• No results found

Information sharing of Early Years assessment data

This section of the report identifies the range of assessment information currently being gathered on children in the Early Years to include for what purposes the information is gathered, how it is being gathered, using what methods, how it is being held (including what software is used), and with whom this information is being shared.

Purpose

When asked to identify the purposes for which their chosen assessment tool(s) is being used, health visitors who completed the online questionnaire provided the following responses.

Purpose % of

respondents

To monitor development/progress 97%

To identify a child’s strengths and any developmental needs 90%

To inform parents/carers of children’s development 90%

To inform other health professionals of the developmental

needs of individual children 83%

To inform other agencies of the developmental

needs of individual children 74%

When asked to identify the purposes for which their chosen assessment tool(s) is being used, childcare practitioners who completed the online questionnaire provided the following responses.

Purpose % of

respondents

To monitor development/progress 95%

To identify his/her strengths, interests and developmental

needs 94%

To inform parents/carers of children’s achievements and

next steps for their learning and development 86%

To get to know the individual child 83%

To inform colleagues of children’s achievements and next

steps for their learning 81%

To form an on-entry baseline assessment 79%

To meet the National Minimum Standards for Regulated

Child Care (Welsh Government, March 2012) 75%

To inform other practitioners, e.g. health professionals of the

developmental 74%

To inform transition throughout the Foundation Phase 70%

To meet the quality standards expected by your

membership organisation 60%

To compare the particular strengths and needs for the group

as a whole 57%

To inform children of their achievements and next steps for

their learning and development 56%

When asked to identify the purposes for which their chosen assessment tool(s) is being used, education practitioners who completed the online questionnaire provided the following responses.

Purpose % of

respondents

To monitor development/progress 94%

To identify his/her strengths, interests and developmental

needs 93%

To inform transition throughout the Foundation Phase 91%

To form an on-entry baseline assessment 86%

To inform colleagues of children’s achievements and next

steps for their learning and development 85%

To inform parents/carers of children’s achievements and

next steps for their learning and development 86%

To get to know the individual child 78%

To compare the particular strengths and needs for the group

as a whole 71%

To inform transition between the Foundation Phase and Key

Stage 2 71%

To inform other practitioners, e.g. health professionals of the

developmental needs of individual children 69%

To inform children of their achievements and next steps for

their learning and development 65%

The results across health, childcare and education sectors show a

considerable degree of uniformity with practitioners focusing very much on the needs of the child and the importance of sharing relevant information with parents/carers.

How is the assessment information being gathered?

Health visitors use a variety of methods to record developmental assessment information. The most commonly reported methods are:

1. On paper using a standardised recording form

Paper copies are forwarded to the LHB and the information is inputted into the All Wales National Child Health Database by administrative staff. For

example, in BCUHB a paper record in triplicate is generated; copies go to parents, the LHB for data inputting and final copy is retained by the health visitor. Similarly in Cwm Taf LHB copy sheets from the assessment are sent to Community Child Health Office where the information is stored centrally in both paper and electronic formats. Health visitors in Hywel Dda LHB

undertake initial assessments on paper and then an electronic system, the

‘TRIBAL’ data base, is used to record assessment information from Flying Start settings only.

2. Using an electronic computer-based profile

For example, health visitors in Cardiff and Vale LHB record the initial developmental assessment on paper but then the enter assessment information onto the PaRIS electronic profile (Patient record information

system) to create an Electronic Patient Record. The Child Health Surveillance Programme captures information for national reporting. Similarly Flying Start health visitors from Abertawe Bro Morgannwg University Health Board, use the local authority PaRIS electronic recording system.

Some LHBs have also trialed electronic recording systems (not specified) which do not work effectively as they rely on mobile phone reception which is unpredictable in rural areas. For example, Cwm Taf LHB trialled a hand-held electronic data collection system two years ago using the community

information system (CIS), however, due to reorganisation this work has not progressed. In Powys LHB all contacts by Flying Start health visitors are recorded centrally on an electronic data base (not specified) held by the local authority.

