Northampton Sure Start Evaluation of the Home Safety Equipment Scheme

The Home Safety Equipment Scheme (HSE) Provides and fits free home safety equipment to registered Sure Start users – includes stairgate, fireguard, smoke alarm etc Service provided in partnership with: Workbridge – Learning Disability centre – who make up the packs The Probation Service: delivery and fitting carried out by supervised offenders serving community sentences

Objectives of the service Reduction in immediate and longer term harm to children caused by domestic accidents To achieve cultural change and increase safety awareness in the community To provide an incentive to register for Sure Start To improve partnership working with other services and agencies A reduction in costs to health, education and social care services

Approach to evaluation Part of the overall evaluation of Sure Start – prioritised by stakeholders Followed NESS principles for cost benefit analysis: Total resources committed Benefits for service users (costed if possible) Could the resources be better used elsewhere? Viewed as a system – inputs, processes, outputs and outcomes

Methodology – information sources Management and cost information from HSE scheme records Postal survey and telephone interviews with service users Interviews with agency staff and other stakeholders – including health visitors, probation staff and medical consultants Focus group sessions with parent evaluators Research carried out at Stoke Mandeville Hospital (Burns Unit)

Inputs Total budget for year (set up and running costs) £13,956 which covered: 251 packs delivered at time of research Unit cost - £38 per pack (280 packs) Administration including set up costs - £7.70 per pack Assembly and packing - £1.00 per pack Delivery and fitting – no cost to Sure Start Total: £46.70 per pack

Processes Administration and quality assurance provided by Sure Start All families registering with Sure Start are offered packs Packs put together by learning disabled adults Packs delivered and fitted by offenders on community sentences

Outputs At time of research 251 Packs delivered Percentage of eligible families taking up service - 251/750 = 33% 45 packs fitted by probation service (18%)

Outcomes / service quality Postal and telephone survey - user satisfaction with delivery process (41% response) 100% satisfied with the delivery process, including the standard of the work and the behaviour of the worker 61% said the place had been left clean and tidy

Outcomes / impact Reduction in domestic accidents Burns and scalds lower in Sure Start area than comparator area Falls in the home lower in the Sure Start area Reduced to zero admissions in year 3 Survey shows raising of safety awareness in local families Benefits in positive interagency working

Relevant research Stoke Mandeville Hospital research – 55 children admitted over 3 month period 60% male, 40% female 58% aged 0-3 95% injuries in own home – mostly in kitchen East Midlands (Towner et al 2004) Injury main cause of death in childhood – high in EM Injury is a major cause of ill health and disability Social class gradient for deaths from injury is steeper than any other cause

Costs of domestic injuries Costs of treatment includes A and E, Ambulance Extra contractual services Transport Long term medical care Costs of missing or provision of specialist education Cost of social care support Total costs of injuries in the home estimated nationally at £25 billion pa Hospital costs alone can be in excess of £50,000 per admission for falls, £15,000 for burns and scalds

Quality issues Parent evaluator focus group – issues raised Recycling the equipment when no longer needed Concern /lack of knowledge about the offenders fitting the packs – later addressed by meetings with the probation service and offenders Agreed that the scheme has raised safety awareness Suggestions about additional equipment – eg cooker guards, ways of fitting stairgates Suggestions about improving the promotion of the service – identity cards for fitters Views from professionals Health visitors strongly supported scheme and would like to extend to non Sure Start areas Burns consultant, Stoke Mandeville – very supportive of scheme Probation service – “brilliant” scheme which meets national criteria

Impact on Sure Start Objectives Sure Start national objective Is the project likely to have an impact? Improving social and emotional development: in particular by supporting bonding between parents and children … Yes: the project raises issues of safety awareness necessary to protect children. It also provides an incentive to access Sure Start services Improving health: in particular by supporting parents in caring for their children to promote health development before and after birth Yes: direct impact on health care and attitudes to child safety Improving the ability to learn: Indirectly by helping to ensure safe places to play, and care for children’s development. Strengthening families and communities: No direct impact.

Costs and Benefits Benefits: Costs Prevention of long term damage to children’s lives Positive impact on interagency working Costs Financial costs can be in excess of £50,000 per hospital admission The overall cost of the service is £14,000 pa and may reduce Alternatives: no suggestions for alternative use of this funding. Many of the financial savings benefits partner agencies. Important for Children’s Centre development

Recommendations Include accidents occurring outside the home. ie children falling down the stairwells outside the flats. The operation of the scheme, and the close supervision of fitters, should be more clearly described in the leaflets The fitters should carry clear ID from the probation service Interpreters should be made available for fitting in Bangladeshi and Somali households, and leaflets should be available in appropriate languages. Raise profile of the scheme with partner agencies to promote further development into the new Children’s Centre areas Improve routine outcome monitoring in collaboration with the local health centre, Northampton General Hospital and with the Fire Service, to assess the success of the scheme in preventing accidents and to ensure sustainability