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Educational Psychological Services

VSE Exploration of Themes:

What have we achieved in relation to the national themes:

For the purposes of VSE, the South Ayrshire Council Educational Psychological Services (SAC EPS)

team considered ways in which they deliver services under the national themes of:

Learning and teaching: exploring EPS contribution to learning and teaching with a focus on

raising attainment and achievement for all and closing the poverty-related attainment gap

Partnership working/ impact on wider community: to capture health and wellbeing, Getting

It Right For Every Child and partnership working. Prevention and early intervention will be

central to this area.

The SAC EPS works at all three levels of service delivery – individual and family, school, and local

authority/ national contexts - in order to address national objectives and close the poverty related

attainment gap in South Ayrshire. Prevention, early intervention and partnership working are key to

service delivery with robust self-evaluation being a continuous process throughout. As a team, the

EPS Psychological service delivers these priorities by:

1. Building capacity as a key role in service delivery through developing skills and confidence in

front line staff to increase sustainability of approaches.

2. Developing strong partnership working consistent with GIRFEC principles, especially the

principles of least intrusion, most inclusion.

3. Distributed leadership for key strands of strategic service delivery to increase leadership capacity

within the service and with partners.

The work of the service at strategic and national levels across both themes is shown in diagrams 1 ,

thus highlighting the role of the EPS within the local authority. The exploration of themes exhibits

the work of the team at individual, family and whole school levels.

The philosophy of South Ayrshire EPS is that the psychologist is looking at the child in their ecological

context. Learning and teaching encompasses a broader meaning than purely academic learning

and teaching. EPs are cognisant of the child’s need to develop their skills in building relationships

and connections, developing resilience, achieving in the wider community and attaining

academically. For example, it is believed that teaching infant children soft skills such as self-control

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and social skills might help in keeping at-risk children out of criminal trouble in the future (Sorenson

et al, 2015). Much of what EPs are consulting on are difficulties which impact on a child’s or school’s

learning and teaching. Current thinking is that partnership working is the best vehicle to sustain any

supports provided.

Mind maps show original discussions around the themes of learning and teaching and partnership

working and possible questions that could be the focus for VSE. Discussions and previous Service

Improvement Plans highlighted that much work had been carried out on both areas throughout the

past 4 years. Although there were several areas the SAC EPS could have explored, the themes

chosen for further self-evaluation were two which had been prioritised over the last 3 years. It was

felt that it was vital to explore the impact of these areas to ensure the EPS team were focusing their

energies on practice which was effective and best value for the local authority, as well as those

which have a positive impact on reducing the attainment gap associated with pupils from

economically deprived backgrounds. Examples include nurture groups and programmes, whole

school reforms which are informed by research evidence and professional development which is

high quality, evidence-informed and context specific (Sosu & Ellis, 2014). The areas of focus are:

Learning and teaching: Consultation

Key questions: A large percentage of EPS time in South Ayrshire is spent working

consultatively with stakeholders at the three levels of service delivery. Does this have a

positive impact on the learning and teaching of children and young people in South Ayrshire

especially for those who are most vulnerable?

Partnership working: Nurture Approach

Key questions: Does the Nurture Approach help develop partnership working and

build capacity?

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National Theme: Learning and Teaching

Key question: A large percentage of EPS time in South Ayrshire is spent working consultatively with stakeholders. Does this have a positive impact on the learning and teaching of children and young people in South Ayrshire especially for those who are most vulnerable? GENERAL: INWARDS Data collated termly by the EPS since August 2013 shows that an average of 65% of EPs service delivery in South Ayrshire schools is at a consultation level either at individual or whole school level. Much of the service’s strategic work also has this as its basis when the role of the EP within working groups is considered. Head teacher’s satisfaction with the service being delivered by the EPS over 2014-15 has increased by 10% since 2013/14, with 91% of HTs agreeing “the Educational Psychology Service provides highly effective support for learners”. 88% of Pupil Support Coordinators are also satisfied with the service they received from EPS with consultation being the most highly rated function of service delivery. They advise that EPs have the biggest impact on school staff and children and young people and although there is still felt to be a positive impact on parents/ carers, this is felt to be at to a lesser degree. Stakeholder focus groups, although small in numbers, indicated a possible discrepancy in the understanding of what consultation was and how it was utilised across the service. GENERAL: OUTWARDS In considering the research base for consultation there is evidence to suggest it is an effective way of an Educational Psychology Service working with schools, partners, children and young people, parents, Local Authority, Children’s Services (Wagner, 2008; Conoley & Conoley, 1990; Gurtkin & Curtis, 1999; Sheridan, Welch & Orme, 1996; Larney , 2003). The EPS national report ‘ASPECTS’ (2011) suggested that almost all services in Scotland view consultation as a key approach and high quality consultation in collaboration with others is an important strength nationally. Focus groups were carried out involving two other EPSs in December 2015 and they advised they had difficulties collating meaningful data on the impact of consultation at an individual and family level.

