The difference we makeAnnual Report 2016

As Chair of Ripplez, I would like to welcome you to our 2016 Annual Report.

My thanks go to our committed and dedicated staff who work creatively to deliver our services, and also to the Business Team who continue to seek out new opportunities and develop different models to support vulnerable families.

Our Chief Executive, Justine Gibling, has successfully navigated the organisation through some difficult financial challenges, and has worked with our commissioners and partners to seek solutions to the shared pressures faced by many organisations working in the sector.

We have said goodbye to some of our staff this year who have moved on to new opportunities, in part due to our re-structure. All of them made huge contributions and are missed.

We also said goodbye to Maura Teager, who was a non-executive Director on our Board since the inception of Ripplez. Maura had a wealth of experience and gave a lot of her time to Ripplez, which helped develop and shape the organisation. We miss her and wish her well

in her retirement.

The past year has yet again been one of significant change. It is to the enormous credit of all the staff involved in Ripplez and to their continued professionalism and commitment that we have had another good year and continue to make a difference.

We have a dedicated and committed Board of non-executive Directors who continue to provide strong governance, strategic leadership, challenge and support and are passionate about the work of the organisation.

I strongly believe we have the leadership, commitment and ability to continue to develop, innovate and find different ways with our commissioners and partners to provide the very much needed services for the families and communities we work with in these particularly challenging financial times.

On a final note, if you have been inspired by what we do and want to get involved, we are currently seeking non-executives to join our Board.

Maggie

McGrath

A warm welcomeMessage from the Chair of the Ripplez Board

3

This annual report, which provides an insight into our work and achievements in 2016, as well as our financial performance in the year 2015-16, demonstrates what a very busy time we’ve had.

In Worcestershire, we have been focusing on embedding a new contract and the team were very excited when the first baby was born at Christmas! Meanwhile in Derby City the teams, expertly led by their Supervisors, have responded phenomenally well to the requirements of the new contract and have adapted to meet the needs of families. The Derbyshire and Staffs Teams have continued to deliver FNP to a wide number of families.

When I look back over the last year, what strikes me the most is the many achievements made by our clients. We have both clients and their partners who have passed their driving tests, mums who continue to breastfeed... the list could go on. We see mums and dads grow in confidence by engaging well with the FNP programme and go on to complete accreditation. We see first time parents grow

into loving, sensitive and responsive carers and build secure attachments with their children. Don’t take my word for the great difference we have been making, though – read a summary of the Care Quality Commission’s report on our services which you’ll find on pages 12-13.

This year has seen many significant changes in the commissioning environment and for FNP at a national level, which have led to us having to make some difficult decisions – but I am so proud of the way my colleagues in the Business Team have responded. They have maintained stability with the utmost professionalism and positivity throughout uncertain times and I want to thank them most sincerely.

In the year ahead we know we will continue to face challenges but, with such a passionate and committed team, any changes will be met positively and overcome. We continue to grow and maintain partnerships with service delivery organisations as we reach out into areas that complement the FNP work we currently do.

Justine

Gibling

Reviewing the yearMessage from the CEO

5 4

Established in 2011, Ripplez is a staff led Social Enterprise registered as a Community Interest Company (CIC). Our key beneficiaries are vulnerable families, teenage parents and their babies for up to two years, as well as the wider community and family members of the clients we work with.

The Ripplez overarching vision is: to develop a self sustaining business culture and further develop a range of complementary services for vulnerable families.

We achieve this by following our mission every day, which is: to make a positive difference to the lives of young families so that they benefit future generations.

We work alongside families to meet their health and social needs, encourage aspiration and promote self-efficacy through high quality evidence and strengths based programmes.

Building trusting relationships, sharing learning and supporting people and communities to grow and develop are at the heart of everything we do.

Ripplez delivers FNP in Derbyshire, East Staffordshire and Worcestershire. In Derby City we offer FNP and two other programmes, all with the aim of breaking the cycle of disadvantage and improving the lives of young parents and their children. We do this by creating positive changes in health

What we do

PTO...

behaviour, relationships, the parental role and by supporting maternal wellbeing. The programmes Ripplez delivers achieve wider community benefits by improving pregnancy outcomes, child health development, future school readiness and achievement, and improving parents’ economic self-sufficiency.

Family Nurse Partnership (FNP)

Ripplez has been providing the Family Nurse Partnership (FNP) programme since 2007. FNP is a licensed, evidence based, preventative, early intervention therapeutic programme for vulnerable first time mothers aged 19 and under. It offers intensive and structured home

visiting, delivered by specially trained nurses, from early pregnancy until the child is two years old.

FNP ADAPT

Derby is one of 11 ADAPT (Accelerated Design and Programme Testing) sites working with the National FNP unit and the Dartington Social Research Unit on ‘FNP: Next Steps’.

The aims of FNP: Next Steps are –

• Achieve greater outcomes for vulnerable families, with clear evidence of cost effectiveness.

• Be more flexible to allow the FNP programme

7

to be more personalised to individual families and responsive to local contexts.

• Support the exchange of good practice between services to improve outcomes for all families.

