Civic conversation

“Me, Myself & Amelia”

Scottish Government figures reveal that the number of families that are headed by a single parent in Scotland is 22 per cent. It’s thought that around 90 per cent of these families are headed by a single mother.

This compares to Greece (4.8 per cent), Spain (7.1) and Holland (11.5). Latvia has the highest percentage of one-parent households with 23.3 per cent, with Ireland at 23.2 per cent.

Being a parent is probably one of the most rewarding things I have done with my life to date – but I wouldn’t have coped on my own ( far too selfish) – so I have great admiration for those single parents I know who do cope so well. Sadly, however, statistically children of single parents are more vulnerable for social and health problems than children of two parent families. That is probably largely because many single parents get trapped in poverty and become isolated from supportive networks and opportunities. There are some things that make it easier for single parents to get by – like good quality childcare at a cost that can be afforded, a supportive social network, and opportunities for education, training and work. I am not sure what evidence there is for this but my instinct tells me that children of single mothers also probably do better if they have access to positive male role models.

Organisation like Single Parent Scotland campaign on behalf of single parents and are quick to point out that single parents are a diverse group and add a lot to life in Scotland

Lone Parents play a vital role in Scottish society as parents, carers and contributors to their local community. That so many feel outside the mainstream of economic and social activity, means that Scotland misses out on the potential contribution of citizens who bring valuable insights and experiences.

This is short film – Me, Myself & Amelia – I think gives a very realistic but positive insight into the life of a single mother. It is about three days in the life of Shelley and Amelia. Shelley who is a film maker also helped to make the the short film ‘These are the things that matter to me..’ looking at what parents in Mid and East Lothian think is important in terms of support for parents and families.

Support from the Start phase 2

Equally Well test sites are due to come to an end in March 2012 – East Lothian has been looking at the lessons from the test site as part of a review of early years services commisssioned by the Support from the Start planning Board. The following represents the current thinking in that review of how the lessons from the test site can be developed in the coming years. The ideas in the following paper will be disccussed and developed further at a conference on the 7th Feburary.

East Lothian Council Champions Early Years

A launch pad for the second phase of Support from the Start

1. The Case for Early Years

We know that getting it right for children and young people, families and carers, from the start, ensures that young children are healthy, happy and ready to succeed in life. To a very large extent, children’s life chances, depend on the quality of experience they have in their first years; the secure and reliable attachments they have with parents and other adults important to them; the relationships they build with other children and within their families and communities; the quality of care they are given by parents and other carers; the richness of the learning opportunities they have; and the support and services which children, parents, families and carers can rely on.

East Lothian Council and its partners in health, the voluntary, third and private sectors have done much in recent years in this area. A key development has been the Support from the Start test site which has been running in some areas of the county. Learning from the outcome of the test site will be used to launch an engagement and partnership approach across the county, for the benefit of all East Lothian’s children.

The main aim is to ensure that East Lothian’s children all get the best possible start in life.

To achieve this we will:

· Promote awareness of the importance of early years for everyone in the county

· Engage with parents, young people and partners to take local action to improve the lives of young children and families

· Raise the profile of East Lothian as a national and international example of a place where people work together to give all young children the best possible start in life

· Create an approach free from jargon and unnecessary red tape which is firmly rooted in our communities

· Do things which fit in well with other council and partner priorities and ways of working

· Be open to and share information about imaginative sources of funding, help and learning about what works

· Work with partners to help local people reach their own solutions

2. Engagement with Local People is Key

We will, with our partners, engage with parents, carers, young people, and other people in the county to find out how they think the quality of life of young children and their families can be improved and work with them over the coming years to take action for improvement. We will engage with them to find ways of working together and supporting each other to ensure all young children:

· Have positive parenting and experience good attachments at an early stage

· Are ready to learn and achieve

· Can access quality child care experiences

· Are healthy & happy

· Are not living in poverty

· Have a good opportunity for play, and

· Are protected from harm

3. Cluster Based Engagement

3.1 To achieve this level of engagement we will establish Support from the Start Link-up groups in each cluster area (East Lothian’s school cluster model). These groups will have close relationships with and be linked to local community planning structures where these exist. Each Link-up group will comprise of, champions from a range of services and organisations from all sectors as well as, parents and carers, and others having an interest in the early years. The Link-up groups should be empowered to engage with any relevant Council or Health department.

3.2 In keeping with the lessons from the evaluation of Support from the Start, Council and Health colleagues on Link-up groups should be regarded as Early Years “Service Champions” who should think and act imaginatively and nimbly to assist local parents and communities to improve the quality of life of young children and their families. Council and Health staff serving in Link-up groups should be given time to devote to this work.

