1. Mendip Children’s Centres- looking to the future Claire Glover / Lauren Stimpson Data Presentation 30 th Jan 2013

2. Objectives To look at the what the demographic, indicator and contact data tells us about the picture for Somerset To look at the what the demographic, indicator and contact data tells us about the picture for Mendip To consider the potential implications of the story that the data can tell us [We will try to do all these things at once]

3. Firstly, what does the Indicator / demographic data tell us about Children’s Centre service need across Mendip?

4. Number of children 0-4 and population density There are 29,414 0-4 children living in Somerset (Jan 2012). Of these, just over 6,000 live in Mendip. Across Somerset, each LSOA has a varying number of children 0-4 living in it from 34 to 287 children. Across Mendip it ranges from 34 to 194. ‘Map C – Number 0-4’ shows the LSOAs which have a larger number of children 0-4. Higher numbers of 0-4 children (i.e. more than 100 children) are highlighted red and found in some of the urban areas (i.e. Taunton, Bridgwater and Yeovil) and across Mendip. However, it is more accurate to look at population density. The number of 0-4 children per square mile has been calculated. This ranges from 1 to 2141 children aged 0-4 per square mile. ‘Map B – 0-4 per square mile’ shows those areas in red with less than 5 children per square mile. As expected West Somerset is showing as having a low population density of less than 5 children aged 0-4 per square mile but so are large areas of Mendip and South Somerset. This indicates that some of the areas with a low density of children aged 0-4 might be relatively built-up areas (i.e. with large numbers of housing) inhabited by other household types (i.e. elderly people).

5. ‘Map C – Number 0-4’

6. Map B – 0-4 per square mile

7. Implications? It is harder for Mendip to find children 0-4 ‘hidden’ over large geographical distances but still within areas of high population density What are the implications for future service delivery / resource need?

8. LSOA IMD Deprivation Rankings The IMD is a basket of measures used nationally to provide a measure of deprivation at LSOA level. Across Somerset the range is between 4 and 97.4. ‘Map A – Deprivation’ shows a varied picture across the county. 24% of the LSOAs in Sedgemoor are ‘most deprived’ (with an IMD ranking of 30% or less), followed by West Somerset (22%), Taunton Deane (15%), South Somerset (8%) and then Mendip (7%) Of the 67 LSOAs across Mendip 66% have an IMD ranking of above 50% (and so are areas of relatively affluence), 27% have an IMD ranking of 31-50% and only 7% (30% or lower)

9. Map A – Deprivation

10. The most deprived LSOAs in Mendip

11. How does Mendip compare with other districts Looking at both numbers of LSOAs and numbers of children 0-4 living in LSOAs

13. Implications? Where should we be targeting our service delivery and resources? Funding by areas by number of children in IMD 30% areas or IMD 50% areas? How well does IMD deprivation correlate with other indicators?

14. CC KPI Workless Households Overall Somerset has been assigned an Amber rating (trend). Since 2008 Somerset has been consistently better than England as a whole. The current picture is: The trend is also better for Somerset than nationally- national figures have got 2.3 percentage points worse since 2008 whilst Somerset only got 0.8 percentages worse. There are, however, still 22 LSOAs in Mendip with a higher percentage of Workless Households than the Somerset average. Mendip Map

16. Workless Households - Mendip Map

17. Take up of childcare by low income families Overall Somerset has been assigned a Red rating Somerset has performed consistently worse than national since 2007 but a small (0.3% points) improvement has been made over time. The national picture is for a higher take up but nationally this has been getting worse over time (1.1% points). There are many LSOAs in Mendip that are performing badly (40 LSOAs are less than Somerset average of 16.2 (max 37.5, min 4.8)- those with a take up of childcare by low income families of 10% or less are: Please Note: CC KPI Eligible for childcare element of working tax credit – data set not available

18. Child poverty Overall Somerset has been assigned a Green rating. Somerset is significantly better than England and getting better over time. There are 10 LSOAs across Mendip that have a percentage of children in poverty that is higher than both the national and county averages And a further 14 LSOAs that have a percentage of children in poverty that is lower than the national average, but is still higher than the county average.

