Prevention in action

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Hull City Council empowers staff using cascade training

Spreading accident prevention messages can be both effective and economical when it’s done strategically. This is the central pillar of an ongoing strategy by Hull City Council to train and support all staff who interface with families, to recognise opportunities to share vital information about child accident prevention.

Building on an initial input of funding, Hull City Council has found ways to keep costs to a minimum by delivering cascade training and empowering staff on the ground to pass on accident prevention messages to families. This work has been supported by CAPT’s Improving Capacity and Collaboration (ICC) project, which has a particular focus on preventing home accidents to the under 5s.

Combined remits

April Cundy is a Health Improvement Officer for Hull City Council. She has worked for the Council for many years and her current role combines a remit of accident prevention for 0-5s with tobacco control.

‘My remits appear different but there’s a lot of similarities in the demographics,’ April explains. ‘The greatest number of people who smoke and the people who are most likely to have accidents tend to be in our most deprived communities.’

Setting up a steering group

Recognising that deaths from accidental injury were significantly higher than the English average, April and her colleagues from Public Health took a paper to the Children and Families Board. This explained the nature of the problem, the impact on the community and the scale of costs to the NHS, and sought endorsement at a senior level. The board gave this endorsement and a steering group was set up, called the Strategic Accident Prevention Task and Finish Group. This was chaired by the Public Health portfolio holder, and attended by a consultant from children’s A&E, managers of children’s centres, senior representatives from the Clinical Commissioning Group, April representing Public Health, and staff with skill in data analysis.

CAPT gave a presentation to the steering group explaining how safety messages could be spread through workforce development.

‘We have so many staff going into homes and interacting with parents in many ways, and training them to share accident prevention is a cost effective way of sharing messages. If you’re visiting a family it’s so easy to do something such as move a hot drink to the centre of the table saying something like ‘‘can I just move that… I’ve got a thing about hot drinks’’, using your personality and life experience to give the message without finger wagging,’ April explains.

Having the backing of the steering group and the council portfolio holder, has been very helpful in encouraging staff to attend training. April says ‘I can say in meetings ‘‘Our portfolio holder is very interested in seeing this happen’’ and that helps to get commitment. When resources are short you have to seize every opportunity to make things work.’

Existing initiatives

April was able to use an existing Public Health funded initiative as a starting point. The Focus on Safety Award Scheme was developed by Hull City Council’s Public Health and Health and Safety Teams in partnership with Early Years Team, with contributions from Humberside Fire and Rescue, Hull City Council Trading Standards, Road Safety Team, Animal Wardens and Hull Safeguarding Children’s Board. The Award – which has four levels – bronze, silver, gold and platinum (progressively needing more staff training and extra activities with children and parents) aims to help childcare providers think about how they encourage safety amongst children, staff and parents, and how they can meet minimum legal requirements and incorporate elements of best practice, to ensure that accident prevention is high on the agenda . Nurseries receive a pack with everything they need to deliver this scheme both in hard copy and electronic version, along with a catalogue of resources available on loan.

April and colleagues from Health and Safety visit nurseries, to support them in going beyond the minimum standard of the regulations. April says:

‘It’s not always easy getting engagement and we have had to keep evolving what we offer. These days everybody has to provide evidence of what they are doing, so we’ve tried to make it really simple for them. Instead of having to collect different portfolios of evidence, they can use one piece of evidence and use different elements of this for Ofsted or STEPS’.

Input from CAPT

In the context of Hull’s existing activities, CAPT’s offer, in 2016, of supporting April to deliver and extend the scope of her accident prevention work, through the Improving Capacity and Collaboration (ICC) project, was well received.

‘CAPT presented at one of the first meetings of the Strategic Task and Finish Group, which was very informative and useful, giving attendees both information they weren’t aware of and reminding them of things they were,’ April says.

Identifying gaps and opportunities

CAPT did some mapping work to identify other services that could be included in training events and the national and local messages which would get their ‘buy in’. For example, Homestart volunteers were identified as being in a very helpful position to share accident prevention messages with parents. CAPT’s consultant also identified the need to raise awareness around medicines and household chemicals, and provided support and advice on how to do this. The organisation has also provided evidence for Hull’s Home Safety equipment scheme.