3.3 The link up groups will be supported with administrative time and Public Health Practitioners employed by the NHS will help to establish, facilitate and coordinate the work of each Link-up group. A key role will be to ensure that all parents and carers, especially those who do not have positive experiences of working in groups like these, have a voice.

3.4 In keeping with one of the main messages from “Joining the Dots” there should be a “bias for action” and reporting and scrutiny should be kept to a minimum. The Public Health Practitioners would, however, be expected to ensure that any public monies spent by Link-up groups are properly accounted for. In the establishment phase development funds would remains with the Education and Children’s Services department and be administered by the Public Health Practitioner (s), but this may change to more local arrangement as the groups develop.

3.5 Each cluster based Link-up group will be provided with detailed information on their local area, including population trends and service availability and accessibility. This will be provided by Council and Health information analysis working together. Information would be updated on an annual basis. Updates will include data from the use of the Early Development Instrument (EDI) which will help provide an evidence base for early year’s community development. This data from EDI will be available next year but the establishments of Link-up groups should not wait until this is available. Link up groups should also gather and evaluate information about their own areas.

3.6 Link-up groups will be empowered to discuss how services are currently delivered and to engage with service managers to secure change and innovation to better meet local need where change is required. This is not a “one size fits all” approach. Rather it is an approach which will help tailor services to meet the discrete needs of different communities. There will be challenges made to the current way of doing things in some link-up group areas and service managers and staff will need to be responsive to these challenges.

3.7 To be fully effective, each Link-up group will have access to funding which they can deploy to develop new initiatives in their area, or to adjust or build upon existing provision to achieve the objectives set out in sections one and two above. Link-up groups will be encouraged to secure matching funding from a variety of sources.

4. Governance

Link up groups are accountable directly to the Support from the Start Planning Board and their local community through the locality community planning structures. The chair of each link up group would have a seat at the Support from the Start Planning Board. Each link up group would operate within terms of reference set by the Planning Board but would adopt its own ground rules and procedures. The terms of reference would include ensuring that appropriate representation and reporting is established at ommunity/neighbourhood planning groups where these exist.

Each group would have a “simple rules” process for local champions to access the development fund. During the development phase link up groups will report through the Support from the Start engagement officer to the head of childrens services and the Support from the Start Planning Board. The budget for each group would ibe held by the had of chidlrens services and managed by the public health practitioners who would provide reports to the Support from the Start Planning Board. Arrangements for locally held budgets will be developed in accordance with local need and require approval by the Planning Board.

5. Timescale

5.1 The Public Health Practitioners will seek to establish Link-up groups in each cluster from autumn of 2011. While each group will have their own distinct character and priorities, and while each will develop at a varying pace, learning between each will be important and encouraged.

5.2 A county wide conference will take place in February 2012. This conference will be the formal launch pad for the second phase of Support from the Start, it will bring together the range of parents and partners engaged in each of the Link-up groups, Early Years Champions and elected members. The minister for Children and Early Years, national or international experts in the field will be invited to address the conference.

Ronnie Hill

Head of Children’s Services October 2011

The Year to come

The Scottish Government recently published its spending priorities for the next year. I’ve taken the section on early years and reprdouced it below. There is a lot in it and much to be excited about.

However, it seems odd that the coming year has the promise of being a great period of opportunity for early years and early intervention. I say odd because there is also a lot of fear about the future in the real world. My wife (a nurse) came home this evening with the ‘news’ from the NHS staff grapevine that people on my pay grade in the NHS are to be made redundant. Whether this is real or chinese whisphers it represents the uncertainty which many families feel. Pay freezes and rising bills mean that for families in work things are tighter, and a changing benefits system is a real concern for some of the poorest families. There is little doubt that the next few years are going to be tough for families and services.

What will turn high profile support for early years and early intervention into more resilient families or better support for families that are struggling and prevent families from ‘failing’? Scotland is good at policy, but policy makers need to bring ordinary families with them so that we can all believe that we can contribute to a future Scotland that will be a better place for children.

