Please come talk to me about sure start/children's centres.

[HealthCareProfessional]

Hi All,

I am hoping some of you could take the time to help me with regard to the following:

I am a health care professional who has recently started a job with a health visiting team. Prior to this I spent 17 years working with children with special needs including those with complex medical needs and life limiting conditions.

So today I went to a strategy meeting to develop links between HV's and the children's centres, and developing the services provided. When I suggested that families with children who have special needs would benefit from using the children's centres the response was generally that this was a hard group to establish contact with and uncertainty as to what would required/used/of benefit.

I will admit that I got a bit flustered due to my enthusiasm and passion, and therefore struggled to make a valid impact. So if you would spare a few moments to answer the following questions then I would be grateful as it could help shape the future of services provided.

1)Have you had any contact from the children's centres re the services they provide? If yes, please give details, e.g. what age was your child at the time, had they been diagnosed, and what service was offered? What fromat was the contact? eh, phone call, leaflet, face to face contact etc.

2)Have you ever accessed the children's centres? Again if yes, please give details.

3)If you haven't used children's centres, why not?

4)What services would you like to see provided in children's centres?

5)What things could be put in place to enable you to access these services?

6)Are there any services you are using/have used that you would recommend?

7)In my mind children with special needs should be facilitated to access sessions open to those without SN e.g stay and play sessions, cooking groups etc, and also targeted sessions for children with SN. What are your thoughts? Would you be interested in using the groups currently running or would you be more interested in specific SN sessions? What kind of sessions would you like to see being run?

If you've got this far, thank you for reading and thanks in advance for your responses.

HPC

Do mean mean using their service or just so happens to be where the room is booked??
The family support worker at the childrens centre should be the person responisable for making contact with those hard to reach families and making plans to address the issue.,

DS too old for SureStart however, local SureStart provides a free venue for a long-running parent-run SN baby and toddler group. Another couple of SureStart centre have good nurseries which I believe are welcoming to children with SN. Various groups certainly used to run - baby massage, makaton, communication etc, - that would be relevant to SN (though in my experience, more likely to be offered to non-SN children since SureStart took over!!!!)

I would check there is no other SN groups first, then see if you can get parents - NOT the staff! - to do a survey/questionnaire/focus group on what would be useful.

Thank you ladies.

Lisa
I mean what type of sessions would you find useful? (Led by either the sure start staff or HV team.)
Yes I agree the contact should be initiated by the SureStart centre staff. However one issue which arose today was that they only get a baby's details when parent signs a consent form which allows the HV to pass on the details to the centre. This is generally done at the new birth visit. (10-14 days after birth)
Quite often there is no awareness at this stage of any SN. After this there doesn't seem to be a straight forward method of referral. I can think of many other professionals who could refer eg scbu, consultants, etc but trying to think of just one to make the system more fail proof IYKWIM.

By the sounds of it, it isn't as straight forward as just asking parents for their permission either. Apparently the current consent form took many hours of steering group, red tape, clearance to get through before it could be used. When a problem was identified with said form today, I asked quite simply why we didn't alter it, to be told of the saga to get it authorised in the first place.

PipinJo
Sorry your ds didn't get more SALT.
Your after school club example is exactly the type of thing I mean. What was done well in that group? And not so well? Was it a club just for children with sn? Shame he had to stop going because he was too old. Def room for improvement there.

*BakeliteBelle,
More great ideas. Funny enough, this thread is my first attempt at a focus group!
Makaton, communication, etc ideas are also the kind of suggestions I am looking for. Any other issues/topics that you feel should be covered?

Were there any measures put in place to make this a more practical option for you, such as creche for siblings? soft play area for physically disabled, any thing else to make attending the sessions more than a pipe dream?

Thanks again, really appreciate your input.
HPC

1)I had contact from the SS centre's only after I started using their services. HV did signpost me though (in baby days due to AND) rather than SN related.
In general HVs were as much use as chocolate teapot re:SN issues.

2)In the SN years for a Hanen course (not SALT run, sadly but EP run, bizarrely!) and for a stay and play type course run by a lovely retired teacher.