3. On paper as a record of practitioner’s field notes, observations and assessments

After the initial paper record is produced during the assessment, practice then varies. In some LHBs, e.g. Aneurin Bevan LHB, practitioner’s field notes and observations are recorded on paper in the home during the child’s

assessment and recorded in the Personal Child Health Record, the national standard health and development record. Alternatively, in some LHBs the generic health visitor’s written data is subsequently inputted onto an electronic record and the paper notes shredded.

Practitioners in childcare settings use a variety of methods to record developmental assessment information. The most commonly reported methods are:

 

1. On paper, e.g. practitioner’s field notes and observations

For example, in Gwynedd practitioners record formative assessment

information on post-it notes and post-observation sheets. They subsequently transfer the information to the child development file for each individual.

Secure storage of child assessment records is a particular issue in

non-maintained settings where facilities are often shared with other users.

2. On paper using a standardised recording form

For example, the Development Tracker used in Swansea is a paper-based proforma consisting of a one page check list of milestones for each area of child development. Completed copies of the assessment are sent to the central Flying Start office and inputted onto a computer record, using Excel, for each child.

3. Using an electronic computer-based profile

For example, in Cardiff Flying Start settings SoGS and NBAS assessments are recorded on the PaRIS electronic profile via the Local Health Board.

Flying Start and registered childcare settings in Merthyr Tydfil CBC have been successfully using the Child Development profile (CDAP) electronic database for the past two years. The remaining childcare settings across Merthyr Tydfil were given the CDP database in spring 2012. However not all settings have access to secure IT equipment. In such cases, paper copies of the CDP have been completed manually. The electronic tracking system is able to generate a profile for each child and, if required, for groups of children.

Practitioners in school settings report that they use a variety of methods to record developmental assessment information. The most commonly reported methods are:

1. Using an electronic computer-based profile

Increasingly schools are using electronic tracking systems to store the outcomes of their on-entry baseline assessments and ongoing formative assessments. Examples include a locally developed local authority tool such as the Learning Journey in Wrexham CBC, or their own in-house tool, e.g.

SIMS assessment manager. Examples of commercial tracking tools include Incerts, Classroom Monitor and 2Build a Profile.

2. On paper, e.g. practitioner’s field notes and observations and stored in the setting.

3. On paper using a standardised recording form

For example, the Learning Journal used in Wrexham CBC, has, for on-entry baseline assessment, an OMS standardised mark sheet which is available in paper and electronically; it is a school decision as to which format to use. The electronic version can be entered onto the school information management system (SIMS). Wrexham CBC has worked with Capita to develop the

required software to be compatible with SIMS assessment manager and there is no additional cost to schools. The software is able to run reports by age, gender, free school meals (FSM), etc., to provide information on potentially vulnerable groups.

In some cases, Foundation Phase advisers interviewed did not know how on-entry assessments are being recorded currently or if those schools that are using the CDAP in its entirety or partially are using the CDAP recording form to gather the information. Given the significant change to roles resulting from the establishment of regional consortia, they had not had an opportunity to visit schools, during the period of research, to monitor practice.

With whom is the developmental assessment information being shared?

Health visitors report that they share developmental assessment information with the following groups.

Parent/carers 99%

Other health professionals 75%

The Local Health Board 36%

Other Early Years education practitioners 35%

Other practitioners, e.g. Flying Start coordinators 29%

Childcare practitioners report that they share developmental assessment information with the following groups.

Parents/carers 96%

Other practitioners in the setting 79%

Receiving schools 73%

The local authority/education professionals 62%

Health professionals 59%

I do not know how the developmental assessment information

I gather is used beyond my setting 2%

The national childcare organisations do not collect child development assessment data from their members. In terms of information sharing on transition from non-maintained to maintained settings, practice is variable within and across local authorities. It would appear in some cases that school settings have a lack of trust in assessment judgements made in

non-maintained settings. Schools may dismiss the information due to perceived variability of practice in pre-school settings or they are simply unaware of the range of assessment evidence that is being collected in pre-school settings. Education practitioners report that they share

developmental assessment information with the following groups.

