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Chapter 2: Range and Use of Sure Start Scotland Services

'We do not operate a number of places type of service but there has been an increase in the number of families receiving a service. We have not adopted an attitude of "never mind the quality, feel the width". We respond flexibly to families in need, providing a higher level of service to the families in greatest need'. (Sure Start Contact Officer)

Introduction

Questionnaires comprising quantitative templates were sent to all local authorities. These were then distributed to individual services for completion. A brief description was requested about the service and service providers were asked to specify the main service type and the level of intensity. More detailed information was also quantified on the types of support provided within the service. Data were also obtained on the ages of children supported, the number of places provided, numbers of integrated packages of care and numbers of children or parents waiting for the service. Information was also requested on the funding sources used, the agencies of the core staff, when the service was set up and which Sure Start objectives were being met.

We obtained responses from 27 of the 32 local authorities. A total of 246 services completed templates and these were entered onto an Excel database for analysis ². This total number of services and other data from this exercise therefore underreport activity across Scotland. It should be recognised that completion of these templates was time consuming for many local authorities and service providers; data were not always readily available and despite trying to develop a questionnaire that reflected diversity, it was still at times difficult for a service to 'fit into' the suggested categories. Such diversity is perceived by many as a strength of Sure Start Scotland, enabling innovative practice to develop to meet local needs. A few local authorities had reporting mechanisms that enabled them quickly to ascertain numbers of children and families supported, but for the majority this was more difficult, even though all had some method of reporting and feedback within their planning and delivery structures. This exercise also demanded quite detailed information at service delivery level, often requiring local authorities to consult widely in order to complete their returns to the research team.

This chapter presents the combined results of the quantitative mapping exercise, linking as appropriate with the qualitative data obtained from 31 interviews with Sure Start Contact Officers and 30 qualitative questionnaires completed by them ( see Chapter 3 for further details). Firstly, information on number of places is presented. Secondly, the ages of children supported is reported. Thirdly, information on service type and intensity is presented, with illustrations of different types of service selected from different local authorities. Fourthly, the sources of funding, date services were set up are provided. This is followed by a discussion of meeting Sure Start Scotland objectives.

Use of Sure Start Scotland Services

As the figures discussed below indicate (see Chart 1), there has been a year on year increase in number of places for children 0-3 and their parents from years 2001/02 to 2003/04. These figures also demonstrate an increase on the baseline figures obtained in the 2001 mapping exercise for the years 1999/00 and 2000/2001.

The method for measuring total numbers of children and parents supported has changed since the earlier mapping exercise, with the current mapping focussing on number of places with a straightforward assumption that, for every part time place, one child is supported. Although we are not therefore comparing like with like, a broad indication of year on year increase can be assumed by taking the numbers of children supported from the earlier exercise and comparing this to the number of places reported in this exercise. In 1999/00, 3,387, and in 2000/01, 6,556 children were supported. The number of parents supported was 3,100 and 6,381, although because of the method of counting, a family supported would have been counted as a parent and a child supported, something that did not occur in the current exercise.

Chart 1: Number of Sure Start Places 2001-2004

While the majority of families with young children are supported through day care provision (a very few local authorities had no or little day care provided through Sure Start Scotland), this mapping exercise also shows that parent places for services aimed directly at them have developed considerably, and that children are also supported through other types of provision not categorised as day care. As the details provided in this and subsequent chapters show, the variety of services provided reflects a commitment to meeting the diverse needs of families with very young children in a flexible and integrated way, supporting parents and young children in their communities.

The total number of children reported to be on a waiting list was 1,626 and the total number of parents was 301. It should be noted that many services do not operate a waiting list, while at the same time operating at capacity. The aim of meeting the needs of very young children and their families means that local authorities tried wherever possible to do so at the time of referral; most said that there were considerable levels of unmet need and that services could expand further. Most local authorities said that they did have the capacity to respond in emergency or crisis situations.

As this report goes on to show, all local authorities have moved in the direction of integrated service planning and delivery for early years. This was seen as an essential part of the Sure Start ethos, now embedded in structures, processes and practices. However, at this stage, it was difficult to obtain robust, quantitative data on the number of children receiving integrated packages of care, 'where a co-ordinated approach built around the needs of children and families has led to parents and children receiving more than one service'. However, this does not mean that families were only receiving support from one service. Integrated care seemed to be happening with families accessing more than one service, often at the same time as well as over time. Parents and children might be supported through different services concurrently (for example parent training with crèche provision) or different services on different days.

