Successful inter-agency working case study St. Stephen’s School … · 2019-12-02 · More facilitators •Trust and respect You need to respect each other, my staff coming here

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Successful inter-agency working case studySt. Stephen’s School and Children’s Centre,

London, UK

Professor Jacqueline BarnesUniversity of Oxford

Equality & InclusionUtrecht, November 29th 2019

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Why selectedBased on the agreed ISOTIS criteria: • It had been operaJonal for at least 10 years; The

primary school and nursery school were established in 1951 and the children’s centre in 2007.• There was documentary evidence of evaluaJon

from the UK Government’s Office for Standards in EducaJon, Children’s Services and Skills (Ofsted) that the quality of the services provided is outstandingfor all aspects of the service provision; • The most recent Ofsted inspecJons all rated the

provisions as ‘Outstanding’ (the best on a scale from 1 to 4).

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A quote from the children’s centre Ofsted report (2011) provides some reasons behind high ratings• St Stephen’s children’s centre is outstanding. It is regarded

highly within the community. Inspired leadership has implemented very successfully the vision that a local school federation can be the focal point for an exceptionally wide range of education, health and welfare services for the whole community. Innovative approaches have resulted in the provision of a midwifery group practice. • This joint initiative with health, the local authority, school

and the centre has broken down barriers between health and education. By bringing health and education together the centre provides easy access to services user may not otherwise reach. This, together with excellent care, guidance and support, makes a significant difference to users’ lives. All are empowered to change their individual and family circumstances for the better.

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Funding

• Funding is from the Local Authority, Newham Council, for the education and children’s centre services • Except for midwifery which is funded through the

local National Health Service Trust. • The day care is a fee-paying provision, with some

support available for parents through tax credits, plus (at the time of writing) a national provision of 30 hours a week free for every three- and four-year-old.

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Methods• Documentary analysis of Ofsted reports, Local

Authority publicaJons and newspaper arJcles• Twelve interviews with stakeholders:

§ 2 LA managers responsible for commissioning and oversight

§ 4 managers within St Stephens (also pracJJoners)§ 1 manager of a service ‘bought in’§ 2 pracJJoners delivering services§ 3 parents

• Informal observaJons in the centre

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Theoretical Background• The concept of integrated working between agencies was

highlighted during the most recent Labour government (1997 to 2010).• Initially (2000) known as Sure Start Local Programmes,

the Sure Start Children’s Centres were designed to improve and integrate a range of services for young children and their families in the most disadvantaged neighbourhoods• The aim was to provide a wide range of services that

worked together, ideally as a ‘one-stop-shop’, tailored to local conditions and needs.• They should target provision to support the most

vulnerable families with the greatest needs.

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St Stephen’s• Schools established in 1951, Children’s Centre

established in 2007• Situated within one of the 10% most deprived

areas in the country, in a Labour controlled local authority• The local area is culturally rich with the large

majority of families coming from diverse minority ethnic groups. Most are from Pakistani, Bengali, Indian, Tamil and East European backgrounds• 98% of pupils in the primary school have English as

an additional language, with 38 languages represented

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GovernanceA federaJon made up of the primary school, nursery school and children's centre, providing from pregnancy to age 11.Legal ‘FederaJon’ since 2010

A federa&on is where a number of maintained schools come together under one governing body. The schools' individual governing bodies are disbanded and a new single over-arching governing body is formed.

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Agencies represented; all co-located• Education (nursery and primary, from ages three up to

11)• Fee paying day care (8 a.m. to 6 p.m.) ages 1-5• Primary health care (health visitors)• Antenatal health care (midwifery) open 365 days a year• Family support• Speech and language therapy• Adult learning, especially English for speakers of other

languages (ESOL)• Adult learning and parenting classes (with crèche)• Family sport/leisure sessions.

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Local Authority agenda guiding the workLocal, boPom-up support

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Newham Best Start in Life OfferFive promises1. 30 hours of free eligible childcare2. Stay and Play sessions every week3. Programmes, workshops and sessions offering

evidence-based advice and guidance to improve parenting capacity

4. Regular employment advice sessions and help to get into work

5. A range of family health and development sessions including: antenatal support; the transition to parenthood; the early weeks of life; perinatal wellbeing; breastfeeding initiation; health weight and nutrition; managing minor ailments and reducing accidents; and supporting speech and language development

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Several levels of collaboraRon represented

1. Little communication beyond networking, loosely defined roles, all decisions made independently

2. Exchange of information co-operative, somewhat defined roles, all decisions made independently

3. Co-ordination, frequent communication, sharing of information and resources, defined roles, some shared decision making

4. Coalition, frequent and prioritized communication, sharing of ideas and resources, joint decision making

5. Collaboration, members belong to one system, frequent communication with mutual trust, consensus reached on all decisions

Frey et al., 2006

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Extent of inter-agency working• Level 5 –For some of the services – primary school,

nursery school and children’s centre (which includes health visitors and family support) - the extent of collaboraJon is unified at the highest level, with common management and a common vision

There is one head teacher, who oversees everything. We’ve got two deputy head teachers who are federated so they oversee everything. Then you have assistant head teachers that run the children’s centre and the maintained nursery. So leadership is preCy much one across the board

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Other services• Level 4 - Some services – such as Midwifery and

ESOL classes - are offered in centre that are not part of federation, staff are not managed by head teacher but all share ideas and managers meet regularly [note: highly unusual to have midwifery provision within Children’s Centres]• Level 3- Some professionals come to the centre to

provide services (e.g. Speech and Language therapists) who have a shared vision about what to offer but with completely separate management and governance