From the Scottish Spending Review and draft budget document

In 2012-13 we will:

i) Have a greater focus on early years by:

– introducing legislation on the rights of the child and young people;

– consulting on legislation for the early years and early intervention – a draft Children’s Services Bill for introduction later in this parliamentary term;

– introducing an Early Years and Early Intervention Change Fund and working with partners to focus Scottish public sector spend on early intervention, accelerating the implementation of the early years framework

– delivering the next phase of the Play Talk Read programme and developing a national parenting strategy that encourages agencies to work together to support new parents, giving parents the skills they need to best support their children;

and

In addition, we will develop support for families to meet a range of needs, including a new generation of family centres, flexible childcare options, and support for families in conflict.

ii) Help improve the life chances of vulnerable children and young people by:

– continuing the implementation of Getting it Right for Every Child ensuring that universal services deliver for the most vulnerable children;

– implementing the Children’s Hearings (Scotland) Act 2011 to improve outcomes for children and young people, and their families, who experience the Children’s Hearings System;

– working with partners to strengthen strategy and practice around looked after children and young people, children and young people at risk of going into care and young people who offend, giving a greater focus to earlier and more effective interventions to improve outcomes for some of our most vulnerable children and young people, and their families and communities, and to reduce the bureaucratic burdens on those working with them;

– driving and supporting the development of a competent, confident, valued social services workforce, primarily through the Scottish Social Services Council.

– working with the Care Inspectorate to develop a new integrated children’s services inspection, ready for piloting in 2012; and

– improving guidance for frontline child protection professionals: – on working with children affected by parental substance misuse; in families where disability is a key factor; on assessing the risks for vulnerable children; and on training.

Baby Brain Map

Morag Nicholson – senior health promotion specialist and service champion recently brought this web resource to my attention.

It is an interesting interactive baby brain map site

http://www.zerotothree.org/baby-brain-map.html

Is this the kind of thing that could be promoted to parents in Scotland?

As a 49 year old who considers himself reasonably computer/ Internet literate, I am still very aware of a gulf between my generation and younger generations of people who are growing up immersed in a web based information culture.

I belong to that generation who wear wrist watches even though such single use devices are now completely outmoded. The mobile phone is the new generations wrist watch, just as I automatically put my wrist watch on in the morning my sons turn their mobiles on. In fact its their mobiles that wake them up with their alarm functions.

During some engagement work with parents in Midlothian I asked parents of nursery aged children where they would go for advice and help – the Internet was a very common response.

Chief Medical Officer meets East Lothian Children’s Services staff

As part of our agenda of looking at how we can improve outcomes for our most vulnerable children, Children’s Services staff in East Lothian council asked Dr Burns to speak to us about the role of Attachment in Early years and the impact it has on health and outcomes in later life.

It was very inspiring talk. Many of us in Children’s Services are very aware of how important attachment is. The key messages and learning for us were:

· The physiological consequences of poor attachment in relation to brain development and good physical health in adulthood.

· As service providers we need to be aware of the danger of making people passive recipients of services rather than being actively engaged.

This increases their sense of hopelessness and being out of control

A summary of the talk follows below helpfully provided by Vivien McVie (Policy and Planning Officer) Children’s Services. Dr Burns presentation is linked at the bottom of the post

Hopelessness and Life expectancy:

Studies have compared life expectancy in Liverpool, Manchester and Glasgow: there is 60 % excess morbidity in Glasgow – predominantly in four areas: drug-related, alcohol-related, suicide, violence

Susan Everson did a study of men in 1997 which found a connection between increased risks of dying from heart disease (x4) and hopelessness. The reason for this was that the group of men who felt hopeless had laid down more fat in the carotid artery than the others. Thickening of the carotid artery causes blockages in the artery and leads to stroke and death. For a brief summary of the study see: http://atvb.ahajournals.org/cgi/content/short/17/8/1490

What causes the fat to be deposited in the artery?

Hopelessness is stressful. Stress produces cortisol – used for fight or flight reactions. Cortisol causes abdominal fat to be mobilised for use as energy (for use in fight or flight) so when it breaks away, it can end up lining your arteries if it does not get used up (e.g.by running).

Hopelessness may not be acutely stressful but causes ongoing stress – people have been observed to have consistently higher levels of cortisol over the long-term. Only a slight rise can produce damage over the long-term.

A study on re resilience

A study of Jews surviving concentration camps (Aaron Antonovsky) found that while 70 % had the expected poor consequences for health and mental wellbeing, there were 30% who had survived the experience very well. Before their experience in the camps started, these resilient 30% had already developed a sense of coherence in their view of the world, which they had experienced as structured, predictable and explicable, and also had the inner resources to deal with what came next. They felt they could meet things head on and try to purposefully deal with what happened each day – i.e. a sense of self-efficacy, even in such circumstances:

“a feeling that … these demands are seen as challenges, worthy of investment and engagement.”

Causes / Consequences of stress:

People need to experience the world as understandable, manageable and meaningful, or they will experience chronic stress. Tests in Canada showed that the longer a child remained in residential care (“orphanages”) the higher their levels of cortisol were at the end of each day. Tests of adults have shown a link between lack of control in their working lives and higher cortisol levels.