CONSULTATION: EPS STAFF PERCEPTIONS

In comparison to Wagner’s four principles of ‘consultation’, EPS staff evaluated themselves highly on ‘constructionist’, ‘transparency’ and ‘self-reflexive’ principles but results were more mixed regarding the ‘comprehensive’ principle (EPS Survey, December 2015). All respondents indicated solution focused approaches were apparent in their consultation work and some also advised that systems thinking and social constructionist theories were part of their approach. There were strong views from all EPs that they used solution focused language to improve situations and change perceptions. Staff feel they have a bigger impact on children and young people and staff than on parents through their current service model. Other data indicates there is a mixed view from staff about the specific role of the consultation. With some feeling that it is used as an overarching model or is felt to be a separate function alongside other core functions. Although this could be viewed as a technicality, drilling down deeper into this and the stakeholder’s views of what makes a consultation effective could lead to equity of a more effective service across the EPS.

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HOW DO WE KNOW? Survey monkey of staff views Literature review of consultation Annual staff questionnaire ASPECT report EPS strategic folders Minutes of team meetings and development days PSD database

FORWARDS:

Explore views of stakeholders on what makes a consultation effective and what needs they would like to be addressed through consultation.

Develop a service delivery model for consultation.

CONSULTATION: INDIVIDUAL LEVEL

There are currently 669 (January 2016) children and young people referred to Psychological Services at a consultation level. This means there is limited or no direct work completed with the child or young person, rather the EP will be working alongside school staff, parents/ carers or partner agencies or that the EP is exploring/ negotiating what their role is. Recent self-evaluation activities have shown that the average attainment of primary 5 children (2014/15) with EP involvement at a consultation level increased significantly since 2012/13 for developed ability and mental arithmetic. Attainment in reading remained stable but there was a decrease in general maths over this time. Five case studies further explored consultation at an individual level with a nurture basis and have highlighted improved outcomes for children and young people such as a decrease in referrals to management, improved attendance, reduced risk of self-harm, better engagement with staff, higher self-esteem, supports from CAMHS agreed and nursery placement maintained. Both self evaluation activities are recent and need to be explored further as a possible means of collating information and linking consultation to specific outcomes for children and young people especially in learning and teaching. There is further scope for exploring ways to do this in a more robust and regular basis. Although this is a similar challenge across the profession, it was felt to be a priority for SAC’s VSE as so much time is spent using consultation. Although school stakeholders continue to recognise the value of individual work with children and young people, there is an increased recognition and value of the role of the EP at a more whole school level and building capacity in staff. This more strategic approach to an EP’s role is something the service is promoting as research indicates that this is the best use of EP time (Wagner, 2008) and can have a more long-lasting impact.

HOW DO WE KNOW? Stakeholder annual survey School files Improvement Plan PDRs South Ayrshire ASN Review (Aug 2015) Case Study Reviews Head teachers’ Survey Service Level Agreements CEM data Focus groups PSD database ASN Review (2015)

FORWARDS:

Explore ways of linking consultation and learning and teaching using a more robust and regular approach.

Explore what data other partners collate which the EPS could utilise to provide evidence of impact.

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CONSULTATION: SCHOOL LEVEL

LITERACY

Dyslexia Friendly Schools HMIE identified DFS as good practice in the ‘Education for Learners with Dyslexia’ report in 2008. In South Ayrshire this approach was initially implemented in 2010-11, just as the Dyslexia Assessment Toolkit was launched. It is important to identify and address issues with literacy early as failure to do so can lead to a number of secondary difficulties including frustration and anger, marginalisation, learned helplessness, anxiety and embarrassment, low academic self-esteem and apathy, disengagement and avoidance (Humphrey & Mullins, 2003; Alexander-Passe, 2013). The DFS approach is different in that it focuses on empowering children and young people as well as parents. It leaves behind the medical model of ‘wait and fail’ prior to any supports being put in place and as such is viewed as early intervention. It is also felt to improve universal support for learners by improving ethos. SAC EPS developed training and supports for schools as well as developing the implementation strategy including an accreditation scale of DFS for Bronze, Silver and Gold for primary and secondary schools. There are currently 42 schools with Bronze, 21 with Silver and 7 with Gold accreditation. DFS in South Ayrshire continues to be viewed as an example of very good practice nationally with schools being recognised by government ministers for their work on DFS (Kyle Academy in 2014) and EPS staff being asked to present at national conferences (October 2015). An exit strategy for EPS was attempted in 2014/15 with a school staff steering group leading the approach. Feedback from schools and partner agencies has highlighted this has not been successful. Therefore further support and exploration of an exit strategy for the EPS that maintains the approach is required. In addition, information from a local support group has indicated that the sustainability of the quality assurance of the awards needs to be considered further too. The impact of consultation and DFS has been analysed using attainment data for P3, P5 and P7. On its own DFS does not appear to have a significant impact but when combined with a nurture approach or group, there is a trend towards children performing closer to their developed ability in reading as the DFS accreditation increases from Bronze to Gold. There is a significant difference but small effect size when schools achieve Gold DFS accreditation and use a Nurture Approach. For Maths attainment, there was also a significant difference between silver and bronze schools and like reading, a significant interaction between DFS and Nurture schools. Those with gold and nurture status performed much better than schools with gold and no nurture status.

