Research and analysis

Ofsted review into Start for Life services: terms of reference

Published 28 July 2023

Applies to England

Background

In the report ‘The best start for life: a vision for the 1,001 critical days’, published in March 2021, the government committed to identifying opportunities to make proportionate improvements to the early years regulatory framework. The government re-stated this commitment in ‘The best start for life: a progress report on delivering the vision’, published in February 2023. As a first step to meeting this commitment, the government has asked Ofsted to carry out a joint thematic review with the Care Quality Commission (CQC) of Start for Life services, including their delivery through the family hub model.

What the review will assess

Start for Life services are those available to families during the critical 1,001 days from a child’s conception to age 2. This includes the services that are available to all parents and carers who need them (such as health visits and infant feeding support) as well as services for which provision differs across the country (such as support with alcohol abuse).

The review will:

• evaluate families’ experiences of local services and whether these services are joined up effectively
• identify ways in which families can be further supported to give their babies the best start in life
• identify whether the current level of inspection of Start for Life services is sufficient to capture any issues around join up and to improve families’ experiences of local services

Participating local authority areas

The government has provided funding of £300 million over 3 years to establish a family hubs and Start for Life programme. This will deliver improvements in outcomes for babies, children, parents and carers in 75 local authorities. Of this funding, £81.75 million is supporting local authorities to create family hubs networks. These networks will improve access to a wide range of integrated support service for families with children up to the age of 19, and up to 25 for young people with special educational needs and disabilities.

This thematic review will cover a sample of volunteer local authorities that are participating in the family hubs and Start for Life programme, and that have already established family hubs networks. The review will only consider the experiences of families during the Start for Life period (from conception to age 2).

Timelines for the review

Ofsted will work with local authorities and health professionals to gather information for the review and will hear directly from parents and carers. The review will finish by the end of the summer 2023.

How the recommendations will be used

It will report on emerging themes and make recommendations to support the continued improvement of families’ experiences of Start for Life services, and their delivery through the family hub model. We anticipate that these recommendations may be of use and relevant to government and to all local authorities that provide these services.

Focus of the review

The review will focus on answering one question:

To what extent do families have a positive experience of Start for Life services, delivered through the family hub model?

Experiences of families

The review will take a flexible approach to answering this question, reflecting the local circumstances of each area.

We may ask the following questions as part of this:

• To what extent do families have a clear understanding of the Start for Life services available to them?
• To what extent do families feel confident that local Start for Life services will be available and accessible to them when they need them?
• To what extent do families have confidence in the quality of the services and support in their local area?
• To what extent do families feel confident they would know where to seek help or guidance if they cannot access the services they need, or do not feel their needs have been met?
• To what extent have families provided feedback on the services they have accessed?
• To what extent do families feel empowered to provide feedback?

Join-up of services

The report ‘The best start for life: a vision for the 1,001 critical days’ found that the experiences of families are affected by the join-up of the services that they use. We will therefore look at the effectiveness of the family hub model, which is the delivery model for Start for Life services (as well as other services available to families), in the local authorities being reviewed.

We will have access to local authorities’ self-assessments on elements of the ‘Family hub model framework’, which sets out how local authorities should deliver services at a system level. This includes self-assessments of co-location, commissioning, data-sharing and governance.

Where possible, we may also consider reviewing the join-up of local services by asking questions such as:

• Do families find themselves repeating their baby’s health ‘story’ and experiences to different professionals?
• Are relevant health records and information about a baby’s development and safeguarding shared between professionals within local Start for Life systems? And to what extent does the family hubs model support this sharing?
• Do professionals have a consistent and ambitious vision of what good joined up services look like for families?
• Do professionals within different parts of the family hubs network have a clear vision of shared outcomes that they will work collectively to achieve for families?

Inspection of Start for Life services

The review will also consider whether the current inspection of Start for Life services helps to improve families’ experiences and reduce issues around the join-up of services.

To do this, we may consider asking questions such as:

Do local authorities, professionals and families feel that the current level of regulation and inspection is able to improve families’ experiences of local services? And what would enable this to be done more effectively?

Approach to the thematic review

In order to answer these questions, the review will take the following approach:

Ofsted will review published inspection reports of Start for Life services in the sample of local authorities. This includes relevant inspection reports published by the CQC.

Given the importance of health services during the Start for Life period, Ofsted and the CQC will work together on this thematic review. Inspectors from both inspectorates will carry out the review activities. Ofsted will lead on the final report.

Ofsted will evaluate the Start for Life offers of a sample of volunteer local authorities, approved by the Department for Education/Department of Health and Social Care, as well as local governance and data-sharing arrangements.

Ofsted will have access to relevant data collected as part of the Start for Life and family hubs programme, including each of the sample local authorities’ self-assessments of their own maturity on elements of the ‘Family hub model framework’.

Ofsted will visit each of these local authorities to look at how they deliver Start for Life services. Ofsted will hear directly from families during these visits.

The review will make recommendations to help support the continued improvement of families’ experiences of Start for Life services, and their delivery through the family hub model. We will share recommendations with central government, and these may be of use to all local authorities that provide Start for Life services.