Foundation Years: Sure Start children's centres Years: Sure Start children's centres Fifth Report of Session 2013–14 ... The current staff of the Committee are Dr Lynn Gardner (Clerk),

Published on 8 January 2014 by authority of the House of Commons London: The Stationery Office Limited

House of Commons

Education Committee

Foundation Years: Sure Start children's centres

Fifth Report of Session 2013–14

Volume III

Additional written evidence

Ordered by the House of Commons to be published 11 December 2013

The Education Committee

The Education Committee is appointed by the House of Commons to examine the expenditure, administration and policy of the Department for Education and its associated public bodies.

Membership at time Report agreed:

Mr Graham Stuart MP (Conservative, Beverley & Holderness) (Chair) Neil Carmichael MP (Conservative, Stroud) Alex Cunningham MP (Labour, Stockton North) Bill Esterson MP (Labour, Sefton Central) Pat Glass MP (Labour, North West Durham) Siobhain McDonagh MP (Labour, Mitcham and Morden) Ian Mearns MP (Labour, Gateshead) Mr Dominic Raab (Conservative, Esher and Walton) Chris Skidmore MP (Conservative, Kingswood) Mr David Ward MP (Liberal Democrat, Bradford East) Craig Whittaker MP (Conservative, Calder Valley) Charlotte Leslie MP (Conservative, Bristol North West) was also a member of the Committee during the inquiry.

Powers

The Committee is one of the departmental select committees, the powers of which are set out in House of Commons Standing Orders, principally in SO No 152. These are available on the Internet via www.parliament.uk

Publications

The Reports and evidence of the Committee are published by The Stationery Office by Order of the House. All publications of the Committee (including press notices) are on the Internet at www.parliament.uk/education-committee

Committee staff

The current staff of the Committee are Dr Lynn Gardner (Clerk), Katy Stout (Second Clerk), Martin Smith (Committee Specialist), Claudia Sumner (Committee Specialist), Ameet Chudasama (Senior Committee Assistant) and Caroline McElwee (Committee Assistant).

Contacts

All correspondence should be addressed to the Clerk of the Education Committee, House of Commons, 7 Millbank, London SW1P 3JA. The telephone number for general enquiries is 020 7219 6181; the Committee’s e-mail address is [email protected]

List of additional written evidence

(published in Volume III on the Committee’s website www.parliament.uk/educom)

1 Play Therapy UK (PTUK) Ev w1

2 National Union of Teachers Ev w1

3 Sheffield Children’s NHS Foundation Trust Ev w3

4 Tavistock Centre for Couple Relationships Ev w4

5 Andrea Leadsom MP and Sharon Hodgson MP (Parliamentary Group for Sure Start) Ev w5

6 Save the Children Ev w6

7 Children and Young People’s Mental Health Coalition Ev w10

8 Family Action Ev w14

9 Association of Senior Children’s and Education Librarians Ev w17

10 The Early Childhood Forum Ev w18

11 Ofqual Ev w19

12 The Children’s Society Ev w20

13 Lancashire County Council Ev w24

14 The Communication Trust Ev w26

15 ATL Ev w29

16 TACTYC Ev w33

17 Mrs Claire Oldham Ev w35

18 NHS England Ev w35

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Education Committee: Evidence Ev w1

Written evidence

Written evidence submitted by Play Therapy UK (PTUK)

1. PTUK is the professional organisation for Play and Creative Arts Therapies. Our members work in anumber of Sure Start Centres.

2. PTUK supports the evolution of Sure Start children’s centres.

3. PTUK has always urged the measurement of the effectiveness and impact of Sure Start children’s centresto date and welcomes the role of Ofsted inspections

4. PTUK urges that provision must be made for Play Therapy and Filial Play Parent Coaching services atSure Start children’s centres. Our evidence based on over 10000 cases shows the effectiveness and efficiencyof these interventions with younger children. Between 74% and 83% of children show a positive change. Ourexperience also shows that many of the existing staff at the Centres may be trained to carry out this work. (Weare prepared to provide detailed reports supporting these statements).

5. PTUK has used three measures of effectiveness: the Goodman SDQ, the ASQ:SE and Hopes andExpectation questionnaire. These have been effective and also been shown as easy to use. We have alsodeveloped special software to process the data. We suggest that these are used to increase the use of evidence-based early intervention in children’s centres.

6. PTUK has developed a manual for Head Teachers in Primary Schools upon how to introduce and manageservices for the emotional well-being of children. This could easily be adapted for use in Sure Start Centres.

December 2012

Written evidence submitted by the National Union of Teachers

Introduction

1. The National Union of Teachers welcomes the opportunity to submit evidence to the Select CommitteeInquiry, Foundation Years-Sure Start Children’s Centres. Children’s Centres provide essential support,signposting and guidance for many families and their children and should continue to be at the heart ofcommunities.

The Importance of Teachers in Children’s Centres

2. The NUT believes that all children are entitled to a high quality education in their early years. ForChildren’s Centres to deliver such an entitlement it is important that where they provide early education,children have access to input from a qualified early years teacher.

3. Teachers play a key role in improving outcomes for young children. The Core Purpose document itselfsupports this assertion. The NUT argues, as does a significant section of the early years’ community, thatqualified teachers and early years’ professionals serve different roles within Children’s Centres and one cannotbe substituted for the other. The Review of Early Childhood Qualifications, carried out by Professor KathyNutbrown, also supported this view. The NUT welcomed Professor Nutbrown’s recommendation that an EarlyYears QTS qualification should be introduced to replace the Early Years Professional Status.

4. One of the findings of the Effective Provision of Pre-school Education (EPPE)1 research was that havingtrained teachers working with children in pre-school settings for a substantial proportion of time, and mostimportantly as the curriculum leader, had the greatest impact on quality. Teachers must be seen as integral tothe work of the Centre and not an “add-on”. Where teachers are “hands-on” and work alongside colleagues todeliver and support children’s learning, the outcomes are most significant.

5. The NUT is extremely concerned that where provision is being outsourced by the local authority, costcutting pressures on budgets will lead to a further reduction in the role of teachers and well qualified supportstaff delivering early education in Children’s Centres.

6. The NUT urges the Select Committee to recommend to Government that, as part of the remit foroutsourcing Children’s Centres, a statutory criteria should be the guarantee of qualified teacher input whereearly education is being offered.

The Core Purpose

7. The core purpose of Children’s Centres should be the provision of high quality services relevant tochildren’s education, health, social care and welfare from birth to five years old. The NUT maintains, as it hasalways done, that early education and childcare should be at the heart of any legal definition or defined corepurpose of a Children’s Centre. This does not detract from the importance of the other services for children1 Siraj-Blatchford, Sylva, Taggart, Sammons, Melhuish and Elliot (2003) Technical Paper 10-Case studies of practice across the

foundation stage, EPPE.

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Ev w2 Education Committee: Evidence

and families offered by Children’s Centres. It does, however, retain as a central element of the purpose ofCentres the premise that they were set up to primarily benefit children and to provide them with the best startin life.

8. Early intervention measures in Children’s Centres must be of the highest quality, at all times deliveredby professionals.

9. The current Core Purpose document is weak in this area as it simply says that “all Children’s Centresmust directly provide some activities for young children, for example stay and play sessions”. The NUT, asstated above, believes that the educational element of Children’s Centres is crucial to the enhancement of lifechances for young children. An hour’s “stay and play” is not the same as high quality input from well qualifiedstaff over a sustained period of time. Loss of the early education element from many Children’s Centres willweaken the core purpose and detract from potential outcomes for some of the most deprived and vulnerableyoung children and their families.

10. It is hoped that any revised version of the Core Purpose document would include an appropriate definitionof “school readiness” or preferably remove this phrase completely.

School Readiness

11. School readiness is a phrase about which most early years sector professionals feel uncomfortable. Theearly years is a distinct phase of education and should not merely be seen as a stepping stone to “school”.Many professionals would consider that a child ready to move to year one would be able to socialise withpeers, be comfortable with key adults, be able to happily separate from family members, be able to use thetoilet independently and dress and undress independently. For some children with special educational needsthese milestones may be reached later than their peers.

12. School readiness should relate to attitudes and dispositions to learning and not specific targets being metsuch as phonic knowledge or the ability to operate in numbers up to twenty. The NUT remains concerned thatthe “too formal too soon” approach being embedded into the EYFS with the introduction of Early LearningGoals, which stretch children further and steer them towards a learning style which is developmentallyinappropriate, will be used to judge Children’s Centre provision.

International Evidence

13. Research from the OECD2 suggests that in looking at the purpose of early education, France and theEnglish speaking world have adopted a “readiness for school” approach, which focuses heavily on cognitivedevelopment in the early years, and the acquisition of a range of knowledge, skills and dispositions.

14. The OECD, Starting Strong, research suggests that the disadvantage in this approach is the use ofprogrammes and approaches that are poorly suited to the psychology and natural learning strategies of youngchildren. In countries inheriting a social pedagogy tradition (Nordic and Central European countries), thekindergarten years are seen as a broad preparation for life and the foundation stage of lifelong learning.

15. Government must consider such evidence in looking at the role of Children’s Centres in early educationprovision. The recent legislation which allows independent schools exemption from the EYFS may well leadto a more formal approach too soon for young children, which as the evidence quoted above suggests iswholly inappropriate.

Ofsted Inspection of Children’s Centres

16. In submitting evidence under this heading the NUT reiterates its opposition to the current Ofstedinspection model. A key area of concern across the early years’ sector and particularly relating to Children’sCentres is the lack of specific knowledge and experience in the early years possessed by inspectors. Anecdotalevidence from members in Children’s Centres indicates that the intense focus on paperwork and tick boxexercises by inspectors mean that they sometimes miss capturing the core work of the centre with families.

17. Of equal concern is the payment by results element of setting targets for Children’s Centres. Whilst itcannot be argued that English language classes for parents are not useful it seems that they are also aneasily measureable target so therefore given prominence over other areas of work which relate more closelyto children.

18. It is important, for example, for children to gain confidence and learn to play appropriately with theirpeers. Children’s Centre staff may work closely with parents to support them in the behaviour management ofdisturbed children and success with one child would make a significant difference to that child’s life chancesand future opportunities.

19. The current inspection process does not allow for such success stories to be recorded as part of thejudgement on the work of the Centre. This is disappointing as it means that the current inspection process,which is effectively a tick box exercise, is missing so much of the excellence of children’s centres and thesmall things which make a huge difference to families.2 Starting Strong ll: Early Childhood Education and Care OECD 2006.

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Outdoor Space

20. In reviewing Children’s Centre provision the Select Committee should consider as one of itsrecommendations the statutory requirement for outdoor play space. Early years settings often provide the main,or only, opportunity for children to play and learn outside, on a regular basis. Evidence3 shows that changingurban and rural landscapes and lifestyles limits children’s opportunities to go outside and play.

“…children are disappearing from the outdoors at a rate that would make the top of anyconservationist’s list of endangered species if they were any other member of the animal kingdom…”—Gill (2005)4

21. Playing outdoors can inspire and enable children to learn more effectively, become more active, developtheir motor skills and connect with nature. The NUT agrees with the vision of “Learning through Landscapes”that all children should have the opportunity to experience outdoor play space and learning opportunities.

Family Involvement

22. Whilst the clear importance of the involvement of families in engaging with Children’s Centres has beenproven, this does not mean that volunteers can ever substitute for professionals delivering key services.

23. Cuts to local authority support services and local health provision have meant that Children’s Centresfind it increasingly difficult to secure the services of behaviour support teams, SEN specialists, health visitorsand midwives, all of whom provide essential support to families and none of which can be replaced by anunqualified volunteer.

Conclusion

24. The Select Committee, in considering the evidence submitted for the Inquiry into Sure Start Children’sCentres, should take into account the real costs of high quality provision and recognise that it requires dedicatedappropriate funding and cannot be provided “on the cheap”. For Children’s Centres to really make a differenceto young children and their families’, significant funding commitments must be made by the Government. Thismust be backed up by a commitment to employ well qualified staff who may nurture and work alongsidevolunteers but who should not be reliant on them to run services.

December 2012

Written evidence submitted by Sheffield Children’s NHS Foundation Trust

1. The needs of the families within the Sure Start Children’s Centre’s are increasing as the economic climateimpacts. As a result we are seeing damaging effect on poverty and lower social wellbeing, mental health offamilies is becoming one of the symptoms that Family Support workers are dealing with on a regular basis.This is a progressive cycle of depression that the communities in the Children’s Centre areas are strugglingwith on a daily basis. Generations of families are being effected by job loss, worklessness and reduced capacityto go out and earn money. Thus having sub-sequential impact on children’s and adults social and emotionalwell-being making it hard to motivate and offer aspirational guidance to adults and children.

If the parent no longer has to wake up in the morning to go off to work then there is no urgency to get thechildren to school. The families’ routines become irregular and normal patterns become hard to maintain.Whilst parents are preoccupied with coping, the children’s needs are not always the carer’s main priority.

The quality of work is not easy to maintain whilst increasing work load and capacity from ever decreasingbudgets. Previously Sure Start Local Programmes were able to concentrate the budget into particular areas,supporting families faced with debt, housing crisis, unemployment, etc. and target work around these factors.The budget now only covers the staffing cost leaving little or no funding for additionality or creativity. Ourpartners in the local community are in exactly the same position and therefore being able to act responsivelynot reactively is becoming more difficult.

The complexity we face now is how we support many families through such difficult times when faced withjob losses and cuts to our own services. The proviso that one worker can offer family support to a vast amountof families in crisis is unrealistic and also draining on the worker. There is no certainty on the Sure StartChildren’s Centre’s and staff are feeling as demotivated and demoralised as some of the families they are tryingto support. The constant deluge of short lived initiatives that are supposed to alleviate families problems arenot long enough to support them out of the crisis and back onto an even keel, thus perpetuating the cycle ofconcern, involvement and patching up the cracks before the next serious issue to affect the family.

2. The Ofsted inspections in my opinion are a good measure of the effectiveness of the impact of Sure StartChildren’s Centre’s but consistency is paramount to enable informed inspectors to make robust judgments andrecommendations about Children’s Centre work. The local knowledge of trained professionals is oftenoverlooked and can be key to understanding why certain priorities are not always achievable eg knowing that3 Learning Through Landscapes Website-www.ltl.org.uk/wecanhelp4 Gill, T., (2005) Let our children roam free, The Ecologist www.theecologist.org/archive_detail.asp?content_id=481



in an area with a transient population of Roma Slovak families hospital attendance will be higher as thesefamilies may well not be registered with a GP’s surgery and the cultural norm would be to present at A&E.

The percentage target representing the Ofsted grading is not conclusive in its evidence to say whether aChildren’s Centre is outstanding or good. I feel that more evidence should be based on actual impact ofservices, case studies, progression pathways the actual ground work that makes the difference, quality ratherthan quantity.

December 2012

Written evidence submitted by Tavistock Centre for Couple Relationships

1. In relation to questions 1 and 3 in particular, TCCR welcomes the focus of the “Core Purpose” documenton Children’s Centres aiming to reduce inequalities in child development and school readiness through“supporting personal, social and emotional development”.

2. However, TCCR finds the document’s statement that such reductions are to be supported by improved“parenting aspirations, self esteem and parenting skills” and “child and family health and life chances”somewhat problematic; not because we do not agree with the potential for improvements in these areas to leadto better child outcomes, but because the document should also acknowledge the beneficial impact whichimprovements in the quality of the relationship between parents can have on children’s well-being andoutcomes.

3. While we accept that the Core Purpose document subsequently notes that “the quality of the relationshipbetween parents is linked to positive parenting and better outcomes for children”, it does so only in the contextof “families with the greatest needs”, referring to parenting and family support as a “targeted service”.

4. We believe that the Core Purpose should therefore include relationship support as one of the bullet pointsunder point 1 (i.e. the Core Purpose). Relegating relationship support to the section on targeted interventionsfor families in greatest need—as the document currently does—will do nothing to change the culture aroundrelationship support, something which is one of the Government’s own objectives(http://www.education.gov.uk/childrenandyoungpeople/families/relationship/a00212569/relationship-support-first-time-parents-trial ).

5. After all, it is not only “families in greatest need” who can be helped by relationship support. Focusingonly on “parenting aspirations, self esteem and parenting skills” as the means to improve child developmentand school readiness will mean that the opportunity for services for help parents whose relationship is runninginto difficulty before such problems become entrenched (http://tccr.ac.uk/policy/policy-briefings/273-relationship-difficulties-tccr-policy-briefing) will be missed, with all the negative consequences that parentalrelationship distress, conflict and/or breakdown can have on children’s emotional, social and cognitivedevelopment (http://tccr.ac.uk/policy/policy-briefings/267-impact-of-couple-conflict-on-children-tccr-policy-briefing )

6. Regarding the delivery of relationship support services through Sure Start centres (“Using evidence-basedapproaches to deliver targeted, family-centred support”), notwithstanding the points made previously about thisneeding to be seen as part of a universal offer, TCCR believes that the workforce implications of the aspirationcontained in the document that relationship support could be provided on a targeted basis are significant.Despite evidence showing that parenting work which specifically focuses on the parental couple relationshipis more effective in improving outcomes for children than parenting work that focuses on parenting issues alone(http://tccr.ac.uk/policy/policy-briefings/276-parenting-work-tccr-policy-briefing), how best to support parentalrelationships does not form part of the training of frontline workers such as health visitors and children’s centreworkers (http://tccr.ac.uk/research-publications/practitioner-guides/200-a-short-guide-to-working-with-co-parents). Until and unless such skills form a core part of the training of these professionals, it is difficult toenvisage how Sure Start centres will actually make relationship support part of their offer.