As an ADAPT site we are working hard to co-design and test complex innovations for FNP such as –

• Develop new materials, in different formats and to be delivered at different stages of the programme.

• Strengthen links and pathways with our wider health and social care colleagues.

• Design different training options and elements for nurses to build skills and capacity for future adaptations.

We are proud to be part of this exciting work to future proof FNP and we will be able to share more about this and the outcomes for our families in the future.

Families First

Recognising that not all vulnerable mothers are able to access the FNP service and the need for a more flexible approach, we have used our

specialist knowledge and expertise to design and develop an innovative intensive home delivery programme ‘Families First’ (F1st). The F1st programme is based on the principles and ethos of other home visiting programmes and enables us to reach a wide cohort of vulnerable first time mothers according to need.

The target population is under 25 years with additional preventative factors. The model also supports integration between FNP, F1st, universal services and service users. The outcomes of F1st are that parents:

1. Have a healthy pregnancy.

2. Become a knowledgeable, responsible and sensitive parent.

3. Develop positive health, social and economic outcomes for themselves and their children.

The model has 15 key touch points and has the ability to signpost to further services if additional needs are identified by the goal setting model “Helping Hand”.

The vision of Families First is that the learning, delivery style and tools can be shared with all 0-19 practitioners so the families in Derby city can benefit at varying levels dependent on their need.

What we do continued

6

Ripplez CIC and YMCA Derbyshire have been working in partnership to help support teenage mums living in unsuitable accommodation but who are not classed as statutory homeless. A housing worker supports the work of the Family Nurses and is funded by BBC Children in Need.

Our housing worker aims to provide consistent non-judgemental and high quality, holistic support to our young clients to move in a planned way towards independent living.

Meet Kelly, who has benefitted from the partnership. She explains, “I was 18, pregnant and sharing a bedroom in my ex-boyfriend’s sister’s house after he had assaulted me. I didn’t have anywhere else to go, but my Family

Nurse told me that she could get the housing worker to come and talk to me. At first I didn’t think she could help me – I didn’t think anyone could – but we met and she was really nice and listened without judging me.

“Without her help I wouldn’t have known where to start, but she supported me to go the Council which agreed to put a deposit on a place I found with the housing worker’s help. It made me feel really happy that when the baby was born we would be safe and warm.

“I’m in a better place now. She helped me to see the bigger picture and never judged me even when I made some bad decisions and I think that the future will be ok.”

Housing worker partnership

This photo is of a genuineRipplez family but not of the one featured in the report on the left.

9 8

Ripplez has developed a Community Parent Programme as an affiliate of Parents 1st, who promote a nationally acclaimed peer support training programme.

‘Community Parents’ are volunteer mothers, fathers, grandparents and carers who are carefully recruited for their ability to build trusting peer relationships with young parents, sitting midway between a professional role and that of a friend.

The volunteers’ learning is accredited by City & Guilds, giving them a nationally recognised qualification and enabling them to develop their own skills.

Derby’s Community Parent Programme

currently has nine active volunteers undergoing training and we envisage having another 25 active by the end of 2017.

The volunteers will go out into their local communities reaching local expectant parents, through outreach work in community settings.They will enable parents to access our service, other local services and evidence based information for a happy healthy pregnancy.

Services are commissioned by local authorities and co-funded by philanthropic organisations.

Parents are supported by the volunteers through 1-2-1 mentoring and support to attend groups, with the aim of helping them to become resilient and responsive carers to their children.

Community Parent Programme

My name is Alice and I started my journey with the Family Nurse Partnership when I was a first time teenage mum. I found it difficult being pregnant at 19; however, having the support I had from the partnership was amazing and helped me grow as a person, to believe in myself and become the best mum I could be to my son.

I always knew I wanted a career in something similar to this so, when the opportunity arose to take part in a peer volunteering programme with Parents First, I was really interested. The more I was informed about the programme, the more I knew I wanted to become a part of it, as I know what it is like being a first time mum having experienced all the emotions. I wouldn’t have been aware of this opportunity or even have had the confidence to apply if it wasn’t for being a part of Ripplez.

I believe my future has changed for the better and I’m thankful to the Ripplez Family Nurse Partnership team.

11 10

Inspectors from the Care Quality Commission (CQC) paid an unannounced visit to us on 6th and 7th July 2016.

The inspectors not only visited our centre in Derby but also our staff bases in Bolsover and Burton-on-Trent and accompanied staff on home visits. Here are some of the key quotes in their subsequent report:

“There were robust incident reporting systems and examples of shared learning. Staff at all levels of the organisation understood their responsibilities to protect clients from avoidable harm.”

“Family nurses were well trained and supported to deliver the FNP programme and received regular clinical and psychological supervision.”

“There was a strong client-centred culture. Staff were highly motivated and provided individualised and compassionate care.”

“The provider was… developing innovative, cost effective models of care”

“Staff spoke positively about managers. They told us both the

When the Inspectors called

chief executive and clinical director were approachable, visible, and cared about staff members as individuals. We found there were very high levels of staff satisfaction and engagement across all groups of staff.”