4)A mixture really - of MS events where parents of kids with SN feel welcome, and of SN only events. mixture of courses/social/information gathering

5)a creche for courses. also some many need transport to the centre, depending on distances involved, nature of their child's needs etc

6)I have recomended the Hanen course on here several times as something worthwhile to do while on SALT wait lists.

7)both. depends very mucho n what the parent feels appropriate.

As a general comment - HV/GP/hospital staff need to proactively promote what SS can do to help families with SN. Also many parents of pre-schoolers will be at pre-diagnosis stage, or there never may be a specfici diagnosis, so they can miss out on support groups, so there needs to be non-DX releated support groups. The only SN suppor group at SS in my time was for DS.

Well our SN Hv is aware of most SN children in the area.
The children's centre staff need to go where the parents are and then give them a reason to come to the centre.
Our local one let's the autism group rent the room an also hire the local sensory room out for parents.
The cc I work at, have no SN services but local groups are invites to use the space.
I'm a fairly confident parent so would happily go along to a group if it wasn't SN.

when I asked I was told there were no specialist SN HVs in my city btw.

agree completely with Lisa, that you need to go to the parents and find out what they want/need.

1)Have you had any contact from the children's centres re the services they provide? If yes, please give details, e.g. what age was your child at the time, had they been diagnosed, and what service was offered? What fromat was the contact? eh, phone call, leaflet, face to face contact etc.
No formal invite, but as a new mum I was given the standard brochure by the HV team for our surestart. The first time we were given anything different was when we wre told we'd have an SN HV, who was clearly suffering from depression, made mocking comments about the hospital we had received treatment at and generally made me even more miserable, she also didn't instigate the things I wanted like portage. I have today (DD is 17 months) had in the post a book of services for children with additional needs in our county, I cried because so many of the groups would have been great early on whereas now we've learnt to just get on into mainstream.

2)Have you ever accessed the children's centres? Again if yes, please give details.
My old one we went to weekly for stay and play, cake, weighing

3)If you haven't used children's centres, why not?

4)What services would you like to see provided in children's centres?
I asked for a monthly ex NICU support group to be set up and hosted at the surestart. They all agreed we could get funding and run it but it never happened.

5)What things could be put in place to enable you to access these services?
DD is able to cope with most things (mild hemi CP)

6)Are there any services you are using/have used that you would recommend?
Our new surestart is in a rough area but they have a fabulous sensory room which we try and use regularly. I also think that unless you tell your surestart that you think something is good and or could they try to provide it they won't.

7)In my mind children with special needs should be facilitated to access sessions open to those without SN e.g stay and play sessions, cooking groups etc, and also targeted sessions for children with SN. What are your thoughts? Would you be interested in using the groups currently running or would you be more interested in specific SN sessions? What kind of sessions would you like to see being run?
I feel piggy in the middle, I get miserable at mainstream when I see happy children with normal sized heads running around, but equally I feel miserable in very specialist SN groups where DD makes the other parents feel miserable and no one talks to me. To have an inclusive group where children have some form of SN, including the whole spectrum would perhaps help relax me. Also to have a greater number of facilitators for the group who know a bit about each child's background and can perhaps link up parents. I do think that ALL sessions should be inclusive, if DD wants to do forest school or cooking I hope some provision would be made to enable that. Also being up front with SN parents and asking what activities their children would enjoy instead of being frightened to upset us etc etc. Oh and facilitating better parent networks.

There was something else too but I'll return when I remember it.

TBH the health visitors have shown no interest in offering help other than filling in form to get nappies from PCT. Didn't attend any groups with dc because I found it too depressing to continually explain about dc's special needs. Later on nearly enrolled ds in a club for ASD in nearby cc but changed my mind after the battery of visits and the list of 'rules' came through. The sessions were very structured and would have put stress on ds to conform. He does this at school and I knew he wouldn't enjoy this at the weekend. It would also be stressful for us. I really would have loved somewhere non judgemental where he could go and be himself. We have since found this in a local SN playscheme but have never found it in local authority run centres at all. When both dc were little there was very little available at all.

I have just glanced at these responses just now, but they are great. Exactly what I need.