7. In answer to question 2, TCCR believes that Ofsted should be required to appraise the extent to which afocus on the parental relationship is embedded in the work of the centre. Given that the Core Purpose documentstates that “the quality of the relationship between parents is linked to positive parenting and better outcomesfor children”, it would surely be reasonable to expect an effective and well-functioning centre to take thequality of the relationship between parents as a focus of its work. Furthermore, measuring the degree to whichcentres adopt this approach would be measurable and act as a spur to improving practice.

8. In answer to question 5, please see this document—Finding and using effective measuring tools—whichsets out a range of tools for use with children and young people: http://pelorous.totallyplc.com/public/cms/115/237/85/6728/Evaluation%20tools%2015%20Feb%202012.pdf?realName=uKkLx6.pdf And this document for adiscussion on the subject of measuring school readiness: http://www.idocshare.com/pdfview/khxj7k/children/school-readiness-eugene-m-lewit-linda-schuurmann-baker-i-n-05_02_Indicators.pdf

December 2012



Submission of evidence on behalf of Andrea Leadsom MP and Sharon Hodgson MP, Chair and Vice

Chair of the All Party Parliamentary Group for Sure Starts

Introduction:

Since the 2012 AGM this summer, the Sure Start APPG has been holding evidence sessions as to:

— collect evidence of best practice from Sure Start centres and the services operating within them;

— highlight areas where improvements are necessary;

— contribute to delivering better services for families across the country.

This submission of evidence to the Education Select Committee will reflect the early findings from theAPPG, and jointly offer our thoughts on the points of consideration raised by the Education Committee.

Summary:

1. Conception to the age of two is the most important period of a child’s life. The services available tofamilies in Children’s Centres should reflect this fact, and work to achieve strong early relationshipsand secure attachments. We recommend that the Core Purpose of Sure Starts makes specific referenceto this specific period of a child’s life as providing the best chance to improve outcomes.

2. Signposting is a vital part of the work that Children’s Centres do and therefore must be effectual andwell-informed.

3. The front-line workforce (health visitors, social workers, midwives) should be properly trained inspotting relationship problems between parents and their infants, and be able to confidently on-referto the correct service

4. Centres should commission evaluated services with good outcome measures, all with a view toimproving outcomes for families and building stronger parental bonds.

1. Sure Start Centres are a vital part of the lives of children and families across the country. The new CorePurpose of Sure Starts makes clear that Children’s Centres should “improve outcomes” for children and theirfamilies. Therefore Sure Starts must ensure that the parent and infant/child relationship sits at the core ofeverything that a Children’s Centre offers. Whilst children from disadvantaged families deserve particularfocus, as the new vision outlines, it is important to realise that relationship difficulties and parenting problemscan occur within families of any background.

2. We would recommend ensuring that the Core Purpose makes specific reference to the period of conceptionto two years as providing the best opportunity to improve outcomes for all children.

3. Louise Harrington of the NLH Partnership, conducted a 6.5 year research project into Children’s Centres,in over 40 local authorities. She found that not enough clear guidance is available on who “hard to reach”families are. Louise recommended collaborative work with parents which delivers services that people reallyneed. Joanna Tucker from OXPIP also noted that parents should be involved in decision making, meaning thatservices are much more likely to be effective.

4. George Hosking of the Wave Trust has highlighted the importance of the first year of a child’s life. “Inevery second of a child’s life, one million new neural connections are formed.” The quality of the parent-babyinteraction is therefore essential. 30–40% of babies don’t form secure attachments, leading to social issues andservice costs later down the line.

5. Sure Starts must be able to signpost on to vital and relevant services to parents and families. This mightinclude therapeutic support for the relationship between the parent and infant, employment support, legaladvice, or a number of other relevant services. Partnership work is therefore crucial to ensure that families andchildren receive the appropriate service, and that agencies work in a joined up fashion.

6. Louise Harrington has noted that best practice involves strong signposting to key services. Jo Hardy fromContact a Family has also highlighted that the best Children’s Centres will provide help with accessing otherservices such as benefits and healthcare.

7. To this end, integrated work between health, social care and education staff can be achieved through theimproved training of front-line staff. Peri-natal, post-natal and early year’s workforces must be aware of thecritical importance of secure early attachment. Training provision for professionals is not yet good enough, andawareness of the critical period from conception to age two must be more widely understood in our front lineservices. Confident on-referring can only be achieved if health and social care professionals are aware of thebenefits of early year’s intervention. This will also encourage a more joined-up approach between socialservices and Children’s Centres.

8. Jo Hardy from Contact a Family has stated that Children’s Centre staff require more training and supportto properly engage families with children with addition needs, and provide appropriate care for them. WhilstContact a Family are a national charity who support families of disabled children, this point will resonate withstaff who work with all families with relationship difficulties, but with nowhere to turn. George Hosking fromthe Wave Trust noted that the quality of the workforce must be suitable to provide the necessary support.



9. If the focus of Sure Starts is to create the most secure relationship possible between parents and theirbaby, it is vital that the services being offered are evidence-based. This can be done through the commissioningof evaluated services which show quantitative and qualitative improvements in the relationship between parentsand their baby. If social workers are aware of the services being offered, which look to secure parent-infantattachment, this will encourage them to work more closely with their local Children’s Centre.

10. Joanna Tucker from OXPIP suggested that centres must use good outcome measures, and setunderstandable and achievable goals with parents. Both the NLH Partnership and OXPIP have expressedconcerns about Payment by Results, which they saw as creating a “tick box” culture, squeezing innovativepractices, and that excludes potentially valuable interventions.

11. Previous APPG inquiries into the un-ringfencing of the Early Years Intervention fund have demonstratedconcern over a reduction in funding for vital early years work. A reduction in universal services will bedetrimental to Sure Starts if they are to provide a gateway for more targeted interventions.

December 2012

Written evidence submitted by Save the Children

Save the Children believes that it is unacceptable that the learning and development of children living inpoverty is often stunted before they even set foot in school. We believe that no child should endure povertyand no child’s life chances should be shaped by the accident of birth. Policy and practice must shield childrenfrom the effects of deprivation by preventing problems and inequalities before they occur (rather than seekingto solve or redress them after they have taken hold). Save the Children believes that Sure Start Children’sCentres have a crucial part to play in ensuring that children from disadvantaged backgrounds have the verybest start in life.

While the brain continues to grow during adolescence5, it is from the pre-natal period, up until five yearsof age, that it undergoes the most rapid growth6. Evidence shows a) substantial developmental inequalitiesemerge during these critical early years and b) these early indicators of skills and abilities can often reliablypredict outcomes right into adulthood7. In other words children’s life chances are limited by poverty anddeprivation before they even properly settle into primary education.

1. Core Purpose

Save the Children supports the core purpose of Sure Start—”to improve outcomes for young children andtheir families, with a particular focus on the most disadvantaged, so children are equipped for life and readyfor school, no matter what their background or family circumstances”8.

However, we strongly urge that access to Sure Start remains universal. 4Children argues that there are anumber of risks if Sure Start Children’s Centres are restricted to low income families:

— Stigmatising those families who use children’s centres.

— Vulnerable families who are living in poverty, but not in official “areas of deprivation”, fallingthrough the net.

— Preventing parents from accessing help for problems that are not related to income, such as breastfeeding and post natal depression.

— Denying children and families the social mobility benefits of interacting with children from a diverserange of social backgrounds9.

We also know from our FAST programme that adopting a voluntary access or universal approach improvesrecruitment and retention rates with low income and isolated families in particular.

Whilst we support a universal approach, we believe that Sure Start should remain a core service providerfor low income families, providing high-quality services and care for children and families who are mostin need.5 Feinstein (2009). Secrets of the Teenage Brain: Research-based strategies for reaching and teaching today’s adolescents. CA:

Corwin Press.6 The National Scientific Council on the Developing Child (2004). Children’s Emotional Development is Built into the Architecture

of their Brains. Working Paper #27 Feinstein, Centrepiece 2003—Very Early, Centre for Economic Performance.8 Department for Education website [Accessed 15 October 2012] http://www.education.gov.uk/childrenandyoungpeople/

earlylearningandchildcare/a00191780/core-purpose-of-sure-start-childrens-centres.9 4Children website [Accessed 15 October 2012] http://www.4children.org.uk/News/Detail/Ofsted-Reports-Show-Sure-Start-Is-

Helping-The-Most-Vulnerable



2. Funding

— Save the Children is concerned about the removal of the ring fence funding for Sure Start children’scentres, and believe that this is a serious threat to the viability of the early years infrastructure. Weare extremely concerned about recent reports regarding further cuts to the Early Intervention Grant(EIG) and the devastating impact this would have on early intervention services and children’scentres10.

— We were supportive in 2010 of the move to combine a range of previously separate funding streamsas one Early Intervention Grant. However, removing all control over the funding of children’s centresrisks diversion from children’s services into other areas perhaps suffering more severe cuts.

— Without sufficient funding, there is concern that while children’s centres may not actually be closing,staff numbers have had to be cut, staff time is therefore stretched, and this in turn means a reductionof the services that centres are able to offer.

— There is a danger in children’s centre managers having to be responsible for “clusters” of children’scentres. This leads to difficulties in that individual knowing what is happening in each centre, orwhat the local needs are in that particular area.

— Further to this, as better qualified staff are given the task of running a number of centres, lessqualified staff are left on their own to do the front line work with families.

— The fundamental question should not be how many children’s centres do we need, but what is asensible service for families and young children depending on the complex needs for family supportand childcare, making best use of the investment in children’s centres.

3. Evidence-Based Early Intervention

— Save the Children would like to see a broader remit for children’s centres as commissioners of area-wide early years support, coordinators of prenatal and antenatal care and providers of birthregistration and community outreach services.

— Evidence-based early intervention ensures that high-quality programmes benefit children and familiesand represent good value for money.

— We would like to see an increase in the number of parent support programmes that are focused onchildren’s education. The main focus of most evidence-based programmes is on helping parents todevelop parenting styles that support positive behavioural development in their children. Theirorigins were typically in concerns about children’s behaviour and the relationship with less effectiveparenting styles.

— This support is clearly necessary and important, but it needs to be available to more parents andcombined with interventions that have a broader reach if we are to improve the life chances of allchildren affected by deprivation.

— In its 2011 response to the government’s child poverty strategy consultation, the Joseph RowntreeFoundation argues that “tackling child poverty and the rich-poor attainment gap requires significantchanges to the outcomes of around 20% of the population- not just the bottom 5%” (Joseph RowntreeFoundation, 2011, p.3). It says we must act to “expand the evidence for broader groups”.

Role of government

— Government has a responsibility to set the right strategic direction. Evidence-based early interventioncurrently is not the norm, and therefore changes need to occur.

— We believe the Government’s role should be to set the strategic direction. This means a.) supportingthe Early Intervention Foundation (EIF) so that a repository of best practice can be made availableto local authorities and children’s centre management so that they can commission from endorsedlists of programmes, and b.) creating a financial incentive for local authorities and children’s centresto commission and implement evidence-based programmes and practice from within existing funds.

— At the moment, the incentive is for local authorities and children’s centres not to divest fromhistorical ways of working that are unlikely to involve evidence-based early intervention. Financialincentives could relate to a higher proportion of funding being given via the existing EIG to localauthorities that implement EIF endorsed programmes in future.

— As mentioned above, we are aware of proposals to take away the EIG ring-fence. We would like tosee a proportion of it to be allocated in future to implementing evidence-based programmes. Localauthorities would only be able to access this proportion of funding (relevant to local need) toimplement these programmes. This could encourage the change we need to see happen and ensurethat future spend does not get sucked into only covering existing statutory duties.

10 The Guardian website [Accessed 15 October 2012] http://www.guardian.co.uk/education/2012/sep/27/free-nursery-places-funded-sure-start



— We do not believe that the Government’s role should be to determine which programmes localauthorities can select from. It should be the role of an independent EIF to suggest particularprogrammes. Local authorities would then select evidence-based programmes which relate to theircontext. This financial incentive could help to solve one of the main barriers to implementationat scale11.

— In terms of payment-by-results, over time if the market matures, local authorities could and shouldreap dividends from improving outcomes via more effective evidence-based practice as per agreedearly intervention investment contracts between the private sector, local and central government.

Role of local authorities— Ensuring that senior management within local authorities buy into evidence-based programmes and

promote an under-pinning prevention philosophy. This could mean agreeing to re-position resourcesto focus on evidence-based programmes rather than historical ways of working.

— More efficient and effective local commissioning practice based on cyclical re-investment in servicesthat achieve expected outcomes and social return on investment. For example, new funding vehicles,such as social impact bonds, that are able to frontload investment in skilling-up local workforces inevidence-based programming.

— Firm commitment to fidelity and quality assurance mechanisms of evidence-based programmes, suchas, supervision and evaluation, so that any temptation to change models locally to reduce expenseis resisted.

— Shared standards of evidence need to become part of core business for local commissioners.Standards of evidence are a much needed tool that would enable the identifying and disseminatingof best practice, alongside, smarter commissioning and more sustainable planning. In this way, everylocal authority could have access to a common language and collective vision on which programmesare most likely to deliver the best outcomes for children and families, as well as, a decent socialreturn on investment both individually and as part of a pipeline of services. While this kind ofguidance would clearly promote interventions with the most robust evidence of impact,commissioners would still be able to select from a range of high quality programmes so that anyintervention will serve their area’s specific needs.

Role of children’s centre management— To prioritise training for staff in evidence-based programmes and child development.

— To imbed a prevention philosophy focussed on outcomes and high retention rates rather than redtape and outputs.

— Focus on partnerships with health and education to ensure that families receive a joined-up servicefocussed on children’s on-going development.

— Focus resource into identifying best practice via evaluation and into manualising it so that otherscan replicate. Not every programme could or should be an evidence-based programme as these tendto produce specific outcomes and have very limited reach. Centres need to strive to adoptingevidence-based programmes where appropriate, but at the same time to evaluating on-going workand innovations in order to decide what to continue investing in or divesting from. By identifying,quantifying and training best practice, centres can implement a strategic approach that encompassesEBP and programmes more adapted to the local context and families’ needs.

Role of practitioners (in centres and outreach)— There is a need to imbed a culture of monitoring and evaluation. While we want to remove

unnecessary bureaucracy, we should collectively emphasise that evaluation is core practice.

— Save the Children has experience of training a number of Families and Schools Together (FAST)teams, who are made up of local parents, school, health and early years professionals, and otherlocal authority staff and community leaders. Anecdotally, we have found that there is sometimes aresistance to adopt evidence-based practice at the start, as it challenges ingrained ways of working.

4. Defining and Measuring Good Practice— Good practice can be defined by the achievement of positive outcomes and high retention rates,

particularly of low income and isolated families. Therefore all delivery needs to be monitored andevaluated in order to understand which practice areas are most effective at improving outcomes, aswell as being measured using standardised measures so that attribution can be proven.

— We need to enable wider implementation of evidence-based family and parenting programmes, whereappropriate. But, the biggest change in family and parenting support in terms of reach and outcomeswould come from supporting commissioners to fund and practitioners to implement evidence-

based practice.

11 Children and Young People Now website [Accessed 15 October 2012] http://www.cypnow.co.uk/cyp/news/1072992/children-s-centre-intervention-schemes-lack-evidence-base



— This is because evidence-based programmes have been designed for specific target groups on thewhole and will not necessarily be suitable for population-wide delivery. However, normalisingevidence-based practice within children’s centres and through outreach, ie recognition andmanualisation of, as well as adherence to, the fidelity of core practice components that lead topredictable outcomes and the use of monitoring and evaluation to continuously improve practice,will lead to true early intervention at scale and improved life chances for many more children.

— Save the Children’s Scotland Office recently commissioned a piece of research called “Thrive atFive”, which sought to produce a Child Development Measure that compares the development ofchildren from different socio-economic backgrounds12.

— The Child Development Measure is a holistic, population level instrument that gauges thedevelopment of children across a range of indicators at around the time they start primary school.

— It reveals that children born into poverty are twice as likely as other children to face developmentaldifficulties when they enter formal schooling, severely damaging their future educationalachievement and life chances.

— This large disparity is evident across all developmental areas included in the Measure—physicalwellbeing, emotional wellbeing, social skills, cognitive development and communication.

— The instrument is an example of the type of comprehensive measure of child development that isrequired to guide and monitor the various early years policy and legislative initiatives currently beingpursued. The findings of the Child Development Measure reinforce the need to provide additionalsupport in the early years for children in poverty13.

— We are also supportive of the Tickell Review’s recommendations to slim down the EYFS and toprovide parents with a formal summary of their child’s development, alongside the health visitorcheck at age two, to help identify any early problems or special educational needs.

— We also agree with the recommendation that a greater emphasis should be placed on making surethat children have the basic social, emotional communication and language skills they need to learnand thrive at school—like being able to make friends and listen effectively (The Strengths &Difficulties Questionnaire is the most well-known measure for socio-emotional and The BritishAbility Scale works for Language).

— The main barrier is not agreeing which measures to use as there is broad agreement on the threethemes (as referred to in the Tickell’s Review) and internationally recognised indicators, but there isa need to incentivise and enable the statutory workforce to administer the age two developmentalchecks as there has been understandable resistance from an already stretched health visitor workforce.

5. Integrated Services

— We strongly welcome the emphasis on children’s centres to work in an integrated way with otherservices. We believe that the key to tackling child poverty and improving children’s outcomes is forall agencies engaged with children and families from disadvantaged backgrounds to work in a holisticway to tackle the often multi-layered causes and effects of poverty.

— We would like to see this integrated approach to working go even further and for local authoritiesto include Children’s Centres within a larger community-based model of support to the mostdisadvantaged children and families within a community. Locally-driven partnerships could bringtogether early years settings, schools, health agencies, housing services, and family support providersto design and implement a pipeline of cradle to career supports so that every child can overcomedisadvantage and realise their potential.