Working Memory (CogMed) Since its launch, screening used by the DFS approach highlighted difficulties with working memory and retention rather than specific literacy difficulties for some. Therefore the EPS looked at supports that could be provided at an early stage and prevent further difficulties. CogMed is an ICT based intervention that is peer reviewed. Therefore the evidence base is robust including its impact on learning and teaching. Through consultation with clusters and individual schools, a pilot began in 2013 across one cluster and this has since extended to other clusters through EP consultation. There are currently 14 schools being supported to deliver this programme on a pilot basis. In 2014-15, 160 children completed or are in the process of completing their CogMed programme by Easter 2016. For those who have completed the programme, results show a reduced gap between children’s

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mental maths ability and general maths scores as well as improvements in children’s general comprehension and spelling (CEM data, 2014-15). Impact was also shown through standardised assessments completed pre and post intervention. The Working Memory rating Scale highlighted improvements in concentration to task, problem solving skills and organisational skills. Parental and teacher feedback advise that the children involved are more able to sit down and complete homework on their own, concentrate more readily and following instructions more, post intervention. Children’s feedback shows they feel they can sit for longer and their concentration has improved. However the children also advise they find the programme difficult due to its intensity. CogMed advise results should be maintained for 6-12 months at the highest levels and therefore the EPS are tracking the children’s learning profiles through the schools tracking and monitoring processes, the Automated Working Memory Assessment and CEM data. The EPS are keen to explore how to upscale this approach and continue to develop whole school approaches.

HOW DO WE KNOW? DFS accreditations and evidence gathered DFS Steering Group minutes DFS Handbook Accreditation process Service Level Agreements Annual stakeholder survey Standardised assessment in working memory INCAS data, 2014-15 Quantitative and qualitative feedback from school staff and parents Pupil feedback

FORWARDS

DFS: what is the role of the EP in leading the approach at school and local authority level?

DFS: how do we ensure quality assurance and maintenance of DFS accreditation?

DFS: What data do schools collate on DFS and how can we utilise this?

DFS: is there a forum for schools to share good practice?

CogMed: how do we upscale to a whole school approach to working memory?

CogMed: explore assessment measures that schools can use to assess working memory confidently

INCREASING CAPACITY THROUGH INCREASING UNDERSTANDING OF ATTACHMENT Attachment can have a huge impact on a child’s ability to form relationships and their ability to engage and perform at school (West et al, 2013; Oldfield et al, 2015). Recent NICE guidelines published in November 2015 advise all staff who come into contact with children and young people with attachment difficulties receive appropriate training on attachment difficulties. South Ayrshire Psychological Service database information highlighted the highest number of referrals to the service was for support for children with social and emotional difficulties. In addition the local authority has 343 children who are looked after (July 2014). The majority of these children have experienced trauma or chaotic family situations at some point in their lives. The more traditional behaviourist approaches have limited impact on children with attachment difficulties and so a different approach is required. In August 2013, the SAC EPS team agreed a nurture approach and increasing awareness of attachment was to be a priority for the service in order to meet this need. This was supported by the stakeholder evaluation highlighting an interest in the nurture approach.

School consultation and training on attachment and nurture principles In December 2015, two clusters (16 schools) have nurture principles and attachment within their Cluster Improvement Plans. The EPs for both clusters have delivered twilights for all schools either as a cluster or individually when travel was an issue. Another cluster (3 schools) has received a ½ day awareness raising session (n = 104 staff). For the other clusters, 7 schools have received awareness raising sessions from the EPS on attachment or nurture principles. In total 55% (n=28) of

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South Ayrshire schools including two special schools have received awareness raising sessions on attachment from the EPS in the last 2 years. This does not include the more specific 4 day Nurture training or the Nurture training for managers. Evaluations of the training have been positive with comments such as “I found the information about attachment really interesting, it’s not a subject I had given much thought to as a teacher but will now!”, “.. provided food for thought on the reasons behind some behaviours”, and “it has given me lots of ideas that I hope to use when I am teaching on placement and for my future.”. Most respondents have advised that they feel the training will lead to a change in the teaching practice.

