Education CommitteeFurther written evidence from the NSPCC

BLUEPRINT FOR A “BEST START” CHILDREN’S CENTRE

The potential of children’s centres is enormous, as is the list of services that policy makers have suggested that they could deliver. However, in this age of austerity with contracting budgets and increasing levels of need, it is clear that children’s centres need to focus their activity. At the NSPCC we believe that this focus should be on the period from conception until a child is two, the so-called “age of opportunity”. This is the time when the foundations of a child’s life are laid and parents are often most in need of, and receptive to, support. We believe that children’s centres should focus on ensuring all children have the best start in life, rather than waiting until later, when gaps in development may already have emerged.

This short paper sets out a vision or “blueprint” for what a children’s centre would look like if it focused on supporting families from their child’s conception until their second birthday. This blueprint draws on much existing practice, and we have supplemented this paper with examples from children’s centres that are already offering parts of this proposed model.

Five principles underpin our vision:

1. Children’s Centres must Focus on the Outcomes that Matter Most

We believe that there should be a clear outcomes framework for children’s centres, which sets out specific outcomes that children’s centres should achieve for younger children. To inform this work, we reviewed a number of existing frameworks,1 and identified six key areas of focus for “Best Start” children’s centres. These are:

Supporting children’s early communication and language development.

Supporting children’s social and emotional development.

Promoting children’s physical health (including supporting early nutrition and improving child safety).

Improving parents’ parenting knowledge, confidence and skills.

Helping parents to tackle stresses in their lives, particularly risk factors such as social isolation, mental illness, domestic violence and substance misuse.

Enabling parents to improve their financial wellbeing.

2. Decisions about what Children’s Centres do Must be Based on Clear Evidence

The services and support available in children’s centres must be based on two types of evidence:

Evidence of local need, including data collected by health services during pregnancy and the views of local parents.

Evidence of what works in improving the outcomes set out above.

However it is important to note that children’s centres may also need to provide some activities which in and of themselves do not directly improve outcomes, but which are vital to engaging parents in the first place, and act as a “touch point” to engage parents in order for them to access other services.

3. Children’s Centre Provision Must be Designed as Part of Clear Pathways for Parents

Children’s centres must not be developed in isolation, but should have a distinct place within clear, comprehensive and integrated pathways of support for all families from pregnancy until their child is two, and beyond. Integrated care pathways should set out the services that all families can access from health and children’s series at different points in their child’s development, and should describe how families with additional needs will be identified and what services will be available to them. It should describe how families can access additional help, and also the support provided to those who finish more intensive programmes to help sustain any progress made.

Children’s centres can play three roles in these care pathways for families:

Children’s centre can help services to be better integrated and made more accessible. For example, if breastfeeding support is offered in the same place that a mother came for her antenatal appointments, she might feel more comfortable asking for this support.

Children’s centres can help to ensure families get appropriate and timely support, through identifying additional needs, signposting and helping parents to access other services. For example, volunteers at a children’s centre may be able to identify if a mother struggles to provide for her baby because of financial difficulties, and help her to apply for other financial support.

Children’s centres can commission additional services to fill any gaps in provision in the local area. These gaps are likely to be in the “early help” services, for families with additional needs but who may not yet meet the thresholds for specialist services.

4. Making Every Contact Count

We believe that engagement with children’s centres should not be a goal in and of itself. Every contact that a parent has with a children’s centre should be seen as an opportunity to support the family and ensure they are receiving the appropriate help to achieve key outcomes. For example, a family should never come to a drop in activity, or register at a children’s centre, without efforts being made to understand if they have unmet needs and help them to access additional support if appropriate.

5. Strong Relationships Between Professionals

Partnership working must be a reality at every level in the children’s centres. Professionals from different services should work together not only in the provision of services, but also in deciding what the children’s centre offer should be. The intelligence and insights of different providers, as well as their data, must be drawn on to ensure that the right services are being commissioned to meet local needs.

It is important that time and effort is invested in building strong working relationships between different professionals to help them to work together to provide consistent, continuous and high quality support for families. This might be done through joint training or joint meetings to share intelligence and plan care pathways for families with additional needs.

The table over the page sets out the services that a children’s centre focused on the period from conception to age 2 might deliver, although in each case the exact make up of services must respond to the local needs and context.

Goals	Children’s communication and language development.	Children’s social and emotional development.	Children’s physical health. Including nutrition and safety.	Parental risk factors. Including social support, mental health, domestic violence, substance misuse.	Parent financial wellbeing, skills and employment.
	Parenting knowledge and skills (which contributes to the children’s outcomes above).
Universal Offer	Information and resources for new parents on display or available to take home (This might include the NSPCC’s Preventing Head Injury film and Best Beginnings resources.)
	Community Midwifery and Health Visiting Services delivering the Healthy Child Programme.*				Opportunities for parents with a child under 2 to build skills and self-esteem through volunteering (eg. helping to provide services in the children’s centre or peer mentoring). Childcare or support in finding suitable local childcare.
	Universal antenatal education covering all the themes in the Department of Health’s Preparation for Birth and Beyond framework.
	Infant massage and drop-in groups for 0–2’s (eg. baby signing). These may be led by volunteers or provided at a small cost. They should be focused on promoting early communication and positive interaction, with workers trained to identify issues and signpost additional support.		Drop in support for breastfeeding and smoking cessation.
Targeted and Specialist Offer	More intensive antenatal education for vulnerable parents, such as Baby Steps.			Specialist midwives to support particular groups of vulnerable parents (eg. mental health )* Support groups for vulnerable parents eg. those with postnatal depression. Evidence based programmes for parents at risk, such as parent-infant psychotherapy for parents with mental illness.
	Evidence based services to promote infant mental health and early attachment eg, parent infant psychotherapy, video interaction guidance.
	Evidenced based parenting programmes to promote positive interactions and a safe and active home/learning environment, Incredible Years, Triple P.
	Family support workers who can signpost parents to additional services, help them to access these services, and advocate for them where necessary.
	Links to social work services and early intervention services, including home visiting programmes such as FNP, Safecare and Parents Under Pressure.**
	Links to speech and language therapists**	Links to infant mental health services**	Links to specialist health services (eg, physio for disabled children)**	Links to adult services (eg, domestic violence, mental health, substance misuse)**	Links to benefits, housing, childcare & employment services**

*Ideally health visiting and midwifery services should provide at least some of their services in children’s centres, although this will depend on the local context. Whether or not this is the case, it is important for these professionals to have clear links with their local centre(s) to build good relationships with children’s centre staff, and to encourage parents to access appropriate services there.

** There should be agreed protocols to enable children’s centre staff able to refer or signpost parents to be assessed for additional support. Ideally, specialist services should run some clinics or outreach activity regularly in children’s centres.