RESPECT: A personal development programme for young people at risk of social exclusion. Option One - Social Return on Investment

This research report evaluates the RESPECT programme, which targeted 11-16 year olds who displayed anti-socal behaviour

RESPECT: A personal development programme for young people at risk of social exclusion - Option Two Impact report

This report discusses RESPECT - an scheme funded for three years by the government's Invest to Save initiative which offers targeted intervention for 11 to 16 year olds who are disaffected and/or displaying anti-social behaviour with the aim of re-motivating them. The impact of option two (led by Youth Federation) on programme attendees between May 2007 and April 2008 was evaluated and key findings are listed.Cheshire Fire and Rescue Servic

Understanding the impact of the Cheshire Children’s Fund: Findings from 11 family case studies

The Children’s Fund was created in 2000 as part of the Government’s commitment to tackle disadvantage amongst children and young people. The aim of the Fund was to facilitate the development of more extensive and better co-ordinated early intervention services for children and young people aged 5 to 13 years who were at risk of social exclusion. Cheshire Children’s Fund, the local response to this national initiative, is guided by the Children’s Fund Partnership which is made up of representatives from local voluntary and statutory organisations. The aim of this research was to explore the impact of a number of projects which had received funding from the Cheshire Children’s Fund, specifically to learn how these projects had worked with children and families where there had been a positive outcome. The objectives of the research were to identify, for each child or family, the reasons for the provision of a service, the type of service that had been provided, and the impact that it had had on their lives. The research explored the factors that enabled a positive outcome for each family: the similarities and differences between the cases were also examined to determine whether any contributing factors were present across the services. The 11 projects were selected to cover a range of themes to reflect the breadth of the Children’s Fund work in Cheshire. They provided a range of services under the headings of crime prevention, promoting inclusion, success in schools and family support.Cheshire Children’s Fun

RESPECT: A personal development programme for young people at risk of social exclusion

This project report discusses the development and delivery of the RESPECT project, a personal development programme run by Cheshire Fire and Rescue Service for young people in Cheshire who are at risk of social exclusion

RESPECT: A personal development programme for young people at risk of social exclusion - Option One impact report

A three year evaluation was built into the RESPECT bid in order that the individual, community and societal benefits of the programme could be quantified and evidenced. This report is part of the outcomes evaluation. Its focus is to explore and evidence the short and medium term impact of the Option One courses upon the young people who were allocated places during 2007

Parents as sex and relationship educators: A local evaluation of Speakeasy 4 Parents

This was a small scale-study designed to evaluate the effectiveness of the Speakeasy 4 Parents course in improving participants’ knowledge, skills and confidence to communicate and discuss sex and relationship issues with their children. A predominantly qualitative approach was adopted. There is evidence in this study that the Speakeasy 4 Parents courses run at Children’s Centres in Cheshire have been effective, from the perspectives of parents attending the courses and professionals facilitating them

RESPECT: A personal development programme for young people at risk of social exclusion - Final Report

This is the final, summary report in the series of reports written on the RESPECT evaluation.The RESPECT programme was funded for three years from the Government’s Invest to Save initiative. It brought together a number of elements of Cheshire Fire and Rescue Service’s earlier work with young people in a concerted attempt to tackle wider challenges pertinent to the fire services and partner agencies. RESPECT was a targeted intervention for young people living in Cheshire, Halton and Warrington who were aged 11 to 16 years and who were disaffected and/or displayed antisocial behaviour.The RESPECT programme was funded for three years from the Government’s 'Invest to Save' initiative. The RESPECT partnership was made up of the following organisations: Cheshire Fire Service; The Youth Federation; Cheshire County Council; Halton Borough Council; Warrington Borough Council; and Cheshire & Warrington Connexions

RESPECT: A personal development programme for young people at risk of social exclusion - Phase Two evaluation report

This is the second report of the RESPECT evaluation which has been commissioned by Cheshire Fire and Rescue Service and its partners as part of a project funded by the Invest to Save budget

Sure Start Blacon reach report, April 2004 - March 2005

This project report discusses Sure Start computerised records (covering personal details of all registrations within the Sure Start programme and records of each serivce and which service users have accessed them) which allow the 'reach' of the local programme across Blacon to be established between 1 April 2004 and 31 March 2005

Using mixed methods for evaluating the effect of a quality improvement collaborative for management of sleep problems presenting to primary care