One of the perceived strengths of Sure Start Scotland was that service use was voluntary (not statutory) and that providers and families worked together to meet needs that may change rapidly. While this was sometimes co-ordinated as an integrated package of care, and could be documented as such, integration was also achieved in a more flexible and ad hoc way across most local authorities. In the qualitative data, families with young children were reported as accessing a range of services to meet their needs and promote development. Therefore, although many services were unable to provide numerical information on actual numbers of integrated packages of care, the qualitative data suggest that many families were accessing integrated support.

A total of seven local authorities provided numerical information on the quantitative templates for their services. In the year 2003/04, 5,075 children were reported as receiving integrated packages of care; however, a considerable proportion of this number was taken up by West Dunbartonshire who were able to specify clearly the number of children receiving integrated packages of care as 2,123. The qualitative information reported in subsequent chapters suggests that integrated care and joint working is developing well in most areas, as the following example suggests:

'The area admissions panel is a good opportunity to create packages of care for children and families. Many families are experiencing a package of Sure Start, Better Neighbourhood Services, Young Families Support Services funded by Changing Children's Services and Statutory Services, e.g. social work, health , education'.

In the Scottish Budget 2003-06, a target was announced to ensure that at least 15,000 vulnerable children under five have an integrated package of health, care and education support which meets their needs by 2006. The figure of 5,075, for 0-3's, for 2003/04, across just seven local authorities, indicates that the Scottish Executive will be able to achieve their target through Sure Start funded services, especially when the qualitative evidence suggesting a high level of integration in the provision of a range of supports for families with very young children is also taken into account.

There has continued to be a steady year on year increase in numbers of places for children and parents. In 2001/02 there were a total of 12,840 places (comprising 4,277 for parents, 8,563 for children (7,223 for day care, 1,340 for other services)). In 2002/03 there were a total of 18,429 places for children and parents (comprising 6,016 for parents, 12,413 for children (10,701 for day care and 1,712 for other services)). In 2003/04 there were a total of 25,060 places for children and parents (comprising 9,660 for parents, 15,400 for children (13,138 for day care and 2,262 for other services)). Such rapid year on year increase for parents and children provides a quantitative indication of the development of Sure Start Scotland within local authorities. As this chapter goes on to show, this is often in conjunction with other funding streams, suggesting an integrated approach and an embedding of Sure Start within Early Years' services across the country.

Ages of children supported

Sure Start Scotland aims to provide support for families with young children aged 0-3. This mapping exercise asked specifically about support provided across the age range, including pre-natally in order to identify if the whole age range was being covered by Sure Start Scotland. Although a smaller number of services were catering for pre-birth, it is clear that intervention at this stage is valued highly in practice. As the examples below and later in the report confirm, such early intervention often involves innovative ways of working with partners from health. Although the quantitative templates did not ask about services beyond 3 years, the qualitative data suggest that many services did not operate with a clear cut off point. One of the future challenges is to promote smooth transitions to pre-school and school and integration of children's services across a wider age range.

Chart 2: Age range of children supported

While services seemed fairly evenly spread across the 0-3 age range (see chart above), it is interesting to note that some now provided for pre-birth demonstrating that Sure Start Scotland is developing to embrace this stage. These services would be for parents and parents-to-be, and can be considered to form an important arm of early intervention and prevention strategies. Many services supported children across more than one age band and responses reflect this; the age categories are not mutually exclusive. The following example shows how a range of ages can be catered for:

East Renfrewshire

Barrhead Family Centre and McCready Centre: these centres are managed by one head of establishment but are two separate campuses. The McCready Centre has 12 places for babies and 20 for children aged 2-3 years. Barrhead Family Centre is an 80/80 nursery for 3 and 4 year olds. The Centre has a Sure Start social worker who runs positive parenting classes and mellow parenting sessions. The Centres also offer opportunities for parents to learn, e.g. through storytelling sessions. The provision of a mobile crèche allows parents to participate in health cooking classes, eating on a tight budget, etc. The community ethos established in the Centre is enhanced by speech and language therapists, play therapy sessions, support from dieticians, etc.