Other practitioners in school, e.g. SENCO, Inclusion coordinator 96%

Parents/carers 84%

The local authority 57%

Health professionals 51%

Perceptions are that there is improved sharing of information within settings and a developing culture of shared responsibility and accountability for a child’s progress across a phase or key stage.

Given the range of assessment practice and tools used in schools within and across local authority boundaries, collection of data for comparative purposes has no value and consequently does not take place. The exception is

Wrexham CBC where schools are strongly encouraged to use the Learning Journey and on-entry baseline assessment data is collected electronically by the local authority. End of Foundation Phase outcome data are shared with the local authority and collated electronically for national data collection (NDC) purposes. Foundation Phase advisors reported having difficulty accessing DEWi, the national Data Exchange Wales Initiative.

The Wales Accord on the Sharing of Personal Information (WASPI) provides a framework for service-providing organisations, including those in health and education to, where appropriate, share personal information on individuals;

legally, safely and with confidence. The Flying Start programme also has specific requirements around information sharing. However, from the evidence

gathered, reciprocal sharing of child development assessment information across settings and agencies does not appear to be the norm and practice varies considerably across Wales.

When asked ‘Do other settings and agencies share their child development assessment information with you?’ practitioners who completed the online questionnaire provided the following responses.

 

SoGS II outcomes are consistently shared with local and regional Flying Start coordinators electronically and also reported nationally to the Welsh

Government. However, practice at local level varies considerably. For

example, the outcomes of SoGS assessments are not shared uniformly with Flying Start advisory teachers and Flying Start childcare practitioners across local authorities which can be a source of frustration.

In some areas it is standard practice for the initial 24 month SoGS II

assessment results to be shared routinely. For example, Flying Start childcare settings in Cardiff receive the 24 month SoGS II results which identify any child that requires extra support. SoGS II results are discussed with parents/carers who are routinely informed about their child’s progress.

Parents/carers sign a consent form regarding sharing of information and individual children are referred to other professionals if required, e.g. speech and language therapist, dietician, physiotherapist, paediatrician. In other local authority areas, however, SoGS II assessment results are only shared with parental consent on ‘a need to know basis’ or if a developmental delay is confirmed.

A similar tale emerges regarding the 36 month SoGS II assessment. In some areas the Flying Start health visitor works with the child’s key worker to complete the final 36 month SoGS II assessment. However, in other areas,

the 36 month assessment outcomes are not shared with the childcare setting which in turn creates difficulties when the child’s transition document is being prepared.

Typically child development information is shared with the parents/carers and, with their consent, other health professionals. In Flying Start areas of Neath Port Talbot, development assessment information generated by the

Developmental Tracker is made available for parents/carers in the childcare setting but is used mainly by practitioners and the Flying Start team to plan the future support needs of the child. Information is only shared with other professionals if there is a concern on ‘a need to know basis’.

Referral protocols and pathways are in place, e.g. children in need,

safeguarding, direct practitioner referrals for specific therapies, audiology and portage which enable anonymised information to be shared more widely with other professionals. The format by which referrals are made varies. For example, in Powys referrals are made on paper using the designated referral forms for each service. The SoGS II assessment is attached with the referral to the paediatrician. If the referral is to an external agency such as Action for Children or Barnardos, then the Common Assessment Framework (CAF) assessment is also attached.

In other LHB areas referrals may be verbal, written referral by letter or electronic depending on the procedures adopted. For example, in Cardiff Flying Start settings, if information is gathered that indicates further tests are required then a ‘Goal for Actions’ sheet is completed by the key worker in the childcare setting and shared with parents/carers and others in the following ways.

• electronically where possible through PaRIS

• paper referral forms

• multi-agency meetings, e.g. Early Years Forum

• verbally.

Local authorities also have transition documents which vary in format.

Usually, the childcare key worker agrees the content with parents/carers and the transition document is passed to the receiving setting as a paper record.

There is no evidence of electronic transfer of assessment information from the childcare setting to the receiving setting. The Common Transfer System works effectively between maintained settings.

