Meeting individual needs

Dianne Jones, health visitor, and Brenda Stevenson, parent support worker, describe the support that Sure Start provides.

Tackling inequalities

Sure Start is a government initiative which aims to improve the health, education and emotional development of young children and their families by focusing on the early years.

Sure Start is a multi-disciplinary approach that offers a framework for a co-ordinated holistic service. The ethos behind Sure Start’s principles is to tackle inequalities – it also aims to bring communities together.

Sure Start is able to support families in a different way to mainstream services which often fail to offer a comprehensive service when individuals fall out of the norm. Sure Start enables a reflexive service that can meet individual needs. The additional resources allow innovative practice and enable practitioners to go one step further.

Sure Start supports equal opportunities and we have been happy to support Rachel and her family who were referred by the mainstream family health visitor as she lived within the Sure Start geographical area.

Rachel’s disability meant that she was virtually housebound after the birth of Zoë and this was affecting her health, social and emotional well-being. The property she is living in is not adapted to suit Rachel’s individual needs which means that it is difficult for Rachel and Zoë to physically leave their home without some support, and restricts their opportunities to socialise and use local facilities. This emphasises the restrictive access to services and exacerbates the isolation and stress that people with disabilities often experience.

Rachel’s case highlights the fact that due to limited resources, mainstream services often cannot be flexible enough to meet individual needs. Failing to be flexible may even result in widening inequalities further. It also provided us with a practical insight into the difficulties experienced by people with a disability and the unrealistic expectation that we often have that just because there are services available they can be accessed.

Support provided

After receiving the referral, the first visit was undertaken by the Sure Start health visitor and a community services team member as it was felt that an assessment would be helpful to identify which services Rachel would like to engage with. Since that time Rachel has had contact with the wider Sure Start team, including the lifelong learning outreach worker, the volunteer service, community services and neighbourhood workers. Sure Start also supported Rachel’s application for re-housing and attended a meeting at Rachel’s home with the housing department and occupational therapist.

The service means that Rachel has been able to attend groups with the help of a neighbourhood worker to assist both with transport and to support Rachel within the group. Rachel and Zoë have enjoyed Peepo sessions which are part of a family learning programme run by community childcare workers. These sessions involve activities for developing children’s communication skills and speech, and builds parents’ confidence. Rachel and Zoë have also attended the Messy Rascals toddler group, and Baby Splash activities run by the physiotherapist and, more recently, Rachel has attended a gymnasium induction run by Sure Start at the local leisure centre. The benefits to parents, carers and children attending such groups are well documented. But there are other vicarious benefits, such as the peer support that Rachel both receives and reciprocates and the development of wider support networks as other parents have also offered to help Rachel attend groups.

Dianne Jones, Ellesmere Port Sure Start, Cheshire, UK.

Sure Start: supporting families with a disability

I work as Parent Support Worker in Creevagh Springtown Sure Start Project.

My role is to support families from all backgrounds in a variety of ways – from one-to-one support within the home to encouraging attendance at all the programmes we run such as our parent and toddler group, parenting programmes and outings. I am assisted in this role by another parent support worker and our Sure Start health visitor.

Developmental work with parents and children

In November 2001 I was introduced to a family by our health visitor and was appointed as their support worker.

There are three people in the family: a mother – Sue – who has been registered blind since birth, and her two sons Sam and Ryan. (These are not their real names.) Sam was then aged 2 years 11 months and Ryan was 3 months old. At that time, the family was living in a two-bedroom bungalow with no outdoor play area for the children.

I supported Sue by visiting once a week to help with Sam’s development in areas such as learning colours, shapes and numbers, and reading and playing with him, while observing his development and behaviour.

Early in 2002 Sam was offered a part-time place at a local playgroup which Sue was pleased to accept. With her oldest child at playgroup in the mornings, she found it easier to attend some of the programmes Sure Start was offering such as the parent and toddler group, mobile library and a variety of other activities.

Transport was arranged to enable Sue and Ryan to attend the programmes and be home in time for Sam when he returned from playgroup.

Tackling isolation and lack of support

While the family had solid support from Sue’s family, there was very little contact or support from the boys’ father, and Sue found herself more and more isolated in a house that was unsuitable for her growing family. This isolation and lack of support were adding to her already innumerable responsibilities and having a negative effect on her overall well-being and general ability to cope. In order to address all her issues we decided to prioritise her problems and, with my support, deal with them one at a time. Throughout this process I kept our co-ordinator and health visitor fully aware of our plans and progress.

Sue’s housing problem was causing major stress and the family needed to be re-housed in more suitable accommodation. I contacted our local housing authority and Sue was placed on the register for urgent re-housing. I also contacted local councillors to back her case, which they duly did, and an area nearby was located where suitable new accommodation was being built.

Multi-disciplinary approach … holistic services

At the same time as tackling the housing issue, I encouraged Sue to attend our different programmes regularly, making it easier for her to do so by organising transport. This is provided by a locally registered company which has staff vetted, and willing and able to help out. For any programmes where handouts or information are being used I make sure that all information is available in Braille so that she can always participate fully. Where an outside agency is providing training or courses that she wants to attend, I contact them in advance so that they can be prepared and, again, all information is transcribed into Braille. We have an arrangement with our local prison service to transcribe information into Braille.

Sue and I worked to devise a programme of speech and language therapy for her eldest child who was experiencing some difficulties in that area. As well as working with Sam at home, I also took the programme to his key worker at playgroup and trained her how to deliver the programme. We agreed that it should be carried out daily to help both Sam and Sue. I sought feedback on his progress every month and, within a year, Sam no longer needed the speech and language therapy intervention.

Tailor-made programmes

In July 2002 the family heard that they were being re-housed and received the keys to their new home. It needed some minor alterations to make it safe and secure. These changes were negotiated by liaising with the family’s occupational therapist and the housing association, and the family moved in.

The opening of our respite crèche in our new purpose-built family centre also provides Sue with much needed respite care for two hours, several days a week. Our crèche co-ordinator also negotiated respite care in another day care setting on the other days.

I still visit the family every week. With Sam now at school and Ryan starting playgroup in September, Sue is feeling less and less pressurised – so much so that she is considering volunteering her services to some of our local groups.

Brenda Stevenson, Creevagh Springtown Sure Start, Derry, UK.

Sue comments:

“Sure Start has provided an invaluable service to both myself and my two sons. I have been able to attend courses in the centre, and been supported at home by Brenda and Monica, improving my health and social well-being. My children have been able to mix and socialise with other children and have their progress monitored and fed back to me; they have blossomed and flourished through Sure Start.

“We have benefited from access to a health visitor and parent support worker and all the various programmes that Sure Start provides, more recently the provision of respite crèche facilities within the family centre at Ringfort Road.”

First published in Disability, Pregnancy & Parenthood international, Issue 46, Spring 2004.

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