The following example from Scottish Borders provides a good illustration of early intervention and its impact. Early identification of vulnerability and early involvement of a Sure Start midwife leads to intervention during pregnancy. This is then integrated with post natal outreach support. In subsequent chapters, further examples of Sure Start services will be provided which illustrate the importance of early intervention but also of working across the full age range, including beyond 3 years.

Sure Start Midwife and 0-3 Intensive Outreach Workers - Scottish Borders

This service provides pre and post birth support to families that have been identified as vulnerable. This includes young parents and those with mental health, drug misuse or learning disability issues. The Sure Start midwife receives referrals from GPs and Community Midwives regarding vulnerable parents and where possible support/teaching is also provided pre birth. The midwife prepares the hospital midwives for the admission and has developed recording tools and training for NHS staff. Where there are concerns about parents' ability to look after a child on return home from hospital, the 0-3 outreach staff offer a package of home visiting support to families. This can be two visits per day seven days a week if required. This service is giving children and their families the best possible start in life. Fewer children are being received into care from birth and families are being given the opportunity to remain together during the teaching/assessment period.

As the qualitative data presented later shows, although Sure Start services focus on the 0-3 age range, some services do not operate a strict cut-off point at age 3, for example if the family still needed Sure Start support beyond age 3 or if older siblings were involved. Indeed, flexibility was considered by many to be important and some Sure Start Contact Officers specifically mentioned the need to provide a seamless service up to Primary 1 and indeed beyond, for example:

'Unfortunately where increased expectation from parents continues, the demand for the range of services offered via Sure Start continues to outweigh supply….Additionally, when the child begins primary school, the family can often feel no longer fully supported and the progress made can falter due to support structure no longer being available to family'.

Types of services provided

The following three charts demonstrate the range of Sure Start Scotland services provided. Services were categorised as intensive (with a high staff ratio of 1:1 or 1:2); group (a lower staff ratio) or resource (little or no interactive back-up). The questionnaire did not ask for the main type of provision, so services could be providing more than one level of intensity and families could also be supported by services that varied in intensity. This recognises the integrated and flexible nature of many Sure Start services. The first chart below demonstrates that the main form of support provided through Sure Start Scotland services is through group support, with 166 services for which we have data providing group support. 126 services provided intensive support and 43 provided resource support.

Chart 3: Intensity of Services Provided

The following three examples, drawn from the qualitative questionnaires completed by Sure Start Contact Officers, illustrate each of these levels of intensity.

Intensive provision:

Aberdeenshire - Capability Scotland Supporting Families at Home

This now has one full-time and three part-time workers. The purpose is to assist parents with behaviour management of very young children. This is through self-referral or by referral from health visitor or another professional. It meets the Sure Start Scotland objectives in the sense it's helping people help themselves. It's also really helping children and their carers to be in a position, when they start school, to really benefit. So it's therefore targeted at children who would have difficulties at school. I believe it has an enormously positive impact. We are supporting two sorts of children. First of all there are the children you would consider to have a disability and very often the parents, even though they are excellent parents, they haven't got any experience of dealing with this, so it's a very good way, even at a very early stage, of helping the parent to learn how to properly manage their child's behaviour. The other sort of child is the child whose parents probably find parenting itself quite difficult. We're able to go in there and identify and think maybe whether more thorough assessments are needed either by an educational psychologist or through the health service……but also to give very very practical help and assistance but not because there are particular issues within the child themselves but the parents have difficulties, so we really try to help them out, hopefully in a very unthreatening way, it's a bit like a good neighbour scheme, our workers are very very skilled……So very one-on-one piece of work, often short-term, for example, six sessions.

Group Provision:

East Dunbartonshire - Supporting Training and Recreation (S.T.A.R)

This provides quality childcare (crèche provision) within a local community centre. Families can access the crèche service (no costs incurred by family) enabling access or attendance at a variety of services within the same building e.g. first aid training, exercise class, healthy cooking, drop-in etc. The S.T.A.R. committee organise a number of courses for families themselves which have included assertiveness, the importance of play etc. This service covers all of the Sure Start objectives both for parents/carers and for young children accessing the crèche. The crèche is staffed by local people some of whom are fully qualified and others who are attending training thereby working towards a qualification.

