1. Northampton Sure Start
Evaluation of the Home Safety Equipment Scheme

2. The Home Safety Equipment Scheme (HSE)
Provides and fits free home safety equipment to registered Sure Start users – includes stairgate, fireguard, smoke alarm etc
Service provided in partnership with:
Workbridge – Learning Disability centre – who make up the packs
The Probation Service: delivery and fitting carried out by supervised offenders serving community sentences

3. Objectives of the service
Reduction in immediate and longer term harm to children caused by domestic accidents
To achieve cultural change and increase safety awareness in the community
To provide an incentive to register for Sure Start
To improve partnership working with other services and agencies
A reduction in costs to health, education and social care services

4. Approach to evaluation
Part of the overall evaluation of Sure Start – prioritised by stakeholders
Followed NESS principles for cost benefit analysis:
Total resources committed
Benefits for service users (costed if possible)
Could the resources be better used elsewhere?
Viewed as a system – inputs, processes, outputs and outcomes

5. Methodology – information sources
Management and cost information from HSE scheme records
Postal survey and telephone interviews with service users
Interviews with agency staff and other stakeholders – including health visitors, probation staff and medical consultants
Focus group sessions with parent evaluators
Research carried out at Stoke Mandeville Hospital (Burns Unit)

6. Inputs
Total budget for year (set up and running costs) £13,956 which covered:
251 packs delivered at time of research
Unit cost - £38 per pack (280 packs)
Administration including set up costs - £7.70 per pack
Assembly and packing - £1.00 per pack
Delivery and fitting – no cost to Sure Start
Total: £46.70 per pack

7. Processes Administration and quality assurance provided by Sure Start
All families registering with Sure Start are offered packs
Packs put together by learning disabled adults
Packs delivered and fitted by offenders on community sentences

8. Outputs At time of research 251 Packs delivered
Percentage of eligible families taking up service - 251/750 = 33%
45 packs fitted by probation service (18%)

9. Outcomes / service quality
Postal and telephone survey - user satisfaction with delivery process (41% response)
100% satisfied with the delivery process, including the standard of the work and the behaviour of the worker
61% said the place had been left clean and tidy

10. Outcomes / impact Reduction in domestic accidents
Burns and scalds lower in Sure Start area than comparator area
Falls in the home lower in the Sure Start area
Reduced to zero admissions in year 3
Survey shows raising of safety awareness in local families
Benefits in positive interagency working

11. Relevant research
Stoke Mandeville Hospital research – 55 children admitted over 3 month period
60% male, 40% female
58% aged 0-3
95% injuries in own home – mostly in kitchen
East Midlands (Towner et al 2004)
Injury main cause of death in childhood – high in EM
Injury is a major cause of ill health and disability
Social class gradient for deaths from injury is steeper than any other cause

12. Costs of domestic injuries
Costs of treatment includes
A and E, Ambulance
Extra contractual services
Transport
Long term medical care
Costs of missing or provision of specialist education
Cost of social care support
Total costs of injuries in the home estimated nationally at £25 billion pa
Hospital costs alone can be in excess of £50,000 per admission for falls, £15,000 for burns and scalds

13. Quality issues Parent evaluator focus group – issues raised
Recycling the equipment when no longer needed
Concern /lack of knowledge about the offenders fitting the packs – later addressed by meetings with the probation service and offenders
Agreed that the scheme has raised safety awareness
Suggestions about additional equipment – eg cooker guards, ways of fitting stairgates
Suggestions about improving the promotion of the service – identity cards for fitters
Views from professionals
Health visitors strongly supported scheme and would like to extend to non Sure Start areas
Burns consultant, Stoke Mandeville – very supportive of scheme
Probation service – “brilliant” scheme which meets national criteria

14. Impact on Sure Start Objectives
Sure Start national objective
Is the project likely to have an impact?
Improving social and emotional development: in particular by supporting bonding between parents and children …
Yes: the project raises issues of safety awareness necessary to protect children. It also provides an incentive to access Sure Start services
Improving health: in particular by supporting parents in caring for their children to promote health development before and after birth
Yes: direct impact on health care and attitudes to child safety
Improving the ability to learn:
Indirectly by helping to ensure safe places to play, and care for children’s development.
Strengthening families and communities:
No direct impact.

15. Costs and Benefits Benefits: Costs
Prevention of long term damage to children’s lives
Positive impact on interagency working
Costs
Financial costs can be in excess of £50,000 per hospital admission
The overall cost of the service is £14,000 pa and may reduce
Alternatives: no suggestions for alternative use of this funding. Many of the financial savings benefits partner agencies. Important for Children’s Centre development

16. Recommendations
Include accidents occurring outside the home. ie children falling down the stairwells outside the flats.
The operation of the scheme, and the close supervision of fitters, should be more clearly described in the leaflets The fitters should carry clear ID from the probation service
Interpreters should be made available for fitting in Bangladeshi and Somali households, and leaflets should be available in appropriate languages.
Raise profile of the scheme with partner agencies to promote further development into the new Children’s Centre areas
Improve routine outcome monitoring in collaboration with the local health centre, Northampton General Hospital and with the Fire Service, to assess the success of the scheme in preventing accidents and to ensure sustainability