Foundation Years - Sure Start Children's Centres

Written evidence submitted by Annette Wray, East Riding of Yorkshire Council.

Foundation Years – Sure Start Children’s Centres

East Riding of Yorkshire

Context

There are currently 19 Children’s Centres covering the whole of the Local Authority, which is one of the largest Unitary authorities covering 930 square miles.

Ten Children’s Centres have been inspected by Ofsted and all are judged to be good with many outstanding features. Currently 79% of all children under 5 in the East Riding are registered with a Children’s Centre and 36% are actively involved in their centre, accessing services and of those 18% are receiving one to one support through home visits.

The council is part of the Sure Start Children’s Centre Payment by Results (PbR) trial in conjunction with North Yorkshire County Council, the only joint trial nationally. The trial is focussing on the work of all 57 Children’s Centres in the antenatal to five month period, developing stronger partnerships and effective means of sharing information to support parents and their young babies.

Effectiveness and impact of Children’s Centres to date and the role of Ofsted

1. There is a considerable amount of emerging evidence to show the effectiveness of our Children’s Centres and the impact they are making. Through the detailed information Centres hold on individual children and cohorts of children that have accessed support through a Children’s Centre we have clear evidence to show that children who attend East Riding Children’s Centres make better progress at the end of the Foundation Stage. This is particularly evident for scores on personal, social and emotional development and for communication, language and literacy.

2. Tracking the long term outcomes for parents is more problematic but we have some successes with parents gaining more confidence, accessing education and training and gaining employment.

3. There is evidence to show that the most vulnerable two year olds accessing a funded early education place in a good or outstanding setting and supported by a Children’s Centre practitioner is making rapid progress which is reflected in their Early Years Foundation Stage profile score. The mental health of mother was identified as an issue for almost half of the funded two year olds, a crucial factor contributing to many children not meeting their potential.

4. Children’s Centres have been effective in bringing together parents, partner agencies and the community sector through the Advisory Boards and community events to look at unmet needs, gaps in services and joint planning in localities. Data and information about local need and local intelligence about uptake of services, location of services and the provision have helped to reshape services and provide more flexible models of delivery. This has been useful in a large rural authority in making the most effective use of resources for all agencies. Health visitor clinics run alongside a Children’s Centre activity in a village hall ensuring parents/carers without access to a car or public transport can use these essential services and reduce isolation.

5. Ofsted inspections have validated the work that has been taking place in and through the Children’s Centres. This external judgement has helped raise their profile within the Local Authority and with partners. Within East Riding 50% of the Children’s Centres have been inspected achieving 100% judged as good. Of those centres inspected, 80% of individual outcomes were good and 18% were judged as outstanding. The Ofsted framework for inspections has been useful in engaging partners with shared targets such as increasing the numbers of mothers breastfeeding at 6-8 weeks, shared with health services. The Self Evaluation Form is a good document to bring all the strands of the work together and can easily be shared with parents and partners to show this in a concise way. The clear recommendations for both Children’s Centre and the Local Authority have given a focus for further improvement and through the development of subsequent Action plans following the inspection have involved partners in taking the work of the centre forward.

6. The impact of inspections has made it even more important to sharpen up the data and information needed in order to prove effectiveness of interventions and measure the longer term impact. An example of this is the tracking of vulnerable two year olds not only on their Early Years Foundation Stage profile results but we will be able to track these children throughout their school career.

7. Another key benefit of the Ofsted inspection is capturing the voice of the parent and listening to how they see the Children’s Centre operating and the support they have received and difference it has made. This can be evidenced by a number of parents who have told Ofsted inspectors that they didn’t always agree with the Children’s Centre practitioner when they referred them family to the social care team because of their concerns ,but could see with hindsight that the worker had made the right decision. The continued support for the family had given the parent/carer confidence and support to develop their parenting skills and over time the social workers’ involvement was not needed.

How to define and measure good practice in family and parenting support and outreach, including the effectiveness of the Government’s payment by results trials and what measures of child development and school readiness might be used.