Health visitors also share information, with parental consent, before children enter a maintained setting so that teachers are informed if an individual child has a developmental delay that needs more input and support. A face-to-face handover of information is normally arranged for children with an identified developmental need but who are not necessarily on the special educational needs (SEN) register.

In BCUHB, child development information, in the form of a checklist of developmental progress, is handed over by the health visitor to the school nurse at age four years. Procedures for the transfer of health records for children leaving the LHB area are well established. This is normally in the form of paper records as not all LHBs in Wales have compatible electronic recording systems.

Senior LHB managers report that information gathered is analysed and then utilised for operational or strategic planning purposes in a variety of ways including to:

• monitor health outcomes for children across the LHB area

• improve upon any general areas of deficit identified, e.g. encouraging outdoor play to improve gross motor development

• provide standard comparators across the LHB area

• inform future service planning, e.g. to ensure the right mix of professionals to meet the needs of all children

• enable comparisons to be made between the different cohorts

• demonstrate the impact of specific interventions

• show compliance with national programme requirements, e.g. Flying Start

• meet national public health targets, e.g. immunisation

• produce statistical reports for the Welsh Government.

In Abertawe Bro Morgannwg University Health Board data is collated as part of the care programme review, as specified by NICE guidelines, which has been in place for three years. As part of its monitoring processes, Powys LHB is exploring currently ways of profiling the universal contacts health visitors have with children aged 0 to 5 years to record information such as how many children have had their six week, eight month, two year and school entry health reviews and how many children were recorded as having

developmental delays.

Health visitors report that, typically, they use the developmental assessment information they gather on children in order:

• to make a formal referral to health services, e.g. speech and language therapy, paediatrics (94 per cent of respondees)

• to make a formal referral to educational services, e.g. Education Psychologist (48 per cent of respondees)

• for LHB strategic planning (12 per cent of respondees)

• for local authority strategic education planning (7 per cent of respondees)

Other reasons stated included:

• to evaluate the effectiveness of Flying Start services (13 per cent of respondees)

• for child protection and safeguarding purposes/to inform Social Services (6 per cent of respondees)

• to provide data to assess child and maternal health and so inform health promotion/public health work.

Childcare practitioners report that, typically, they use the developmental assessment information they gather on children to:

• make a formal referral to educational services, e.g. Education Psychologist (37 per cent of respondees)

• make a formal referral to health services, e.g. speech and language therapy, developmental paediatrics (43 per cent of respondees).

Other reasons stated included:

• to ease transition into the Foundation Phase setting (13 per cent of respondees)

• for child protection and safeguarding purposes/to inform Social Services (5 per cent of respondees)

• to evaluate the performance of Flying Start settings.

Education practitioners report that typically, they use the developmental assessment information they gather on children:

• to make a formal referral to educational services, e.g. Education Psychologist (75 per cent of respondees)

• to make a formal referral to health services, e.g. speech and language therapy, developmental paediatrics (69 per cent of respondees)

• for LA strategic planning (35 per cent of respondees)

• to identify CPD training needs (26 per cent of respondees)

Approximately 11 per cent of practitioners in school settings did not know how the developmental assessment information they gathered is used beyond their setting.

Perceptions

To gauge their perceptions of child development assessment, practitioners were given options in which they chose a point between two extreme positions to represent their views. They provided the following responses when asked to identify the extent to which, in their opinion, child development assessment is:

Essential

1 2 3 4

Unnecessary 5 Childcare

practitioners 75% 18% 5% 1% 1%

Education

practitioners 75% 18% 6% 1% 0%

Health visitors 73% 22% 4% 1% 0%

Helpful

1 2 3 4

Hindering 2 Childcare

practitioners 71% 17% 8% 3% 1%

Education

practitioners 67% 26% 4% 3% 0%

Health visitors 78% 15% 6% 1% 0%

Diagnostic

1 2 3 4

Labelling 5 Childcare

practitioners 49% 26% 17% 5% 3%

Education

practitioners 48% 35% 14% 3% 0%

Health visitors 30% 38% 29% 3% 0%

The results are very consistent across health, childcare and education sectors, with the overwhelming majority of practitioners agreeing that child development assessment, carried out rigorously, is both essential and helpful.