— Indeed, as stated by Naomi Eisenstadt: “For particularly poor children, a combination of qualityinterventions with mothers and fathers around birth and for the first three years, combined with high-quality early education and encouragement towards employment, all need to be in place to have themaximum impact”14. There are pockets of best practice across the UK where such a package isbeing delivered, but this is not consistent everywhere.

— Save the Children has recently published a new piece of research with the University of Manchestercalled “Developing children’s zones for England”. We wanted to find out what could be learnt fromthe incredibly successful Harlem Children’s Zone (HCZ) in New York. HCZ is a geographicallybased non-profit organisation. It currently serves around 100 blocks in Harlem which ispredominately home to low-income black families. It offers them access to an interlocking networkof education, health, family and social welfare services. These are not simply wrap-around services,but have been designed to create a “pipeline” of support for children from cradle to career.

— Save the Children would like to see children’s zones piloted in England, and believe that Sure StartChildren’s Centres would play a key role in this pipeline of support for children from deprived areas.

12 N.B. This research has not yet been published but we would be happy to send a copy of the report if this would be helpful.13 N.B. Important to note here that we do have an equivalent of this in England with the Early Years Foundation Stage Profile.14 Naomi Eisenstadt, ‘Providing a Sure Start’, (2011) p. 143.



6. Engagement With Parents

— Universal high-quality early education is key to improving the outcomes of children, particularlythose from low-income backgrounds. However, in particular, involving parents in this process is alsocrucial in order to work towards creating a positive home learning environment. As stated in a Savethe Children report published last year:

“The universal skills that parents need to be able to deploy to nurture their children withpositive parenting are care, discipline and instruction. These elements are essential to theeffective and loving upbringing of children. However, parents’ capabilities in relation to positiveparenting are subject to their own circumstances and knowledge.15“

— The Sutton Trust states that “identifying effective parenting programmes is crucial, given theprominent role that differences in parenting play in explaining cognitive gaps”16. Save the Childrenbelieves that parents are children’s primary teachers and nurturers, and, ultimately, their foremostprevention agents. There is a wealth of research that demonstrates the impact that parents can haveon their child’s outcomes (Desforges 2003, Feinstein 2003). A recent study by Jane Waldfogel (2009)and colleagues suggested that half the gap between affluent and poorer households in the USA wasexplained by the home environment and quality parenting.

— In particular, it is essential that guidance is acted upon, and that this is used as a way of enablingparents to have a real opportunity to be able to choose from proven and quality provision that trulysuits their needs. Local authorities and Children’s Centres should examine ways of involving parentsby giving them access to all accredited options as recommended by, for example, C4EO and GrahamAllen’s reviews into Early Intervention, and for parents, local authorities and Children’s Centres tobe able to discuss these from an evidence point of view, and a user-demand point of view.

— Whilst there are a plethora of evidence-based parenting programmes that operate out of early yearsproviders, there are few that support whole communities of parents to engage with and support theirchildren’s early learning and development. Parents want the best for their children and they deservesupport so that they can best support their early development.

— Similarly very few programmes can claim to have high retention rates with low income and isolatedfamilies (Save the Children 2009) and few facilitate multi-agency working and integrated serviceapproaches between statutory and service providers, parents and the local community. Further tothis, when programmes are accredited by various arbiters, such as, governments or national bodies,this is based on outcomes data from various studies, such as randomised controlled trials. However,there are very few studies that actually measure how well programmes are able to engage and retainlow income and isolated families in their service as one of the key criterion for success.

— Save the Children believes that early years providers and professionals have a duty to implementprogrammes proven to really engage “parents as partners” in their children’s education. By this wemean, evidence-based programmes and practice proven to reduce family stress, to empower parentsto create a stimulating home learning environment, to broker better home-school links, and, also todemonstrate positive impact on children’s educational achievement and behaviour.

December 2012

Written evidence submitted by the Children and Young People’s Mental Health Coalition’s

1. The Children and Young People’s Mental Health Coalition (Coalition) brings together a variety of thirdsector organisations to campaign on behalf of and with children and young people to effect change in policyand practice that will improve their mental health and wellbeing. Zurich Community Trust has funded theCoalition, whose core members are Mental Health Foundation, Rethink Mental Illness, Right Here, RoyalCollege of Psychiatrists, Place2Be, The Prince’s Trust, YoungMinds, Youth Access, Youth Net, NSPCC andThe Tavistock Centre for Couple Relationships.

2. Executive Summary

2.1. Sure Start Children’s Centres (SSCC) continue to be important services for families and their children.The Children and Young People’s Mental Health Coalition (Coalition) generally welcome the Core Purpose,but we still have some concerns. SSCC s are key to the early intervention of mental health problems in boththe parent and the child. We believe that the Core Purpose should include relationship support within the sectionon universal services, as it is not only “families in greatest need” who can be helped by relationship support.

2.2. The lessons from literature on evidence based interventions indicate that it is not just what you makeavailable, but also the way that you make evidence-based programmes available (Fixsen, 2005; Centre forMental Health, 2012). For instance engaging people and preventing them from dropping out of the service isvital; you need high quality staff; more integrated inclusive single needs assessment and outcome settinginvolving all key partners; and you need stable funding.15 Save the Children, ‘Bringing Families and Schools Together’, (2011) p.4.16 Waldfogel and Washbrook (2010), Low income and early cognitive development in the UK.



2.3. Children often communicate emotional or developmental distress through their behaviour; and researchshows that early behavioural problems have a huge impact on later outcomes. Therefore, behaviour should betracked just as you would track hearing or other developmental progress. There are a number of relevant NICEguidelines and other evidence based/informed practice that could be implemented in SSCC to help thesechildren. There are some well validated tools, which will help SSCC measure children and families outcomes.

2.4. We are concerned that Early Intervention Grant (EIG), which can be used to fund SSCCs, has beenreduced already, and there are plans to hold back money from the EIG to fund free nursery provision. SSCCsare part of the local provision to support children and their families. We know that SSCCs and other servicesare facing cuts, and this will result in some children and their families not being able to access early interventionservices when mental health issues first arise. If these problems are not tackled early on, they are likely tobecome chronic and entrenched and continue into adulthood. So cuts to these services do not make clinical oreconomic sense.

3. Core Purpose

We generally support the Core Purpose for Sure Start Children’s Centres (SSCC) and are particularly pleasedto see that promoting child development and mental health is included in the overall aims of SSCCs.

3.1. Overall SSCC’s should focus on social and emotional learning outcomes in order to underpin the schoolreadiness aspect of the new core purpose. For example if parent child attachment issues are resolved by thereception year, attendance at school is likely to be a less traumatic event. Also, if children have developed acalm behaviour they are more likely to tolerate the demands of structure and focus at school and be able toengage successfully with teachers and other children.

3.2. Parental, particularly maternal mental health is known to impact on child behavioural outcomes. WhereSSCC have good multi-agency working and strong use of the Common Assessment framework they are in agood position to identify parents with mental health needs linked to pregnancy. For instance, if they identifiedperinatal depression, they could start engaging the mother and her children, with the SSCC services as soon aspossible. Family Action does this through their volunteer befriending based Perinatal Support Project, whichis located in West Mansfield children’s centres. Islington Council has a First 21 months strategy whereby arange of relevant health professionals for example midwives are based in all their children’s centres. Given theimportance of the first two years in child development a focus on parental mental health and well-being wouldboost SSCC outcomes overall and in social and emotional learning and boost uptake in respect of the two-yearold offer.

3.3. The overall focus of the core purpose is on disadvantaged children, the higher flows of disadvantagedchildren through the two year old offer, and the expectation that councils will link SSCCs to the TroubledFamilies Programme would suggest increased engagement with families with multiple complex needs. Thiswill mean that SSCCs will need to provide a range of services—including intensive, outreach and group-based-that can support parental and child mental health and well-being. This is particularly important given theexpectation of the core purpose that SSCCs should increasingly function as community hubs and thatdisadvantaged parents should engage with activities and participate in the running of the centres. Better parentalmental health will need to support these levels of participation.

3.4. We believe that the Core Purpose should include relationship support as one of the bullet points underpoint 1 (ie the Core Purpose). Relegating relationship support to the section on targeted interventions forfamilies in greatest need—as the document currently does—will do nothing to change the culture aroundrelationship support, something which is one of the Government’s own objectives(http://www.education.gov.uk/childrenandyoungpeople/families/relationship/a00212569/relationship-support-first-time-parents-trial).

3.5. After all, it is not only “families in greatest need” who can be helped by relationship support. Focusingonly on “parenting aspirations, self esteem and parenting skills” as the means to improve child developmentand school readiness will mean that the opportunity for services that help parents whose relationship is runninginto difficulty before such problems become entrenched (http://tccr.ac.uk/policy/policy-briefings/273-relationship-difficulties-tccr-policy-briefing) will be missed, with all the negative consequences that parentalrelationship distress, conflict and/or breakdown can have on children’s emotional, social and cognitivedevelopment (http://tccr.ac.uk/policy/policy-briefings/267-impact-of-couple-conflict-on-children-tccr-policy-briefing)

4. However, there are some omissions in the current terms of reference. The lessons from literature onevidence based interventions indicate that it is not just what you make available, but also the way that youmake evidence-based programmes available (Fixsen, 2005; Centre for Mental Health, 2012). So:

4.1.1. Engagement and stopping people from dropping out is key. All the literature makes it very clear thatsome of the most powerful factors supporting engagement with interventions are the practicalfacilitators (convenience of contact, crèches, ease of transport, venues etc). The Centre for MentalHealth’s recent evaluation of national practice in relation to evidence-based parenting programmeshighlighted that these were the areas of practice most likely to be cut by commissioners (Centre



for Mental Health, 2012)—anything that interferes with your engagement and retention levels is afalse economy.

4.1.2. Research highlights that you need person-centred, therapeutically skilled and highly engaging stafftrained in delivery (otherwise in some instances you can make outcomes worse for children—(Scott,et al., 2008); staff need a system of ongoing coaching and supervision supporting continuousimprovement and reflective practice to maximise their ability to turnaround children’s outcomes andreplicate promised results. This is also important as a support for paraprofessionals (Korfmacher, etal., 1999).

4.1.3. More integrated working relies on more integrated and inclusive strategic needs assessment andoutcome-setting involving all key parties (midwives, voluntary sector, health visitors, social care,speech and language therapist, EY workers, parents, CAMHS/IAPT, education, housing etc). Healthand Well Being boards must play a key part in drawing together a broad range of data and partnerssetting clear messages about ambitions for local children.

4.1.4. Centres need stable funding in order to sustain good quality practice (Fixsen, 2005)

5. The early evaluations of the local Sure Start programmes found that often the most vulnerable childrenand their families were not accessing these services. This is a concern as these children are potentially atgreatest risk of developing mental health problems and are likely to have negative outcomes more generally.So, it is good to hear that the most recent evaluation has shown that SSCCs are now engaging with the mostvulnerable groups.

5.1. However, the national evaluation found that there were improved outcomes for parents, but not forchildren. So it is important that SSCCs understand what the needs of the children in their area are,and use evidence based/informed practice to improve outcomes for children as well.

6. Evidence Based/Informed Practice

6.1. Children often communicate emotional or developmental distress through their behaviour. Given whatresearch tells us about the dramatic impact of early behavioural problems on children’s long term prospects(Fergusson, 2005); it is particularly essential to see children’s behaviour as a critical gauge for theirdevelopmental well-being (Centre for Mental Health, 2012). Behaviour should be tracked just as you wouldtrack hearing or other developmental progress.

6.2. There are a number of relevant NICE guidelines and other evidence based/informed practice that couldbe implemented in SSCC. Evidence-based parenting programmes focusing on supporting positive parentinghave now been proven to support better outcomes for children with early behavioural problems through over100 RCTs. They are suitable for use from three years of age, building on the important foundation of parentalrisk/attachment-based work highlighted above. They also form an important part of core CC provision. Someof these programmes are delivered in some areas by well-supported parent graduates.

7. There is a lot of potential for SSCCs to improve outcomes for children and their families, but it dependson what services are available, and which professionals are employed and what grade they are. We have heardanecdotally that GPs find SSCC really useful as a service to refer families onto regarding mental healthproblems; but some SSCC have lost their clinical psychologists. The loss of these mental health professionalsfrom the SSCC has implications for the mental health support available within the centre, and can mean thatGPs can no longer refer families who have a child with mental health issues to SSCCs.

8. Measuring Outcomes

8.1. There are some well validated tools, which will help SSCC measure children and families outcomes.

8.2. The Strength and Difficulties Questionnaire is a validated tool which tracks children’s behaviour andemotional well being in relation to norms. In Wales it is used by Health visitors as a key part of standarddevelopmental health tests supporting children’s well being. Through this routine contact, health visitors buildup a whole population picture of where children sit in relation to UK norms. They can then also work withChildren’s Centres to assess to what extent these units are engaging these families (ie work out who you arenot engaging). In this way, Health Visitors can also identify children and families who may need extra outreachsupport with parenting support or motivational help from voluntary sector or mentoring services to accessbroader Children’s Centre services.

8.3. Collation of SDQ data also assists Children’s Centres in Birmingham evaluate the accuracy of theiroutreach to vulnerable families in local communities; before using SDQ, estimates of accuracy were based onguesswork and worker perception which often proved to be unreliable (Social Research Unit, 2010).

8.4. There are other tools available. More information about relevant tools can be found in the followingresources: Finding and Using Effective Measuring tools http://pelorous.totallyplc.com/public/cms/115/237/85/6728/Evaluation%20tools%2015%20Feb%202012.pdf?realName=uKkLx6.pdf and a systematic review ofrelevant tools from the Anna Freud Centre—http://www.ucl.ac.uk/clinical-psychology/EBPU/publications/pub-files/Mental%20Health%20Outcome%20Measures%20for%20Children%20and%20Young%20People.pdf



9. Funding and Cuts

9.1. We know that local authorities have taken a big cut in funding, and for many this has resulted in theirchild and adolescent mental health services (CAMHS) budget being radically cut (YoungMinds, 2011). This islikely to result in early intervention services provided by the local authority, or by commissioned voluntarysector organisations being reduced or cut. So, if a GP, for instance can’t refer a child and their parents withmental health issues to a local SSCC, it is likely that there will not be any other services they could be referredto. They are unlikely to be referred or have their referral accepted by a specialist CAMHS teams, unless thechild is in significant mental distress. If what might be minor mental heath, behavioural or relationship problemsisn’t addressed at an early stage they can get worse and potentially turn into chronic and entrenched mentalhealth problems that continue into adulthood.

9.2. We know that there are already a high number of young people with mental health problems. Forinstance, 1 in 10 children and young people have a mental disorder; and many more have milder problems,which haven’t yet reached the clinical threshold for a disorder. Having a mental health problem can have a bigimpact on a child’s academic and life outcomes. For instance they are more likely to be excluded from school;more likely to leave school without educational qualifications; Children with conduct disorders and severeAttention Deficit Hyperactivity Disorder (ADHD) may be four to five times more likely to struggle to attainliteracy and numeracy skills (Green, et al., 2005) (Parry-Langdon, 2008).

9.3. We are concerned about funding for SSCC and the consequences this will have for the number andrange of services available. The 4Children’s SSCC Census (2012) found that there was a reduction of 281centres since April 2010. Back then most were coping, but 10% were struggling. Funding can come from theEarly Intervention Grant (EIG), but this has been reduced already, and there are plans to hold back moneyfrom the EIG to fund free nursery provision.

9.4. So it is likely that more SSCC will close or merge, and many more will struggle. Closing of SSCC islikely to mean that it is harder for some families to access these services, so those families who most needsupport may not access the help.

9.5. Closing SSCC is very short sighted as research has estimated that £4.60 will be generated in socialvalue for every £1 invested in effective Children’s Centres (Action for Children and NEF, 2009).

References

4Children (2012) Sure Start Children’s Centres census 2012. London: 4Children. http://www.4children.org.uk/Resources/Detail/Sure-Start-Childrens-Centres-Census-2012

Action for Children and New Economics Foundation (2009) Backing the future: why investing in children isgood for us all. London: New Economics Foundation. http://www.actionforchildren.org.uk/media/94361/action_for_children_backing_the_future.pdf

Centre for Mental Health, 2012. A Chance to Change: delivering effective parenting programmes to transformlives. Centre for Mental Health: London

Fergusson, D., Horwood, J. & Ridder, E., 2005. Show me the child at seven: the consequences of conductproblems in childhood for psychosocial functioning in adulthood.. Journal of Child Psychology and Psychiatry,46:8,, pp. 837–849.

Fixsen, D. L. et al., 2005. Implementation Research: A Synthesis of the Literature, Tampa, FL: University ofof South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation ResearchNetwork.

Green, H., McGinnity, A., Meltzer, H., et al. (2005). Mental health of children and young people in GreatBritain 2004. London: Palgrave. See http://www.statistics.gov.uk/downloads/theme_health/GB2004.pdf

Korfmacher, J., O’Brien, R., Hiatt, S. & and Olds, D., 1999. Differences in programme implementation betweennurses and paraprofessionals providing home visits during pregnancy and infancy: a randomised trial. AmericanJournal of Public Health, 89(12), pp. 1847–1851.

Parry-Langdon, N. (ed) (2008) Three years on: survey of the development and emotional well-being of childrenand young people. Newport: Office for National Statistics.

Scott, S., Carby, A. & Rendu, A., 2008. Impact of Therapists’ Skill on Effectiveness of Parenting Groups forChild Antisocial Behavior. [Online] available at: http://www.incredibleyears.com/library/items/therapists-skill_08.pdf [Accessed 4 January 2012].