Resource-based provision:

Highland - Play@home

This programme aims to encourage children's development and family bonds. Three books (Baby, Toddler and Pre-School) suggest ideas for games that involve physical exercise and language acquisition. The Baby book (0-12 months) has gone out to approximately 5,000 babies since the programme began on 1 August 2002. It is delivered by the health visitor, usually around their first visit. The Toddler book (1-3 years) is posted directly to families within approximately 6 weeks of the child's first birthday. The Pre-School book (3-5 years) will start going to families from August 2005, as children begin their pre-school education sessions. This is a universal programme, with extra resources aimed at ensuring vulnerable families are enabled to access the ideas. Family support organisations have received supplies of the books and encouragement to demonstrate/model the games with families. Practical games sessions have been delivered in communities with vulnerable families.

The templates for each service asked about the main category (not intensity) of provision, with the categories ranging from centre-based provision, playgroups, parent and baby groups through to resource-based provision. As noted above, services, especially centre-based provision, are likely to offer services across different ranges of intensity and incorporate a range of services for children and parents. The chart below identifies centre-based provision as the most common form of provision, with 71 (25%) of services being of this kind. However, outreach work was identified as the main service type for a further 59 (20%) of services and 30 (7%) services reported that crèche facilities were their main service type.

Chart 4: Main service type

The following examples provide illustrations of outreach, crèche and centre-based provision.

Outreach provision

In East Lothian, the Family Outreach Service provided by Children 1 ^st works intensively with families of young children where there has been identified a serious level of unmet need and risk in respect of the children. The service provides support for both parents and children relying on both individual and group work. They provide ongoing risk assessment and management to ensure the safety of the children they liaise with and access other mainstream services as appropriate from within health and education. They provide reports for such central decision making forums as the Children's Hearing System, Looked After Reviews, Fostering and Adoption Panel. The impact includes increased safety for the children, improved quality of life and attention to their basic needs, better quality of parenting, greater access to and support by mainstream services within health and education.

Crèche provision

West Dunbartonshire has mobile crèche facilities for all areas of the Local authority. Qualified staff, supplemented by trained sessional staff, provide crèche facilities of high quality, continuity and consistency and linking with other services as appropriate. Provides opportunities for parents to attend self help groups or clinics/treatment to improve their health and ultimately children's well-being. Children have opportunities to develop their social, emotional and personal skills to promote self esteem and enhance their ability to learn.

Centre-based provision

In North Ayrshire, the Garnock Valley Early Years Centre opened in 2002. This centre offers positive learning experiences for children and adults. Children aged 0-3 years are referred to the Area Admission Panel. A support package is put in place which may include:

• Planned play sessions for the child
• Planned support sessions for the child and parent/carer in the centre
• Outreach support for the family
• Group support for the parent/carer
• Opportunity to attend adult learning groups
• Attendance at Fit Ayrshire Babies ( FAB) Parents and toddler group

The evaluation of this project based on a period in 2003 has clearly shown the impact that this centre has had on families with young children in the Garnock Valley.

As the above example of centre-based provision suggests, Centres provide a range of services to meet the needs of families and very young children in flexible ways. In many local authorities, centres provide the main focus of provision, offering a mix of services, as the following information from Glasgow City illustrates:

'Since 2001 we have continued to expand our number of Family Learning Centres, the vehicle which facilitates the delivery of the Sure Start objectives across Glasgow: these are innovative models with flexible methods of delivery, which will meet the needs of the local population. These centres offer families a range of support including individual access to advice on a range of issues including: future employment; counselling; drug awareness as well as group based support or training. These services are offered through the joint working of education, health and social work Services, this work is further enhanced by the development and expansion of a more cohesive service for parents and children'.

Services were also asked to provide further details of the range of support provided, specifying all that applied rather than just the main service as reported above. Focussing on centre-based provision in more detail, the data received demonstrate the wide range of provision offered within centres (these have slightly different names in different local authorities, for example, early years centres). This suggests services support the varying needs of families with young children, offering services for parents, such as learning support to parents and services for children, such as nurseries. Other provision supports parents and young children, such as play groups and parent and child groups.

The chart below, using data from the quantitative service templates, provides information on the range of services provided within the 71 centre-based provisions across local authorities. A total of 476 different services were reported, across twelve different types of provision, ranging in intensity. These would be in different combinations in different centres. This suggests considerable integrated and multi-disciplinary service delivery and supports for parents and children that can be flexible and variable to meet changing needs.