Kevin Lowe, CAPT’s former head of consultancy and training services reviewed the Focus on Safety Awards and concluded:

‘This is an impressive scheme that identifies opportunities to engage parents, staff and children to consider how accidents happen and how to avoid them. I think nurseries and childminders will find this a very useful resource’

Recently CAPT has been supporting April to explore opportunities for wider community outreach, such as ways to engage with pharmacies and local area coordinators, and develop links with local residents, foster carers, and housing staff.

Training for a wide range of disciplines

Alongside the project support, CAPT developed a programme of staff training. CAPT delivered 10 training courses to a range of Hull employees, including Train the Trainers events, so that information could be cascaded down. Those attending training sessions in 2017 to 2019, included health and development practitioners, registered childminders, social workers, staff from children’s centres, Homestart volunteers, fostering services, probation staff, extended schools co-ordinators, family support workers, public protection colleagues, and drug and alcohol services. Some nursery staff attended but April is still looking for ways to further engage this group.

April developed a distribution list from the training to send out useful information such as alerts about safety issues and Child Safety Week.

Involving housing colleagues

April is very keen to raise awareness of accident prevention among housing colleagues because she feels they don’t necessarily recognise the vital roles they can play in child accident prevention. She says: ‘It’s about trying to get everyone to understand that it is their business if a child has an accident. Housing staff are in a great position to use their professionalism and personalities to notice and say ‘’he’s going to be walking soon and he’ll soon be able to reach that…’’ It will feel a bit uncomfortable at first but how much more uncomfortable would you feel if an ambulance had to be called for that child, and you’d said nothing!’

Ian Evans, CAPT’s training and consultancy manager, delivered awareness-raising training to housing staff in early 2019 and April has continued this training with other local authority housing teams in the City and plans to roll it out to private landlords.

Work with midwives

Recently April started working with midwives and she says that the enthusiasm of the member of staff she is liaising with is making her job a lot easier. She says:

‘Individuals can make such a difference. When you have someone who is passionate and has a lot of connections it really helps. I’m hoping to extend this work into A&E. At the moment there’s nothing in A&E about accident prevention and when a person is sitting there with a little one who has just had an accident, it might be good to read about Ages and Stages and children’s development and how to avoid future trips to A&E.’

Public Health funding has enabled April to purchase resources. She has worked closely with midwives on the HEY Baby project at the Women and Children’s Hospital in Hull. CAPT has helped her to identify the most relevant information to share with them, and to create resources around Ages and Stages. April has also supported midwives to turn one of the three contacts they make to parents before the birth, into an accident prevention session. All parents get a copy of the CAPT As I grow… picture book.

These resources are also shared through regular ‘Carousel Events’ which midwives hold with other organisations, where parents are able to drop in for information and advice. Initially April was staffing the accident prevention stall but has had to pass this over to a midwife colleague, due to time constraints. A large ‘spot the hazard’ resource that had been developed several years ago for the Focus on Safety Scheme but previously underutilised, was given for use in the Carousel Event, and a small magnetic ‘spot the hazard’ game was developed for use with families.

Making budgets go further

April says that over the last few years she has been very lucky to have a budget which has enabled her to (In addition to what has been mentioned above), purchase a licence for the Good Egg Accident Prevention downloadable resource, which has been promoted widely across Hull. She has also been able to part fund a Home Safety Equipment Scheme, and most recently short film clips that will be used on social media, plasma screens in surgeries and A&E, and for training.

‘In 2019 there will be very little or no budget, but because we’ve had the initial input and used it in areas that can be utilised long term, we should be able to continue to deliver messages with little or no cost.’ April explains.

What makes it work

Elements which April believes have helped in Hull:

  • A dedicated member of staff who is passionate about the issues (even if this role is only two days a week, at present)
  • Endorsement from senior staff, and a dedicated steering group
  • The support of the portfolio holder helps to motivate and give gravitas to the issues
  • Information to help service providers understand why they need to take accident prevention seriously
  • A specialist consultant (CAPT) to engage senior staff and deliver tailored training
  • Opportunities to deliver train the trainer courses for cascading information
  • Finding people in services who are passionate about accident prevention and can influence others
  • Utilising everyone who could give a message – just one passionate person in an organisation can make a big difference

The challenges

Challenges to be overcome:

  • So much to be done, and not enough time to do it all
  • Not enough resources to do everything which could be done
  • Busy staff don’t recognise their responsibilities for accident prevention
  • Some professionals feel they already know about accident prevention and don’t recognise that new products on the market pose new risks
  • Short-staffed services are reluctant to send their staff on training, even when it’s provided for free 
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