The Social Research Unit, 2011b. Preliminary Findings from Evaluation of Evidence-Based ProgrammesImplemented in Birmingham (updated), Dartington: The Social Research Unit.



YoungMinds (2011) Children and young people’s mental health services slashed by funding cuts. London:YoungMinds. http://www.youngminds.org.uk/news/news/430_children_and_young_peoples_mental_health_services_slashed_by_funding_cuts

December 2012

Written evidence submitted by Family Action

This response is based on the views of our senior children’s centre practitioners and Family Action’s generalexperience of running and working with Sure Start children’s centres:

— Offering our core model the Family Action family support service, (FSS) as part of multi-agencyteams in children’s centres in Roehampton and Battersea, Wandsworth, and Edge Hill, Liverpool.

— Managing Sure Start children’s centres in Miles Platting Manchester; Southend, Essex; Islington andWest Mansfield, Nottinghamshire.

— Via staff who previous to working via Family Action worked in roles in local authorities establishingearlier Sure Start programmes and centres.

The new Core Purpose of Sure Start children’s centres, how this has evolved and is different from theoriginal design and purpose of Sure Start

1. The core purpose of children’s centres was stated by the DfE in April 2012 as r. Improving outcomes foryoung children and their families, with a particular focus on the most disadvantaged families, in order to reduceinequalities in child development and school readiness. This is to be supported by improved: parentingaspirations, self esteem and parenting skills; and child and family health and life chances.

2. Some evolution of the core purpose is inevitable. The early days of Sure Start were about developmentand experimentation in provision, now, following learning from the experience of Sure Start, there is a needfor the core purpose to address improvement

3. The new core purpose differs from the original which focussed less on school readiness, and more onchild-parent interaction and the role of parent as first teacher. The new document also places greater emphasison transiting parents to employment.

4. In some respects the core purpose is now looser, and more holistic. For example there is a greater drivefor more of the community to derive benefit from children’s centres by using them as social hubs and extendingtheir reach to older children.

5. At the same time, at a time of reduced children’s centre budgets, the reality is that implementation of thecore purpose is under greater scrutiny, and providers greater pressure to demonstrate that they are reachinghigh proportions of groups targeted as disadvantaged, and that budget is being directed at these groups.

6. Despite the moves to extend children’s centres as community hubs the underlying reality is that children’scentres are not for everyone in the community, and are in fact targeted at the most disadvantaged children andfamilies. Arguably this returns Sure Start to its original purpose and is where the focus must be at times ofrestricted funding. At the same time the concern will be to ensure that families are not stigmatised for engagingwith children’s centres.

7. In practice many disadvantaged families contain older as well as younger children; and in line with FamilyAction’s ethos and ways of working there is a need to work holistically with the whole family to tackledisadvantage so the more holistic emphasis of the new core purpose is welcome. The concern will be to retainthe focus on excellence in early years provision even as children’s centres offer activities for older children;also that as centres deliver helping parents access work this does not have unlooked-for, inimical impacts ontheir parenting or the budget for directly working with children at a time of cuts.

8. There needs to be some thought given as to how all current providers of children’s centres are placed interms of skills to meet all aspects of the new core purpose, including the increased stress on targeting the mostdisadvantaged. For example our experience is that school providers, while strong on learning outcomes, doless well at targeting the most disadvantaged and safeguarding.

The effectiveness and impact of Sure Start children’s centres to date, including the role of Ofsted inspections

9. The children’s centres that we manage in Manchester, West Mansfield and Southend have been judgedgood and outstanding in recent Ofsted inspections, including in terms of children’s learning outcomes.Hometalk, the programme our West Mansfield centres operate with in partnership with the Nottinghamshirespeech and language therapy team, can cut the number of children requiring speech therapy by around 80% byworking with parents to make sure that they provide a more effective language learning environment at homefor their children. A similar programme, Narrowing the Gap, is being delivered in our Southend children’scentre with the aim promoting parental support for children’s learning at home, and is also showing goodresults. However adult learning and progression into employment are more difficult outcomes for all our centres



to reach given the low qualifications and literacy of very disadvantaged parents; and high unemployment. Itcan take up to a year and sometimes longer to ensure some parents are job-ready.

10. Overall the National Evaluation of Sure Start found that:

— At age three, SSLP children had more advanced social skills—they were more independent andshowed more self-control.

— Parents living in SSLP areas showed less of the characteristics of “negative” parenting.

— Overall, there were positive effects relating to SSLPs in seven of the 14 areas assessed. (NESS(2008), p.4).

11. Overall it is disappointing that research into Ofsted reports show that children’s centres remain patchyin delivering on the core outcomes. For example they are generally doing well on safeguarding and supportingfamilies and parents, but less well on delivering improvements in learning.

10. Some of this may be to do with the data collection and trail. In particular the linkages to the EYFSresults are not always clear. Certainly it is our experience that the outcomes are optimised when local authoritieshave clear strategies for structuring their delivery and measurement from the start. For example Wandsworthhad a clear strategy to reduce the EYFS gap between the most advantaged and disadvantaged wards, linkedFamily Action family support into specific children’s centres with this aim and linked this into data collectionfrom schools so that it could be shown that our services were having an impact on reducing the attainment gapin the reception year.

11. Overall there is a lot of emphasis on hard indicators but by themselves these do not enable effectiveanalysis or planning. For example one hard indicator used for children’s centres is the number of looked-afterchildren using centres. However a soft indicator for this group which does not exist is the number of childrenbeing placed in the children’s centres out of area by other local authorities. Children under five with a disabilityincluding SEN are a group for whom data or an indicator do not generally exist.

12. Another aspect of data collection that affects outcomes is that children’s centres do not generally operateon an individual, but on a cluster, basis with children and parents registered at one children’s centre being ableto take up programmes and activities at other centres in the cluster. However children’s centres are limited tomeasuring outcomes for children and parents registered with their centre only.

13. In recent years Ofsted inspections have changed to reflect the targeted reach of children’s centres andinspectors require children’s centres to demonstrate that they are reaching the most disadvantaged. Inspectionsare generally more rigorous.

14. While children’s centres are now being expected to act as community hubs and deliver for older childrenOfsted are only measuring outcomes for the under fives

15. In general Ofsted inspectors are largely drawn from teaching backgrounds, they are not drawn from theearly year’s sector and consequently they sometimes have poor understanding of the core purpose, the multi-agency working with health which is so important to children’s centres and the presenting data. For exampleOfsted are generally accustomed to understanding educational data, not public health data. It is our experiencethat unless centre managers provide a great deal of background information poor conclusions are reached.

16. The cluster based model of children’s centres as noted above gives particular challenges for judging thedelivery of individual centres; as does the fact that most work delivered in children’s centres is delivered ongroup, rather than on a one-to-one, basis.

The range of services and activities provided at Sure Start children’s centres, and their desired outcomes, andwhether/how these differ from family centres, early Sure Start local programmes and early years settings.

16. Family centres are social care-focused whereas children’s centres are about early intervention. Howeverby focusing on disadvantaged groups and working with older groups children’s centres do risk some duplicationand similar levels of stigma.

17. In order to improve targeting of the disadvantaged Sure Start is increasingly moving out of children’scentres to outreach in community settings. In this way it is returning to SSLP roots.

18. Overall children’s centres are becoming more focused on employment outcomes for parents and learningoutcomes for children than in earlier stages of Sure Start. Overall we consider these are the right outcomes tolook for. However, we believe it is vital that children’s centres retain general child development and thereduction of child poverty at the forefront of their vision.

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

19. Family Action defines and measures good practice in family and parenting support and outreach usingthe Family Star http://www.family-action.org.uk/section.aspx?id=13976. The Family Star is a visual toolfocused on improvement across eight key areas of parenting including “setting boundaries” keeping a routine



“providing emotional support”, providing home and money; promoting good health, promoting learning,keeping your child safe; and social networks. We use this because it is an assessment and monitoring tool thatis readily understood commissioners, parents and practitioners thus enabling a partnership approach with allstakeholders. We have found that many clinical tools, while vital in some contexts, are not readily understoodby all and exclude parents from the process of engaging with the process of measuring their own progress.

20. In terms of child development and school readiness there needs to be a focus on social and emotionallearning; for example the resolution of attachment issues so that children can contemplate their first day aloneat school confidently; the calm and focus necessary so that children can tolerate the demands of structure andattending to input from a teacher; and the emotional intelligence to interact with children and adults outsidethe home.

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

21. The question needs to be asked “what are we intervening in, why and how?” For example children withSEN require intervention as early as possible but the issue remains that even when SEN is identified there isusually little if any resource to respond to them before they leave children’s centres.

22. If we are talking about delivery of manualised parenting programmes then early years staff are often nothighly qualified and do not have sufficient skills or capacity to deliver evidence-based early intervention on aprogramme basis. This is better delivered by family support workers and social workers who have the necessaryskills. It is also more readily scaled when delivered on a cluster basis. However it does require resourcing interms of monies available for training of staff and measurement of the delivery of programmes.

23. Family Action makes use of a number of evidence based parenting programmes such as MellowParenting, Triple P and Solihull. But our experience tells us what is primarily needed is for disadvantagedparents to engage with evidence-based programmes in the first place. As the British Psychological Society hasrecently pointed out the usefulness of such programmes is limited if they are not socially inclusive and theparents who need them most cannot engage with them in the first place (Davis et al, Technique is not enough,British Psychological Society August 2012). There is also little point in adopting behavioral strategies if oneis unaware of the root causes of the behavioral issues. It is our experience that intensive family support carriedout in a partnership spirit with families in their own home can be vital to persuading parents to engage in suchprogrammes and understanding which evidence-based programmes will be of benefit.

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

24. Siloised training of the different disciplines ie education, health, social work early years) and the differingoutcomes looked for in early child development and learning by these professionals are presently obstacles tointegration and require addressing. The proposed integrated two-year-old check may be a useful step towardthis. However there are also resourcing issues which affect capacity for partnership working

25. The CAF (Common Assessment Framework) can provide a useful mechanism for assessing the risk to,and needs of, the most vulnerable children and can improve multi-agency working depending on localrelationships and commitment to this way of working by all the parties.

26. A common risk assessment framework for new mothers judged to be vulnerable at the ante-natal stagewould be valuable in encouraging a range of professionals to work together at the earliest possible stage forvulnerable families. Ideally joint working should start as soon a child is born because that is when parents willbe most receptive to help.

27. Our Perinatal Support Project, based in our West Mansfield children’s centres, is an example of a projectwhich promotes this co-operation on very early intervention. Our professional Perinatal Support Co-coordinatortrains and supervises volunteer befrienders to work with women at risk of ante and post natal depression toreduce their social isolation and build confidence in attunement to the baby’s needs. This activity is backed bymulti-agency referral networks including midwives and health visitors and support groups for parents based inthe centre. This ensures children centres and health professionals work to respond to families needs at theearliest possible stage and parents are encouraged to engage with the children’s centre as soon as possiblewhich should be beneficial to optimizing the two-year old childcare offer .

28. Data sharing by health remains an issue. We understand this will be tackled by a protocol that isforthcoming from DH.

29. A named social worker could be helpful but only in so far as this individual is resourced adequately torespond to the children’s centre and its service users.



How to increase the involvement of families (especially fathers, disadvantaged families, minority ethnicgroups and families of children with SEN and disabled children) in the running of children’s centres and intheir regular activities

30. Family Action specializes in increasing the uptake of children’s centres by disadvantaged families andchildren. In our experience the offer of home-based family support is vital to ensuring that families withmultiple complex needs are able to engage with centres. If parents do not have routines to manage family lifeit is unlikely that they will arrive at centres in time for scheduled activities; children will not be able to engagewith other children successfully or parents may feel unduly stigmatised by their difficulties.

31. The experience of our Hornsey Road centre is that the offer of ESOL classes is vital to engaging parentsfrom diverse groups in the centre, and ensuring that they can volunteer and participate in the running of thecentres and they can take advantage of support with training and employment. Also creche support will bevital to pay for their participation in this and parent fora.

32. It is vital to consult with parents as to what they need and want and to ensure appropriate scheduling ofactivities. For example our Hornsey Road centre runs popular groups for fathers and children on Saturdays sothat fathers separated from their families can engage with their children and other fathers on weekend time.

33. In terms of the running of centres it needs to be recognised that disadvantaged parents are often comingfrom a low base of education and skills, as well as needing to spend time to bring up their children. Typicallywe start engagement with undemanding activities which are attractive to parents and children—Tip Toe Dancesessions for example—we then look to engage them in more obvious learning activity. When they attendregularly we may look to engaging parents in involvement in parent fora and volunteering. After this they maybe ready to participate in advisory boards alongside professionals and to begin seeking employment. Butgenerally by the time parents have the skills to run centres their children are ready to leave the centres; andparents themselves are preoccupied by moving onto training and work.

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

34. Our experience is that funding is restricted while we as a provider are being pressed to do more for less.This scenario presents challenges to all providers for investment in staff delivering in a quality way and hasinevitably meant the loss of some activities. We are deeply concerned that the changes to the Early InterventionGrant will translate into effective cuts for early intervention activities in children’s centres.

December 2012

Written evidence submitted by the Association of Senior Children’s and Education Librarians

The Library Service has worked closely with Sure Start Programmes since these programmes were developedand in many cases library staff involved in the strategic development of the programmes. In some cases Librarystaff were funded through Sure Start to work into centres, for e.g. in Derbyshire where these staff are nowemployed through Children’s Services. This firm partnership has linked to the following Sure Start criteria aslisted in the call for evidence:

— Outreach work with parents is supported in the partnership between libraries and Children’s Centres.The activities that libraries offer through the group work of story times and rhyme times provideparents with a social outing where they are able to talk to other parents and also talk to professionalstaff from Children’s Centres. Some examples of work supported by Children’s Centre staff inlibraries include information on welfare benefits, local nursery provision, safeguarding issues.

— Literacy support to children and families with direct delivery of literacy projects within libraries andChildren’s Centres. High quality book stock for all ages and abilities available free from librariesstimulates a child’s desire to read.. They also offer books and universal resources in different formatsto Children’s Centres to support disadvantaged families, minority ethnic groups and families ofchildren with SEN and disabled children.

— Integrated working through the Bookstart Programme, a multi-agency early years literacy focusedscheme brings together professional staff from health, libraries and Children’s Centres to shareinformation and expertise. In Calderdale research was carried out including interviews with parentsand teaching staff from Children’s Centres. Whilst parents described the value of sharing books withtheir children as being invaluable, the Children Centre teacher describes the outcomes of thisexperience in many other ways. She describes the fine motor skills practiced by children whenturning pages, the building blocks to reading. The vocabulary and hand/eye coordination whichdevelop. The value of talking about stories with all the communication skills this promotes, and alsothe close, bonding one to one time between parent and child that book sharing supports.

— Consultation with families about the provision of regular activities in their local Children’s Centreoften takes place in libraries where families are very comfortable sharing their ideas in a free, safeand comfortable environment. Often parents all know each other as they meet together on a weeklybasis for story times and therefore they are for more confident in their responses.



One final comment links to the current economic climate. In light of the joint working that exists combinedwith the location of both Children’s Centres and libraries with buildings in very close proximity, could thefuture include some joint centres.

December 2012

Written evidence submitted by The Early Childhood Forum (ECF)

The Early Childhood Forum (ECF) is a voluntary organisation hosted by the National Children’s Bureau(NCB). It is a coalition of 61 professional associations, voluntary organisations and interest groups united intheir concern about the well-being, learning and development of young children from birth to eight and theirfamilies. Its vision is to bring together partners in the early childhood sector to promote inclusion and challengeinequalities, and to champion quality experiences for all young children from birth to eight and their families.

We welcome the opportunity to respond to this inquiry.

1. Children’s Centre’s provide the most cost effective way of supporting parents and children in the crucialearly years when interventions if needed are most effective.

Many of the services offered provide parents with support with parenting, breastfeeding, learning English,understanding healthy eating and living and much more.

They provide easy access to professionals with expertise.

2. “Stay and play” sessions, which are offered in many Children’s Centres, are hugely popular and oftenhave long waiting lists. Parents are able to play with their children in a friendly and supportive environmentwith staff who can help with any problems and identify issues which can then be resolved more easily. Theimportance of children playing with their parents cannot be underestimated. Relationships are improved andparents understand why play is essential for children’s health, confidence and wellbeing.

3. Outdoor play is particularly crucial for young—and older children- and can often be offered in Children’sCentres. When children play outdoors they become more resilient to disease, develop a healthy connectionwith nature which reduces stress and have exercise which means they are less likely to become obese. Toomany children suffer from mental health problems; this would not occur to such an extent if they had moreopportunities to play outdoors. The National Trust has recently produced a report on “Natural Childhood”which provides “compelling evidence that...our children are exhibiting the symptoms of ‘Nature DeficitDisorder’ through a lack of contact with nature”. The costs of not doing anything about this in the long termare huge.

4. When health, social care and education experts work together as they do in many Children’s Centre’s theoutcomes for families and children are far better than when they work separately. Everything possible shouldbe done both nationally. Locally and in each Children’s Centre to make sure that this works well.

5. The cost of running Children’s Centre’s with all the services and support they provide is far less than thecosts of putting children into care or dealing with issues at a later stage when problems become more seriousand it is more difficult to find lasting solutions.

6. Evaluations currently being done by Children’s Centre’s show that parents through attending the groupsoffered become more confident and are often helped to find work and childcare . Without this they would belikely to be on benefits.