Chart 5: Range of services within centre-based provision

Sure Start Scotland objectives

The quantitative service templates asked for information on which Sure Start objectives were being met by each service. This provides a broad indication that services are being planned and delivered in accord with the four Sure Start Scotland objectives:

• To improve children's social and emotional development
• To improve children's health
• To improve children's ability to learn
• To strengthen families and communities

All four objectives are reported as being met across the 246 services for which data are available, with many services meeting all four objectives. As the chart below indicated, 228 (93%) services reported that they were improving children's social and emotional development; 198 (80%) improving children's health; 215 (91%) children's ability to learn; and 225 (91%) reported that they were strengthening families and communities. The 2001 mapping exercise noted that joint working with health still required further development and it is therefore not surprising that the health related objective lags a little behind the others. However, as this report goes on to demonstrate, despite some continuing concerns about involving the health sector, much innovative practice and new posts involved the interface with health (such as the Sure Start midwife post highlighted in the earlier example from Scottish Borders). It may be that services were less likely to claim they were meeting this objective if there was not a direct health input or outcome; however, many services are likely to be contributing to overall well-being.

Chart 6: Meeting Sure Start Scotland's Objectives

Further qualitative information was gathered through the questionnaire to and interviews with Sure Start Contact Officers as well as key planners. Sure Start Contact Officers reported that all four objectives are being met by the majority of services in the majority of local authorities, and some provided detailed as opposed to broad brush evidence of how services were meeting specific objectives. Of course, one service may not meet all of the four objectives, and local authorities were also invited to identify gaps in provision. However, it was clear that the objectives were operationalised through thoughtful service planning and delivery. This required integrated and joint planning, developing new skills within the workforce and joint working, issues that will be discussed later in the report. The following service example shows how all four objectives can be met within one service offering a range of support:

Midlothian

Hand-in-Hand project: this service is part of the wider Midlothian Sure Start project, providing support to families with young children in an area of deprivation.

It provides:

• Parent support groups
• Parent/child activity sessions
• Parenting skills groups
• Counselling
• Complementary therapy groups
• Healthy eating group/milk token initiative input
• Information sessions e.g. financial advice
• Dental health input

It meets all four of the objectives by ensuring the emotional and social needs of parents are met which will impact on the parent-child interaction. Children have the opportunity to socialise and learn through play. The service links parents to local community activities and helps some with the transition to work or training.

The following examples show how Sure Start Scotland objectives were described as being met in three Local authority Sure Start Contact Officer questionnaire responses to the request to: 'Briefly describe whether and, if so, in what way(s) you think these services, as a whole, are meeting Sure Start Scotland objectives'.

Services as a whole are meeting the Sure Start Scotland objectives. By developing parents' self esteem and abilities to parent, services are supporting adults to be able to provide care and nurture for their children thus improving children's social and emotional development. By working closely with health and the voluntary sectors we are making significant improvements in the health of young children through, for example, parenting initiatives/parentcraft/guidance and support on breastfeeding, nutrition, smoking reduction, hygiene and safety in and out of the home and direct outreach support. Through supporting parents about child development/nurture/play/self esteem we are improving children's ability to learn and be nurtured to develop and learn. We know that research tells us that if areas within the brain are not stimulated at an early age then those connections vital to a child's development will not occur. By working with a range of partners we are strengthening families and communities.

They (services) are certainly designed with the objectives in mind, with attention paid to the Guidance (and to 'Growing Support' which we found very useful) when choosing methods. These general principles run through all our Sure Start initiatives - bringing services closer to the children and parents who require them, making services easier to use, access to specialist services through universal provision, joining services in the interests of the users, identifying gaps in service and ways of meeting them, improving parent-child relationships, improving parent confidence and capacity for parenting, intervening as early as possible in the life of the child and the life of any problem, creating opportunities for children to develop and learn, involving parents consciously in the development of their children, linking parents into their community and other informal structures that can assist them. Partnership between agencies and services in funding as well as in designing and delivering in new ways. We are looking at evaluation to establish whether we are meeting the objectives - some of the methods we use, such as Mellow Parenting, have inbuilt measures of change. Feedback from parent/carers is built into all the services where they are the users, but this doesn't really give us impact on children. We are hoping that tracking and in some cases perhaps observations can give us some harder data.

The following example suggests that the objectives as a whole underlie service development.

