Thurrock Community Mothers Growing Skills Growing Confidence Growing Communities Thurrock Primary Care Trust Promoting Positive Health and Early Parenting Skills

Mission Statement “We are growing team in the heart of the community enabling parents to help themselves by building confidence, skills and new opportunities” 2 Programme Strands Community Mothers recruited and trained Parents supported

Community Mothers Team Thurrock 2006 Operational base in Community Shop Public Health Practice Development Nurse 7 Programme Development Workers 6 Support Workers 20 volunteers Secretary Evaluation and finance officer

The Model: A Community Development Programme Parents supporting parents By the community and in the community Outreach Builds local skills Mutual learning Addressing health inequalities by transferring skills to the community itself Facilitated but not ‘controlled’ by professionals Advocacy Community networking

Partnership working alongside professionals Complements professionals – doesn’t replace Enables informal easy access to support Non-stigmatising Parents working with other parents as peers and equals Professionals cannot do it on their own!

Outreach & Primary Prevention Developing early parenting skills Promoting health: practical & real life context Nipping early difficulties in the bud Enabling self-help and building confidence Easy access to health and other services Developing literacy and numeracy skills Identifying community views and needs Community participation

Innovative semi-structured monthly home visiting programme to parents with young children Innovative semi-structured monthly home visiting programme to parents with young children Breastfeeding support: community, home & hospital Breastfeeding support: community, home & hospital Health focused literacy & numeracy home tuition for parents with complex needs Health focused literacy & numeracy home tuition for parents with complex needs Active community outreach to homeless & travelling families Active community outreach to homeless & travelling families Parent support & learning groups in the community Parent support & learning groups in the community Services Provided One third of parents supported are single parents

Programme Funding Thurrock Primary Care NHS Trust provides £315,000 mainstream funding per annum

Needs Assessment Targeted outreach to engage with parents who: Are isolated / depressed / low self-esteem May not seek help / vulnerable Are less able to cope Have poor past experience of being parented Are suspicious of professionals “It’s not just about what helpers do it’s also the characteristics of the helper and the relationship developed” Supporting Parents: Messages from Research Professor David Quinton published by the Dept of Health and DfES 2004Jessica Kingsley

Needs Assessment Outreach strategies targeted to geographical communities with highest levels of need (socio- educational / health inequalities / unemployment) Introductory visits offered to all parents, following birth of first baby or moving into area Professional referrals: parents facing difficulties e.g. child behaviour problems, depression Parent empowered to identify own need for service Learning needs assessment for literacy referrals

Parent identifies aspirations / difficulties in context of own daily life Community Mother and parent explore new ideas and solutions together Parent empowered to set own practical and achievable ongoing monthly goals Personalised Needs Assessment Using the Home Visiting Programme Initial needs assessment 6 semi-structured monthly home visits Further needs assessment

Empowerment and Self-help Non-directive approach that enables parents to: Avoid dependency on community mother Identify and reflect on own life Express own views, needs and concerns Recognise own strengths and achievements Value existing skills and build new ones Self-select practical and achievable goals Take small steps and build up to bigger steps Learn from own mistakes and find own solutions Build own social support networks

Sharing of cartoon illustrated information materials during visits is key to success The process of sharing cartoons is crucial: Non threatening Not personalised Triggers & openers for discussion Awareness of literacy issues Tips, suggestions, & reminders Speech Cognitive Child health Nutrition Child behaviour Relationships Breastfeeding Community health Early education General parenting issues

Common issues that parents work on Reducing isolation: support groups, social contacts, child-care and accessing services Coping skills: reducing stress, improving couple relationship, money worries, personal issues Child care skills: sleep, safety, behaviour Healthy eating (whole family) Taking more exercise: walking, swimming General health: dental, immunisations, weight management, cervical screening, relaxing Supporting child’s learning and development

Training & Support Package Responds to both community led and statutory agendas Emphasis on experiential learning / work experience Provides flexible personal development opportunities Community Mother Credentials Able to build trust and keep confidentiality Good communicator, listening skills, sense of humour Caring, likes people, shows empathy & understanding Strengths and insights (overcome difficulties herself) Reliable, responsible, committed to the community Works as an equal: does not ‘look down’ on others Willing to share experiences / work as part of a team

Professional support is vital: Monitoring, supervision, facilitating Taking professional action when needed Clarifying & reinforcing programme boundaries Delivering the accredited training programme Developing partnership projects Encouraging referrals from co-professionals Evaluation and dissemination “Quality and training of staff is vital to programme success, as is good support and supervision” A Review of the International Evidence. Policy Research Bureau for DfES No 578 (2004)

Community Mothers Volunteer to Employment Training and Progression Pathway Community Mother volunteer recruited Introductory training Course for promoting community health and child development. Accredited at levels 1&2 Initial Taster CourseSignposting to other opportunities Introductory training course for breast-feeding support. Accredited at levels 2 & 3 Ongoing training programme (1-2 years): (Generic modules) Experiential learning and work experience Accredited at levels 2 & 3 Literacy & Numeracy Tutor Training & Progression Option NHS Employment Community Mother Support Worker NHS Employment Programme Development Workers (Co-ordinating roles working towards Level 4) NHS Employment Community Mother Health Literacy Tutors

Capacity Building: Sustainable Employment in the Community Employment opportunities within the service: Co-ordinators Trainers Tutors Support workers Employment opportunities outside the service: Community Development Health and social care Education sector Benefits to Community Mothers

A Community Mother Journey: 10 Years Volunteer Breast Feeding Supporter Volunteer Community Mother Learning Support Worker Skilled for Health Project Co-ordinator “The programme has enabled my skills to develop to help me reach higher goals. Doors have opened and I am enjoying going through them. I feel a valuable member of society because I am sharing my skills with my community and watching parents grow and the community going from strength to strength”

Benefits to Parents and Children Improves: Child immunisations Breastfeeding rates Family nutrition Stimulation of children Maternal positive feelings Language development Child safety Health literacy Access to services Reduces: Isolation and depression Child behaviour difficulties

A Single Parent Journey “I have become more confident as an individual. My community mother has arranged visits from the women’s refuge and counselling from MIND has benefited me a lot. I have become more aware of healthy eating and what foods are right for children. I have enrolled on a hairdressing course and I am looking forward to going on this course and maybe making some new friends. I took my son to the doctors and he has referred us for family counselling. This is a very positive step towards helping my son. I have made contact with the single parent support group and have tried to make new friends. I feel my life is on the right path at the moment and I feel really happy.”