7. The over emphasis on requiring a lot of data needs to be addressed. This can distort the way in whichservices are provided Of course there must be evidence of the numbers of families who are reached and theservices they attend but most of the work needs to be outreach work—finding the families who have youngchildren and encouraging them to be involved with other parents and children and to gain skills which willhelp them not only to get into work but also to provide a better life for their children.

8. It is vitally important that those who run Children’s Centre’s are well qualified—teachers with goodexperience and understanding of the early years and how children learn.

Young children need to be offered a range of activities both physical and creative, supported by adults ratherthan “taught” by adults. Through imaginative play children learn many skills and grow in confidence. Formallearning—sitting down, staying still does not help the brain develop. In most countries where children do farbetter than in England formal learning does not begin before children are six or seven. Schools and teachersneed to be ready for children.

9. The early years are an important stage in children’s lives of growth and development, they are not a timeto “get ready for school”. The reason why we have so many children not able to read is because they start tooearly and fail or struggle because the brain is not yet ready for abstract concepts. Evidence for this has beencollected in “School Readiness: a critical review of perspective and evidence” by David Whitebread and SueBingham, University of Cambridge.



10. Inspectors need to have a background, experience and deep understanding of the early years—and manydo not. A few days training cannot compensate for lack of experience and expertise in the development andneeds of young children. Inspections need to support the improvement of Children’s Centre’s. There will alwaysbe variations in quality but help to get better is more productive than condemnation.

11. All Children’s Centre’s need to be of high quality and many are but the cuts which have been made inlocal authority funding and the decision not to ring fence the funding for Early intervention has resulted in aloss not only of services but also of quality. An increasing number of Children’s Centre’s have closed.

12. Successful Children’s Centre’s provide universal, rather than targeted services.

December 2012

Written evidence submitted by Ofqual

1. In relation to the scope of the inquiry, our interest and experience as the regulator of qualifications andassessments focuses on the following points:

— how to increase the use of evidence-based early intervention in children’s centres;

— the effectiveness and impact of Sure Start children’s centres to date, including the role of Ofstedinspections;

— how to define and measure good practice in family and parenting support and outreach, includingthe effectiveness of the Government’s payment by results trials, and what measures of childdevelopment and school readiness might be used.

Our role

2. Under the 2009 ASCL Act, we have a duty to review all aspects of National Assessment arrangementswhich include statutory assessment relating to the Early Years Foundations Stage and the National Curriculum.We review assessments from development to implementation in relation to their specified purpose as well astheir intended uses. Our goal is to safeguard the interests of the learner and we expect all children to haveaccess to assessments which are:

— appropriate to their age;

— an effective measure of their abilities, skills and concept development;

— fair to all irrespective of gender, language, religion, ethnic or social origin or disability.

3. We have two statutory objectives, one relating to the maintenance of assessment standards and the otherto promoting public confidence; these are detailed in our Regulatory Framework for National Assessments:National Curriculum and Early Years Foundation Stage (Ofsted 2011):

http://www2.ofqual.gov.uk/files/2011-regulatory-framework-for-national-assessments.pdf?Itemid=198

Our contribution to the inquiry

Enabling practitioner judgments

4. With regard to evidence based intervention, we understand the importance of practitioners making accurateand consistent judgments about children’s achievement and attainment. Our work in this area has led us toidentify the key aspects of a national system which enable more accurate judgments to be made. Our evidenceis both qualitative and quantitative and draws on small focus groups to large scale surveys of parents.

5. Where an equitable system is required, we would argue that evidence based intervention is enabled whenthere is a clear process in place for:

— developing and publishing national standards—the criteria which practitioners can use to assesschildren attainment;

— providing training, exemplification of standards and guidance for practitioners;

— creating opportunities for practitioners to work with colleagues to discuss and compare judgements;

— moderation of practitioner judgements by an external process and training for moderators;

— defining a clear purpose to the assessment and providing information on how any outcomes fromthe assessment will be used;

— making available guidance and exemplar material for the information of parents.

Threats to accurate practitioner judgments

6. Effective evidence-based intervention is secured when practitioners’ assessment judgments can beconsidered as valid, reliable across settings, Local Authorities and regions and comparable over time. Thosedesigning the approach to assessment should ensure it is manageable for practitioners and should have takensteps minimise any bias so that it is as fair as possible for all learners.



7. Our work in relation to National Assessment has enabled us to identify a number of potential threats toaccurate and comparable assessment and hence to both evidence-based intervention and to ways of measuringthe effectiveness of practitioners and settings. It is important that perverse incentives are not introduced intoassessment systems. We recommend that, where practitioners are required to assess and keep records with aspecified purpose of ascertaining children’s attainment and achievement, accompanying information is madeavailable on the intended and appropriate uses of outcomes of such assessments. In relation to the focus of thisinquiry, this should make clear whether outcomes are suitable to be used as:

— a measure of “value-added” impact which could, for example, be considered by Ofsted inspectors;

— a measure for accountability purposes e.g. payment by results or the setting and achievement oftargets;

— a measure of practitioner competency e.g. performance related pay.

8. We suggest that the use of national assessment outcomes in the ways listed above may introduce perverseincentives and reduce the likelihood that the assessment is valid for its purpose and primary uses; that is tomake accurate assessments of the attainment of each child, to provide evidence for practitioners to plan forand enable children’s future learning and to offer reliable information to parents.

9. We are also aware of current plans to develop and establish a “school readiness” measure based on theoutcomes of the newly configured Early Years Foundation Stage Profile, carried out in the final term of theReception year when children are around the age of five years. We are seeking to be kept informed of suchdevelopments since we have a direct interest in terms of our statutory objectives.

December 2012

Written evidence submitted by The Children’s Society

Introduction

The Children’s Society supports over 48,000 children and young people every year through our children’scentres and specialist services. We believe in achieving a better childhood for every child but have a particularfocus on vulnerable and disadvantaged children. We seek to give a voice to children and young people andinfluence policy and practice so they have a better chance in life. This response is based on the work of TheChildren’s Society with children and families in 43 children’s centres across England.

1. The new Core Purpose of Sure Start children’s centres, how this has evolved and isdifferent from the original design and purpose of Sure Start

The Department for Education (DfE) are moving away from a “core offer” which children’s centres mustdeliver, towards a core purpose, where outcomes are defined, and increased local flexibility is permitted indesigning and delivering services to achieve those outcomes. The DfE have now begun to set out the corepurpose of children’s centres, centred around child development and school readiness; parenting aspirationsand parenting skills; and child and family health and life chances.

We welcome the introduction of a “core purpose” for Sure Start children’s centres, in order to provideincreased focus on the desired outcomes of children’s centres, rather than just the specific outputs required toachieve this.

However, we are very concerned that reductions in the value of the Early Intervention Grant which fundschildren’s centre services, will undermine the ability of centres to achieve the very best outcomes for children.

The core purpose also reemphasises the focus of Sure Start on the most disadvantaged and reducinginequalities (see question 3).

2. The effectiveness and impact of Sure Start children’s centres to date, including the role ofOfsted inspections

We support Ofsted inspections of children’s centres as an important part of the accountability framework forchildren’s centres. Our services often find that the inspections can be a useful tool for reflection, reviewing theservices, celebrating successes and identifying areas for improvement.

We understand that Ofsted is in the process of revising the framework for inspection of children’s centres.Our children’s centres concerns around Ofsted inspections involve the high expectations inspectors have of thedata and information children’s centres can provide. Information sharing at local authority level can be aparticular problem with many of our centres reporting that they are not provided with key information likenew birth data from their local health service. Another issue is that Ofsted has high expectations of theinvolvement of partner organisations in inspections. Our experience is that it can be difficult to get externalpartner organisations to be involved in inspections.



Recommendation: Local authorities should support further integrated working between children’s centres andpartner organisations in order to enable more effective Ofsted inspections. See section 7 for suggestions forimprovement to integrated working.

3. The range of services and activities provided at Sure Start children’s centres, and theirdesired outcomes, and whether/how these differ from family centres, early Sure Start localprogrammes and early years settings.

Children’s centres provide a range of services and activities that can be loosely divided into universalservices that are open to all in their reach area, such as stay and play sessions, and more targeted services likefamily support aimed at supporting the most disadvantaged families17. The children’s centre core purpose re-emphasises the need for children’s centres to focus on supporting the most disadvantaged children and families.

The originally principle behind Sure Start Local Programmes was “progressive universalism” involvingproviding universal interventions alongside targeted work to support the most disadvantaged. These LocalProgrammes were well funded and targeted at very deprived areas.

With the new core purpose and often less resources, our children’s centres report a greater pressure fromlocal authorities to focus on services targeted at particular groups of disadvantaged families. Some have hadto reduce universal provision.

The importance of universal services should not be underestimated as our practitioners report that they arewhat get families through the door, enable staff to build relationships with families and identify any issues/problems families may be facing before they reach crisis point. Children’s centres delivering purely targetedservices risk losing focus on early intervention/prevention, and becoming an extension of social care, or as oneof our practitioners stated, a “poor relation to the original Sure Start dream”.

Recommendation: We believe that children’s centres need to continue to be supported to provide acombination of universal services open to anyone within the centre’s reach area, and services targeted at themost vulnerable families.

4. The introduction of Payment By Results in Early Years settings18

The department for education are looking at introducing the use of Payment by Results (PBR) for Sure Startfunding. The key aims of introducing PBR are:

— Incentivise LAs and providers to reach families in greatest need, and improve their outcomes;

— Improve local transparency and data quality to inform commissioners and support parental choice,and

— Longer term improvement of cost effectiveness so public money is focused on achieving results.

DfE have proposed that a proportion of the budget for children’s centres is linked to PBR, and that even atlow proportions of funding delivered in this way, this will encourage innovation and behaviour change inservice delivery.

The DfE have established 27 pilots of PBR for Sure Start children’s centres. The aim is to establish a finalset of measures so that PBR can be rolled out nationally in 2013–14.

We believe six principles must underpin the introduction of PBR in early years settings:

1. No children’s centre should find itself without enough funds to deliver their core purpose—incentivesof additional funds should be used to encourage a focus on outcomes, targeting of the mostdisadvantaged, and fostering of innovative approaches to service delivery. However, a base budgetmust be at a minimum level, sufficient to achieve the core purpose, and to ensure that children andfamilies retain access to key services.

2. Outcomes against which centres are assessed, and how these are measured, must be tailored to thecircumstances of individual children’s centres—generic measures based on absolute performance,e.g. a particular Ofsted rating, risk a vicious circle with greater funding flowing to already highlyperforming centres, reinforcing the quality divide between centres.

3. PBR must be linked to improved outcomes for the most disadvantaged groups—outcomes which arenot targeted at the most disadvantaged people could result in “cherry-picking” of cheaper and easierto run services, which do not target support at the most disadvantaged people. However, for thereasons given in question 3 above, care also needs to be taken to ensure a balance with supportingUniversal area based provision.

4. Children’s centres must be given support to ensure their data collection and evaluation techniquesare robust enough to assess performance otherwise they will be unable to design outcomes or assessperformance accurately and effectively, many centres may currently lack these methods andexpertise. We are pleased that the government has announced support for the trial areas to support

17 Such as families affected by domestic violence, mental health issues, those living in poverty etc.18 Question 4 has not been addressed in this response as international interventions are not our area of expertise.



the introduction of PBR, and believe that this support should be extended to all areas followingnational roll out.

5. Sufficient time must be given between local pilots and national roll out, to ensure that the impact ofthe pilots can be properly evaluated. Evidence shows that for all services there is a relatively longtime lag between changes in services and the emergence of a measurable impact on outcomes.

6. PBR arrangements should be flexible enough to respond to ongoing changes of circumstances whichaffect the ability of centre to meet PBR targets. Additionally, in assessing success at meeting targets,the process would benefit from an independent appeals process so that children’s centres can appealfindings regarding their success in reaching targets. For example, this could be done by peer reviewby a neighbouring authority.

5. How to increase the use of evidence-based early intervention in children’s centres

The most commonly available evidence based early interventions in children’s centres are parentingprogrammes which are widely used in The Children’s Society children’s centres. The main driver for the useof evidence based programmes is from local authorities, many of whom encourage the use of a particularevidence based parenting programme. For example one of our children’s centre’s local authority requires themto use an evidence based parenting programme as one of their key performance indicators.

However, there can be some practical issues that make it difficult for centres to run evidence basedprogrammes. For example, some of these programmes require crèches as parents can only attend the course iffree childcare is provided. Some of our children’s centres struggle to run crèches alongside their parentingprogramme as the staffing and additional costs of providing this childcare is an added strain on already tightbudgets. Another issue is that finding staff capacity and training for the parenting programmes has becomemore difficult with less resources. Our children’s centre managers have reported that it is becoming increasinglydifficult to provide evidence based early interventions like parenting programmes with what one of ourpractitioners has called a “skeleton staff”.

An increase in the use of evidence based early interventions requires sufficient funding to ensure there areadequate staff levels and training to provide evidence based early interventions in children’s centres and enablethe running of crèches to support these interventions.

6. How to strengthen integrated working between health, social care and education as part ofa multi-agency early help offer, including how to improve information-sharing and theproposal for children’s centres to have access to a “named social worker”

Integrated working should be at the heart of children’s centre practice as they have a positive impact onchildren’s outcomes and are welcomed by parents where this means they can access a range of support underone roof.

Integrated working can be over reliant on individual workers retaining personal links with different services.Such over reliance can make integrated working unsustainable and create problems when staff move on. Inorder to be sustainable, integrated working needs to be integrated into the centre’s strategy, with a strategiclead, to ensure that it is built into the core practice of the centre.

One key form of service integration is the sharing of information. This can currently be inconsistent betweenlocal authorities. We believe, in particular, that all children’s centres should have access to live birth data aboutchildren born within their reach area. This helps to ensure that all families can be approached by the centrefrom the very start of a child’s life to enable early engagement with services.

Recommendation: There should be an explicit requirement for local authorities to share live birth data withchildren’s centres in their area.

Integrated working between children’s centres and social services is crucial. We welcome proposals that allchildren’s centres should have a named social worker. However, this needs to be supported by a commitmentto ensure that that social worker is meaningfully engaging with the centre they are attached to. Practitionershave reported that on some occasions children’s centres have had named social workers who do not regularlyengage with the centre.

Recommendation: All children’s centres should have a named social worker with a clear commitment tomaintaining regular contact with the children’s centre.

Recommendation: In order to maximise engagement with children’s centres amongst the most disadvantagedfamilies, social workers should be committed to ensuring that, where the family consent, they are sharingdetails with their local children’s centre, of those families with children with children in need and childprotection plans in place.



7. How to increase the involvement of families (especially fathers, disadvantaged families,minority ethnic groups and families of children with SEN and disabled children) in therunning of children’s centres and in their regular activities

We support increasing the involvement of families in the running of children’s centres as this is essential toproviding effective children’s centre services and ensuring centres are embedded in their local community.

Parents19 face a number of barriers to getting involved in the running of children’s centres. Our children’scentre practitioners have found that some parents state that they do not have the time to get involved withwork and other commitments taking priority. Our children’s centres support families to become involved in therunning of their centre in wide a wide variety of ways from offering volunteer opportunities, consulting withparents about the services provided to having parents on advisory boards. Centres often find that providingsupport with childcare while parents are participating and in some cases providing support with travel costs isnecessary to support involvement but can be challenging with tight budgetary constraints.

Recommendation: children’s centres should offer a variety of routes to engagement with governance, toensure that parents have the flexibility to engage with governance on the level to which fits their individualneeds.

Involving disadvantaged families and other targeted groups (including fathers, minority ethnic groups andfamilies of children with SEN and disabled children) in the regular activities of children’s centres is also animportant priority for our centres. We are currently undertaking research into the barriers disadvantaged familiesface in engaging with children’s centres.

Initial findings suggest a range of issues creating barriers to disadvantaged families accessing children’scentre services, for example:

— In some areas there is still a lack of awareness and understanding of what children’s centre are andthey are not widely promoted by the local authority and partners organisations. This can make itdifficult for particularly isolated disadvantaged families to know that these services are available tosupport them.

— Similarly children’s centres are not always able to access all the relevant data and information onthe families in their reach area from their local authority or local partners like health. For example,some of our children’s centres do not always receive information on domestic violence incidentseven if families in their reach area are involved.

— Practical issues such as the size and shape of a children’s centres reach area, make it difficult fromfamilies (particularly if they are living on a low income) to travel to the centres especially in ruralareas with poor transport links.

Recommendation: Local authorities and partner organisations should provide children’s centres withsufficient data and information to ensure they are able to identify disadvantaged families in their area andprovide effective outreach.

Recommendation: The government should consider encouraging local authorities to reassess the extent andshape of the reach areas of their children’s centres to ensure all families are able to access the services of thecentre in their area. Local authorities should also ensure that they are supporting and promoting children’scentres with these disadvantaged families and raising awareness of their services.

Specific groups such as fathers, minority ethnic families and those with children with SEN and disabledchildren face specific difficulties particularly if they are also from a disadvantaged cohort.

— Fathers face barriers as children’s centres are often predominantly female environments with mainlyfemale staff. It can also be difficult for working fathers (as well as working mothers) to attend whenactivities are during work hours. children’s centres must be able to adapt to the needs of fathers. Forexample, some children’s centres have had father volunteers specifically to encourage engagementwith fathers.

— Minority ethnic families can also find children’s centres unwelcoming environments particularly ifthey face language barriers. The importance of integrating with the local community is essential totackling these cultural/language barriers. Our children’s centres in Bradford have successfully workedwith a local Eastern European migrant charity and have a number of staff and volunteers from SouthAsian backgrounds which helps to engage with families from these groups.

