Evaluation of how we support organisations to deliver Baby Steps Our implementation evaluation of the scale-up of our Baby Steps service

Mother and babyBaby Steps is an evidence-based perinatal education programme that helps vulnerable parents prepare for parenthood.

Following a successful evaluation, we supported other organisations to replicate Baby Steps, a process called scale-up. This is a way of reaching and helping more families than we would be able to do alone.

This briefing summarises evaluation findings of the scale-up of Baby Steps in the first six ‘early adopter’ sites. Through surveys and interviews, we gathered the views of a range of stakeholders including commissioners, managers, operational leads, trainers and practitioners (Baby Steps “facilitators”).

Authors: Robyn Johnson and Tove Andersson
Published: March 2018

  • The scale-up of Baby Steps progressed well with all early adopter sites having delivered the programme during the implementation phase. It is a highly valued programme and there was a sense that it was helping families.
  • Training for facilitators was generally very well received although there was a call for more of a focus on practical aspects of programme delivery and implementation. 
  • Sites encountered some challenges with programme delivery, such as the time commitment required for the programme, difficulties with cross-agency working and in meeting the licence requirement for groups to be co-facilitated by health and children’s services practitioners. Having a dedicated Baby Steps team helped with some of these issues. 
  • The nature of funding could be problematic, with short-term commissioning cycles – sometimes of just 1 year – and commissioning taking place across different organisations. There was uncertainty surrounding the future of Baby Steps in 2 of the 6 early adopter sites.

 

Barriers to implementation and actions we are taking to address these

There were issues around clarity and pace in relation to the second part of the training and a lack of focus on delivery in practice in training.

  • We will undertake a review of the Baby Steps training programme to incorporate learning from implementation in early adopter sites.
  • We have established an NSPCC training team which includes experienced Baby Steps facilitators.

There was a perception that the programme can be inflexible. There were difficulties in meeting the licence agreement with regard to, for example, reflective supervision.

  • We will discuss local changes to the model with sites and look at options and solutions with them. We will agree a tailored local approach where this does not compromise the model.

There were concerns around the time needed to run the programme, a lack of administrative support and unanticipated costs such as additional training.

  • We produced detailed implementation guidance and a resource pack for new sites incorporating learning from early adopter sites. This included tools to support sites to map resource requirements and estimate costs as part of their implementation planning process.
  • We will trial a ‘training for trainers’ model in some early adopter sites to enable sites to have their own trainers to minimise on-going training costs.

Some facilitators lacked confidence in delivering “talk and listen time” and filming sessions with parents and babies at the second home visit. There were also difficulties with recording equipment for the filming session.

  • As part of the review of the training programme we will consider ways to improve facilitators’ confidence in filming with parents such as giving them opportunities to practice in training sessions.
  • We produced films of Baby Steps facilitators demonstrating how to set up the talk and listen time activity and clips of Baby Steps parents talking about how “talk and listen time” has benefited them. 
  • Baby Steps sites will be supported to think through equipment requirements, information sharing protocols and data security issues to ensure facilitators are able to deliver this crucial element of the programme.

There was a lack of strategic support for the programme in some sites.

  • The implementation guidance and resource pack includes tools to support sites with stakeholder engagement planning and promotion.
  • The implementation readiness assessment carried out with new Baby Steps sites is being reviewed to ensure that this includes evidence of strategic senior management buy-in to inform assessment of the strength of the local partnership in new Baby Steps sites.

In some cases, there was a lack of infrastructures to support cross agency working including issues around information recording and sharing across agencies using different systems and policies.

  • The implementation guidance and resource pack includes infrastructure considerations that need to be worked through as part of planning for cross-agency delivery.
  • We will recommend that new Baby Steps sites set up a multi-agency steering group to drive the development work required to deliver Baby Steps groups and oversee implementation. This will include ensuring that systems are in place to accommodate programme expectations. We will be actively involved in attending steering group meetings in new sites.

There were logistical issues with group delivery including timings, venue and transport considerations.

  • The implementation guidance and resource pack includes support for sites with planning around venues, transport and timings of groups.

There were issues around staff turnover (at all levels), organisational reviews and funding cuts.

  • Guidance now states that new Baby Steps sites must establish a multi-agency steering group to plan and oversee the implementation of the programme. Sites are encouraged to include representatives at all levels.
  • If training for trainers model is successful, on-going training costs resulting from staff turnover will be minimised.
  • Readiness assessment will address organisational stability.

There was some difficulty providing sufficient evidence to commissioners to ensure re-commissioning/on-going funding.

  • The implementation guidance and resource pack includes guidance for Baby Steps sites to carry out their own local evaluations to support them to demonstrate local outcomes and benefits of the programme.
Executive summary 4
Background 6
Methodology 9
Results 10
How these findings are being used 18
Conclusion 20
References 21
Appendix 1: Recommendations for organisations adopting Baby Steps 22

“The trainer was awesome. Compassionate and inclusive and she really represented what the programme was about…She was exceptionally knowledgeable.”

“Baby Steps makes a difference - often in small ways but they make a big difference. It empowers women, gives them confidence, helps them build support networks.”

Please cite as: Johnson, R. and Andersson, T. (2018) Implementation evaluation of Baby Steps scale-up. London: NSPCC. 

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