All four objectives are being met across the range of projects on offer, for example, group support sessions for vulnerable parents are addressing all four objectives while some of the more specific targeted projects at face value focus on the health agenda e.g. healthy eating, oral health and breastfeeding support. However, we very much see all four objectives as being so inter-connected that it is probably appropriate to say that all of the developments meet all four objectives.

Taking each of the four objectives in turn, the sections below provide illustrative detail of the different ways in which local authorities' Sure Start Scotland services meet these objectives. As noted above, all local authorities were working with and towards these core objectives; the examples below are selective not exhaustive. Details from one of the Case Study areas are also highlighted, as these clearly show how the four different objectives are being met through different services.

Improving children's social and emotional development

This objective is the overriding focus of much of the provision under Sure Start Scotland and much provision is aimed at supporting children's social and emotional development, either directly through day care, crèches, nurseries, play groups, parent and baby/toddler groups, other play initiatives as well as supporting parents in their parenting. For example, in Angus, in addition to work with parents which impacts on children, the nursery/crèche provision that the Family Support Teams provide or commission is of high quality:

'with the staff paying attention to the children's needs and development. This acts in a "compensatory" way with the children, can make up for deficits that may have occurred. In addition, by "topping and tailing" the sessions with the children by contact with the parents when they drop them off and pick them up, there is an opportunity to "model" good practice in adult/child interaction'.

West Lothian Case Study

Locally provided activity based parent support groups facilitate children's cognitive, physical and social development and promote positive parent-child interaction through structured activity groups and are run throughout West Lothian, by Sure Start Team, Knightsridge under 3s and Whitdale Early Years Centre, but targeted particularly at areas where a need is identified. High attendance at these groups indicates parental satisfaction. Parents are involved in evaluation and future planning, and involvement of other professionals is encouraged.

Improving children's health

This mapping exercise reported greater involvement of health colleagues in the planning and delivery of Sure Start services, although as will be examined later, this is still an area where further improvements were desired. Although it is interesting to note that slightly fewer services identified this objective than the others, nonetheless, considerable activity across the local authorities was mapped. For example, East Renfrewshire reported that one of their family centres is working to achieve a health promotion status by improving children's diet and children and parents health. Health visitors in Inverclyde attend Sure Start nurseries, promoting healthy eating and there was a focus on outdoor play and physical exercise opportunities for a child's physical development. In North, South and East Ayrshire 'Fit Ayrshire Babies' ( FAB) provides an exercise programme for babies, focusing on early intervention by promoting exercise and getting into the habit of being active at an early age. This initiative was identified at the COSLA excellence awards. Glasgow City are working with Greater Glasgow Health Board to develop a programme of interagency training in working with parents and the introduction of a 'Fit Baby' programme; Glasgow City, jointly with the health board and education, also delivers the 'Fresh Fruit and Toothbrush' initiatives to children across all Family Learning Centres.

West Lothian Case Study

Groups also focus on children's health through the participation intermittently at these groups of a range of health practitioners to promote healthy life styles, nutritional advice, oral health, accident prevention, psychological input ( i.e. they provide a gateway of core services to which other resources can be added). The groups provide fresh fruit and water for children and incorporate physical activity both within the centres and in the community. In one target area, indicators of progress are seen in the uptake of health visiting services, increased uptake of dental health services, increased demand for physical activity groups and demands for locally available fresh fruit and vegetables leading to the creation of a food co-op.

Improve children's ability to learn

Local authorities are providing a range of services which focus on learning by working directly with the child, the parent or both together. Bookstart or similar resource-based schemes are common, with 43 services reporting that they provide some form of resource-based provision. In Orkney, Bookstart bags are distributed by the health visitors at Baby Health checks: health visitors advise that they have over 90% take-up rate at these health checks so this means over 90% of babies in Orkney are receiving their Bookstart bags. In Shetland, Bookstart and Bookstart Plus are both provided as enhanced resource-based services. Here, the 'Treasure Box' for 3-4 year olds offers the opportunity of a coherent and progressive development of an already existing programme. The pack includes books and drawing materials, as well as information for parents on the benefits of reading together and joining the library. One Sure Start Contact Officer suggested that they see parents as the child's first educator. This suggests that any service that promotes confidence and skills for parents will also support children's ability to learn.

