Flying Start Health Visiting Core Programme - …

1 Flying Start Health Visiting Core Programme Executive Summary This Health Programme is designed to support the principles of the Welsh Assembly Government Flying Start initiative. The Health team will work in partnership with parents and other professionals commencing in the antenatal period and dovetailing through to school. Aims and Objectives Objectives of the Flying Start Health Service To undertake a universal comprehensive assessment of child and family Health needs, which will ensure that those families identified with the greatest need are referred appropriately and engagement in local services is facilitated.

2 To ensure that Flying Start Health Visitors engage with the hard to reach and vulnerable families referring to other agencies and facilitating additional input as appropriate. To develop closer working relationships/practices between Midwifery and Health Visiting to ensure that good antenatal and postnatal support, including parent craft and postnatal groups is provided. Also to ensure that first time parents are identified as a high priority within Flying Start . As Health Visiting caseloads in Flying Start areas will be lower than average, to build on the skill mix Sure Start (Cymorth) model. To offer additional Health Visiting support and recognise the need to work in partnership with other services and agencies. To ensure that Flying Start Health Visitors work in partnership with others, including parents, to ensure that a comprehensive menu of support is available both as individual families and within a peer group context.

3 To undertake comprehensive developmental assessments to enable early identification of developmental issues and ensure early co-ordinated intervention. 2To promote Public Health activity within Flying Start Areas providing support and advice surrounding infant nutrition, including breastfeeding, weaning and toddler diet, maternal mental Health including postnatal depression, immunisations, dental Health and child safety. To promote healthy lifestyles in the antenatal period, raising awareness and providing support relating to issues surrounding smoking, substance misuse, alcohol, nutrition, exercise, emotional Health , to promote a healthy outcome for the child and parents. To provide additional specialist support individually or within a peer group to vulnerable young parents and their children both in the antenatal and postnatal period, ensuring links with other relevant agencies.

4 To promote positive parenting skills with individual families and as a co-ordinated group approach, in partnership with other agencies. To identify need and enable intensive preventative support for children requiring additional input surrounding speech and communication. Scope This Programme includes midwives, Health visitors, registered nurses and nursery nurses working in Flying Start areas across the five boroughs of Gwent. Training All staff will partake in relevant training before undertaking the Programme . Monitoring and Effectiveness An annual audit will be undertaken and a report submitted to the Clinical Governance Forum. References NICE: Routine postnatal care of women and their babies, 2006 3 NICE: Antenatal and postnatal mental Health : clinical management and service guidance, 2007 NICE: Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children, 2006 NSF: Children, Young People and Maternity Services WAG 2005 Facing the Future: A review of the role of Health visitors DoH 2007 Investing in a Better Start : Promoting Breastfeeding in Wales WAG 2001 D.

5 Hall & D. Elliman, Health for All Children, Oxford Press 2004 4 Antenatal Activity Purpose Admin HV Skill mix Health Intervention Home visit All Flying Start mothers to have face to face contact by HV and Care Plan developed Assessment and Health Education Low, Medium, High identified- care plan developed Low Core plan delivered which involves advice given regarding The Health promotion benefits of breastfeeding. The importance of a good diet during pregnancy. Information given regarding local antenatal support. A full history of mother s psychological and physical Health taken to Start developing care plan. Domestic Violence screening tool completed Medium, High need identified care plan developed regarding intervention with appropriate staff regarding antenatal needs Care plan delivered.

6 Antenatal Group Health education and Support (All Flying Start families invited) Advice given in varied formats covering topics The Health promotion benefits of breastfeeding. Practical tips on breastfeeding Nutrition in pregnancy Getting ready for baby ( practical advice) Expectations of parenthood Sudden Infant Death Syndrome preventative advice Protecting babies heads Car safety advice Health advice ( physical and psychological) Attachment ( bonding with your baby) Passive smoking Relationships /emotional Health Postnatal Depression 5 Birth to Six Weeks Activity Purpose Admin HV Skill mix Health Intervention Primary Birth Visit Including weekly visits for 6 weeks Assessment, Health education Low, Medium, High need identified care plan developed Low Core plan delivered which involves advice given regarding assessment of mothers physical and mental Health Assessment of babies Health Record babies weight, length.

7 Head circumference Advice given regarding Infant Feeding Nutrition Immunisation Core Programme Safety at home Protecting babies head Sudden Infant Death Syndrome Dealing with crying baby Brazelton baby assessment Attachment ( skin to skin contact) Emotional Health Assessment of maternal mental Health by clinical interview and EPDS at 6weeks . Completion of Family Health Needs Assessment at 6 weeks care plan developed and agreed regarding further contact. home visits after 6 weeks To deliver additional support when required Medium, High need identified care plan developed regarding intervention with appropriate staff regarding family needs Care plan delivered. 6 Groups in Postnatal Period Activity Purpose Admin HV Skill mix Health Intervention Post natal group/ Baby Club Health education and Support (All Flying Start families invited ) Advice given in varied formats regarding Nutrition Child Development Sleep Dental Health Breastfeeding Speech Development Accident prevention and safety Immunisation Family Planning Emotional Health Baby Massage Group Health education and Support (All Flying Start Families Invited)

8 Bonding and attachment Communication Emotional Health Sleep Minor ailments Post natal depression group Health education and Support (Only clients Identified with need invited) Cognitive Behavioural Therapy Techniques 7 8 Weeks -10 months Activity Purpose Admin HV Skill mix Health Intervention 8,12,16 Week Face to face contact Child -Immunisation Uptake Mother- post natal depression assessment Discuss Immunisations Weaning Feeding Nutrition Medium, High need identified care plan developed regarding intervention with appropriate staff regarding family needs Care plan delivered.

9 4 months Home Weaning and family nutrition Discuss Weaning Feeding Family Nutrition Food handling hygiene Dental Medium, High need identified care plan developed regarding intervention with appropriate staff regarding family needs Care plan delivered. 5-7 months Home Home Safety and Accident Prevention Undertake safety assessment. Discuss Home safety Safety equipment advice Signpost to appropriate safety equipment loan provider if available. Medium, High need identified care plan developed regarding intervention with appropriate staff regarding family needs Care plan delivered. 8 4-7 months Weaning and Safety parties Health Education (All Flying Start Families invited) Community Health Nursery Nurse to run weaning and safety parties.

10 8-10 months Developmental Assessment Home To Identify developmental problems and promote future Health and development. Carry out Schedule of Growing Skills Assessment. Deliver proactive Health and development advice. Review Family Health Needs Assessment. Care plan developed and agreed regarding future contact. Medium, High need identified care plan developed regarding intervention with appropriate staff regarding childs needs Care plan delivered Inform carer of child s needs to be identified to child care provider. 9 1year-2year Activity Purpose Admin HV SKILL MIX Health Intervention 4 face to face contacts Assessment, Health education Low, Medium, High need identified care plan developed Height and weight at 1year, baseline data for yearly follow up.