Roots of Empathy: This approach was led by Community Learning and Development but the EPS were asked to support the development of an evaluation which looked at the impact on learning and teaching. Evaluations in August 2014 showed there was a significant increase in total emotional literacy scores for pupils who scored below average pre-interventions, two schools demonstrated a decrease in negative behaviours, all schools rated the programme highly for enjoyment, almost all pupils demonstrated a knowledge of infant development and a sense of responsibility for younger children and babies and 1/3 children felt their participation in the programme had improved their feelings and how they regulated their emotions and behaviour. Following the positive evaluation, CLD have continued to support Roots of Empathy and now complete the evaluation themselves.

HOW DO WE KNOW?

Training and shadowing opportunities for staff to support delivery of Nurture Approach in consistent manner

Increase in nurture and/ or attachment being mentioned in service level agreements, improvement plans and annual stakeholder feedback

Strategic folders

School folders

Training evaluations

Roots of Empathy evaluation – pupil, teacher and parent questionnaires, Emotional Literacy checklist and focus group, observations in class and playground

FORWARDS:

Role of EPS in taking Nurture Approach forward in a sustainable way

Exploring impact of approach from views of all stakeholders.

SEASONS FOR GROWTH – SPECIAL SCHOOLS There have been several deaths in South Ayrshire’s special schools in recent months. Although South Ayrshire has a guidance pack called ‘Should Crisis Call’, these tragic events led EPs to conclude that there was limited information and resources to support children and young people with severe and complex needs during such sad occasions. The EPS are exploring materials to support special schools.

HOW DO WE KNOW? Should Crisis Call Seasons for Growth & Give Us A Break Winston’s Wish materials

FORWARDS:

Adapt materials or add section to Should Crisis Call to support children and young people with severe and complex needs.

ECOLOGICAL ASSESSMENT INCLUDING DYSLEXIA Consultation within one cluster of schools highlighted high confidence in supporting children with dyslexia but low staff confidence in formally identifying dyslexia. Following a small working group

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with Head Teachers and Pupil Support Coordinators, the EPS agreed to develop a consistent assessment to support schools to identify dyslexia. Through looking outward at research, other authorities models and discussions with the SAC EPS, a staged model of assessment was developed which would encourage schools to look at the wider context for a child and their literacy difficulties as well as providing a consistent approach to identifying dyslexia. This approach was piloted in 2014-15 in one secondary and a primary school, amended and then presented at a Head Teacher’s meeting in September 2015 for further consultation. Some schools are reporting to be using this approach and finding it helpful. How the approach dovetails with the staged model of intervention will be explored at local authority level in 2015/16 as part of the ASN review (2015) and implementation of Children and Young Person’s (Scotland) Act 2014.

HOW DO WE KNOW?

Service Level agreements with schools

Ecological assessment developed

Records of involvement within one cluster

Presentation at HTs meeting

EPS team meeting minutes

NEXT STEPS:

Exploring how the approach dovetails with staged model of intervention within ASN review recommendations.

CONSULTATION: LOCAL AUTHORITY AND NATIONAL LEVEL

CHILDREN’S MENTAL HEALTH STEERING GROUP In Black and Martin’s recent report ‘Mental health and wellbeing among adolescents in Scotland: profile and trends’ in November 2015, there are two main areas that emerged as key to pupils’ mental health and wellbeing: number and nature of pupils’ friendships and pupils’ relationship with school. Those who disliked school, felt pressurised by schoolwork, truanted on multiple occasions or those who had been excluded had poorer mental health and wellbeing than those who did not. Other factors were also associated with poorer mental health outcomes including deprivation. Pupils in the most deprived quintile of SIMD were more likely than those in the least deprived quintile to have borderline or abnormal scores for their overall SDQ. Another factor was area and children who were most likely to have borderline or abnormal SDQ scores lived in Stirling and South Ayrshire. In 2013/14, the PEP led a short life steering group looking at promoting Relationships and Resilience within South Ayrshire. This included representatives from education, health, social work and third sector. The group developed a draft strategy to present to Heads of Service. However with the restructure of services, this was put on hold for a short period of time. During the same time period, the Joint Improvement Group actioned a sub- group to complete case study reviews across children’s files from health, education and social work. EPS information was noted to be a strength within this review. Following the restructures in South Ayrshire, a Children’s Mental Health Steering Group was developed by the Director of Education with the aim of producing a Children’s Mental Health Strategy. During the last year, the EPS have supported this Steering Group through providing the work completed by the Relationships and Resilience Steering Group, representation at the group and auditing and analysing perceptions of staff around the supports they feel promote positive mental health and alleviate mental difficulties with schools and their local authority partners.

