Blog

A little bit about us

Hi, we are Cheryl and Margaret!

We have been on a QI Journey and lots of you will be on a similar one. Our hope in sharing ours is not to say we have made it and it is perfect, rather that after 20 years we are still walking through it and using Quality Improvement to learn what helps us and what does not.

North Lanarkshire Partnership is and has been committed to changing the lives of children and families:

“Our vision is for our children and young people to be loved, nurtured, and empowered to thrive across all aspects of their lives.”

North Lanarkshire Children and Young People Service Improvement Plan 2023-2026

Since 2015 we have been applying Quality Improvement thinking, tools and concepts to improved co-ordination of a multi-agency Solihull Approach training programme. Our aim is to increase knowledge and skills of all practitioner's practice, to consistently understand and respond to children and families. It has not been a straightforward linear journey and, on reflection with colleagues, started in 2004. It has required curiosity, determination and a willingness to experiment, due to the complex nature, there is no one answer or one solution.

The diagram below covers some of the key milestones along the way that created the conditions and are the strategic context of our work. It shows some of the drivers that enabled change and importantly focussed our attention and shaped our approach. It’s difficult to capture the entirety of our journey however we thought it necessary to acknowledge the multiple contributions that enabled us and continue to affect change whilst recognising that it takes a long time.

Creating a movement

In the beginning, staff trained in Solihull felt that their belief in relational practice was validated by attending Solihull training. They could see the benefit directly working with families of using a theoretical based approach with families. The Solihull approach became an essential element of multi-agency workforce development and was included in Lanarkshire’s Parenting Support Pathway in 2009.

This was agreed across the partnership, starting with the development of a pan-Lanarkshire parenting pathway and the implementation of GIRFEC. We knew programmes and interventions would come and go but our vision was imperative to ensuring equity. Today, Solihull training has become a fundamental part of induction for new staff, in North Lanarkshire Council and NHS Lanarkshire.

We then developed a common aim across children services to help unlock and channel the collective knowledge and energy of our workforce:

“To ensure all early years multi-agency practitioners across North Lanarkshire Partnership become effective staff who are knowledgeable and skilled in promoting secure attachment in families; resulting in all families being supported to develop positive relationships with their children”.

This led to a focus on improvement across all our services working with families and communities. There was a growing and developing understanding by the Children Services Partnership Leads, that people make the difference and are the catalyst to change. The aim was not perfect but it was enough to get us started, and we would later redefine and develop multiple aims as we learned more about Quality Improvement and the systems we were trying to improve.

How did we enable people to recognise where they have been and where they are going?

In the development of a Lanarkshire parenting strategy, we looked across the partnership and considered the amount of money being spent on multiple interventions and asked how do we know what is working?

We identified areas of practice that were successful in engaging parents in developing their responsive parenting. There was very good practice in Coatbridge Locality that was underpinned by all staff using a consistent language and approach through the use of Solihull. We worked in partnership to develop an operational definition of attachment. This subsequently informed attachment focused practice and provided a shared understanding and language for practitioners from all services. You can’t work towards a goal if you don’t know what good looks like!

What did we do?

There was no silver bullet, but these are some of the steps we took:

• Nursery centres offered parent focused support sessions on a Wednesday, delivered by practitioners working together from a range of services
• Investing in Infants multi agency group in Coatbridge were curious about infant mental health and explored together how understanding relationships and attachment impacts practice
• As a result of quality inspection by HMIe, the Head of Centre was seconded to develop the approach further and think about what would support adoption on a wider basis.
• In 2013/14 North Lanarkshire attended the 1st meeting of the Early Years Collaborative. We learned that the Quality Improvement methodology could be used to test what works towards the vision we had for children and a language to talk about change.
• During this time, relationships between services developed resulting in practitioners working more effectively together in partnership. This provided a strong foundation to apply the QI methodology.
• We produced an operational definition of attachment.
• Developed a theory of change and Solihull Driver Diagram, the first of many!!
• We communicated it to the power of 10 at every opportunity.

Who helped us along the way?

We provided an annual multi-agency ‘Nurture’ conference and invited high profile speakers with an interest/specialism in this area. They included Sir Harry Burns, Don Berwick, Jason Leitch, Hazel Douglas, Tina Henry, John Carnochan, Suzanne Zeedyk, James Docherty, Karen McCluskey and Darren McGarvey.

Noone said no they were too busy!

