Early Years in Fife

Early Years Collaborative NewsWelcome to the second edition of the Fife Early Years Collaborative newsletter. This brings together the latest progress made by the Collaborative and aims to keep everyone up to date.

Message from John Wilson, NHS Fife Chief Executive

“Be Bold!”Nothing can be more important than the start we give our young people. Over recent years we have been embedding the principles of Getting it Right for Every Child (GIRFEC) in our day-to-day work across the Fife Partnership. The creation of the Early Years Collaborative allows us to build upon the good working relationships we have and to make further positive changes to children’s services. Using improvement methodology and encouraging small steps of change, we want our staff to be innovative and imaginative in how they approach service delivery. Try something new! If it is done on a small scale to start with and doesn’t work then no harm is done. No one will see that as a failure, rather it is an opportunity to learn and modify.

Introducing: Craig Morris, Early Years Collaborative Project ManagerAlready I’ve seen some great work and tests of change across the Collaborative and feel really privileged to have the task of sharing this work locally and nationally. Learning session four was well attended and gave me an excellent insight into the key change areas and the opportunity to share information and learn from colleagues across Scotland. Our storyboard, highlighting a test of change on Permanence, drew much attention from practitioners across Scotland and showed how lives have been changed through improved ways of working. The Collaborative has developed at a fast pace and I look forward to working with you over the next two years so we can continue the momentum gathered, sharing information and learning alike. Best wishes, Craig.

Fife Early YearsCollaborativeA coalition of Fife community planning partners “working together to give children the best start”.

Key Change AreasMoving into the second year of the Collaborative, there is an opportunity to review intelligence and the evidence that supports our work. This way, we can identify and focus improvement efforts on the key changes across the workstreams that have the greatest potential for impact on children and families.Essentially, the “big ticket” items that can really make a difference:• Early Intervention in Maternity Services• Attachment and Child Development beyond

maternity services• Continuity of care in transition between services• 27-30 month child health review• Developing parents’ skills• Family engagement to support early learning• Income Maximisation

Case Study - Vulnerable in PregnancyThe Vulnerable in Pregnancy project continues to support women who are dependent on substances in Fife throughout their pregnancies and beyond. The team at the VIP service has applied a series of PDSA cycles to implement small changes to their practice and study the associated improvements. Outcomes remain generally positive for this group of women, asmostmakesignificantattemptstomaintainaperiod of stability. This subsequently improves the outcomes for the baby and evidences a commitment to the baby when engaged in child protection processes. Thisisacosteffectiveprojectsincethefinancialsaving of this stability on both NHS Fife and Fife Council is not having to treat an affected baby for several weeks in hospital and it keeps the infant within the parental home. Early intervention by identificationofrisksmaximisesthefuturepotentialof the infant if dealt with appropriately. Just as important however, is that several mothers have madesignificantprogresstowardsmovingawayfrom their previously chaotic lifestyle during and following pregnancy and have achieved stability whilst receiving intensive support.

Plan Do Study Act (PDSA)Outlined are a number of case studies to show how the Plan, Do, Study and Act improvement framework is working practice.

A key objective for the Early Years Collaborative is to improve outcomes for the most vulnerable children across all three workstreams. Workstream 2 has focused particularly on the needs of Looked After children and practice in relation to permanence. Permanence practice involves a whole range of skills such as assessment skills; a good understanding of children’s needs and quality of attachment relationships; children’s emotional wellbeing and developmental needs. Practitioners also need to beconfidentinpresentinginformationintheformof evidence-based reports which will support care planning processes.Work in Fife led by James Ross, Social Worker and supported by Theresa Stephenson, Service Manager, was recently showcased at the Early Years Collaborative Learning Session 4 event in January, and has also been included in a series of articles produced by the Centre for Excellence for Looked After children in Scotland (CELSIS) entitled ‘Snapshots of Permanence - What is happening in Scotland’.James worked on a Test of Change applying the Collaborative methodology, with the aim of improving assessment practice and reducing timescale in the completion of permanence plans. Nationally, it has been recognised for some time that some children experience drift and delay in planning for a secure placement and this has an impact on attachment relationships and positive outcomes. Jameshasspokenaboutbeingmoreconfidentinapplying the Plan Do Study Act model and now has other exciting ideas for a Test of Change.

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Mentoring available at pointof plan being agreed

Case Study - Permanency Planning

“A small scale pilot study of mentoring support for inexperienced social workers as part of a test of change has demonstrated positive results both in terms of shortening timescales and also supporting the skill set andconfidenceofworkersnewtothisareaofpractice.” Lynn Gillies, Early Years Change Officer

“Often it is not possible to improve attendance on our own, but working collaboratively with other agencies produced the best results.”Linda Brown Headteacher - Inverkeithing Nursery

Words of the Headteacher -“Applying the PDSA cycle was formalising the work we do in nursery every day around attendance issues. We have had an attendance policy and procedure in place for several years and staff are familiar with it and are very proactive in following up children who are not attending.”“The steps taken try to promote regular attendance and ensure the best outcomes for children e.g. involving other agencies where appropriate, supporting parents to engage with their child’s nursery experience and monitoring attendance even when it improves to ensure it is being sustained.”