HOW DO WE KNOW? Minutes of Relationship and Resilience Steering Group Draft Relationships and Resilience strategy

NEXT STEPS:

Develop an action plan for Steering Group

Negotiate role of EPS within above action plan to ensure effective use of service

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Mental health multi-agency case review summary Minutes of Mental Health Steering Group Audit and analysis of supports presented to MH Steering Group Presentation to multi-agency group (Oct 15)

ATTENDANCE SUPPORT AND GUIDANCE Attendance at school has an association with positive mental health for adolescents (Black & Martin, 2015). In addition, the learning and positive destination outcomes for children who do not attend school are lower than those children who do attend (Thambirajah et al, 2008). Within South Ayrshire in 2012/13, attendance was slightly above the national average in primary but slightly lower in secondary. In 2014/15 when data began to be collated on the attendance of children with ASN in South Ayrshire, this highlighted an attendance rate that was lower than that for all pupils in primary and secondary schools in South Ayrshire.

The EPS were involved in consulting on the development of new management guidelines for attendance and absence in schools in 2014. It was felt that a working group should be led by the EPS to develop further guidance on supporting children with concerns around school non-attendance. Research has been explored and the EPS are leading a working group to devise these guidelines. This is a multi-agency group involving CAMHS, Quality Improvement Officers and school staff.

HOW DO WE KNOW? Research Attendance data for primary and secondary children in SAC Attendance data for children with ASN in SAC New management guidelines Minutes of working group

NEXT STEPS:

Develop guidelines by July 2016

Develop a robust evaluation to measure outcomes of new approach

SUMMARY

STRENGTHS:

Stakeholders value consultation and feel it impacts positively on children and young people, parents and school staff.

Core evidence based approaches are used within the consultation model used by EPs within South Ayrshire.

Literacy interventions consulted upon and used are evidence based and have produced positive outcomes for children and young people as well as building capacity in school staff.

Following consultation, the EPS have increased awareness of attachment and its impact on children in 55% of schools in South Ayrshire. Their input has been positively evaluated as being able to have an impact on staffs’ practice.

WHERE ARE OUR CHALLENGES?

Defining a consistent model of consultation which has most impact and which will increase effectiveness and equity of service

Robustly measuring the links from individual consultation to outcomes for individual children and young people

Developing exit strategies from successful interventions that ensure sustainability of approach

Ensuring the role of the EPS and consultation is embedded and used effectively at a strategic and local authority levels.

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FORWARDS Many psychologists struggle to agree on a definition of consultation (Al-khatib & Norris, 2015). It is important for SAC EPS to agree a definition of what an effective consultation is and the model of delivery in conjunction with their stakeholders. This will ensure equity of service delivery, clearer expectation of role of EP and a more effective service that meets the needs of their stakeholders. Like many EPSs, SAC EPS has been using consultation as its main vehicle for service delivery for many years. Despite this there is limited evidence of direct outcomes from this approach for individual children and young people. A more robust and sustainable model for measuring and collating this information needs to be sought which could include using data already collated through other means or partners. Consultation is used effectively at whole school and local authority levels and here self-evaluation is rigorous and robust. Looking forwards, it is important for the EPS to consider exit strategies that ensure the sustainability of an approach as well as embedding the role of EPS consultation at a strategic level within the local authority.

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National Theme: Partnership working/ impact on the local community

Key question: Does the Nurture Approach help develop partnership working and build capacity? GENERAL INWARDS Marg Thorsborne and Associates (2015) developed a Collaborating Continuum Tool which describes 5 relationships within work places, one of which is partnership. Partnership is described as a formal relationship which includes working together to common goals, shared policies and/ or practices and work plan, shared risks and benefits and balancing organisational and partnership interests. SAC EPS’s key questions are around levels of partnership working with different partners and whether this impacts on capacity building? A part of partnership working is around having a common professional language and terminology utilised between different agencies and within the educational setting (Christenson, 2004). Therefore the EPS’s development of a Nurture Strategy across early years, primary schools, secondary schools, with Children’s Houses and carers as well as strategic development was felt to be the most appropriate theme. Nurture Groups are also viewed as a key strategy for reducing the poverty related attainment gap (Sosu & Ellis, 2014) SAC EPS developed a 3-year development strategy for the Nurture Approach in 2013/14 for education and social work services, involving health colleagues. The current model of training delivered by the EPS for the Nurture Approach is four day training. The EPS then considers factors from Implementation Science or Improvement Science (such as PDSA) to support partners effectively implement and evaluate either a Nurture Approach or Nurture Group. 176 staff have attended four day Nurture training delivered by the EPS since 2014 and it has been positively evaluated by almost all participants. Perceptions of knowledge regarding specific nurture concepts such as nurture principles, attachment, reciprocity, etc are now being measured pre and post training. The majority of participants feel there has been an increase in all areas. The Mental Health audit carried out in October 2015 asked participants to advise on supports they felt were effective in supporting positive mental health and resilience and early intervention for preventing difficulties and the Nurture Approach and Nurture Groups were mentioned by schools as being effective. Gaps regarding nurture included their views that all staff needed to be trained in the nurture approach, there was a need to look at a gradient of supports using a nurturing approach and further links with parents were felt to be needed. GENERAL OUTWARDS: Nurture Groups have been identified as a highly successful area of good practice by Ofsted (2005), DFEE (1999) and the Scottish Government Education Department (2007). Nurture groups and approaches now form a key strand of the Scottish Government’s ‘Rights, Support and Wellbeing Team’s’ supports for promoting positive relationships, better learning and better behaviour. This is one of only six approaches cited as best practice. There is a growing evidence base on the significant impact that Nurture Classes and approaches can make on the outcomes for children with social, emotional and behaviour difficulties.

