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Memorandum submitted by Family Action
The response is divided into the following sections:
1. About Family Action 2. Family Action experience and involvement in running and working with Sure Start schemes 3. Summary of our evidence and recommendations 4. Funding, sustainability and value for money 5. Value for money 6. Are services being accessed by those in greatest need 7. Working with other agencies and services 8. References
1. About Family Action:
Family Action has been a leading provider of services to disadvantaged and
socially isolated families since 1869. We work with over 45,000 families a year
by providing practical, emotional and financial support through over 100 community-based
services across
2. Family Action experience and involvement in running and working with Sure Start schemes:
· Supporting vulnerable families through a number of outreach models and services. · Offering our core model
the Family Action family support service, (FSS) as part of multi-agency teams
in children's centres in Roehampton and Battersea , Wandsworth , and Edge Hill,
· Managing Sure Start
children's centres in Miles Platting Manchester; Southend, Essex and · Via staff who previous to working via Family Action worked in roles in local authorities establishing earlier Sure Start programmes and centres
3. Summary of our evidence and recommendations:
· Family Action celebrates the achievements of Sure Start, in particular the recent Ofsted evidence showing the good or outstanding impact made by integrated services on the learning and development of children and parents in over half of the centres visited[i]. · We applaud the major contribution of the Sure Start brand in increasing awareness of the importance of early years education and intervention where previously they were under-valued and making pre-school provision available to families who were previously excluded from it. · It is our experience that parents in deprived communities benefit from children's centres as havens of support where they learn from each other as well as early years professionals. Successful multi-agency working underpins the best functioning centres realising their potential as integrated service access points. [ii] · We support the ambition of Sure Start as a universal service which helps it to be non-stigmatising, raises aspirations and maximises community buy-in to early years provision · However, if children's centres are to play a part in challenging outcomes for children and existing patterns of social mobility they must meet the challenge of engaging hard-to-reach vulnerable families who may experience very complex needs including mental health problems, domestic violence, learning difficulties, substance misuse and severe financial hardship. · In our view some centres are confusing outreach with home based family support. Out reach is primarily focussed on trying to bring families into the centre. This is needed but it is not a service in itself. Home based support is a support service in the family home. As part of this Families may well be encouraged to use a children's centre but they need the intensive support in the home to resolve complex difficulties. Family Action offers a range of these services which have been evaluated as effective for families not able to access Sure Start centres immediately. These are explained in more detail in section 6 below. · Multi-agency working based in centres should include organisations offering home-based family interventions so as to increase the chances of such families engaging with services and the range of positive outcomes for parents and children. [iii] · While children's centres are potential centres of parenting excellence, to realise this in practice centres need to provide supportive non-judgemental environments through targeted in-centre offerings that gain the confidence of the most vulnerable families. Some of our staff have commented that the quality of Children's Centres is variable and largely dependent on the quality and creativity of the manager and their experience in working with disadvantaged and troubled families and safeguarding issues. · Albeit the aim of increasing free or affordable childcare to support labour market entry is an important one, the delivery of it via Sure Start needs to be carefully communicated and managed if it is not to conflict with the aim of spreading parenting excellence. · The high ambitions for the leadership of Sure Start Centres may not be sustained on some of the Phase Three budgets that are coming to our attention. It is difficult to fund a comprehensive service when the budgets are £100-£150k.
4. Funding, sustainability and value for money:
1. The funding and sustainability of children's centres and associated services need to be seen in the context of the expectations that have been created among parents; and Government's expectations of the people who work in the centres.