— Families with disabled children and children with SEN also can face barriers to engagement withchildren’s centres. These can include parental concerns about the safety and accessibility of centres;concerns about attitudes of staff and parents at the centre towards disabled children and a lack ofappropriate staff training and development. Our children’s centres provide welcoming and accessibleenvironments for children with additional needs and many run specific activities for these childrenand their families. We are also part of the Early Language Development Programme for identifyingearly signs of developmental delay and improving outcomes of children with SEN through providingthe Every Child a Talker (ECAT) programme in our children’s centres.

19 Particularly in disadvantaged families.



Recommendation: children’s centres should respond to the needs of their local population particularly targetgroups like fathers, minority ethnic families and families with children with SEN and disabled children. Thesegroups should be consulted with to establish their particular needs and how they would like to be engaged,and their children’s centre services to be provided.

December 2012

Written evidence submitted by Lancashire County Council

Brief introduction to the respondent

1. This response has been formulated by the Early Years Lead Officer for Lancashire County Council. TheLead Officer has extensive experience of children’s centres, children’s social care and the childcare sector.Lancashire has 79 children’s centres. Of those centres 48 have been inspected by Ofsted to date—25% aregraded “Outstanding” and a further 67% “Good”. The County Council continues to prioritise early support tovulnerable families and recognises children’s centres as a prime vehicle for bringing professionals together toserve families and the community more effectively.

Factual evidence

Changes to the core purpose

2. Lancashire welcomes the focus of the core purpose on the most vulnerable families and on closing theoutcomes gap between the least well performing children and their peers. The Core Purpose, Statutory guidanceand the Ofsted inspection framework supports a move towards consistency of delivery of services andoutcomes, which were not, included in the development of the original Sure Start programmes.

3. It is however important that children’s centres retain a universal element to their service delivery to avoidstigmatisation of children and their families, this model ensures that early support for vulnerable children andfamilies is effective and has a positive impact on outcomes and on strengthening communities.

4. Lancashire advocates that resources should be targeted to need regardless of a family’s income, postcodeor any other arbitrary factor. A good example is the development of a children’s centre on an army barracksin an area that may potentially have been overlooked due to household income levels in the wider area.

5. There is a need to review the commissioning agreements for children’s centres but this is provingchallenging as the new Core Purpose has yet to be published.

Effectiveness and impact of children’s centres

6. Lancashire can clearly demonstrate the impact of effective targeting of children’s centre services by theoutcomes from Ofsted inspections of children’s centres and the increase in FSP scores across the county.

7. The approach of multi-agency working initially developed through Sure Start Local Programmes has beenfurther developed within children’s centres, with an emphasis on joint training, co-location of services, andshared processes which have brought demonstrable benefits to frontline services to families. These areevidenced in Ofsted reports, case studies and tracking systems.

The role of Ofsted inspection

8. Ofsted inspection of children’s centres has had a beneficial impact by supporting centre leaders to focusservices on the most vulnerable children/families/groups.

9. Centre leaders have become more proficient in monitoring outcomes and demonstrating impact as a resultof the introduction of Ofsted inspections.

10. A local and national benchmark for the impact/outcomes of children’s centre services is in place for thevery first time.

11. Prevention of family situations deteriorating is a vital element of many children’s centres’ impact, butevidence to demonstrate this aspect remains challenging.

12. Without further support and challenge from the LA between inspections it is unlikely that inspectionalone would be sufficient to guarantee continued improvement in outcomes for children and families.

Range of services provided and desired outcomes, whether/how these differ from family centres, early SSLPsand EY settings

13. Services continue to evolve in line with the core purpose, statutory guidance and local partnerships.

14. Services offered from children’s centres have become far more consistent and targeted than those offeredin the days of local sure start programmes. Systems are now in place which identifies cost benefit analysis andevidence of impact/outcomes.



15. Children’s centres are unique in what they offer to children and their families, unlike EY settings whogenerally only support the child and family centres where there resources are mainly targeted at children subjectto CIN and CP plans. The Core Purpose and the Statutory guidance ensures that CC’s support the whole child,in terms of meeting their Health needs, supporting their early education, offering one to one family support forvulnerable families, offering access to training, employment and volunteering opportunities, thereforesupporting the whole family and not just one element of the child or family.

16. Children’s centres have a wide range of other professionals working from their centres that supportchildren and their families, a “One Stop Shop”. Where families can access a wide range of services under oneroof at the same time. These include health care professionals—midwives, health visitors, baby weighingclinics, dentists, occupational health and paediatric consultants. Parenting programmes for all carers andparents, including ante natal and post natal programmes, evidenced based parenting programmes and 1–1outreach support. Services, support and advice for parents and carers of CWD and SEN. Access to support andadvice from Jobcentre Plus, voluntary sector providers such as, CAB, Domestic Abuse support and localhousing support and advice. All of these services would NOT be available in a family centre or an EY setting.

How to define and measure good practice in family and parenting support and outreach, including theeffectiveness of PBR and what measures of child development and school readiness might be used

17. Lancashire has developed a family support tracker which measures impact and outcomes for childrenand their families linked to the Continuum of Need. This allows cc to measure the impact of services andsupport offered to children and their families.

18. Lancashire has funded 1,500 two year old places for disadvantaged two year olds across the Countyfrom September 2011 to September 2012. As part of this programme a two year old assessment tracker hasbeen developed and is used by all early years’ providers who provide a funded two year old place, to dateevidence shows that all children have progressed in their development beyond that expected.

19. Evidenced based parenting programmes are used throughout CC, these identify outcomes and distancedtravelled by children and their families. A number of CC have developed their own parenting programmes thatare equally as effective as the National ones and these should be taken into account in the future.

How to increase the use of evidence based early intervention in CCs

20. Where CC have access to other professionals and services as part of an integrated team this will increaseearly intervention work and its outcomes.

21. Lancashire is currently moving towards a model where a number of it’s children’s centres will be basedat the heart of the early intervention strategy therefore enhancing the role and opportunities for centres inthe future.

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

22. A number of children’s centres in Lancashire currently have access to a named social worker; this modelhas strengthened joint working and improved information sharing.

23. A number of children’s centre workers have access to the social care ISSIS recording system, this allowsCC workers to directly contribute to child/family records held by social workers rather than keeping separaterecords on the same child/family. This further supports integrated working, information sharing and decisionmaking.

24. Where CC have concerns about a child/family they are working with they can gain advice and supportfrom a named social worker rather than making a formal referral to CSCS. This model supports earlyintervention and ensures that children and families receive timely and appropriate support.

25. All children’s centre should have a named midwife and health visitor to support their work with childrenand families. Where models are in place access to health services and outcomes has improved for children andtheir families.

26. The Best Start Lancashire programme, funded by the efficiencies within the County Council to the tuneof £5 million over three years, is led by CC in partnership with all primary schools to support early support.This has led to an increase in partnership working between schools and CC. It has also led to a year on yearincrease in FSP scores across Lancashire.

How to increase the involvement of fathers, disadvantaged families, BME families and children with SEN/disabilities in the running of centres and regular activities

27. Centres need to be at the heart of the community and ensure that they engage proactively with all groups,the advisory/governance board of the centres needs to reflect the community they serve.



28. Centres need to establish parents groups to enable all parents to contribute to the running of the centreand voice their views and opinions. Regular feedback to all centre users is essential in moving centres forward.

29. Centres need to use all available national, local and internal data and take the time to understand theneeds of the local community, its priority groups and then plan services in partnership with children, parentsand providers. Regular reviews and consultation with families is essential to keep centres moving forward.There is not a one size fits all approach.

30. Offering services outside of the normal working week can be helpful for fathers, particularly where theyonly have access rights to their children at the weekends and evenings.

31. Liaising closely with partners involved in families including children with SEN/disabilities can overcomebarriers into universal services.

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

32. Lancashire has prioritised funding for early support and prevention throughout a tough settlement period.

33. Going forward, anticipated reductions to LAs settlements from April 2013 increases the likelihood thatthe council will be unable to maintain funding for children’s centres at the current rate.

34. Lancashire has done a significant amount of work to reduce spend on management and administrationfunctions in all children’s centres. Any future reduction to children’s centre funding is therefore likely to impacton frontline staff which families have come to rely on.

35. Possible reductions in children’s centre services, coupled with further changes to the benefits system andwithdrawal of other mechanisms of support give rise to concern for outcomes for the most vulnerable familiesin Lancashire.

36. Quality of service delivery has remained high in Lancashire children’s centres, but capacity is minimalas other services have withdrawn or shrunk due to funding reductions. Quality is likely to suffer if budgetreductions are implemented.

37. Increasing levels of funding for schools (Pupil Premium) and GP consortia (as commissioners of services)are perceived as opportunities. However the extent to which GPs are aware of children’s centre services andtheir impact on local communities varies considerably.

38. Lancashire has committed extra resource to the development of children’s centre services across a broaderage range through Best Start Lancashire. This initiative is targeted at raising the attainment and attendance ofpupils eligible for Free School Meals. It has supported centres to improve relationships with schools inpreparation for schools’ increased role as commissioners of services.

December 2012

Written evidence submitted by The Communication Trust

Background to The Communication Trust and Speech, Language and Communication

1. The Communication Trust is the campaigning voice for children with speech, language and communicationneeds (SLCN). We raise awareness, influence policy, and promote best practice among the children’s workforceand commission work from our Consortium members. We’re a coalition of nearly 50 leading voluntary sectororganizations and an advisory group, which includes the Royal College of Speech and Language Therapists,Association of Educational Psychologists and the General Teaching Council.

2. Speech language and communication skills are the basis for other key life skills: learning, literacy, positiverelationships and regulation of behaviour and emotions20. Speaking and listening skills underpin pupiloutcomes; young people with good communication skills have a wider range of life chances21. As many as10% of children in the UK, over one million, have speech, language and communication needs, which are notcaused by language neglect, or by having English as an additional language or other external factors. Thismeans that in the average classroom, there are two or three children with such communication difficulties.

3. Speech language and communication skills are the basis for other key life skills: learning, literacy, positiverelationships and regulation of behaviour and emotions22. Speaking and listening skills underpin pupiloutcomes; young people with good communication skills have a wider range of life chances23.

4. As many as 10% of children in the UK, over 1 million, have speech, language and communication needs,which are not caused by language neglect, or by having English as an additional language or other external20 Silva P, Williams S & McGee R, (1987): A Longitudinal Study of Children with Developmental Delay at age three years; later

intellectual, reading and behaviour problems. Developmental Medicine and Child Neurology 29, 630–640.21 Improving Achievement in English Language in Primary and Secondary Schools (2003) HMIE.22 Silva P, Williams S & McGee R, (1987): A Longitudinal Study of Children with Developmental Delay at age three years; later

intellectual, reading and behaviour problems. Developmental Medicine and Child Neurology 29, 630–640.23 Improving Achievement in English Language in Primary and Secondary Schools (2003) HMIE



factors. This means that in the average classroom, there are two or three children with such communicationdifficulties. Of this group, a large cohort—between 5–7% of the child population—have specific languageimpairment (SLI), meaning that they have difficulties with learning and using language that are not associatedwith factors such as general learning difficulties, or other conditions, such as cerebral palsy, hearing impairmentor autistic spectrum disorders. A child with SLI might be bright, but struggle to understand the language usedin the classroom, and thus struggle to attain and achieve.

5. The Department for Education annual SEN statistics for 2011 found that speech, language andcommunication needs is the most common type of primary need for pupils with SEN statements in maintainedprimary schools, with 27.9% of all statemented children in this age group having SLCN as their primaryneed24. In some parts of the UK, those with high unemployment and poor housing, the prevalence rate ofSLCN rises. In areas of social deprivation upwards of 50% of children, equivalent to as many as 17%classroom, are starting school with language delay25. There is also evidence of a high incidence ofcommunication difficulties (often unidentified) in those who are young offenders26, looked after children27

and those who have conduct disorder28 as well as other social emotional and behavioural difficulties29 30.

The new Core Purpose of Sure Start children’s centres, how this has evolved and is differentfrom the original design and purpose of Sure Start

6. Whilst there is no doubt that Sure Start Children’s Centres have had a positive effect on children in theirearly years, the Trust are concerned that this has not translated fully into improving children’s speech, languageand communication development. An evaluation of Sure Start, The Impact Of Sure Start Local ProgrammesOn Child Development and Family Functioning31, recognised this problem and called for an increased focuswithin centres on speech and language development.

The effectiveness and impact of Sure Start children’s centres to date, including the role ofOfsted inspections

7. The Trust would like to see Ofsted inspect joint working arrangements between schools, local authoritiesand local health services. We would also like to see inspections consider the contribution of community healthservices and the effectiveness of local authorities support for educational establishments on improving outcomesfor children and young people with SLCN.

The range of services and activities provided at Sure Start children’s centres, and theirdesired outcomes, and whether/how these differ from family centres, early Sure Start localprogrammes and early years settings

8. Early identification and intervention for children with SLCN needs to become central to work of children’scentres. Communication skills are fundamental to children’s life chances: vocabulary aged five is the bestpredictor of whether children who experienced social deprivation in childhood were able to “buck the trend”and escape poverty in later life.

9. The Trust are delighted that the revised Early Years Foundation Stage (EYFS), which began on 1September 2012, puts communication and language as one of the three prime areas for children’s healthydevelopment. We feel strongly that an understanding of speech, language and communication should underpinthe work of the entire children’s workforce. We would like to see a skilled and confident workforce able toensure timely identification and appropriate support of children’s communication and SLCN at every age andstage. It can also be achieved through the mainstreaming of SLC development in the initial training andqualifications of the wider children’s workforce.

10. Within the early years workforce the Communication Trust supports the continuing rollout of Level 3Children’s Workforce Diploma which includes mandatory and optional units based on the Speech, Languageand Communication Framework and we believe the Level 3 diploma should, over time, be the minimumqualification level for early years practitioners to equip them with the skills and knowledge to support earlyintervention. This is supported by the findings of Ofsted’s report on The Impact of the Early Years FoundationStage which demonstrated that developmental outcomes can be improved when an EYFS practitioner hasreceiving specialised training in language development.24 Department for Education, Special Educational Needs 2011: an analysis,25 Locke, A. Ginsborg, J and Peers, I (2002) Development and Disadvantage: Implications for Early Years IJLCD Vol 27 No 1.26 Bryan, K. 2004. Preliminary study of the prevalence of speech and language difficulties in young offenders. International Journal

of Language and Communication Disorders, 39, 391–400.27 Cross, M. Lost for words. (1999) Child and Family Social Work 4(3): 249–57.28 Gilmour, J; Hill, B; Place, M. Skuse, D. H. (2004) Social communication deficits in conduct disorder: a clinical and community

survey Journal of Child Psychology & Psychiatry. 45(5):967–978.29 Toppelberg C O, Shapiro T (2000), Language disorders: A 10-year research update review. Journal of the American Academy

of Child & Adolescent Psychiatry 39: 143–152.30 Snow, P.C. & Powell, M.B. (2005). What’s the story? An exploration of narrative language abilities in male juvenile offenders.

Psychology, Crime and Law 11(3) 239–253.Bryan K Freer J; Furlong C Language and communication difficulties in juvenile offenders (2007) International Journal ofLanguage & Communication Disorders 42 2.

31 DCSF (2008) The Impact Of Sure Start Local Programmes On Child Development And Family Functioning.



11. The Trust would also like to bring to your attention the Level 3 Award in Supporting Children andYoung People’s Speech Language and Communication. This award has been designed for early yearspractitioners, teaching assistants from all educational settings, support staff in a variety of childcare settings,people working in health, social care, play work, youth justice, youth and support work settings. The aim ofthe award is to make a positive impact on the communication development of children across the country. Thisis done through enabling members of the entire children’s workforce to gain accredited continued professionaldevelopment in speech, language and communication.

12. In addition, whilst we welcome the Government’s plans to expand the health visitor workforce, we arecautious about focusing solely on the role of health visitors in early identification (including identification ofspeech and language difficulties), as many young children, particularly those from poorer backgrounds, are notin early years settings or in any contact with such early years professionals. It will be important to ensure thathealth visitors are equipped to identify children with SLCN, that there are clear and explicit pathways forcommunicating and sharing of information between health visitors and early years workers, and that appropriatereferral mechanisms are in place to allow accurate and timely referral to specialists such as speech and languagetherapists where appropriate.

13. The Communication Trust welcomes the proposal in the Children and Families Bill to replace statementsof special educational needs with an “Education, Health and Care Plan” to join up provision between education,health and social care services in meeting children’s needs. However, we would like to see greater detail as tohow these plans will work in practice. The one step that would make single Education, Health and Care Plansworkable is pooled budgets and joint NHS/local authority commissioning of the range of services from whicha Plan would draw.

How to strengthen integrated working between health, social care and education as part of amulti-agency early help offer, including how to improve information-sharing and the proposalfor children’s centres to have access to a “named social worker”

14. As the Government takes forward its reforms to the NHS, the Trust believe it will be important for theGovernment to ensure effective joint working across commissioning bodies, not just within the health sector,but also between education and health commissioners, including schools and special schools as they take ongreater commissioning powers. Arrangements need to be in place to ensure that commissioners are in a positionto commission in the round for services provided by NHS and non- NHS agencies, whether at the local orregional level, and to ensure that local commissioners do not simply “shunt” responsibility up the chain. Wewelcome the proposals in the Children and Families Bill to require joint commissioning between localauthorities and clinical commissioning groups.

15. The benefits of integrated working are clearly identified32, and strongly advocated as best practice insupporting children’s speech, language and communication development33. Collaboration between agenciesand in turn professionals is a key identified element in supporting both children’s language and communicationdevelopment34 and in ensuring success in programmes which support children with SLCN Initiatives such asthe 2–2½ year check lead by Health Visitor teams means that good inter-agency work is essential.