West Lothian Case Study

Locality groups provide activities which enhance development. Some have specific sessions related to storytelling, structured programmes such as PEEP and play-along-maths. Support to schoolgirl mums project enables girls to continue at school after giving birth. High quality care is provided by childminders and a key worker ensures all aspects of care are addressed. The Kickstart project provides books, storytelling sessions, library information and general activities aimed at encouraging children's use of books.

Strengthening families and communities

Strengthening families is of course fundamental to Sure Start Scotland, as ensuring a good start in life will support families, parents and children. By trying to identify vulnerability at an early stage, Sure Start Services often keep families together and a number of Sure Start Contact Officers suggested that such preventive work obviates the need for statutory intervention. The intensive work outlined earlier in this chapter provides this support to strengthen families. Many services are community based and provide a non-stigmatised point of contact to help families access mainstream provision:

'I think Sure Start is reaching families who would not engage with mainstream services without support. Community based resources offer a non-stigmatised point of contact which supports families to access mainstream services which they would not necessarily do on their own'.

Communities are strengthened through local developments, involving parents in service planning and delivery, the use of volunteers, movement into training and through developing connections between parents. In Aberdeenshire, area community support networks and Early Years' Forums have a budget of about £5,000:

'and then they spend it locally and it's a joint decision making between all the Early Years' workers in the area along with parents and that works very well'.

Parent and toddler groups and other parents groups provide a forum for parents to interact with peers from similar backgrounds or in a similar position and increase their social contact, social network and reduce isolation.

West Lothian Case Study

Locality groups provide socialisation opportunities for parents and children and the provision of a range of support groups provided by the Sure Start Team (…) and Barnardos (…) enable parents to develop their ability to parent more effectively. Provision of services for men by men has encouraged more men to play an active role in their children's upbringing and increased their ability to do so. Numbers of men engaging continues to rise and services widened to include antenatal young dads' groups. Individual support targeted at families who are experiencing difficulties is provided by Sure Start family support workers (…), Home-Start, Barnardos and through the provision of childminders, in conjunction with SCMA. Locality groups encourage communities to identify their issues and act upon them. For example, (… ) Sure Start Group promoted community involvement in setting up a food co-op and healthy lifestyle initiatives, all activities which are valuable in themselves but which have also contributed to creating a more cohesive and united community.

Summary and conclusion

This quantitative component of the mapping exercise obtained data on services from 27 local authorities. Completing the templates was an onerous task. With the development of Sure Start, there has been a growth in the number of services in each local authority. Usually the templates were sent on to individual service providers within each local authority for completion as the information was seldom centrally available. Those local authorities unable to provide the data reported that they were too busy, including undertaking their own mapping exercise or undergoing restructuring.

The excel database set up to record the data obtained across the three years from 2001/02 to 2003/04 can be updated as additional data are received. While the research instruments developed for this exercise built on the range of services reported in the first mapping exercise and to meet the specific needs for information of the Scottish Executive Education Department, it should be noted that it remains difficult to capture, in a quantitative way, the range and flexibility of service provision, even more so as services become integrated and Sure Start Scotland services are embedded within wider early years' services and planning. This mapping exercise tried to overcome this by specifying exactly what a Sure Start service was and to categorise each service as its main service type but also documenting additional types of provision. This enabled the mapping exercise to being to capture the range of provision both within and across service types. The mix of quantitative and qualitative data also helps to capture both the breadth necessary for mapping provision and the depth required to understand service planning, development and impact.

Although there are reservations about the completeness of the data obtained, the information provided will be an underestimate of Sure Start Scotland services across Scotland. The templates received were completed well and provide a broad picture of the range of provision. More robust data could only be obtained if all local authorities collected and collated monitoring data in a similar way within frameworks agreed in advance. Nonetheless, the picture of Sure Start Scotland that this component of the mapping exercise has provided demonstrates that:

• There has been a substantial year on year increase in the number of places provided across a diverse range of services for children 0-3
• There is evidence of very early intervention through pre-birth provision
• Parent places have also increased year on year
• Integrated packages of care and integrated provision are becoming well established
• Services reported meeting the full range of Sure Start Scotland objectives and these seem to drive planning and delivery of services
• Fewer services reported meeting the health related objective compared to the other three objectives, although this still comprises a large majority (80%)
• Centre-based provision remains the most common service type with delivery of a range of services often in an integrated and multi-disciplinary way
• Outreach work is the second most common main service type
• A range of intensive, group and resource-based provision is now well established

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