2. Sure Start began as a programme with its sights firmly on supporting the most disadvantaged, but over time its ambitions have evolved to offering a more universal service. Some researchers have remarked that as the expectations of Sure Start have expanded, funding has stayed the same or decreased. "Sure Start funding, which at its peak in 2004-05 reached about 20% of the population of children under four and their families, was increased by about 10% in 2005-06. However, in more-for-less fashion, that funding is expected to reach 35-40% of children 0-5 and their families and to provide care before and after school for older children. Local authorities are supposed to "find" the money to cover budget shortfalls, but this is proving to be unrealistic in practice."[iv] 3. Funding will differ according to local factors, including the level of deprivation and corresponding expectations of service delivery level. In 2005-2006 when nearly all the 1,000 Sure Start Children's Centres then in existence were based in deprived areas the National Audit Office reported they spent on average between £350,000 and £580,000.[v] 4. To properly establish if "more-for less" is the case now that the expectations have changed would require the NAO study to be repeated. However in the process of tendering for the management of centres during Phase Three, we are encountering local authority draft budgets starting from £100,000. While local factors and service delivery levels will vary, and this budget was for a centre in a less deprived area, the overall expectations created by the Sure Start brand remain that children's centres should offer integrated services, and reach disadvantaged families. 5. Our concern is that targeted interventions for the most troubled families are more expensive per head to provide - but they are the most needed if we are to deal with the impact of poor parenting or disadvantage at an early age. Evidence suggests that this is most effective. 6. To be coherent, sophisticated and safe in their offerings, centres should normally employ at least one qualified social worker or equivalent to supervise the team. With requirements to offer up to 20 hours a week of crèche facility and pay general overheads in each centre, integrated services can only be delivered on an annual budget such as £100,000 if multiple centre management is commissioned from a provider. Depending on the provider, the salary for managers charged with responsibility for teams in more than one centre can be as low as £26,016 pa (e.g., post of Family Support Worker, Qualified Social Worker, 18 months post-qualification experience, required to manage teams in two children's centres of the Ladywood and Soho areas of Birmingham, which was advertised by a recruitment agency in September [vi]) 7. In 2008 the then Children's Minister told Sure Start leaders "To be a Children's Centre manager is, in short, to be in a highly demanding, multi-disciplinary management and leadership role....... In the future we want all of you to have the National Professional Qualification in Integrated Centre Leadership qualification or equivalent. That's the same level of qualification as a head teacher, and it needs to be, such are the demands of the job."[vii] 8. Firstly head teachers are paid £36,618 to £109, 658 so that the level of ambition envisioned for Sure Start leaders is not commensurate with centre budgets of £100,000. Secondly the demands on children's centre managers can be so high that multiple centre management and employment of managers with minimal post-qualifying experience are far from ideal ways to deliver to the lower budgets. Working as a source of encouragement to discouraged and disadvantaged parents and managing staff to deliver integrated services demands greater management experience and excellence. 9. Any thinning of budgets therefore does imply risks to the sustainability of energetic good quality leadership of Sure Start centres which will adversely affect the delivery of their aims. While commissioning authorities may find "more for less" a desirable way out of the current economic morass, it will not yield necessarily value for money in terms of good quality support or outcomes for families, particularly those with the greatest needs.
5. Questions on value for money
1. The
Melhuish team at 2. Aside from early concerns about methodologies employed by the DCSF-commissioned evaluation of Sure Start[ix], the long-term nature of the return means evaluation of Sure Start is not straightforward. Outcomes for children around the age of two presently in Sure Start are not going to be effectively tracked until 2012 when they are in primary school. Many of the organisations delivering Sure Start, including Family Action, have found it difficult to track outcomes of their delivery relative to spending, particularly where working in areas of high residential mobility and in multi-agency teams. An additional issue around 2006 was the lack of clarity around the responsibility for the collection and evaluation of information at the transformation of programmes into centres when responsibility passed back from those delivering through local partnerships to local authorities. 