A fresh start for Sure Start

The previous government’s flagship programme, Sure Start, is being refocused on hard-to-reach families. Louise Hunt looks at what this may mean for children’s social workers

The Sure Start children’s centre programme was one of the few pet projects of the former government to be spared the axe in this year’s spending cuts, on the proviso that it refocuses from providing universal support to targeting the most vulnerable families. It is a shift that experts say will require closer working with children’s services.

Although it is unclear what impact Labour’s flagship early intervention programme has had on referrals to children’s services, research has shown that the first centres, set up in deprived areas, did identify children who might be at risk.

But up-to-date information is scant and it will fall on Professor Eileen Munro’s review of child protection systems to examine how children’s centres can reach at-risk families more effectively.

Professor Edward Melhuish, who led the Sure Start National Evaluation Team, says the most successful centres are those that are well integrated with children’s services and other partner agencies.

An effective model, he adds, would use Sure Start-based health visitors, who have contact with children from birth and routinely exchange information with social workers. It should also include an element of joint training of Sure Start staff and partner agencies so they get to know each other.

But children’s centres, despite the statutory duty to deliver integrated children’s services, have suffered “considerable variation” and a lack of a clear vision on how this should be done, says Melhuish.

Colin Green, chair of the Association of Directors of Children’s Services, children, community and young people’s committee, agrees. “Whether there is a direct link between Sure Start and social care is variable, and some authorities have managed this more effectively than others,” he says.

He points to a 2007 study which investigated the contribution of the Sure Start local programmes on safeguarding children’s welfare. The study, by Professor Jane Tunstill, a member the national evaluation team, found that the best Sure Start arrangement had embedded social workers. Westminster Council, for example, has followed this path with its children’s centres (see case study), although Green says this model is not widespread. The least effective approach was where children’s centres had developed as parallel but separate entities to children’s services with no close links. “These arrangements are too universal and there appears to be a reluctance and anxiety with being identified with children’s social care,” Green says. “They are concerned with the negative associations to families rather than tackling safeguarding head-on.”

The latest large review of the programme by the then House of Commons’ children, schools and families select committee, published in March, recommended using children’s trusts as “a mechanism for ensuring that all partners take ownership of children’s centres as a core activity of their organisation”. The report suggests this could be done through multi-agency teams set up or linked to children’s centres to reduce the number of families who could slip through the net.

But being able to work with hard-to-reach families remains one of Sure Start’s greatest challenges. Michael Little, co-director of the Dartington Social Research Unit, believes the centres need to go further. “They tend to be more attractive to middle-class parents and are not reaching the most needy kids who can benefit the most,” he says.

Little urges the government to change the emphasis of the centres from that of simple service provision to improving outcomes for children. “There should be screening in children’s centres to find out who can benefit from extra support,” he adds. Sure Start staff should be trained, perhaps by social workers, in the skills to work with vulnerable families, rather than being “too frightened to reach out”.

Questions remain over how the government’s new plans for Sure Start will work in practice. “The whole work of Sure Start is up in the air. Nobody has any clear plans,” says Melhuish, who has concerns over how well informed GPs are about the work of Sure Start, if they are to receive new commissioning powers under the government’s health strategy. “There may be a need for some additional statutory responsibility assigned to GPs regarding the work of children’s centres,” he says.

Green is optimistic that the government’s intentions are in the right direction. “There should be access to Sure Starts in every community, but I agree they should be refocused on the most vulnerable. They need to gear up to be more engaged with the highest-need families by adopting a case work approach and being actively focused on drawing in the most vulnerable families.

“I hope the new strategy will be less prescriptive – there was a lot of focus on opening new centres rather than the difference they can make to people.”

Westminster’s integrated system in action

Westminster Council has a social worker attached to each of its three children’s centres.

Jayne Vertkin, head of locality (north west) and early years lead, says the social workers facilitate referrals to social services, and work with families at a lower level of need by working alongside health visitors in baby clinics, for example.

“They are trying to break down the myths families may have about social workers,” says Vertkin.

The children’s centre’s social workers are part of locality teams of social workers, which have developed over the past year so that there is a robust system for referrals to children’s services.

The council has also introduced monthly meetings at the children’s centres, including the Sure Start social worker, locality social worker, health visitors and outreach workers, to identify families who may be at risk of disengaging with services at a pre-common assessment framework stage. Families can be referred initially to family support panels for an offer of support.

Vertkin says this integrated system allows practitioners to talk to each other, make joint assessments and build a profile of families without having to make an immediate decision on risk.

“We have evidence from case studies that suggests this approach is helping with early intervention,” she says, although she points out it is still too soon to be able to assess whether it is affecting the number of referrals to children’s services.

For more information e-mail Jayne Vertkin

Evolution of Sure Start

1998 Sure Start programme set up to end child poverty and social exclusion by bringing together early education, childcare, health and family support in local centres for families with children under five.

2004 The first Sure Start local programmes opened in deprived communities.

2006 Local authorities given responsibility for delivering Sure Start and ordered to set up a children’s centre in every community.

March 2010 The government reached its target of 3,500 children’s centres.

May 2010 The Conservative-Liberal Democrat coalition pledged to maintain the Sure Start programme despite imminent budget cuts.

July 2010 Children and families minister Sarah Teather confirmed Sure Start would refocus on supporting deprived families, with the budget ring-fenced for one year.

Community Care inform subscribers can access a guide to family support in Sure Start children’s centres. Click here for more information  or contact Kim Poupart on 020 8652 4848

What do you think? Join the debate on CareSpace

Keep up to date with the latest developments in social care Sign up to our daily and weekly emails