How did we engage and empower the workforce?

• Ongoing multi-agency training, recognising and valuing the benefits of training alongside partner services
• Reporting impact and outcomes at a strategic and local level
• Supporting innovation and testing of new ways of working with families
• Including all services that work with families e.g. third sector, emergency services
• Sharing stories of the difference using the approach made
• Solihull Approach resonated with the fundamental aspect of connection which is core to many of our practitioners’ values
• Annual Nurture conference and branded the communication. Our conferences reached over 1000 multiagency employees and increased their understanding of attachment theory and its significance to their work. We learned that sharing lived experienced of ruptured attachment motivated practitioners to consider the route cause of behaviour. People became curious about what had happened earlier rather than the behaviour today.
• Management buy in to embed the approach in practice for both practitioners development and managers understanding
• Linked our work to the development of Scotland becoming an ACE aware nation
• A Steering Group was developed in recognition of the need for strategic direction to steer the ongoing service buy in to encourage multi-agency ownership of the Solihull Approach

What have we learnt?

• Having a shared method provides us with a common language to talk about and continue to test and learn from
• Executive sponsorship is important but executive leadership is imperative - when leaders get involved in the work, improvement accelerates
• It is constant - the system we are trying to change evolves, changes and resets constantly, so must our improvement focus
• To involve people in change it is helpful to think How well does this fit with existing values, patterns of behaviour?
• Trial it / Test it: We started in one locality with a team around a nursery
• Relative advantage: Staff told us having common language made working together easier and it worked
• Observability: Parents told us they could respond sensitively to their child’s needs in schools, early learning, parenting interventions and in prison
• We tested ways to deliver and engage staff in training, making it easier to grasp.
• The best advert for the change is a willing volunteer!
• Solihull has become a noun, verb and adjective across Lanarkshire - practitioners talk about being Solihulled!

Who has learnt?

• 4451 multiagency staff
• 88 in South Lanarkshire
• 67% of Primary schools and 357 secondary school staff in North Lanarkshire
• 103 practitioners trained to deliver the Solihull Understanding your Child programme
• 90 practitioners are trained to deliver training (*58 are actively using training)
• 8652 members of the public have registered for online – 2818 south 5834 north
• 1331 and 602 have accessed online training using the tartan code = 10, 585
• 3223 Lanarkshire professionals have signed up to advanced learning courses

WOW Moments

Being involved in innovative work, delivering the Solihull Understanding Your Child programme to dads in prison, has helped us to learn how the Solihull Approach can underpin the maintenance of relationships and won the Co-production with Families and Services QI Award in 2016! You can find out more about this work by reading our poster.

Our work in Lanarkshire has been recognised internationally and North Lanarkshire’s journey has been published in “Solihull Approach in Practice 2018”.

Small can go to all - we started in Coatbridge and are now working pan-Lanarkshire as well as talking to and sharing learning with other local authorities.

Other countries who are embracing the Solihull Approach have visited us to hear about our journey, including Ireland and New Zealand.

Impact

What difference has it made?

As improvers we know that in complexity we can only claim contribution to improvement, therefore here are some of the contributions we are making!

Breast Feeding

• We have seen an increase in the number of mums choosing to breast feed, improving those ever breast fed at 1st Health Visitor visit from 43% in 2019 to 55.3% in May 2024.
• 32% of mums completing our Solihull antenatal programme report a closeness to their infant and 33% an intention to breast feed, compared to a national average of 14%.

Developmental concerns

There had been a steady decline in developmental concerns noted at the 27-30 month child health review over several years before the pandemic.

SCRA referrals

• Scottish Children’s Reporter Administration (SCRA) seeing a consistently lower number of referrals per head than in comparator areas between 2018 and 2022

School Exclusions

• School Exclusions have fallen from 2015 when they were reported at 3031 to 556 in 2022/2033.

Integrated Inspection 17th October 2023

• Staff demonstrated trauma informed and relational practices, which helped children and young people experience supportive and trusting relationships with them.
• Children and young people had early access to services to support their mental health and emotional wellbeing, before concerns escalated. Partnership approaches were helping to identify need and to secure support earlier. 

Last word from Cheryl and Mags

It’s been a pleasure and privilege to be a part of this continually growing programme and never-ending journey.  We often refer to it as being about changing hearts and minds of the workforce, as ours were changed at the very beginning.  We look forward to what comes next.