3. In the short-term Ofsted's small scale study has recently found the impact made by integrated services on the learning and development of children and parents was good or outstanding in over half of the centres visited and at least satisfactory in all but one of the remainder. The schools reported that children's improving attitudes to learning and social development are easing their transition into primary school"[x] 4. This is borne out at a local level, for example, at the Roehampton Sure Start service in Wandsworth which we help to deliver through home-based intervention and parental involvement services. As more families have used Roehampton's Sure Start's services over the last 3 years so there has been an improvement in outcomes for children at Foundation Stage Profile (age 5); and the gap between those classed at 30% most disadvantaged and those in advantaged areas ( 70%) has closed more in Roehampton than in any other part of the borough 5. Over the longer term the nef and Action for Children have estimated that a mixture of targeted interventions, universal childcare and paid parental leave could help address as much as £1.5 trillion of the £4 trillion the UK will have to spend over the next 20 years to address problems such as crime, mental health problems, family breakdown, drug abuse and obesity. For every £1 invested annually in targeted services society may benefit by up to £9.20, for every £1 invested in children's centre there may be a return of up to £4.60. [xi] 6. However it would be a mistake to see targeted services and children's centres as either/ors or to deduce that one is a better value option. Targeted home-based intervention can be essential for engaging the hard-to-reach, but intervention in individual families will be time-limited. On the other hand it is not appropriate to lose contact with vulnerable parents. Following a period of intervention it is appropriate to keep parents engaged with services via centres where they can find support. Via centres parents can be supported to participate in delivery of services through committee membership and volunteering, thus enabling them to gain a vital mix of soft and administration skills in preparation for moving into employment. For example, this is delivered via our parental involvement support service at the Sure Start centres in Roehampton and Battersea in Wandsworth. However to ensure the engagement of the most vulnerable with public services in the first place, targeted intervention must be the top priority of investment. 7. One of the ultimate impacts of not intervening in the early years is care proceedings. The House of Commons Children's Schools and Families Select Committee found that at any one time around 60,000 children are looked after by English authorities. The total gross expenditure on children in care in 2007-08 was £2.19 billion, 51% of which was spent on fostering services and 41% on children's homes. The average cost per looked-after child per week in a residential home is £2,428, in foster care £489. [xii]This clearly demonstrates how Family Action's most highly targeted home based intervention packages (costing up to £5,000 a year for its Building Bridges services with families with mental health problems) are value for money especially when they are part of a package that journeys socially excluded parents and children to wider community participation.
6. Are services are being accessed by those in most need?
1. Our Family Support Service is aimed at the most vulnerable hard-to-reach families often affected by one or more factors including domestic abuse, mental health problems, learning disabilities and severe financial hardship. 2. While we work with families where ever they feel comfortable and safe - in their homes or in a community-based centre - the Family Action FSS worker usually starts working with families in their own homes. This is because assisting families in changing their behaviour to one another, bringing structure and routine to chaotic household circumstances and obtaining their trust are often vital stepping stones to not only improving the quality of relationships between parents and children but also ensuring families are able to participate in their wider communities, including attending Sure Start Children's Centres. 3. For example where parenting style has promoted very aggressive behaviour in the child, the latter may need help before they are able to play acceptably with other children in a centre setting. A mother who is depressed may need her confidence raising by a worker before she is ready to attend a setting which requires her to mix with more people. In addition ensuring the parent has a routine that enables they and their child leave the house promptly to arrive at timetabled activities and knowing there will be a friendly face to greet them at a children's centre can be key to ensuring they attend. For many weeks - or if necessary, months - before they attend a centre the Family Action family support worker will attend a family's home in the morning to help them change behaviour patterns, establish routine and, when they are ready to attend, makes sure a Family Action colleague is there at the centre to welcome them. 4. This home support, and outreach methods, ensure that 66 per cent of those engaging with our Southend centre come from the most deprived groups (20 per cent plus level) and that the take-up from ethnic minority groups is running at double those of other centres in the borough. This ensures that hard-to-reach groups' take up of services in the centre is substantial. Their participation rate is 40-100 percent in the specialist women's services, job centre advice, assertive parenting course and Mothers on Their Own Group (where parents and children first eat lunch with workers and workers are able to guide parenting behaviour in a supportive way). 5. Where children's centres are based in the most deprived areas with hard-to-reach groups we need to question the rationale for providing childcare in centres vis a vis outputs which are about promoting excellence in parenting. While such childcare can be valuable in promoting the ability of parents who are further along in self-development to take up training and volunteering opportunities in and outside centres, there is also a risk that seeing children being left in the centre sends the wrong message to newly attending parents who need to focus on staying in the centre with their children to improve their parenting skills. It is essential that the primary motivation for providing childcare through Sure Start is to provide a high quality pre-school experience. If it is primarily designed and communicated as a strategy for getting parents back to work this will impact negatively on the ethos of Sure Start. 