19. CC KPI Obesity (children of reception age) Overall Somerset has been assigned a Green rating- however, this is likely to be amended to Amber (based on new 2012 headline data). Implications? For Resourcing? For service delivery?

20. CC KPI Breastfeeding prevalence at 6-8 weeks Overall Somerset has been assigned an Amber rating This is a new data set (no trend data is yet available) but Somerset is performing only a little better than the national picture. There is an extremely mixed picture of prevalence of breastfeeding at 6-8 weeks across Mendip by LSOA (as there is across Somerset where figures range from 0% to 100%). The Somerset average is 51.0% but the range across Mendip is from 0% to 100% by LSOA as the following data indicates. There are 26 LSOAs with a prevalence of breastfeeding at 6-8 lower than the national average of 47.0% and a further LSOAs which have a higher percentage of prevalence at 6-8 weeks than the national average but which is higher than the Somerset average of 51.0%. Implications? Data should inform discussions with Health partners and further data updates will build a better picture of where the hotspots are…

21. Breastfeeding Initiation Overall Somerset has been assigned a Red rating This is a new data set (no trend data is yet available) but breastfeeding initiation in Somerset is lower than the national picture (63.8% and 74.1% respectively). There is an extremely mixed picture of breastfeeding initiation across Mendip LSOAs There are 27 LSOAs across Mendip that have a lower breastfeeding initiation rate than the Somerset average of 63.8% and a further 15 LSOAs that have a higher breastfeeding initiation percentage than the county average but whose rate is still lower than the national average of 74.1% 0% rates might be due to cross- border issues? Implications?

22. CC KPI Under 18 conception rate Overall Somerset has been assigned a Green rating. Somerset performs better than the national picture and the picture has been getting better. This data is only available at Children’s Centre level. Across Somerset the rate of teenage births ranged from ‘Suppressed’ (less than 5 individuals) to 60.1 teenage births per thousand births. There are 3 Children’s Centre reach areas in Mendip where this is a priority: The Bridge, The Key Centre and Glastonbury Children’s Centres- they have rates higher than the county rate of 17.2 per thousand. The Bridge and The Key Centre have been getting better over time, but Glastonbury Children’s Centre has been getting consistently worse. Implications?

23. CC KPI Percentage of teenage mothers This data was first available by Children’s Centre reach are in 2012. Across Somerset the percentage of teenage mothers ranged from 0% to 10%. There is no historic trend data. All Children’s Centre reach areas in Mendip have rates of teenage mothers lower than the county average of 2.6% apart from The Bridge Children’s Centre reach area which is marginally higher.

24. CC KPI Lone parents Across Somerset the number of lone parents ranged from ‘Suppressed’ (less than 5) to 170. There are 28 LSOAs in Mendip with a greater number of lone parents of dependent children (under 16) than the Somerset average (these are provided on the Mendip Data Analysis paper). There are problems with this data set- NB Under 16s not Under 5s We could use this data set to investigate trends over time and to compare with eStart lone parent registrations (i.e. dividing the number stated by 4 will give a crude approximation of the number of lone parents you would hope to have registered in each LSOA?)

25. CC KPI Percentage of minority ethnic groups Across Somerset the percentage of children recorded as being from minority ethnic groups ranges from ‘Suppressed’ (less than 5 children) to 24.1% – although only 11 LSOAs across Somerset had percentage of children from minority ethnic groups of 15.0% or higher. There are 26 LSOAs across Mendip where their percentage of children aged 0-4 from minority ethnic communities is greater than the Somerset average of 6.0% Implications?

26. Domestic Violence (repeat incident rate) This data is only available at Children’s Centre reach area level. Across Somerset the repeat incident rate per thousand ranges from 14.9 to 152.7. Three Children’s Centres in Mendip have a domestic violence repeat incident rate higher than the Somerset average of 61.7: Implications?