Context This improvement project was set in Lincolnshire, a large rural county in the East Midlands with high prescribing rates of hypnotic drugs compared with the rest of England. Eight general practices volunteered to participate in a Quality Improvement Collaborative (QIC) designed to improve management of sleep problems in patients presenting to primary care. Problem Sleep problems are common affecting around 40% of adults in the UK. Insomnia has considerable resource implications in terms of disability, impaired quality of life and health service utilisation. Up to half of individuals with Insomnia seek help from primary care and hypnotic drugs are often inappropriately prescribed for long term use. Non-pharmacological treatment measures are rarely implemented in practice despite guidance supporting their use. A lack of training as well as limited availability of resources for effective sleep assessment and treatment in primary care are possible explanations for this. It is clear that there is considerable scope for improving management of sleep problems in general practice Assessment of problem and analysis of its causes We used a Quality Improvement Collaborative to introduce practitioners to sleep assessment tools including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and Sleep Diaries and non-pharmacological interventions such as Cognitive Behavioural Therapy for Insomnia (CBTi). Practitioners from participating practices were asked to begin using these where appropriate within their day to day practice. Strategy for change The project team met bi-monthly with practice teams to share learning. We used adult learning techniques to promote rapid experimentation (Plan, Do, Study, Act) cycles, process redesign and monthly feedback of prescribing rates and costs of hypnotic drugs using statistical control charts. Data were collected from the collaborative meetings to understand the facilitators, barriers and changes that practices were making as a result of the Quality Improvement Collaborative (QIC). Measure of improvement Qualitative data were collected via audio recordings of practice and collaborative meetings with practitioners and practice staff. This data was then transcribed verbatim. Thematic analysis was carried out supported by computer software MaxQDA using a framework method. Nine themes emerged which were then reviewed by five members of the evaluation steering group to assess inter-rater reliability of the themes. We used statistical process control charts and an interrupted time series design to analyse prescribing data for the two year period preceding the establishment of the collaborative and for the six months of its operation. Effects of changes There was a significant reduction in hypnotic prescribing of benzodiazepines and Z drugs in the practices over the six months of the project and this improvement has been sustained since the initiative. Nine themes emerged from the qualitative data: - Engagement of staff: Most practitioners showed enthusiasm to incorporate changes in their practice and encouraged other members of the practice to become involved by demonstrating use of the tools and reminders during meetings “It’s brought up at every practice meeting and so it’s always fresh in people minds. It’s not something that’s then forgotten.” Practitioner views of the tools: Practitioners tried the tools and techniques and overall seemed to favour the Sleep diary and Insomnia Severity Index (ISI) over the Pittsburgh Sleep Quality Index (PSQI) “Generally we found that the ISI was easy to complete, score and interpret and can be used in general practice” Practitioner preconceptions: Practitioners came with preconceptions about the feasibility of sleep tools and techniques. Patients’ age and intellect were factors that practitioners thought might affect whether tools were completed correctly or at all. Needs & educational needs of patients & staff: Before this project hypnotics had been seen as the solution to most sleep problems by both patients and practitioners. “When people come in it was so easy to give them a prescription” "As GPs we’re overly limited and actually to have a slightly more sophisticated response would actually be better for us but also for the patient”. Barriers to implementing tools & techniques: This related to systems (of care) practitioners and patients Systems: “Once the psychiatrist says you should have this, it is really hard as a GP to go against it because you know they say the psychiatrist has asked me to take this.” Practitioner: “We come down to the cognitive behaviour therapy approach; it’s a bit thin on my part, we’ve not got great skills in that”. Patient: “I think the key is also definitely how to communicate it…the minute you start even trying to approach the subject that the tablets are not really very good and what about thinking about alternative ways, they will kind of glare very rudely and be like I have been there before doc[tor]. So you have got to kind of approach it in a kind of a fresh way to make them thing they are trying something new. You have got to be a salesman’. Changes initiated by practices: Some practices had taken other measures to try and reduce hypnotic prescribing including implementing withdrawal programmes and limiting repeat prescriptions which let to improvement is patient and practitioner experience GP-Patient treatment & expectations: Practitioners revealed what they thought patients expected and made suggestions of how consultations could be improved to meet patients’ needs and increase successful outcomes from a sleep consultation. Importance of tailored approach: Each patient with Insomnia would need to have their treatment tailored to their individual requirements therefore every consultation could potentially have very different solutions Lack of feedback from patients: Receiving feedback from patients was difficult for some practitioners when patients didn’t return for their follow-up consultation or didn’t complete and return their sleep assessment tools. This lead practitioners to feel unsure as to whether patients had read and absorbed the information provided to them Lessons learnt Qualitative methods for collecting and analysing data were invaluable in understanding the factors which helped bring about change, how change happened and the effect of the change on process of care and patient and practitioner experience Message for others Quality improvement collaboratives benefit from careful analysis using qualitative as well as quantitative methods. Further information www.restproject.org.uk Project manager: [email protected] Project lead: [email protected]