I am very aware of the lack of SN knowledge within more mainstream HCP's such as HV's. Which is why I want to explore this issue further. It really felt yesterday, that there was an opportunity to have an impact on the services offered within our local SS centres. I would love for children with SN to be considered, and even targeted within this planning. It may take work and a bit of stubborness...but I'm up for that.

Would love to hear anymore thoughts/experiences/ideas/suggestions....

HCP

Healthcareprofessional I am stunned at the comment in your OP that "this was a hard group to establish contact with".
I thought that childrens centres were actually targeted for being in contact with hard to reach groups eg teenage mums, traveller community, single dads, people where English is not 1st language (in mainly English speaking areas) and people with disabilities - both the child and /or parent. Childrens Centres are not supposed to be for naice middle class families!!!!
Well done to you for actually trying to address something they have obviously missed!
Is there a Parents Forum for families of children with SN in your area (sometimes badged as Parent and Carers Council - but may have different name). Their role is to help improve services for children and families with SN by working with LA's and Healthcare professionals to help them understand what families actually need - rather than what is currently provided.

My old job at the cc was to reach those "hard to reach" families. Each cc should have an idea of the hard to reach families in their area. In ours it was teenager parents, dads and families firmly involved with SS.
Hope you get somewhere.

I think the 'social exclusion' label quite often leaves SN families out. Wasn't the whole reason that SureStart was started by Labour, was as a way of tackling anti-social behaviour through early intervention? Our families often don't come into the category, but are severely socially excluded non-the-less. Doubly so in many ways.

I also think that professionals who know nothing about SN assume that someone else is dealing with them, or that it is very scary, specialised field and something they couldn't possibly manage. Or, as I have heard a few times, disabled children have gold plated packages, 'because they get to go horse riding and stuff'. The fact that many of them can't even successfully access their local school/park/any sort of community life, due to huge and varied barriers, doesn't seem to register

contact a family is quite active in our area and supports the sn parent forum, most families with a child with sn seem to be on their mailing list and they are great at getting local info out to parents about what is going on, really the hv team don't get involved at all.

we've used cc, portage run about 3 or 4 sessions at different cc in a week that's a play and stay type session which have been brilliant in that the staff are either portage or experienced volunteers. Physio run a group that involves soft play and sensory room. There's also another group that is run by cc staff that is primarily for parents, you can take your child with sn or if they're at school a younger sibling or go on your own.

I haven't used the non sn groups, they're way to noisy and busy for dd3 and just the thought of some one innocently leaving a door open is enough to put me off.

facilities I'd find useful would be easy/disabled parking and proper private nappy changing area, you really don't want to be using one of those drop down tables with a 4/5 year old in the middle of a toilet area.

Our sure start runs a special needs group once a week and a lady from portage attends to help out as well. It was called step by step. Fab group different theme every week lots if signing to the kids and help for parents

Staff focus was on children involved with social services/young parents. As a kid with a Mum in her mid-30's he never appeared on any "watch" radar . Lots of trips/pamper sessions etc for low income families - nice but no real point to them. Parenting/child development/baby first aid etc would be more useful.

The children's centre he attended for nursery was great for his special diet but didn't recognise classic hfa behaviors such as lining up toys, hiding from noisy activities, poor eye contact, obsessions. I did keep asking as he has strong family history of AS & I wanted an ed pysch to come and observe.

He fell apart when he started school. MUCH more training in early identfication of SEN is needed.

The issue for me was that ALL chldren's centre services cut off as soon as DS hit school age. Would have been OK but he was a summer birthday so still frmly 4 and ended up unable to cope with school but not allowed access to childrens centres for social groups.

He was supposed to be under the school nurse service but no access as not in school. HV service was no longer available to him.

The result was he was left with NO social provision for 6 months, until a new school was found. To find social opportunities I had to access church playgroups which are independent.

Some children in my area have access to childrens centres until they are 5, some just until they are 4, depending on their birthday. Transistion between "early years" services and school is a critical time and needs proper management for ALL children, not just those involved with social services or teen parents. In my area this is a common "gap" that children fall through.