The process involved applying three PDSA cycles over the course of three months, between October and December 2013 in an attempt to improve attendance of one pupil. The biggest improvement in attendance is noticed during the second PDSA cycle when there is liaison with the Health Visitor to identify actions to help the family bring the pupil to nursery. Actions were then taken to support the wider family and working collaboratively with the Health Visitor has given a positive outcome. There is now greater involvement from the wider family and extended sessions are being offered. At the third PDSA cycle the attendance has improved considerably from thefirstPDSAcycleandisbeingsustainedbeyondJanuary 2014. Since restarting the new term in 2014, the pupil’s attendance has been sustained at 100%.

Case Study - Applying the PDSA Cycle to improve attendance at a Fife nursery

Case Study - Early Entrant Parenting programme FairIsle Nursery in Kirkcaldy has been piloting a four session parenting programme for all parents who are allocated an early entry place for their child. The programme has been developed by nursery staff and takes account of recent research into how children develop and learn in the early years. The programmes have followed the PDSA methodology to make small changes at every stage and study the impact. Parents are initially informed of the programme through a home visit prior to their child starting nursery and they are offered a time to suit them after their child has settled in to the nursery routines. The sessions, called ‘Talking Together’ involve informal discussion and information sharing with staff followed by a joint stay and play session.A number of programmes have been delivered in FairIsle with good attendance rates and one has also been delivered at Gallatown Nursery. Through studying the programme evaluation and information from the PDSA cycles, a number of positive impacts from the programme have been recorded. Parents reported:• Increased confidence as weeks progressed• They followed up activities and thought the

song cards were a great idea• Reinforcing everyday routines helpful• Some parents did not know that they should

be speaking to their child until their child could speak to them.

TheEarlyEntrantProgrammeisnowonitsfifthPDSA cycle of testing.

“Have you seen?”

Take Time for a Cuddle or Take Time to PlayFife’s “Take Time” campaign aims to encourage parents to take more time to interact with their children by cuddling, playing, chatting and reading and is part of our Early Years’ work to improve outcomes for children and families in Fife through a focus on prevention and early intervention. We’re seeking to increase take-up of advice, support and facilities as well as encouraging parents to spend more time doing creative, healthy and educational activities with their children. To achieve this, we need to prompt parents to think about the difference they can make every day by making a few minor changes. “Take timeforacuddle”isthefirstinaseriesofvisual messages focussing on the physical and mentalhealthbenefitsofasimplecuddle.Lookout for the bus backs and ads inside buses forming the next phase of the campaign, “Take time to play” The Collaborative is running PDSA cycles alongside the campaign, in an attempt to increase the number of parents who see the different “Take Time” messages and take actions to change what they do as a family.

New branding - a visual identity for Early Years in FifeYou’ll start to notice our new branding being applied across the work associated with Early Years and the Collaborative. The elements within our branding for any Campaign work include the Early Years in Fife logo and our strapline, “Working together to give children the best start”. You’ll see we have applied the Early Years Collaborative colour and graphic to this publication but you can check out the other themes, Play Strategy; Family Support in Fife; 600 hours and Family Nurture approach in the guide, which can be provided by any of the contacts below. ConnieFlint,FifeCouncilCommunicationsOfficerconnie.flint@fife.gov.uk Ruth Lonie, NHS Communications Manager ruth.lonie@nhs.net

Key contacts Susan Manion Fife Early Years Collaborative Champion susan.manion@nhs.net Carrie Lindsay Fife Early Years Collaborative Programme Manager carrie.lindsay@fife.gov.ukCraig Morris Fife Early Years Collaborative Project Manager craig.morris@fife.gov.ukIngrid Hale Improvement Programmes Manager ingridhale@nhs.netCath Cummings Leader Workstream 1 catherine.cummings@nhs.net Lynn Gillies Leader Workstream 2 lynn.gillies@fife.gov.uk ext: 443043Jane Mason Leader Workstream 3 jane.mason@fife.gov.uk ext: 442075

Comments or suggestions? email: katrina.mcfarlane@fife.gov.uk

Working together to give children the best startEarly Years in Fife

WorkstreamsThe Early Years Taskforce has renamed the Workstreams as follows:Workstream 1 - Conception to one year (unchanged)Workstream 2 - One year to 30 months (unchanged)Workstream 3 - 30 months to start of primary school (unchanged)Workstream 4 - Start of primary school to end of P4 (previously WS5)Workstream 5 - Leadership (previously WS4)