6. It needs to be recognised that there are some groups which children's centres will always struggle to engage with, for example, when parents of very young children are giving concern and more serious mental health problems are involved. 7. When we come across this in the course of our Wandsworth Family Support Services the preferred option is to refer them to one of our two specialist Newpin centres. This is an intensive centre based service. Severe depression considerably impacts on development of the parent child relationship due to low motivation and engagement of the parent.[xiii] Research shows that the Newpin model improves mothers' mental health with an increased ability to recognize children's needs[xiv] 8. A 2007 evaluation of mothers at our Newpin projects demonstrated that many of them had felt unable to engage with Sure Start because of their depression "And then Sure Start said, come on, we're going to go on this trip but that trip was awful because everybody was happy and I didn't feel like being happy so I thought I'm the only person who can't do it so that trip was awful." .............."Most people don't come from happy backgrounds with no issues, like we all like to read about in books. The fact is that most people don't come from that but maybe at Sure-Start things you either have to come from that or pretend you do" For this group of mothers, attending Newpin where their depression was recognised by other parents, was extremely important to engaging them in parenting skills. Social phobia or fear of a violent ex-partner being able to enter the space may also prevent parents from attending a Sure Start children's centre.[xv]
7. Working with other partner agencies and services
1. The Family Action Support Service works alongside other partner agencies and services to engage the most hard-to-reach families in children's centres as we describe above. An additional aspect of our multi-agency working is the role we play in enhancing and consolidating work done by other partners, for example in fulfilling the programmes of speech and language therapists who may not be able to visit families frequently 2. We welcome proposals for an increased role for health visitors in early intervention. Health visitors can make substantial a number of referrals to our FSS. For example in Wandsworth they provide around a quarter of referrals. 3. Presently our function is distinctive and complementary to that of health visitors. They generally refer and we carry out programmes of work with families. Often we develop the service based on their assessment of family need. For example in cases of post natal depression the health visitor would be able to ask us to help the mother to manage her new born and other children and help her address the depression. This intensive time commitment is needed but would not be possible with present health visitor caseloads. Nor, we suggest, does it need that level of training to carry out the service. Once diagnosed the two services are complementary and a good value for money. 4. However
if an increased role is envisaged for
health visitors, as is indicated by some proposals, much more will need to be
done to recruit and retain them in the most deprived areas which have
historically been priorities for Sure Start and which are less attractive than
areas such as Wandsworth. Our Sure Start centre in 5. Social workers also refer to our Family Support Service. While we work closely with social workers of contracting local authorities in light of concerns over child protection, again referral demonstrates that outreach is presently delivering a function distinctive to that of local authority social workers
October 2009
References
[i] The impact of integrated services on children, parents and families, Ofsted 2009 [ii] Apps J et al, Family Support in Children's Centres, Family and Parenting Institute 2006 [iii] Ibid [iv] John, K: Sustaining the Leaders of Children's Centres: The Role of Leadership Mentoring European Early Childhood Education Research Journal Special Issue, Leadership and Management, 16(1)53-66 http://teacherresearch.net/John-eecerj08.doc. [v] Sure Start Children's Centres, National Audit Office, December 2006 http://www.nao.org.uk/publications/0607/sure_start_childrens_centres.aspx?alreadysearchfor=yes [vi] http://www.myjobsinbirmingham.co.uk/search-results/job/120167408) [vii] "http://www.dcsf.gov.uk/speeches/media/documents/Sure%20Start%20Leaders%20Conference%20-%20FINAL.doc [viii] http://www.ness.bbk.ac.uk/cost-effectiveness
[ix] Barrett H Evaluating evaluations: Evaluating recent evaluations of Sure Start, Home-Start and Primary Age Learning Study, Family and Parenting Institute, December 2006 http://www.familyandparenting.org/item/publication/31/2
[x] The impact of integrated services on children, parents and families Ofsted 2009 [xi] "Backing The Future: Why investing in children is good for us all." Action for Children and new economics foundation 2009, foundationhttp://www.neweconomics.org/gen/z_sys_publicationdetail.aspx?pid=293 [xii] The House of Commons Children's Schools and Families Select Committee Third Report, April 20 2009 [xiii] Sheppard M, Maternal depression, child care and the social work role, British Journal of Social Work 34, 33-51 [xiv] Phillips R Newpin Evaluation Unfinished manuscript (2002) quoted by Sanders L Chapter Six, Newpin Courage to Change Together Helping Families Achieve Generational Change, ed L Mondy and D Mondy, UnitingCare Burnside, Australia 2008 [xv] Lederer J Family Action Southwark Newpin: Evaluation report of Perinatal Project 2009, http://www.family-action.org.uk/uploads/documents/Southwark%20Perinatal%20Support%20Project%20Evaluation%231%23.pdf
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