27. Domestic Violence (individual count rate) This data is only available at Children’s Centre reach area level. Across Somerset the repeat incident rate per thousand ranges from 13.7 to 100.7. Four Children’s Centres in Mendip have a domestic violence individual incident rate higher than the Somerset average Implications?

28. Foundation Stage Profile (FSP)- 78 points This data is only available at Children’s Centre reach level. Across Somerset the number of children achieving 78 points in each Children’s Centre reach area ranges from 37.7% to 85.2%. Overall Somerset has been assigned a Red rating In 2009 Somerset performed slightly better than national and Somerset figures have increased every year since 2009. However, in 2010, 2011 and 2012 Somerset performed worse than the national picture. There are 3 Children’s Centre reach areas in Mendip that have poorer performance than the Somerset average of 63.0% in 2012 and the England average of 64.0%; these are Shepton Mallet, The Key Centre and The Mill Children’s Centre reach areas. However, both the Mill and The Key Centre are doing better over time (especially The Key Centre); however, Shepton Mallet reach area is decreasing over time.

29. Foundation Stage Profile (FSP)- Narrowing the gap This data is only available at Children’s Centre reach level. Overall Somerset has been assigned an Amber rating Somerset has performed slightly better than England ever year since 2009 but England has been improving at a higher rate than Somerset. Across Somerset the ‘narrowing the gap’ figure (where a high number indicates poorer performance) ranges from 47.0% to 8.6%. There is 1 Children’s Centre reach area in Mendip that has a poorer performance than the Somerset average of 29.2% in 2012 and the England average of 30.1%- The Key Centre reach area (30.6%). However this is improving. The only reach area in Mendip in which performance is decreasing is Shepton Mallet Children’s Centre reach area:

30. So can an ‘overall picture for Mendip’ be determined from analysis so far? It is early days – but there is cause for concern if funding is allocated on basis of number of LSOAs with 30% IMD of less (or numbers of children in these areas) Across Mendip- it makes more sense to think about pockets of need at LSOA level rather than CC reach level for most indicators It is harder for Mendip to find children 0-4 ‘hidden’ over large geographical distances but still within areas of high population density Some potential areas for future work: Focus upon areas of 30% deprivation and 50% deprivation Initiatives to support workless households (the ‘social worlds’ element of the Core Purpose) Breastfeeding initiation and prevalence Focus on obesity in Street, Wells and Shepton Mallet CC reach areas Focus on teenage parents in Frome and Glastonbury Focus on domestic violence in Frome, Shepton Mallet and Glastonbury Focus on improving FSP scores in The Key Centre, Shepton Mallet and The Mill CC reach areas Evidence that we are ‘seeing’ (both registrations and attendance at events) high percentages of targeted families and individuals

31. The importance of indicator data Funding and resource allocation (at all levels- county, district/cluster, LSOA) Answering the ‘So What?’ question (i.e. implications) Informing discussions with partners Performance Management

32. Problems with the indicator data Some of it is older than we would like Some of it does not map exactly with what we would like (i.e. lone parents is under 16) Sometimes trend data isn’t available yet (i.e. breastfeeding) The picture is complicated across the county, across Mendip and CC Clusters within Mendip

33. Secondly, what does our ‘contact’ (eStart) data tell us about Children’s Centre service need and delivery across Mendip?

34. Current % registrations of 0-4 children living in LSOA Across Somerset the number of 0-4 living in an LSOA registered with ANY Children’s Centre in Somerset varies from 12.3% to 125.6%. Extremely low figures can occur in LSOAs that border other local authority areas. Extremely high figures (especially those which are over 100% of children 0- 4 in the area) can occur because: children have registered on eStart but then moved house without their address being updated on eStart (esp. moved to another local authority area) or the numbers of 0-4s in the area obtained from Health are inaccurate. Looking at Mendip, however, the problem seems to be low percentage registrations. The average percentage registered of children 0-4 living in the LSOA per cluster (December 2012): It is no secret that Mendip is struggling more than other areas to increase percentage registrations- why is this? Rurality? low 0-4 per square mile? Cultural issues (both service users and with the service)? School sites? Anything else? What can we do to improve things? NB From Jan 2013 SCC will set separate targets for each LSOA based on deprivation, % of current registrations and rurality