Dr Burns observed in his own working life as a surgeon that people who are manual workers do not heal as fast from wounds, i.e. not the usual 10 days but 12 days to recover from abdominal surgery. This is because these people are not as much in control of their working environment as their bosses and so experience more stress. Another consequence of the resultant higher levels of cortisol is an inflammatory response, slowing down healing and this inflammatory response also leads to heart attack and stroke.

The inflammatory response from stress is compounded if you smoke, and are overweight – if you have all three it is x8 worse.

Inflammation in the arteries causes clots to happen, arteries get ruptured – heart attack follows.

Attachment : Causes/ consequences of stress in children:

Inconsistency in parenting is the most stressful for children (more than consistently abusive/neglectful parenting).

Brains of children who have disordered attachment are affected in three parts with a fourth under discovery:

1) The part of the brain that deals with judgment and decision-making is affected

2) Short-term/working memory is affected

3) Aggression, fear and anxiety are all heightened

When fight or flight dominates, there is no room left for learning or any other type of executive functioning.

Domestic abuse can be experienced in utero and it blocks development of certain parts of the baby’s brain because the baby is stressed and is producing higher levels of cortisol – this affects the genes and so they can pass these defective genes on to their own child.

Further consequences – self-control is inhibited so this affects likelihood of committing crime, getting involved in drug-abuse, earning a steady income. Reaction times are slightly dulled so road traffic accidents are more likely.

Supplied byVivien McVie April 2011

Dr Burns presentation

Harry Burns Presentation 8 March 2011

Joining the Dots …

Joining the Dots – A better start for Scotland’s children

AN INDEPENDENT REPORT BY PROFESSOR SUSAN DEACON

?Susan Deacon’s report to the Scottish Government is now available online at :-

www.scotland.gov.uk/Resource/Doc/343337/0114216.pdf

??Just finished reading the report.

In reflecting on how I might introduce the report, and my reaction to it, for this post; I decided that I could draw on the learning of the amazing authors in P2P at Sanderson’s Wynd. The children (who have published an e-book on Amazon) have been finding interesting words, including ‘wow’ words, as part of their literacy work. Here are my wow words for Susan’s report:-

Passionate

Punchy,

Positive

Provoking

but definitely not pallid

Sanderson’s Wynd and Whitecraig Primary have pride of place on the front cover of the report with their great outdoor activity and learning photo’s

Regards

Steven Wray

‘These are the things that matter to me…’

A group of parents who use voluntary sector services for families of early years children were supported to make a short film about what made a difference for them and their children. The film was made at Stepping Forward a Sure Start centre in Penicuik.

The idea for the video came from conversations that Susan Deacon had with groups of parents in Mid & East Lothian as part of her evidence gathering for her report to the Education Minister. A previous post ‘Conversations with Susan’ described the content and impact of the discussion she had with parents. Parents were supported by the Media Co-op to make the video. Many thanks to Shelley for uploading the video to YouTube (I still haven’t mastered that)

We will use the video as part of Support from the Start ‘civic conversation’ about health and the early years. Its first public viewing will be to East Lothian councillors.

Conversations with Susan

Susan Deacon, local parent, former MSP and health minister, is an advisor to the Support from the Start planning board, but also has a national role advising the Minister for education and lifelong learning about how Scotland can move closer to the vision of every child having the best possible start.

I was able to spend a good part of the day on Thursday accompanying Susan to a series of sessions with parents who use early years voluntary sector services in Mid & East Lothian. The aim of the sessions was for Susan to have conversations with parents of early years children about what they find useful as support, and what they see as issues. They weren’t ‘consultation’ sessions or ‘focus groups’, and were by no means scientific – they were simply conversations. Parents had the opportunity to tell their stories to a woman with considerable experience of how government and public service works, and a voice loud enough to be heard on a national stage. Susan had the opportunity to listen to, and ask questions of, people who had current first hand experience of being parents who were coping with difficult circumstances.

It was fascinating – belated apologies to the Woodburn Neighbourhood Planning Group, but I couldn’t pull myself away when the conversations over ran the allotted time.

These are my impressions from listening to the conversations

Firstly how incredibly generous people can be with their stories. I think this was partly testament to the fact that the parents who participated obviously had a lot of trust in the staff of the voluntary services which were the context for the conversations. However, I was also struck by how much many of the parents wanted to be able to contribute – to give back, and telling their stories was one way of doing that.

A theme that ran through all of the conversations was services seeing the whole person, not just the presenting problem or the assessed need. Parents wanted to be dealt with as people and not as problems. It was obvious that this was a quality of the voluntary sector services the parents were using that they valued very highly, and sadly it was often stated in contrast to experiences of statutory services.

