provide and enable services for the widely diverse ethnic, cultural and religious communities that make up the borough. Our approach is holistic and inclusive, bringing communities together to promote and enhance community cohesion at the earliest points of family life. 5.3 Our planning information plots and records ethnicity details for all children in the borough. We are able to record usage of services by particular ethnic communities, plot where real communities are clustered or spread for targeting purposes as well as note any gaps in use by communities to challenge our types of support. Our extremely high levels of engagement with the diverse range of communities in the borough show that this approach works. Details of this data are in the appendix to this document. 5.4 Newham's regular residents' surveys pick up this local perception of a high level of community cohesion with 87% saying that people from different backgrounds get along well in the local area (Liveability Survey 2009). This is despite the high levels of challenge across many other indicators.
6. Proposition 6.1 Only strongly targeted services, tackling the most difficult families, provide effective use of tax payers' money. Evidence in Newham 6.2 In Newham, we believe that children's centres need to be used as part of an essential continuum of services. Engaging at the earliest and most cost effective stages prevents later expensive crisis intervention and long term care and support issues for children in care or anti social behaviour. 6.3 Early intervention in targeted health outreach services or lower intensity level parenting training and family support, for instance, can prevent a slide into dependence and family crisis and break poor parenting cycles. Early employment support and targeted training for parents who are far from the jobs market (because of literacy, numeracy or lack of language skills) can tackle benefit reliance and provide positive role models for children growing up in a working household. 6.4 While there will always be a need for specialist services dealing with families deep in crisis, children's centres provide an opportunity to intervene earlier and more cost effectively to enable better life chances for children and their families. 6.5 Early intervention through targeted health services is achieved through assertive outreach, working with parents through home visits, telephone contact and using other key workers already engaged with family (nursery officer/teacher, health visitor or midwife for example). Services and support are delivered in the family home, children's centre or other accessible community venue. Health services, delivered by the children's centre, local authority and local health trusts working in partnership are: · Child and family consultation services - assertive outreach to referred families not engaging in mainstream family therapy services - 82% of those hard to reach families engaged by assessment and support services. Families encouraged and supported from these sessions to attend other children centre services. · Midwifery - women identified as vulnerable in pregnancy are supported through assertive outreach in both the home and children's centre. The breastfeeding rates amongst these more vulnerable women was 6% higher than the Newham average at 89% and 56% of these vulnerable women breastfed past 6 months after birth. · Previously, women needing extra post natal support could only access this through their GP. Psychology services in children's centres improved access to this service for women. 75% of women who accessed this support through children's centres reported that they would not have accessed this support through their GP. Pathway and referral training for health visitors, midwives and early years settings' staff around post natal issues meant that services could be targeted and effective when these vulnerable women required support. · Through children's centres, parents/carers can be referred to nutrition sessions to increase awareness of healthy eating, while practising healthy recipes that parents can replicate at home. These sessions empower parents to make healthier food choices for their family and provide necessary cooking skills to cook a healthy balanced meal for their family. 92% of parents/carers who attended sessions reported they were able to sustain the changes in their eating behaviours and diet 3-6 months later.
7. Proposition 7.1 Children's centres are very expensive to run and create more layers of ineffective professional do-gooders. Evidence in Newham 7.2 In Newham we have found that operational models for children's centres must include important cost effective and performance management elements in order to provide good value and impact for families. 7.3 In Newham, our centres are run with a diversity of partners, on different sorts of sites and with different needs in mind. The borough, while significantly deprived, has a wide range of different communities and needs and requires a range of approaches to engage parents and target effective services. 7.4 To be cost effective, we make best use of existing centres and venues, using schools and community centres where possible to link children's centre services with compatible services (such as extended school services, voluntary sector training or community services) and minimise additional infrastructure and management costs. Our six directly managed centres (developed from 8 sure start programmes) provide an additional base for multi agency services and are managed on a locality model. There are no additional managerial layers running centres and staff are part of a local multi agency workforce supporting and engaging families with an emphasis on targeting vulnerable children at the earliest possible stage. 7.5 Our core childcare offer is run on a market basis. We give only start up funding for childcare provision in centres and in the majority of centres we have a partnership with private sector providers to provide childcare. This generates rental income to support infrastructure costs and provides opportunities for our partners to resource crèches and other services where appropriate and effective. 7.6 Our funding for centres is allocated on a transparent funding formula basis which provides a core infrastructure base but requires additional activity and service provision in order to claim additional funding for staff and resources such as crèche provision. This ensures that where funding is not given to some centres, others will benefit with additional funding based on need and innovative working. These planned services are agreed with the local authority through a delivery plan jointly reviewed every six months. While some of this plan is based on process as measured by central government and help to build the self evaluation forms required nationally, the majority of the plan focuses on activities and outcomes. We will further track and evaluate performance and impact by using cost benefit analysis and we are currently following this through to withdrawal or awards of funding based on outcome and value for money. 