NURTURE: EARLY YEARS All of the staff in two Nursery Centres were trained to use the Nurture Approach in 2014-15. This four day training block was over two in-service days and four twilight sessions. Training was well received although it was impacted upon by the increase to 600 hours for nurseries at this time. This

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had an adverse effect on capacity to be released for training and for follow-up coaching sessions which then impacted upon implementation of the approach. A trainee EP supported and evaluated the implementation of the approach across both nurseries. SDQs results were used to measure the impact on children, pre and post intervention. In one nursery there was a statistically significant decrease in pupil’s hyperactivity and in the other there was a statistically significant improvement in prosocial skills and a statistically significant decrease in behaviour difficulties. The ECERS-R scale was also used to measure changes in the environment pre and post intervention. Across both nurseries there was improvement across all subscales but there was the greatest improvement in language reasoning (observation of staff encouraging children to communicate and use language to develop reasoning skills). In one nursery there was a high level of improvement in personal care routines (eg greetings/ departures and snack time) and in the other there was a high level of improvement observed in interactions between children and staff (eg how the staff supervise children, behaviour management, supportive interactions). Pre and post intervention measure showed that staff’s understanding of the concept of attachment had increased. A nurture coaching framework was successfully piloted with five children in two nurseries in 2014-15 and is being looked at as a method of coaching for early years and other areas such as carers for the approach. The other two nurseries have received initial awareness raising sessions from the EPS and staff are also considering how parents can be involved in nurture. A recent meeting with the Paediatric team highlighted possible joint working which could impact on children’s attention levels.

HOW DO WE KNOW? Training evaluations ECERS-R Scale – pre and post SDQs – pre and post Nurture coaching framework Evaluation of staff readiness and understanding of attachment questionnaires HNIOS – 1 nursery Service Level Agreements Care Commission Inspection reports

FORWARDS:

Explore ways of involving parents using the approach

Upscaling approach to include additional 2 Childhood Centres.

What has worked so far?

Consider methods of measuring impact on children more robustly and longitudinally

Nurture: Primary School There are currently four schools within South Ayrshire that are funded through the initial pilot in 2010 to develop a Nurture Groups within their schools. These schools were chosen due to their SIMD and other factors increasing vulnerability of children and young people such as a high level of children from travelling backgrounds. The EPS role has changed since 2010. Initially the role was around supporting evaluation but this has since developed to consider quality assurance of the nurture groups as well as methods of ongoing support In 2014-15, 69 pupils were supported across these four Nurture Groups using the classic nurture model involving a withdrawal from class as part of their school day. Other children experienced ‘nurture time’ within the nurture rooms but this was not at an equivalent level as the other children. For example some children would attend for snack time only. Results from the Strengths and Difficulties Questionnaire (SDQ) pre and post intervention show improvements in prosocial behaviours such as interactions with others, being able to share, etc. In addition there is a reduction