8. Through the use of data and information collected about the type of support offered and the length on the intervention with parents through outreach and home visiting it is clear that this is a cost effective intervention both in financial terms and with successful outcomes for the family. The sustained contact with families is being monitored more closely through the PbR trial measures and work is proceeding to calculate the cost of these contacts and the outcomes achieved. Analysis of children’s development and progress is currently underway to see if there is a correlation between the number of contacts and the types of activities accessed and the child’s profile score at the end of the Early Years Foundation Stage. This may reveal the optimum number of contacts needed to have the maximum benefit.

9. The PbR trial links seamlessly with the local Health Visitor Early Implementer Site project to develop the role of the Health Visitor in the antenatal period in Goole, one of East Riding’s most disadvantaged areas. There is significant synergy between the two projects and this has enabled detailed discussions about family support, parent education offer and consultation with prospective parents about the content and delivery of the support that is on offer. The data collected for the measures within the PbR trial will show the effectiveness of the antenatal and parenting support.

10. Plans are in place to recruit two nurses for the Family Nurse Partnership to start in January 2013 to work in two towns in East Riding. It is hoped that the learning and some of the methods used to engage young first time mothers and their partners can be shared and developed to be used more widely with other vulnerable parents.

11. A number of centres have worked in partnership with local primary schools and childcare providers to plan and deliver transition projects with identified children and their parents to help settle them into school. In one area parents were asked about what their concerns and a bespoke course was delivered by the Head teacher and Children’s Centre leader that addressed issues such as the importance of children getting a good nights sleep, helping with reading books and overcoming the fears of parents who had a bad experience at school themselves. Parents were worried that their children wouldn’t be able to open the food packaging in their lunchboxes and needed to familiarise themselves with the classroom and where the toilets were.

How to increase the use of evidence –based early intervention and in children’s centres

12. To make the most difference to the lives of children and their families the earlier the information and support can be offered to parents the better. Parents to be are particularly receptive to the information and advice that is offered so the antenatal period is crucial and the Birth and Beyond resource developed by the Department of Health is a very effective and positive evidence based resource that is being used. Vulnerable parents may need more support so identifying these parents early to offer support and timely interventions is important. By not getting their details until 28 weeks into the pregnancy the work that can be achieved is more limited and the parenting education may not be as effective.

13. Practitioners use validated parenting courses [Family Links and Triple P] and one to one support of parents based on strengths based and solution focussed approach. Skilled practitioners use appropriate parenting education models adapted to individual family circumstances. Clear goals are set with the family after careful discussion and these are reviewed on a regular basis. There is evidence of the success of this approach but there is a need to validate our own work with families through the effective use of data and information to show long term impact and demonstrate that early outcomes can be sustained for children.

14. Baby massage is offered to all babies at about 6 weeks old which promotes early attachment and bonding that is so important for that child’s future development and wellbeing. It also allows practitioners to identify parents/carers who may be struggling in those early days and support can be given. We know that this gives each baby the best start which is especially important for vulnerable parents, parents with mental health difficulties and babies with special needs.

15. Research showing the influence of the home learning environment has shaped the services on offer in East Riding such as toy libraries and home learning packages. These are seen as vital services for rurally isolated families who appreciate the opportunity to meet other parents with young children and discover play ideas and find out more about their child’s development and enjoyment through loaning toys and learning how to make cheap and effective toys at home. Through the 2 year old funding scheme children are supported through a joint home visit with a Children’s centre practitioner and a worker from the setting who would become the child’s key worker. These visits have been invaluable in developing the relationship with parents and engaging them in home learning activities.

How to strengthen integrated working between health, social care and education as part of a multi-agency early help offer, including how to improve the information sharing and the proposal for children’s centres to have a named social worker.