7.7 These cost efficiency measures allow us to fund an additional 4 centres on top of our current 20 centres, enabling geographically targeted provision for isolated communities (see maps at appendix) and an ability to focus on need and specific local requirements. In addition to this, we have used a children's centre on the edge of the Olympic site to deliver Playing for Success support for school children that require additional curriculum support in different environments alongside core services for young children. Many of our centres are based in primary schools, joining up the extended services in schools and children's centre offer for families with children of different age ranges to mainstream and pool resources. 7.8 Our attached heat maps show actual numbers of children in different areas of the borough, birth rates and under five population in order to see where changes are occurring and new services may be required. 8. Proposition 8.1 Children's centres have little impact on vulnerable children because of their lack of focus on need and vulnerability. Evidence in Newham 8.2 Children's centres in Newham are clearly focused on integrating and delivering services at the earliest opportunity to those families who need targeted and outcome based support. 8.3 We aim to identify vulnerable children and their families as early as possible through a clear multi agency process. The process is action orientated and allocates resources at the lowest intervention levels across agencies where possible. 8.4 Our data on vulnerability is informed by initial contact referrals from a range of different agencies. A comparison of the density and type of referrals enables us to look at particular hot spots to tackle underlying problems where possible. 8.5 Our Every Child Matters (ECM) meetings are recognised as good practice in identifying concerns from a range of agencies and acting effectively to impact on family difficulties as quickly as possible. Practitioners from Health (midwifery, school nursing and health visiting teams) children's social care and children's centre staff come together as a core with schools, nurseries and voluntary sector partners also attending. The joined up approach to services for young children and their parents tries to ensure that pooling of information leads to tenacious services that prevent children falling through the net within a borough with a high birth rate and transient population. We draw on a wide range of possible services - from universal and low level support such as hand holding support to attend carer and toddler groups to referrals to more intensive and specialist services. Short case studies in the appendix show how ECM meetings can work to support vulnerable families, lessen the need for specialist services and move families into training and employment. 8.6 The aim is to support families holistically, using the range of resources available to different agencies and joining them up to enable better outcomes for children as well as maximizing and rationalizing resources. 9. Proposition 9.1 Children's centres undermine the role of parents and add to the nanny state. Evidence in Newham 9.2 Effective children's centres contribute to the parental role by enabling parents to take their responsibilities seriously and understand how to deal with them. Parenting courses providing early intervention to families experiencing difficulties with children's behaviour or becoming overwhelmed with a range of problems. These families are likely to form part of the group of parents who have later difficulties with children and young people. As families slip into crisis, they need to be rescued by the state when opportunities to turn lives around have been narrowed or lost. These late interventions - where the state steps in as a corporate parent - are far more expensive, intrusive and undermining for family life. 9.3 Earlier versions of support for difficult families through council run or voluntary sector services such as day care often removed children from families to delay, rather than tackle, fundamental issues around parenting and environment. Children's centres work alongside parents to resolve issues with a range of multi disciplinary services to focus on what is needed at the lowest possible level of intervention. Peer support from other parents is used to reinforce approaches to parenting in mixed groups wherever possible. More cost effective universal services are used to underpin any specialist services and include vulnerable families alongside others. 9.4 Children's centres empower parents to take responsibility rather than replacing parental roles with institutional processes. 9.5 Our parenting training shows an exceptional success story of support for different levels of need across a range of agencies and providers. Our approach was to ensure that we worked alongside more specialist areas such as anti social behaviour and community and mental health services, requiring real reciprocal action for staff training, validation and support. This approach ensured that we had access to a far wider workforce to deliver parenting training at a range of levels, empowering parents at the appropriate and lowest point of intervention to boost responsibility rather than reliance. 9.6 Our evidence based parenting programme (Triple P) shows an impact with parental attitudes and abilities in evaluation follow up. We hope to continue this with ongoing assessment and tracking into the future to show trends and longer term outcomes.
10. Recommendations for action · Recognise that the universal and early intervention model works - in Newham we are beginning to find evidence that children's centres tackle fundamental causes around poverty, social exclusion and deprivation. · Recognise that multi agency communication and co-operation is vital to child safety and that children's centres are the natural local vehicles for doing this. · Recognise the potential impact of children's centres to deliver local services in a cost effective way. Targeted and universal services (in non stigmatising accessible centres) fit effectively with localised multi agency provision. · Ensure that resources go further by joining up initiatives like extended schools, Think Family and parenting with children's centres, reducing the separate layers of inspection and support and making better use of existing service based infrastructure.
· Look at what works in outcomes and impact on families and children's lives when measuring performance rather than just outputs defined by process, structure and organisational targets. This is not a plea to reduce or minimise targets or output measures, but to focus more effectively on joined up services that make a difference.
· Make cross professional challenge a condition of consultation and recommendation. Do not listen to any single profession groups alone - including 'professional' voluntary sector or national body lobbyists and civil servants.
· Ensure a period of medium term resource stability for initiatives requiring long term cultural, organisational and local change.
October 2009 |