35. eStart Quarterly Reporting (main spreadsheet) The Data displayed here is 1 st October 2012 – 30 th December 2012 This can tell us a number of things about CC service delivery within Mendip (i.e. total % of children 0-4 seen reach, children 0-4 volume, some ‘hard to reach’ attendance

36. eStart Quarterly Reporting- NEW Activity Reporting The Data displayed here is 1 st October 2012 – 30 th December 2012 Each Children’s Centre is now provided with a list of the activities that they carried out each quarter that provides the following information: This type of detailed activity reporting enables us to answer many questions about Children’s Centre service delivery across Mendip- such as how many people attended ‘breastfeeding support’ groups; how many lone parents attended family support; how many children 0-4 lived in the reach where they accessed the service… The key question is- what do we need to know? Suggestions?

37. Payment By Result- ‘in greatest need’ This is new eStart functionality Need to establish county-wide definition and agreed process Claire and Lauren will be working on this in the next couple of weeks – there will need to be agreement about shared definition before we can start to implement this functionality This could potentially simplify eStart ‘Hard to Reach’ reporting – making it is easier to allocate resourcing and evaluate service performance

38. The importance of contact (eStart) data Indicator data is often time-lagged and not specific to CC service users- information that we hold about our service users can provide us with more valid and reliable data It is only by spending time with a family completing a CC Family Membership Form that we can really say that we ‘know’ a family and their needs. Can inform funding and resource allocation (at all levels- county, district/cluster, LSOA)- what outputs do we want? Answering the ‘So What?’ question (i.e. implications)- what are we doing with the resource invested- outcomes? Informing discussions with partners Performance Management More work has to be done in the current months by CCs to evidence that they are using their eStart data (registration data and detailed activity planning data) to plan and evaluate service delivery

39. Problems with contact (eStart) data We have information on only 62% children 0-4 across the county (less in Mendip) Registration can feel like an ‘endless battle’ It is difficult to keep our data up-to-date and accurate Children’s Centres record different things in different ways (although we are getting better at standardising our data across the county)

40. Bringing it all together- using indicator, demographic and contact data to inform CC service planning, delivery, monitoring and evaluation There is a lot of data available now- which data sets do we prioritise? The ‘So What?’ question must be the basis of our data analysis: -What do we want to know? -How can we evidence impact / outputs / outcomes? -What questions do want to answer? (i.e. how many carers attended parenting courses or targeted family support? Claire to action over the coming weeks) Further Analysis It would be much easier if there were correlations between the IMD deprivation index and all CC KPIs across Somerset (then the IMD could be used as a ‘shortcut’ for determining funding resource etc)- Claire is going to look at this next….

41. More questions than answers? Some questions raised at a pre-meeting that this presentation and associated data analysis has provided a ‘first step’ towards answering: Is there any need with Mendip? If so, where is the need within Mendip? What is the need within Mendip? How does Mendips need compare with the needs of other areas? What additional measures are pertinent to CC service delivery (i.e. sociability of reception age children, parents keeping health appointments)? Individual children seen per year figures - are we seeing enough children for this to be worthwhile? What are we qualified to deliver? Health / Social Care / Children’s Centre. What is our added value? Can Health help CCs identify ‘targeted’ families? Family Health Needs Assessment- if Health referred all the families to CCs via Health Child Meetings (for case work based or play based services) then we could look at which families of these we are working with- could we have this as a tick box on eStart? Do we need to register them all then?

42. Any questions? Claire Glover cglover@somerset.gov.ukcglover@somerset.gov.uk and Lauren Stimpson LRStimpson@somerset.gov.ukLRStimpson@somerset.gov.uk will be working over the coming months to pull together county-wide and district level analysis to inform the commissioning process. This is a two-way process – please let us know if there is anything else you think we should consider as part of this initial needs assessment. Please feel free to use the content of this presentation (deleting slides as appropriate) for staff or Advisory Board information sessions