16. For children with SLCN, this is particularly important as inter-agency collaboration is recognised as theonly effective solution to the management of complex problems35. We would therefore support disadvantagedfamilies receiving a guaranteed home visit from a trained health visitor which includes a discussion oncommunication skills/support and signposting to further services at the local Children’s Centre.

17. In terms of reinforcing partnerships, we would like to see health and local authority partners workingtogether to identify potential speech, language and communication needs across the age range with particularemphasis on key transition points. We would also recommend that the Healthy Child Programme is adaptedbecause it highlights a child’s speech and language development as one of eight priority topics for health anddevelopment reviews of children.

How to increase the involvement of families (especially fathers, disadvantaged families,minority ethnic groups and families of children with SEN and disabled children) in therunning of children’s centres and in their regular activities

18. We are concerned that there is still a lack of information about what Sure Start Children’s Centres offer.For example statistics published by the Department for Education found that only that 22% of participantswere aware that centres offered advice and support around speech and language development36. In addition itwas found that this advice/support was only being accessed by 2% of respondents and 5% of all users37.32 Sylva, K, Melhuish, E, Sammons, P, Siraj-Blatchford,I. and Taggart, B. (2004) The Effective Provision of Pre-School Education

(EPPE) Project: final report. A longitudinal study DCSF.33 Gascoigne M (2006) Supporting Children with Speech, Language and Communication Needs within Integrated Children’s

Services: Position Paper RCSLT.34 Melhuish E, Belsky J and Leyland A (2007) Promoting Speech and Language: a themed study in 15 Sure Start Local Programmes

Sure Start evaluation report 002.35 Law, J, Lindsay, G, Peacey, N, Gascoigne, M, Soloff, N, Radford, J, Band, S with Fitzgerald, L (2000) Provision for Children

with Speech and language needs in England and Wales DFEE.36 DCSF (2009) Sure Start Children’s Centres Survey of Parents Research Report No DCSF-RR083.37 DCSF (2009) Sure Start Children’s Centres Survey of Parents Research Report No DCSF-RR083.



Talk of the Town

19. For many years now experts in the field of speech, language and communication have known that earlyintervention and integrated working are vital components of improving services for children and young peoplewith SLCN. In responding to this challenge we would like to bring to your attention that The CommunicationTrust has developed Talk of the Town (TOTT), a community approach to early identification of SLCN. TOTTis an integrated, community led approach to supporting speech, language and communication in children from0–19 which is being piloted in a small community in Wythenshawe, South Manchester. It aims to facilitateearly identification, encourage joined up working and improve outcomes for children with SLCN. It addressesthe worryingly high need of language delay that exists, especially in areas of social deprivation.

20. We have included alongside the submission a case study of TOTT and we think that the model canbecome an exemplar to be used across other parts of the country.

December 2012

Written evidence submitted by ATL

ATL, the education union, is an independent, registered trade union and professional association, representingapproximately 160,000 teachers, head teachers, lecturers and support staff in maintained and independentnurseries, schools, sixth form, tertiary and further education colleges in the United Kingdom. AMiE is the tradeunion and professional association for leaders and managers in colleges and schools, and is a distinct sectionof ATL. We recognise the link between education policy and members’ conditions of service.

ATL exists to help members, as their careers develop, through first rate research, advice, information andlegal advice. Our evidence-based policy making enables us to campaign and negotiate locally and nationally.

ATL is affiliated to the Trades Union Congress (TUC), Irish Congress of Trade Unions (ICTU), EuropeanTrade Union Committee for Education (ETUCE) and Education International (EI). ATL is not affiliated to anypolitical party and seeks to work constructively with all the main political parties.

ATL response

1. ATL strongly supports Sure Start Children’s Centres (SSCCs) as an important initiative to bring togetherhigh quality early education and childcare for the benefit of all children, and in particular those fromdisadvantaged backgrounds and those with complex needs. By privileging the needs of children in order toprovide them with the best start in life, we also welcome SSCCs’ provision of related services to help familiesto support their children’s learning and development.

2. Children with three years of high quality (which ATL defines as integrated care and education, whichprivileges play, real-world learning and talk, rather than formal skills teaching) early years provision have beenshown to be a year ahead in terms of cognitive and social skills by the time they start formal education.Research from the Effective Provision of Pre-school Education (EPPE) project38 also indicates that the qualityof provision is higher overall in early years settings that integrate early education and care. As the mosteffective early years provision and outcomes are still largely found in the state-maintained sector, we believethat the testimony to the strength of this sector establishes a clear rationale for well-resourced public services.39

3. ATL would welcome firm assurances from the Government that SSCCs will be fully supported to remainat the forefront in serving children in poverty. Local authorities in deprived areas have already had to makedrastic reductions to their frontline children’s service provision due to a severe drop in their grant income.40

4. The Guardian has suggested, in an article on 9 October, that the Government intends to scrap the EarlyIntervention Grant in order to fund the extension of free education to two year-olds. We are already concernedabout the impact of cuts on Sure Start provision and any further cuts are likely to put young children atincreasing risk of disadvantage or poor outcomes.

5. ATL welcomes the “particular focus on the most disadvantaged families, in order to reduce inequalities...”,however we are concerned that this may result in SSCCs becoming more “ghettoised” and viewed as placesof stigma. The degree to which this is implemented may also result in less interaction between all elements ofsociety. EPPE also showed that “disadvantaged children in particular can benefit significantly from good qualitypre-school experiences, especially if they attend centres that cater for a mixture of children from differentsocial backgrounds.”41

6. The new core purpose also states that parents and carers ought to be involved in governance andvolunteering. Whilst we welcome this and the accompanying financial transparency, we would question howparents and carers might be empowered and encouraged to do so and how busy working parents would have38 http://eppe.ioe.ac.uk/eppe/eppepdfs/RB%20summary%20findings%20from%20Preschool.pdf39 DCSF, Issues in Earlier Intervention: Identifying and Supporting Children with Additional Needs, March 2010 and House of

Commons Children, Schools and Families Committee, The Early Years Single Funding Formula, Seventh Report of Session2009–10, para. 8, p.4, (2010).

40 CYP Now, Children’s services bear the brunt of grant cuts, 26 January 2012.41 http://eppe.ioe.ac.uk/eppe/eppepdfs/RB%20summary%20findings%20from%20Preschool.pdf



time to volunteer. There also appears to be a lack of focus on pre-natal attendance of SSCCs and interactionwith Jobcentre Plus and other assistance, such as advice on financial support available through tax credits oremployer-supported childcare voucher schemes for example.

7. We note that the Government intends to re-consider children’s centre inspection arrangements, and wewould welcome a full and comprehensive public consultation on this issue. While the revised statutory guidancemakes reference to inspections by Ofsted, ATL would like to receive further information on whether any healthprovision offered by SSCCs would also be inspected by Ofsted or whether there are alternative inspectionarrangements for this aspect of provision. We believe that this needs to be reflected in the revised statutoryguidance.42

8. ATL continues to maintain that setting out an inspection framework suitable for all children’s centresassumes that they are set up and managed in the same way across the country. It also appears to assume thata children’s centre manager is, or should be, responsible for all aspects of staffing, provision and outcomes ina similar way to a headteacher’s responsibilities with regard to a school.43 We have reservations about theseassumptions not only on the basis of the Government’s own priority, however questionable, of promoting adiversity of organisations to provide early childhood services, but also on the basis of children’s centres alreadydelivering a joined-up offer consisting of a range of services in the locality.

9. As regards impact, the second NESS found positive results from the survey overall. The reach of thesecentres was good with 78% of parents and carers aware of their local centre and 45% having used or attendedtheir centre. Furthermore the profile of users was very similar to the profile of respondents overall, suggestingthat reach was good throughout the target population. There was no evidence of particular groups of parentsor carers monopolising the centres. Equally, the results suggest that no sub-groups are being excluded from orfailing to access the centres. Those who have used or attended their local centre were very happy with theservices they had used. When considering all of the services they had used at the centre, 92% of users saidthey were satisfied (68% were very satisfied). Satisfaction levels were also very high with each of the individualservices used.44

10. However, little research has been conducted on measurable outcomes, and the methodology of that whichexists has been questioned. There is also little research on BME, SEN and other minority groups’ use ofSSCCs, beyond ethnic composition of baseline surveys and monitoring data, although there was some mentionof services as adult language courses, social meeting groups, and specific activities designed for BME groups.No outcome evaluations were reported either for these activities or for the work of outreach workers.45

11. There are also concerns about the issue of staff appointments and roles and the dilemmas of hierarchyand status between minority ethnic staff and other staff, explored in the NESS Implementation Report.46

12. Love et al. (2002) identified key messages from the positive impact of Early Head Start in the USA oninfants, toddlers and their families.47 Findings were:

— Fully implementing the Head Start Programme Performance Standards resulted in stronger patternsof impact on children and parenting.

— Centre based programmes enhanced children’s cognitive ability and by the age of three reducednegative aspects of social emotional behaviours.

— Home based programmes contributed to enhanced language development at two (but not at three)and the quality of parent/child play interactions.

— A mixture of centre and home based programmes produced stronger impacts.

— Enrolling parents on programmes before their children were born was more likely to engage themin services.

— There was less impact on the highest risk families with young children.

13. ATL disagrees very strongly with Government proposals to reward local authorities, as commissioningbodies, and providers with payment by results (PbR).48 Where joint-working has been shown to be the key toimproved outcomes for the most vulnerable children, ATL believes that payment by results is likely to bedivisive and disadvantages providers, particularly in the state-maintained sector, that serve hard-to-reachfamilies and communities in the most challenging circumstances. We also fear that a PbR scheme would tend42 ATL, Revised Sure Start Statutory Guidance, consultation response, June 2012.43 ATL, Ofsted Inspection of Children’s Centres, consultation response, September 2009.44 http://www.ness.bbk.ac.uk45 Lloyd, N. and Rafferty, A. (2006) Black and minority ethnic families and Sure Start: findings from local evaluation reports.

London: National Evaluation of Sure Start (NESS).46 http://www.ness.bbk.ac.uk47 Love, J.M., Kisker, E.E., Ross, C.M., Schochet, P.Z., Brooks-Gunn, J., Paulsell, D., (2002). Making a difference in the lives of

infants and toddlers and their families: The impacts of Early Head Start. Washington, DC: US Department of Health and HumanServices.

48 House of Commons Education Committee, Sure Start Children’s Centres: Government Response to the Fifth Report from theChildren, Schools and Families Committee, session 2009–10, p.3.



to create the wrong incentives and that many of the proposed measures, including parents’ aspirations, self-esteem and self-reported wellbeing cannot be determined, attributed and recorded in any consistent way forand across different providers.49

14. ATL is concerned that the emphasis on the role of Private, Voluntary and Independent (PVI) providerswill not only lead to significant variations in “local offers”, a lack of transparency in determining local needand in supporting any families who “cross the border”, but within the parameters of this Government’s budgetand the current economic climate, it is also highly likely to compromise quality at the expense of meeting theneeds of the most vulnerable children. We strongly agree with the House of Commons Children, Schools andFamilies Committee’s Report on the Early Years Single Funding Formula (EYSFF) that the standards set bythe state-maintained sector in early years provision “are there for others to follow, and they should not be putat risk by the implementation of the Single Funding Formula” nor by the removal of ring-fenced fundingfor SSCCs.50

15. ATL recommends that the revised statutory guidance makes explicit reference to the need to implementeffective practice, and we welcome the APPG for Sure Start’s recommendation that local authority bodiesshould work with the Government and the voluntary sector to produce guidance to this effect which will bemade available free of charge to local authorities.51

16. ATL does not believe in the concept of “school readiness”, instead we maintain that schools should beready for children, not children ready for schools. In Scandinavia, for example, children don’t start school untilthe age of six or seven. Play-led pedagogy is far more suitable and enables children to develop curiosity aboutlearning, without being strait-jacketed by prescriptive formality.

17. Colocation of services and strong support for and promotion of SSCCs would improve multi-agencyworking, as well as better sign-posting to relevant services. ATL believes that it is important for SSCCs tofocus on the provision of services for children, ranging from early education, childcare and health to socialcare, and that this core purpose should be further strengthened and supported through effective inter-agencyworking.52 This, in our view, is best achieved by building on existing public services provision throughSSCCs, including giving local voluntary and community organisations a platform for their services within astate-maintained model as appropriate, rather than assuming that PVI providers should be a first choice formeeting local needs.53

18. The rising cost of childcare is of great concern to all families, but in particular to those headed by loneparents, those from BME communities, (whose rate of employment is 56.4%), and those with disabled children.This may have an impact on their usage of SSCCs.

19. Overall, there are significant variations in the levels of formal childcare usage among families fromdifferent ethnic groups. High childcare costs, a work-based entitlement to subsidies and variable levels ofmaternal employment are clearly important, as are high rates of lone parenthood among Black African andCaribbean families, and the typically larger family size of many Southern Asian communities. These issuespose particular challenges to the Government’s current childcare strategy, especially given the relatively higherrates of economic and educational disadvantaged faced by children from BME families.54

20. Daycare Trust’s Ensuring Equality paper found that BME families want childcare that reflects andunderstands their culture. It also found that black families are more likely to use childcare because of economicreasons and require childcare at evenings and weekends due to work patterns. Asian families are more likelyto use childcare for educational reasons, consequently free early-years provision is important for them.55

21. Their Listening to BME Families report highlighted the need for, “encouraging children’s centres andother childcare providers to create more innovative ways of engaging the local BME community and prioritiseoutreach; making base-line training in race equality and race/cultural awareness compulsory for all childcaretraining courses for all staff; conducting local recruitment campaigns to encourage BME groups to considerchildcare as a career option…”.56

22. In Rotherham, one of six authorities invited to take part in a DCSF project to increase the take-up ofchildcare by BME families, six free childcare sessions were offered to parents in pilot areas. Parents whocompleted feedback forms stated that the sessions gave them the confidence to use childcare again, with 92%of respondents stating that they would use childcare again either to take up their child’s free early educationplace or to enable them to return to work.

23. The National Audit Office publication Sure Start Children’s Centres (December 2006) identified thatoutreach remained a particular challenge for programmes, specifically with regards to improving services for49 NCB/NFER, “Feasibility study for the trials of Payment by Results for Children’s Centres”, NCB: November 2011.50 House of Commons, The Early Years Single Funding Formula, para. 8, p.4, (2010).51 All Party Parliamentary Group for Sure Start, Sure Start Delivery in 2011/12, interim report (2012).52 House of Commons Children Schools and Families Committee, Sure Start Children’s Centres, Fifth Report of Session 2009–10,

vol.2, memorandum submitted by Prof E Melhuish, (2010).53 All Party Parliamentary Group for Sure Start, Sure Start Delivery in 2011/12, interim report (2012).54 Equal Access? Appropriate and affordable childcare for every child, ippr 22.55 Daycare Trust, Ensuring Equality in Childcare for Black and Minority Ethnic Familes: a summary paper, 2008.56 Ibid., Listening to Black and Minority Ethnic Parents About Childcare, 2007.



fathers, the parents of children with disabilities, and for ethnic minorities in areas with smaller minoritypopulations. This observation has also been highlighted by Ofsted.57

24. ATL believes that SSCCs need to reach out to transient populations, train their staff in equality anddiversity issues and be sensitive to competing claims from different minorities and to recruit from the localarea and communities where possible. Activities need to be scheduled in a more inclusive way and employersshould take childcare seriously as an issue, by allowing parents to work flexibly in order to attend sessions.Male carers need to be included more, so that they are not made to feel as if they are invading a women’s space,perhaps through sessions for male carers only. In some SSCCs, activities come to a halt in school holidays.

25. The Childcare and Early Years Survey of Parents 201058 found that problems with finding flexiblechildcare were strongly associated with families with a child with SEN. According to the survey, 46% of thesefamilies accessed formal childcare and 52% of families with a child with health problems or a disability. Italso found that formal childcare was accessed by 62% of Black Caribbean families, 39% of Black Africanfamilies, 33% of Indian and Pakistani families, and 24% of Bangladeshi families, which correlates witheconomic and cultural patterns found elsewhere.