“The provider had a clear vision, set of values and strategy, which was shared by all staff within the service.”

“There was strong evidence of multidisciplinary working with other health professionals and organisations”

“Clients spoke positively about the FNP programme and felt it had made a difference to their lives. They valued the relationships they had developed with their family nurses, appreciating the emotional support and practical advice and guidance they had received.”

You can read the full report here: http://www.cqc.org.uk/location/1-338285413/inspection-summary

13 12

Making an impact in 2016

100%

of children had up-to-date immunisations at graduation 70%

of mothers initiatedbreastfeeding

My eldest child, Riley, is six years old and I was 17 when I gave birth. His Dad, Kyle, was 18. We were both at college and living with my Mum. It was a daunting time but I have to admit that when I was given the opportunity to have a family nurse, I was slightly sceptical but agreed – and I can honestly say I never looked back!

My family nurse was Liz Harman and she was absolutely fantastic. I could never put into words how much her visits meant to me. She was always there to give me advice.

I applied for my first job when Riley went in to nursery school. Liz provided a reference for me and I got the job! Then we also moved out of my Mum’s in our lovely first home.

After just one year I got a promotion and Kyle opened his own business. We have been together nearly eight years now and had our second son two months ago.

I will forever be thankful to the FNP for the opportunities I was given and truly believe that being part of it enabled me to be a good young Mum and gave me the motivation to do well for myself and family. Thank you FNP!34.4% of smokers had stopped

smoking at 36 weeks’ gestation

43%

of parents were in employment, education or training at graduation

15 14

17 16

Chloe was 16 years old and 11 weeks pregnant when I first started to visit her. She had low self-esteem and confidence, did not attend school and was also dealing with the separation from her parents. She had become pregnant very early into a new relationship; her boyfriend was a care leaver and had poor anger control and a criminal history. Kai had a difficult relationship with professionals due to his removal from his mother at an early age. He was a daily drug user and had a history of mental health issues.

At first Chloe found it difficult to touch her bump or talk to it, and I was concerned that she wouldn’t be able to respond to her baby sensitively when she was born. After working with other agencies and due to all the other factors involved, the unborn baby was placed on a child protection plan.

Using FNP materials, Chloe and Kai began to work through their issues and, over time, both began to trust and work with me and other professionals. Kai engaged with drug services and this helped him with anger control. He was

discharged from the service due to his progress and has now secured full time employment.

Chloe has blossomed during her time on the FNP programme; she has gained confidence in her abilities and has completed her accreditation. She has a loving and secure attachment to her baby and continues to seek advice to support her baby’s development. She has a clear plan to return to education and achieve her ambitions.

Chloe’s baby was removed from the Child Protection Register, and Social Care ended their involvement as there was no longer a risk from harm for the baby.

Chloe and her partner have worked hard together in what they have achieved. They are visibly happier, relaxed and have rebuilt their trust in professionals. Chloe will continue with the FNP programme without the need for the involvement of other agencies, build upon the skills she has already developed and continue to be a positive parent.

Meet Chloe and KaiA Ripplez Family Nurse tells the story

This photo is of a genuineRipplez family but not of the onefeatured in the case study. “

“Chloe has blossomed during her time on the FNP programme. She has gained confidence in her abilities and has a loving and secure attachment with her baby.

2011-12 2012-13 2013-14 2014-15

£0.8m

£1.3m

91% commissioned income

9% grants

Ripplez delivers the Family Nurse Partnership funded by NHS England in Derby City, Derbyshire, East Staffordshire and Worcestershire. Almost 10% of our current income comes from the Impetus Trust and other philanthropic sources.

Our vision for the futureFunding and financial turnover: 2015-16

Establish Ripplez as the provider of choice to deliver FNP and Parenting Support Services.

Evidence our young parents’ and their children’s progress, towards achieving our ambition for school ready children and employable parents.

Establish the ‘Wavez’ charity so it will benefit future generations.

Secure funding for future financial sustainability and growth.

Develop and embed a culture of continuous improvement within our workforce and at Board level.

18

2015-16

£1.8m£1.8m £1.8m

Ripplez CIC, Revive Healthy Living Centre, Roe Farm Lane, Derby DE21 6ET

ripplez@nhs.net • 01332 888091 • www.ripplez.co.uk Design by Dominic Baster • Published by and © Ripplez 2017 No part of this publication may be reproduced without the prior consent of the publishers.

How you can help us with our workOur mission is to help the most vulnerable parents in society, by delivering high quality evidence based programmes. We want to work alongside families to meet their health and social needs, encourage aspiration and promote self-efficacy through high quality evidence and strengths based programmes.

Building trusting relationships, sharing learning and supporting people and communities to grow and develop are at the heart of everything we do.

We know that by investing now in targeted early interventions, we can:

• protect and safeguard vulnerable young mothers and children • improve child health and development • improve economic self-sufficiency, and • help raise the aspirations of young parents and their children.

To be able to continue the work we have begun we need to develop and grow our business, if you think you can support us to change the lives of more families please contact our team on 01332 888091 or visit our new website: www.ripplez.co.uk