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in difficulties expressed with emotions, conduct and hyperactivity. The Boxall Profiles, pre and post intervention also show significant improvement in the development strands measured, in particular organisation of experience (purposeful attention and starting to engage with peers) and internalisation of controls (more emotionally secure and able to respond to adult instruction). Children’s feedback has shown that the effectiveness of nurture groups comes from having a safe space to go, having a quiet place and being able to develop a positive relationship with an adult. The EPS have Boxall and SDQ data since the pilot of Nurture in South Ayrshire. Therefore the team are keen to explore how to measure any longitudinal impact nurture groups may have on children and young people. In addition for the past 2 years, the EPS has used the How Nurturing Is Our School framework to assure the quality of supports being provided by the Nurture Groups. This has highlighted positive practice as well as practice that needs to be developed within specific schools. In October 2015, another ten schools attended the four day training aimed at primary schools. Twenty eight people attended the training, including fifteen staff from one school as it was felt to be a key approach to build capacity in school staff. All indicated an increase in knowledge for most key areas covered in the training and indicated that they felt it would have a positive impact on their practice. A Primary Nurture Network was developed in 2014. Attendance ranges from 5 people to 20 people depending on the theme being explored. One of the most popular themes was policy development. Feedback from the Nurture Network highlighted that staff felt it was a good way to share practice, EPS offers support and guidance and a valuable CPD opportunity. They also highlighted the need for top up training, linking with across clusters, further CPD for whole school. Staff are currently being supported to use the PDSA model to evaluate impact of Nurture.

HOW DO WE KNOW? Boxalls – pre and post Strengths and Difficulties questionnaires – pre and post Views of young people Views of other teaching staff Views of parents Training evaluations Nurture Network minutes and evaluation How Nurturing is Our School documentation from for all 4 schools completed by EPS – annual basis Cluster and School improvement plans Service Level Agreements ASN Review (2015) Levels of partnership working questionnaire Mental Health Audit Case Study reviews Focus group data

FORWARDS:

Explore impact of whole school approach

EPS need to look at ways of involving parents

Explore pupil views of Nurture and its impact more fully

Do Nurture Groups build children’s capacity which is then transferred to the wider school environment?

Does How Nurturing is Our School meet school need for quality assurance and building their capacity?

Nurture: Secondary School Since 2014, the EPS has supported two secondary schools to pilot nurture groups. They are following a classic secondary school model of providing nurture support through a nurture group. Both schools, supported by their EPs, were successful in their bid to gain funding from Education Scotland to develop this approach within their own context. Both schools have been supported by the EPS with their evaluations of the Nurture Group.

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In their first year, there were four pupils in one school and thirty five in another. The qualitative feedback from pupils, parents and school staff was consistent in identifying improved confidence, self-esteem and better behaviour. Pupils were felt to be getting along better with one another and displaying more kind and helpful behaviours. Overall, pupils, parents and staff felt that relationships had improved within the context of the Nurture Group environment but views were inconsistent about the degree to which these skills could be transferred to wider school and community. The Secondary Nurture Network which began in 2014 is facilitated by the EPS. During the last meeting three schools attended but five have expressed an interest in attending. Normally two people from each school attend. These three additional secondary schools have indicated an interest in taking the Nurture Approach forward, one of which has completed the National four day training delivered by Education Scotland.

HOW DO WE KNOW? Boxalls – pre and post Strengths and Difficulties questionnaires – pre and post Views of young people Views of other teaching staff Views of parents Training evaluations Nurture Network minutes Education Scotland funding bids were successful Visits from Education Scotland re: bid How Nurturing is Our School documentation from one school ASN Review (2015) Cluster and school improvement plans Case study reviews Levels of partnership working questionnaire Mental Health Audit Pupil View Templates Evaluations from secondary schools

FORWARDS

The role of the EP in supporting the sustainability of nurture groups and the approach in secondary

How do we share good practice?

Quality assurance using How Nurturing is Our School: does this meet need?

How do EPS tap into other services’ data around the children accessing nurture?

Explore impact of whole school approach

EPS need to look at ways of involving parents

Explore pupil views of Nurture and its impact

Do Nurture Groups build children’s capacity which is then transferred to the wider school environment?

NURTURE: CHILDREN’S HOUSES, CARERS AND FOSTERING AND ADOPTION TEAM Stable care enables children to form secure attachments and has benefits for a child's education, health and emotional development. Greater stability can be delivered in part by a reduction in the number of care placements for any one child, which in turn will reduce immediate costs to the local authority by reducing social workers' time, use of expensive agency and residential placements, and therapeutic support. (NICE guidelines, Nov 2015). Through using an approach that is relational in its conception, attachment theory suggests this is more likely to meet the needs of children and young people with insecure attachments (Golding et al, 2013). Since March 2014, thirty seven staff from the Children’s Houses have attended the four day Nurture training delivered by SAC EPS and CAMHS over 3 different blocks. This has included management staff. Training evaluations are positive in their feedback. Anecdotal evidence from staff management has indicated the approach is being well used. However this needs to be explored further as do the next steps for the EPS and CAMHS in taking forward coaching sessions with staff to ensure sustainability of the approach. Since August 2013, 8 staff from the Fostering and Adoption team and over 50 ‘caring’ households

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have been trained in the nurture approach. Training is delivered by SAC EPS with the Fostering and Adoption team shadowing the training in order to build their staff’s capacity. The Nurture Approach is being taken forward by the service as their key framework for supporting carers. Again training is evaluated positively but further self-evaluation is required in the longitudinal impact of the training. The EPS meet with the Fostering and Adoption team to support implementation of the approach on a termly basis. Self-evaluation questions during these meetings have highlighted that there are many carers who do not feel confident in taking the approach forward and the Fostering and Adoption team would like further support to help carers in doing so.