Another and perhaps related theme was that the way services were delivered seemed to be just as important as what was delivered. In other words a friendly face, a welcome non judgemental manner, and perhaps above all a relationship with a trusted individual were valued by parents as much as the particular type or brand of support they received.

Self- help or peer support was also seen as very important – the opportunity to spend time with others in the same or similar situation was valued highly. This might be as simple as time over a cup of tea to chat, it might be a shared confidence building activities. It might also be the opportunity at the right time to offer support to somebody else, or to take on a helping role – fundraising, advocacy etc.

Another theme was about how people access services. Pride kept coming up as barrier to people actively looking for help – ‘I should be able to cope with this’, or, ‘people will think badly of me because I need help’. Parents valued highly services that reached out and smoothed the path into support and didn’t rely on people crossing the door on their own. There were many stories of how people felt that they had been ‘saved’ because someone had ‘helped them across the door’ or made it easier for them to start accepting support.

On the same theme of access was the importance of rapid support in a crisis, especially access to quality childcare envronments – I was particularly struck by stories of how events -social, psychological, financial and medical, mostly beyond our control can overturn lives often literally overnight, and leave us in a position where it is difficult to be the kind of parent we want to be. I was particularly touched by one woman’s story of having to deal with the acute illness of a loved one and trying to balance this against her desire to maintain the kind of stability she wanted for her small child. She recognised that the stress she was under, and the unpredictability of the demands of treatment, meant that her child was not getting the secure, stable environment she desperately wanted for it. By coincidence, a worker turned up on her door with the offer of a nursery place in a voluntary project that she had applied for before the illness of her loved one. She hadn’thought to ask for help, or been offered it, because of her situation, but the offer of support came as a ‘Godsend’. She feels this helped to provide the stability her child needed and allowed her to focus on dealing with the impact of illness without the additional guilt and stress. Who knows what that simple intervention saved in terms of stress and upset for the child and the parents, what did the alleviation of that stress save in terms of stress induced problems for the parents and child. Certainly her feeling was that both her and her child were ‘saved’ .

Almost all of the parents Susan spoke to stressed the importance of qualitychildcare, as the pre-requisite for making it possible for parents to get the support they need, and this was paticularly so where a child had additional needs. Many parents stressed how they felt their child had been ‘ brought on’ in terms of socialisation, language skills and emotional stability through access to the childcare offered by the services they were using.

Finally, I have been reading lots of information about the economic impact of investment in early years – for every £1 spent on early years £5-£7 can be saved from services that are not needed to address problems in later life. Anybody listening to the conversation Susan had with parents over the course of one day in Mid and East Lothian would have no trouble believing that research.

Many thanks to Stepping Forward, First Step & Dadswork for hosting conversations with Susan.

Engaging parents, communities and services in the message of early intervention and reducing health inequality has always been seen as of key importance for the test site. We have called the engagement process a ‘civic conversation’.

The following report summarises the first eighteen months of the ‘civic conversation’ and the next steps to be taken in developing the conversation

civic-conversation summary no pics

This version of he report has had some of the photos strippped out to keep the file size down – if you would like a version with pic email me on swray@eastlothian.gov.uk or steven.wray@nhslothian.scot.nhs.uk

Reports from GUS

Yesterday Lesley Kelly, dissemination officer for the Growing Up in Scotland survey, gave a presentation about the finding of the survey to staff in Mid & East Lothian with particular reference to readiness for learning and supports for parents.

Lesley gave an overview of the findings from the survey and there was a lively discussion at the end of the session.

For me one of the key findings presented by Lesley was the type of supports that were utilised by parents whose children were not experiencing difficulties. It was clear that parents that were accessing a range of informal and community based supports were also experiencing less health, social and emotional problems in their children. In other words parents using community and family based support seems to support the resilience of children. Strengthening the capacity of community and family based support for parents along with supporting parents who are experincing difficulties to access this type of support seems to me to be good value for money, but will it be be valued an protected in the current climate. The childrens commisioner has released a press statement which raises concerns about how supports for parent can be maintained and enhanced when the pressures are for service reductions.

The other key finding for me was that parents / carers who spend time playing with and reading to their children can influence the childs readiness to learn independant of their income status. So often the message from statistics about health, education well being can seem negative. If you have a low income the dice can seem to be stacked against you statitistically speaking. Here is a different story – it doesnt matter if you are on a low income you can still make a difference for your kids

Her presentation is linked below

GUS presentation for East & Midlothian 28th Oct 2010