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Why does it work well? Facilitators• Strong leadership and managementInter-agency working comes down to the issue of management and making sure that the coordinated working, those efforts are there and they are tight. The systems and procedures are there to make sure that whoever is coming through our centre that we are on top of what they are doing

• Joint planning and training; extending professional skills

We have an annual School Development Plan (SDP) meeting at the beginning of term with the school, the children’s centre, the nursery, the day care, we all get together and we draw up a plan for the year on how to develop. The whole federation comes togetherAll staff here are trained to offer the sessions for parents, they have all these different activities and sessions run by them. They have all been through the training, done safeguarding, health and safety, food safety, so they have all got various training so they can run these sessions by themselves

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More facilitators• Trust and respectYou need to respect each other, my staff coming here need to be respected like any other staff working full-Kme on the premises. That pays off and if that isn’t there, if those values don’t exist then inter-agency working won’t be good

• Good communicaJonFor inter-agency working we need to value each other, respect each other, and also talk to each other when there are issuesThe children’s centre manager and I are on the phone all the Kme … So the staff know we are talking and that is very important in partnership working, effecKve, good communicaKon

• Co-locaJonThe fact that we can say ‘If you come here on Tuesday aOernoon we have ESOLrunning, if you want to have a bit of exercise we run Zumba on a Friday, if you need to come and see the Health Visitor, come here on a Thursday’. Parents like to know that they can come to one place, they don’t want to be scaCered all over the borough, going here and there.

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Co-location central to the parentalsupport provision

I suppose the terminology ‘one-stop-shop’ covers it. The parents know that once they step into the centre there are a range of services available to them –health, midwifery, classes so they can access further education, crèches attached to that, and a more overarching health and fitness/healthy living approach. We are trying to address the healthy side for them so we do lots of exercise classes, cooking activity, they might develop their understanding about how it is to live more healthily.

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Facilitator and barriers-Data sharing• Collecting, using and sharing informationIf you put on programmes which you think will be good without needs analysis, then that is not a good model.We do user surveys and we also get information from the local authority (about the number of local births).Having in-house health visitors, the RIO health system for the collection of data it is now technically local authority data.

BUT – Midwifery data including local births was not available for sharing. Midwives employed by local hospital trustWe are only able to share new births with children’s centres if those families had already signed up to the centre during the new birth visit

And social work not good with data sharingIt’s about social care really for me. We are working very closely with health and even some of the IT systems, we are beginning to join them up, but not with social care.Social work will not share data. At the moment social workers should be informing the children’s centre if there is an under five on the Child Protection Register; that happens sometimes.

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Barriers• Money and spaceThe biggest constraint is space and capital funding to get works done. Co-locaKon is important. You need office space so that different agencies can sit down together rather than e-mails and phone calls, which only takes you so far

• OrganisaJon of some servicesIf the schools are allocated parKcular Social Workers that would be a beCer way of structuring it. They can have children at different schools all over the place.

• Different professional methodsWe have worked really hard to break barriers because health visitors oOen have different ways of working with the families …. we build relaKonships, we talk to parents about playing with their children. They tend to be direcKve, ‘you do this’ and ‘you don’t do that’.

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Impacts for service delivery• Services appropriate and accessible• Smooth referral system• Enhanced work satisfaction and staff retention• I don’t have a lot of sickness with the team, a sign

that everybody is happy. The sickness rate for my centre is zero• We don’t get very many [staff] leaving us, and some

are travelling quite a distance to come• We feel very lucky, we are very supported here and

everybody gets on and I do love my job, I love what I do, it’s varied, it’s interesting and you never know what you are going to get the next day.

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Impact for families and children• Better access to and take-up of servicesSo, if they are able to tell the teacher they are pregnant or they want a pregnancy test that is where it starts. They [teacher] can say ‘pop in to the midwives’

If you are in toddler group if there is toilet training going on, ‘bin the bottle’, other small sessions, ‘five a day’, ‘fruit smoothies’, anything extra session during that time, they come in toddler group or stay and play, they come with leaflets

• Strengthening the whole familySo this centre is not always just about children, it’s about parents, carers, grandparents. We have stay and play and they specifically say in leaflet ‘parents, carers, grandparents, anyone with adult responsibility welcome’

• Work on parent’s role for child development and achievement

When it comes to learning we often see lack of independence and children not able to do things for themselves. So we continue the parental programmes [from the Children’s Centre to the primary school], head teacher Q & As, parent workshops and curriculum evenings and careers evenings to get our children to aspire higher

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Demonstrated impact• Academic achievement is expected and apainedThey are very focussed on performance indicators from an early age. And I think it sets them apart, they have a ‘golden thread of expectaKon’ from two year olds right through to when the children leave at age 11 around aCendance and engagement and early reading, wriKng, numeracy.

School of the year 2017:An East End state school in one of the poorest parts of England has beaten every private school to come top in the Sunday Times league tables, published today (November 2017). The 11-year-olds at St Stephen’s Primary School in East Ham — where nearly all the pupils speak English as a second language and most are from Indian, Pakistani or Bangladeshi backgrounds — were the best at reading, spelling and doing their sums. It is the first Kme that a state primary school has topped the tables.

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Optimism for the future in the face of low top-down support

Answering a parliamentary question, the Department for Education reported that more than 350 Sure Start children’s centres had closed in England since 2010 and that spending on the centres in the 2015-16 financial year was 47% less in real terms than in 2010 with more cuts planned I would hate to see the demise of the children’s centre or the breakdown of the multi-agency working. We have become established now and it’s effective, I really believe that it has a massive impact.

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hpp://www.st-stephens-primary.org.uk/hpp://www.st-stephens-nurserychildrenscentre.org.uk/

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