HOW DO WE KNOW? Training evaluations Meetings with Children’s Houses managers Termly meetings with Fostering and Adoption team

FORWARDS

Evaluate carers views longitudinally on the impact of nurture training and their current usage

Consider further implementation strategies with the Fostering and Adoption team to ensure sustainability of approach

Explore children’s views of nurture and also whether training for young people would be valuable

LOCAL AUTHORITY/ NATIONAL Training The Principal EP has delivered two one-day sessions for management staff regarding the Nurture Approach and supporting its implementation within a school since 2013. This follows an implementation science approach as it is ensuring that staff have support and understanding within their management structures in order to take the nurture approach forward (Fixsen et al, 2009). Twenty eight people attended this training, covering 21 schools. From the 13 schools who attended the training in 2014, 92% (n=12) have gone on to implement the nurture approach either through asking for further staff training for the whole school from their EP or implementing practices related to the nurture approach. In 2014/15, the ASN team (N=32) requested the 4-day Nurture training from the EPS. The training evaluated well and following the implementation of the ASN review, the EPS team will be working with the ASN team to consider how the ASN team can take the approach forward across all schools and establishments in South Ayrshire. The PEP was heavily involved in the National Steering Group for Secondary Nurture alongside Education Scotland and EPS colleagues from four other local authorities. She was also asked to record her ideas describing good practice for Nurture Principles. This is now used as part of the national training. Strategic approach: The ASN Review (2015) identified the targeted nurture provision as having had a positive impact on pupils with social and emotional needs. However it also identified the need for a better continuum of service for children with social and emotional needs. Therefore included in the review’s recommendations were: an aim to enhance current nurture provision through ensuring nurture approaches are used in all schools while providing an enhanced nurture provision in specific schools for children with social and emotional needs from all SAC schools. In addition, a strategy for nurture is required to take this forward. This is in contrast to proposals made in 2014 to cut nurture staff and groups within SAC.

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Following the development of the Health and Social Care Partnership in South Ayrshire, the Head of Children’s Health Care and Criminal Justice is in the process of developing a LAAC Strategy. The Nurture Approach has been identified as an approach that social work colleagues wish to extend and continue to use to support children who are looked after.

HOW DO WE KNOW? Training evaluations ASN Review (2015) School service level agreements and records of involvement National Steering Group for Secondary Nurture minutes LAAC Strategy (draft) (2015)

FORWARDS:

The EPS needs to further consider how they work in partnership with other services to take Nurture forward at all levels

The EPS needs to consult with local authority management on their views of nurture and explore next steps.

SUMMARY

STRENGTHS

Nurture Approach has been used effectively to develop aspects of partnership working across education, health and social work as described by Thorsborne et al (2015).

Nurture Approach has built capacity in staff, in particular through its four day training model

Training is well evaluated and the majority of participants report on an increase in knowledge as well as a belief that the training will impact on their practice.

Nurture Groups positively impact on children and young people’s prosocial behaviours, relationship with others and self-confidence.

Due to the EPS promotion of the Nurture and a relationships-based approach, the interest in nurture at both a strategic and school level has steadily increased over the past 3 years as a means of supporting children with social and emotional needs within South Ayrshire.

The EPS was viewed as a strength by the ASN Review in terms of their capacity to provide improved strategic leadership and support of children and young people with social and emotional needs

WHERE ARE OUR CHALLENGES?

Although training is well evaluated, a longitudinal analysis of its impact should be developed to ensure the longevity of the capacity being built by staff.

There is a need to further explore the transferability of skills that children and young people gain from Nurture Groups to the wider class and community environments.

Explore parental involvement and pupil views of nurture

Does the How Nurturing is Our School framework continue to meet the needs of stakeholders?

Role of EPS in supporting the next steps in nurture approach across the local authority in a sustainable way.

FORWARDS The relationships-based Nurture Approach has steadily gained support and interest from schools and central local authority managers within South Ayrshire. The training programme which has been delivered has been well-evaluated but further self-evaluation is required following a period of implementation. This will review the outcomes achieved for staff and children and young people as well as the transferability of any skills gained through learning. The way in which the quality of the approach is measured would also benefit from further exploration to ensure the fidelity of the approach and the likelihood of positive impact. It is vital that the EPS continue to work with local authority managers to embed the approach in future developments.

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