26. A 2011 study by the Department for Education (DfE), found that private childcare providers often havelimited experience of catering for vulnerable children and will require training to provide a high quality offer.59

27. The Government’s presumption against the extension of children’s centres is reflected in the changedrole of local authorities (LAs), which are accountable for SSCCs under the Childcare Act 2006. The revisedstatutory guidance no longer contains any specific reference to LAs providing information and advice servicesfor parents and prospective parents, which suggests an expectation that LAs will increasingly contract out themanagement of SSCCs. This means that SSCCs are initially responsible for ensuring that parents are givenadvice and support in accessing services that are not delivered on-site. With a greater diversity of providers,or providers managing children’s centres on behalf of the local authority, together with some LAs alreadylacking clarity about the offer for families in their areas, the quality of information and advice for parents andprospective parents will inevitably differ amongst providers.60

28. Research has shown that lack of knowledge about local early years provision, together with lowawareness of the part-time free entitlement for three and four year olds, amongst the most vulnerable familiesis one of the most substantial barriers to accessing early education and childcare.61 The revised statutoryguidance needs to be explicit in its expectations around the role of LAs in providing information, advice andassistance to parents and prospective parents and of the local Families Information Service. This shouldspecifically include that information, advice and assistance will cover childcare and other child-related servicesand facilities, and that LAs “should consider the needs of disadvantaged and hard-to-reach groups” whenproviding this assistance and support.62

29. The inquiries by the APPG for Sure Start have further established significant concerns with regard tothe transparency in assessing the needs of communities and in consulting with parents and service users. LAsneed to be supported through national statutory guidance in how to report the number of SSCCs in their areaand the services they offer for families. The LA’s duty to consult when considering making significant changesto children’s centre provision in their area must also be strengthened to ensure that parents and prospectiveparents can make their views heard and influence any final decision made by the LA.63

30. In the interest of consistency of provision, ATL believes that the revised statutory guidance needs todefine more specifically what constitutes a “significant” change to the range and nature of services and howthey are delivered rather than leaving this entirely to LAs to determine. We also agree that children’s centresshould engage with their local communities in an on-going way rather than as a “one-off” exercise prior to theimplementation of any changes.64

Conclusion

ATL believes that the reduction of the Sure Start Children’s Centres statutory guidance, the lack of referenceto any “best practice” guidance and the lack of guidance on how parents and prospective parents can bebetter informed and involved by service providers in their children’s learning and development is presenting57 Ofsted How well are they doing: The impact of Children’s Centres and Extended Schools and Ofsted report Extended Services

in Schools and Children’s Centres.58 http://www.education.gov.uk/rsgateway/DB/STR/d001073/osr12–2012brief.pdf59 Gibb, J., Jelicic, H., and La Valle, I., Rolling out Free Education for Disadvantaged Two Year Olds: an implementation study

for local authorities and providers, DfE Research Brief DFE-RB131, June 2011.60 APPG for Sure Start, Sure Start Delivery in 2011/12, interim report (2012).61 DfE, Towards Universal Early Years Provision: Analysis of take-up by disadvantaged families from recent annual childcare

surveys, Research Report DFE-RR066, (2010).62 See ATL, Supporting Families in the Foundation Years: Proposed Changes to the Entitlement to Free Early Education and

Childcare Sufficiency, consultation response, February 2012 and Code of Practice for Local Authorities on Delivery of FreeEarly Years Provision for 3 and 4 year olds, chapter 6, p.36.

63 APPG for Sure Start, Sure Start Delivery in 2011/12, interim report (2012).64 DfE, Sure Start Children’s Centres Statutory Guidance, (2010), p.14.



a considerable risk to the provision of high quality early childhood services for the most vulnerable anddisadvantaged families.65

ATL believes that more needs to be done to recruit and train an Early Years workforce which reflects thecommunities they work in. Sure Start Children’s Centres ought to undertake more evaluation of the servicesoffered and the take-up of services by BME families and families with a child with SEN, health problems ora disability. More multi-agency working is needed to encourage and signpost some BME communities toSSCCs, as well as extra financial support from the Government for those in poverty and low pay to accesschildcare.

We are extremely concerned that rather than acknowledging and building on the increasing evidence of thelink between children’s centres’ high quality provision and better outcomes for children, the Governmentcontinues to assume that PVI providers are more effective at meeting the needs of the most vulnerable childrenand their families. As some LAs already struggle to determine and meet local need, we believe that an increasein the diversity of providers will only exacerbate this problem. Children’s centres which are accountable to theLA should be at the heart of the provision of early childhood services and give local voluntary and communityorganisations a platform for their services as appropriate.

Effective early intervention cannot be obtained on the cheap, and ATL calls on the Government to ensurethat SSCCs will be fully supported to remain at the forefront in serving children in poverty.

Written evidence submitted by TACTYC

The main reason that there is such widespread concern about the concept of school readiness in the field isthat practitioners and parents understand through their first-hand experience and observations that children’sdevelopment is very variable—and the variation is within each child as well as between individuals and groupsof children. School readiness has a very different meaning to people looking from the perspective of home andnursery, compared with the perception of people whose starting point is schooling. Although the ability to sitstill and take in information is important, it is by no means the only, or most effective, way of learning atany stage.1

Expectations at the end of the EYFS

There is well founded anxiety that children will be forced into a mould designed to meet unrealistic andsimplistic expectations of their understanding and development. This is compounded by our very early schoolstarting age. In England, although statutory school starts the term after children turn five, in practice manychildren begin school long before they are five, given that annual entry for all at the beginning of the year isnow mandatory.

Although the reception year is intended to be part of the Early Years Foundation Stage (EYFS), the EarlyLearning Goals (ELG) for literacy our set very high. A smaller percentage of children reach the expected levelin the writing goal than any other since the Early Years Profile was introduced, with boys and summer bornchildren most likely to find them difficult. This should at least raise the question as to whether the goal is setat a suitable level. Research published by the DfE in 20103 showed a weak correlation between points scoredon the writing ELG (which has remained substantially the same since the introduction of the revised EYFS in2011) and achievement in writing at the end of Key Stage 1. The new Early Learning Goal for number in therevised EYFS has been raised to the level previously described for children in Key Stage One, and is alsolikely to result in increasing numbers of children finding this expectation challenging, with consequentinappropriate pressure applied in teaching approaches. This inevitably undermines children’s motivation aswell as their understanding of key concepts underpinning their future mathematical development and logicalreasoning.

August born children’s achievement in the Foundation Stage Profile is significantly lower relative to thoseborn in September. Their lower achievement across several measures impacts on summer born children’sperceptions of self-worth and their views of the value of school.2 It would be useful to introduce an analysisof children’s achievement at the end of the EYFS by their month of birth, as has been done in relation to theYear 1 phonics check. This shows a predictable drop in percentages of children reaching the expected scorefor younger children, month by month.4 The long term effects of mis-identification of SEN in YR and Y1 isof grave concern, when many children are diagnosed as having problems, although they are younger and lessexperienced rather than less able than their autumn-born peers.5

The phonics check itself, which is based on questionable evidence,6 is having a damaging and counter-productive top down effect on the curriculum and morale of many children in Year 1 and also, regrettably, inYR. Worryingly, this pressure is also felt in many pre-schools. The limiting effects of high stakes testing havebeen recognised for older children, and are even more damaging in the EYFS.65 ATL, Revised Sure Start Statutory Guidance, consultation response, June 2012.



Impact of Annual Entry to Primary School

Although the schools admissions code (2.16) states that “Admissions authorities must make it clear in theirarrangements that parents can request the date their child is admitted to school can be deferred until later inthe academic year or until the term in which the child reaches compulsory school age”, most parents are notaware of this, and those who do want to defer entry often have a difficult battle. Some feel that the social costof separating their child from the rest of the cohort is too great, even at the expense of their learning. Othersare told by schools that due to the high demand for admission, a place cannot be guaranteed for a child toenter the school part-way through a school year. Admitting up to 30 young children into class at one timemakes settling them very hard, for staff and parents as well as children, and this further exacerbates what canbe a difficult transition. Summer born children have a particularly demanding time as they are less mature andless experienced than the older children in the cohort. At the age of four, even a few months’ difference issignificant. Although it is predictable and normal for younger children not to reach an arbitrary averagestandard, they are too often perceived and labelled as “failing.”

Impact of Early Entry on Nursery Provision

The recent insistence on annual entry to primary school does not sufficiently take into account the effect thepolicy has on the lives of individual children, parents and educators, nor the inevitable consequences for feedersettings. Pre-schools have a large number of vacancies to fill each September. Financial considerations meanthat nurseries in all sectors need to admit children as quickly as possible, so the settling in process is inevitablymore demanding and stressful than it should be for all involved. The foreshortened time in pre-school educationleads to a lack of coherence in the experiences we are offering our youngest children, just at the time whenthey need continuity, consistency and well-tuned stimulus and challenge in their social, emotional, intellectualand physical development.

Countries with effective provision for early care and education keep children in pre-school for at least threeyears, which enables staff to provide a coherent programme focusing on the skills that underpin later moreacademic learning, and the building of secure relationships with families. In this country, early years educationis disjointed, and is undermined by the loss of five year olds from nursery settings. These older children provideinvaluable role models for the younger children, enriching social skills and the quality of play and learning.Being the oldest in their group, even only for a term, gives summer born children the experience of being “atthe top of the class” at least once in their lives, and contributes to their ability to cope with the demandsof school.

It is essential that we make appropriate provision for all young children entering school so that they canflourish in spite of the early age of entry in this country. This is why our schools must be ready to supportchildren in all their variety and vitality, and help parents to understand what they can do to contribute to theirchildren’s development as eager and effective learners.

References:

Whitebread D, and Bingham S (2012). School Readiness TACTYC occasional paper available on line athttp://www.tactyc.org.uk/occasional-papers/occasional-paper2.pdf

Institute for Fiscal Studies, (2012) “Does when you are born matter?” Presentation of The impact of month ofbirth on the development of cognitive and non-cognitive skills throughout childhood project, Institute ofEducation, 14th March 2012. Available online at http://www.ifs.org.uk/conferences/ioe_born.pdf

3. DfE-RR034 available on line at https://www.education.gov.uk/publications/eOrderingDownload/DFE-RR034.pdf

4. United Kingdom Literacy Association survey of teachers implementing the phonics test, reported in theDaily Telegraph, November 2012, available on line at

http://www.telegraph.co.uk/education/educationnews/9681475/Compulsory-reading-test-should-be-scrapped.html

5. Sykes et al. (2009) Birthdate Effects: A Review of the Literature from 1990-on Cambridge Assessmentavailable on line at http://www.cambridgeassessment.org.uk/ca/digitalAssets/172426_172417_Cambridge_Lit_Review_Birthdate_d3.pdf

6. Professor Martyn Hammersley on R4 programme “Bad Evidence” broadcast on 1.1.2013. Comment availableon line at

http://www.localschoolsnetwork.org.uk/2013/01/robotically-following-the-results-of-one-trialcan-be-a-very-dangerous-thing-says-author-of-bad-science/

January 2013



Written evidence submitted by Mrs Claire Oldham

I am responding as a parent who has used and much needed the Sure Start provision.

1. Having moved to the area whilst I was pregnant, I was at a very delicate point in my life where I couldhave been left feeling very isolated. Although I had my newly married husband as support I was worried thatnot having my work, friend and family network as support that I would be left feeling alone with my newbornchild. Thankfully I attended the anti natal groups provided by Sure Start which were not only very informativeand supportive but also gave me a chance to meet “mums to be” from the area, who of which I am still friendswith now, 18 months on.

2. Having breastfed my child, which I found very difficult to begin with, my husbands’ family had only everbottle fed so I found little comfort with their support. Again thankfully the breastfeeding groups provided anetwork of much needed support, when I felt like giving up. From which I met a further two more mums whowere also breastfeeding at the time and we continued to give each other support, and again are still very goodfriends today. Without the support from the staff and other mums I don’t think I would have continued tobreastfeed for nine months as I did.

3. Having resigned from my full time job in Stoke on Trent, I felt it took me a little longer to adjust to mynew lifestyle with my newborn. I hadn’t got the idea of maternity leave in my mind and the knowledge that Iwould be going back to work in the imminent future. Therefore I felt the need to fill my days with productiveactivities with my child, in order to gain some sort of routine. I was given the “Whats on” leaflet by my HealthVisitor and was excited to see lots of groups that I would be able to attend. As a result I have attended manyof the groups on a regular basis (Messy play, discovery play, tea and toast, babble and sign, baby massage andHENRY) and my daughter has thrived from them, from this attendance I believe that they have contributed tomy daughters’ excellent speech development, confidence and general happiness. They give us a purpose to ourdays, an opportunity for my daughter to learn and play safely, a chance for both of us to meet new people anda comfort to know that there are educated staff who are supportive and available to help you if needed.

4. Although not formally diagnosed with post natal depression, I had completed a questionnaire with myhealth visitor who advised me to see my GP. At the time I felt I could deal with my insecurities and worrieswithout the help of medication. It is only now 18 months on that when I have talked about it with my husbandthat I can admit that I may have had mild depression. I truly believe that if I had not had the Sure Start groupsthat were available every day, every week that I may have been a lot worse than I had been or may have neededsome kind of medication to get me where I am today, which thankfully is a very happy and proud mummy.

5. Not being from the area, attending the Sure Start groups has given me a real sense of community. I havegained knowledge of the local areas, met people from different walks of life, and gained confidence throughspeaking to fellow mums who have helped and encouraged me to gain employment in the area. I have chosena change in career and have gained employment helping the elderly in their homes and hope to possibly worktowards entering social care in the future. I really do feel that having the opportunity to attend the Sure Startcentres and meeting the warm natured and friendly staff have made me the confident and proud mum I amtoday. They have given me the insight and confidence to help my family and to ensure my daughter has thebest start to life.

6. I personally feel that I am a very lucky and privileged person to be in the situation I am and I have foundthe Sure Start centres to have a massive impact on mine and my daughter’s life. Therefore I am sure that thereare mothers/families that need a lot more help than I have needed and for them not to have the support of theSure Start provision would be to a massive detriment to the community and society as a whole.

May 2013

Written evidence Submitted by NHS England

NOTE FOR EDUCATION SELECT COMMITTEE ON COMMISSIONING SERVICES IN CHILDREN’SCENTRES

NHS England General Policy

1. NHS England is keen to promote integrated health and social care services wherever possible and whereit is designed to meet people’s needs. We know from our work with national partners on integrated care andsupport that people want services that are tailored, seamless and relevant to their lives and their communities.NHS England is also committed to encouraging Health and Wellbeing Boards and Clinical CommissioningGroups to explore local partnerships to demonstrate its support of the value of early intervention and thedifference community partnerships can make to improve outcomes and long-term wellbeing for children andtheir families, particularly those who are most vulnerable.

Local Determination of Services

2. Ultimately, Health and Wellbeing boards and their communities are in the best position to determinelocally what services should look like in their area. This includes the whole range of services for children and



where they may be delivered in a variety of settings, including Children’s Centres. Clinical commissioninggroups (CCGs), which commission local health services, are required to work with their local Health andWellbeing Boards to determine how best to meet local patients’ needs. Where integrated service provision isthe best local fit, CCGs are likely to decide to commission accordingly. Addressing health inequalities is a keycommitment of NHS England and the role of Children’s Centres in promoting health and wellbeing within thecommunity in partnership with others is one which we would encourage local CCGs and Health and WellbeingBeing Boards to explore.

3. It is important to note that, although in some places the answer may be to co-locate health and socialcare, it is known that a one-size-fits-all model dictated from the top may not always be the best solution forlocal service users, children and their families or carers. For this reason the Health and Wellbeing Boards aretasked with determining this with local partners, through robust planning processes that map local demand andput at their heart what children and their families want from local services. Although some children with bothphysical and social care needs might benefit from having their needs met on one site, many others with a needfor healthcare or social support but not both might be better served by services more accessible or appropriateto them.

Children’s Services

4. Children’s health services are delivered in a variety of places in the community, including patients’ homes,in primary care settings and in hospitals, and sometimes in schools. NHS England’s health visiting servicespecification makes repeated reference to children’s centres as one site for provision of health visiting servicesand the need for partnership with other services based there. The need for these services to co-locate and towork in an integrated way is becoming more pressing as we approach 2015 and the transfer of commissioningof health visiting services to local authorities, which also commission children’s social care which is providedin children’s centres. Children’s Centres are based in local communities and provide a focus for a range ofchildren and their families and carers including those who are most vulnerable. Where they exist, theircommunity location makes them well placed for health services including maternity, health visiting, GP clinics,speech and language, dietetics, infant mental health services and community Paediatric clinics to be located.

5. The value of bringing a range of professionals together in a child centred environment promotescommunication in a face to face manner and sharing of professional expertise. The benefit of strongrelationships between professionals from multi-organisations is critical in transforming outcomes. Focusedinterventions such as outreach into homes where necessary and peer support for very young parents areexamples of services that make a difference in promoting longer term wellbeing of families by buildingconfidence in their parenting abilities to promote effective emotional and physical development of theirchild. We recognise that GPs, paediatricians and other child health professionals in some areas of the countryare often not fully aware of the potential and opportunities collaboration with their local children centres andthe third sector could offer. Raising awareness of the ability to “think and do differently” in challengingfinancial times utilising shared accommodation and greater collaborative partnerships is important. However,as concerns about the economic viability of children’s centres are being considered by financially challengedlocal authorities, this may become more of a virtual than an actual setting.

Co-commissioned Services

6. Another useful way of providing integrated services for users is to co-commission them. An example ofa co-commissioned service is the Family Nursing Partnership service. These partnerships can be commissionedfrom a range of providers including the local provider of community maternal and child health services, andsocial enterprises and charitable settings as long as they are able to demonstrate they can meet the requirementsof the licensing and fidelity measures that cover clinical delivery, staff competencies and organisation standards.The programme crosses the boundaries of health and social care.

Safeguarding

7. The benefits of multi-agency working to safeguard children and young people have been demonstratedthrough the establishment of integrated teams, for example, youth justice services, looked after children servicesand partnerships with the third sector. Children’s centres are based within local communities and offer a broadrange of early intervention family support services to support young parents and parents who may not usuallyaccess services. These parents particularly are vulnerable and may need additional help. The services providedin the children’s centres provide a wide range of early intervention for families and the interests of childrenare at the heart of the staff who work in them. Aligning services together promotes better communication andinformation sharing; it offers opportunities for less duplication and ultimately provides a better experience forfamilies. The benefits for safeguarding children and supporting families through jointly commissioned serviceswould be welcomed. The new working together framework supports professionals to develop locally strategiesthat offer early help to families to improve outcomes for children.



Conclusion

8. The benefits of close integrated working between a whole range of health and social care professionals toidentify and provide early intervention and support for children and their families and carers are fully supportedby NHS England. While this may be helped by co-location of services, there are parts of the country whereChildren’s Centres may not be available or where there may be other ways of achieving integrated workingwhich work better for children and their families and carers, and local service commissioners and Health andWellbeing Boards should consider the views of their service users in determining how to commission serviceswhich best meet their needs.

August 2013

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Documents

Foundation Years: Sure Start children's centres Years: Sure Start children's centres Fifth Report of Session 2013–14 ... The current staff of the Committee are Dr Lynn Gardner (Clerk),