16. The development of an antenatal to five month pathway ensures that all families are identified and supported at the earliest stage using the expertise and skills of all services involved. In East Riding this is complicated because out of approximately three thousand new births a year only 380 are born within the local authority boundary at Goole Hospital and a limited number of home births. The overwhelming majority are born in hospitals in Hull, York, Doncaster, Pontefract, Scarborough or Scunthorpe, and are part of different maternity services. Information sharing with each provider has to be negotiated individually and each provider has their own system and paperwork that the Children’s Centre has to use or adapt. Each provider has their own system to share information, with different timescales, e.g. some trusts are willing to share information [with consent] at 12 weeks others not until 28 weeks. This can make planning for antenatal education programmes difficult and is already too late to pass on key messages about smoking cessation, healthy eating and information about the developing foetus to parents. It can also cause delay in supporting more vulnerable parents with issues with debt management, housing issues and relationship issues. Strengthening integrated working and developing information sharing with partners is the main priority for the work through the Payment by Results trial

17. It has been difficult to identify a clear procedure for passing on information from maternity services to Children’s Centres and in some instances there is no formal procedure for midwives to pass on details to Health Visitors. Currently the system relies on the working practices and goodwill of those involved, making it difficult for Children’s Centre staff to be part of the process. It has been extremely time consuming to develop the relationships and trust between professionals in order to influence the working practices of well established health services. To develop this work further a joint specification for Health Visiting and Children’s Centres is being formulated building on the Healthy Child Programme, Health Visitor Early Implementer Site project about antenatal contacts by Health Visitors and the Children’s Centre Payment by Results trial measures focussing on the antenatal support offered through centres.

18. Work is ongoing to review the parent education programme so that an integrated antenatal parent education offer can be made to all prospective parents that is consistent and based on the evidence based Birth and Beyond resource [Dept of Health] and uses the expertise and skills of Midwives, Health Visitors and Children’s Centre practitioners in a cost effective way.

19. Over the last two years successful work with Social Workers has resulted in Children’s Centre practitioners being involved with and supporting every child under five with a Child Protection Plan or Child in Need plan. We have evidence to show that the effective partnership working has resulted in a number of children now no longer needing a plan and are being supported through universal services provided by the centre or supported by home visits by skilled centre practitioners.

20. There is an automatic invitation to every initial child protection conference for a Children’s Centre practitioner who then becomes involved in the package of support offered to parents and children. This enables the practitioner to build a relationship with the parent/carer and is able to continue to offer support when the child no longer needs a Child Protection Plan. There is a clear model for working with child and parents, with clear lines of accountability, strong and effective supervision and detailed documented notes on the contact and support offered. This way of working has been recognised by Ofsted in recent inspection reports as an Outstanding area of work in East Riding centres.

21. The need for a named social worker has not been an issue as all Children’s Centre practitioners know the social worker involved with the family they are working with. Centres have regular meetings with social workers or the team manager and are in frequent contact if they are working with a child that has a Child Protection Plan. Currently consideration is being given to the possibility of having a social worker as part of the Children’s Centre team in centres where they are supporting a large number of children subject to Child Protection Plans.

22. Team around the family meetings are co-ordinated by the Early Help and Advice team and involve the family and all relevant professionals in agreeing packages of support to meet the family’s needs. Children’s Centres are vital in identifying and working with the family to write the Common Assessment recognising areas where a family may need help while also building on their strengths thus ensuring a shared approach to improving their situation.

23. Children with disabilities and/or special needs receive co-ordinated support through the Early Support panel which brings together parents, health colleagues, voluntary sector specialists and local authority officers to support the child and family. Schools, private, voluntary and independent childcare providers and Children’s Centres are also key partners in supporting parents and their children.

How the overall level and quality of provision is being affected by moves to local funding.

24. Until now the overall level and quality of provision has not been affected in East Riding. There has been as significant investment in, and restructure of the staff managing Children’s Centres to secure a Leader in each centre and resources appropriate to meet identified need. At the time centres were opening a wide range of activities were on offer to attract and draw in families. This was not a differentiated or targeted approach. With more detailed information available about levels of need in an area, services have been streamlined to meet those needs. Financial savings have been made without the need to reduce the number of centres the number of services provided.

25. With much larger savings to be made the future may be more of a challenge. Providing effective services to our most vulnerable and deprived children and their families may be more difficult. All options are being considered to make services as cost effective as possible, including the introduction of technological solutions. Detailed analysis is being undertaken to see if by investing in the most effective early interventions a saving can be made later in a child’s life when a more costly intervention may be needed.

December 2012