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The Thurrock Community Mothers Programme -
Thameside Community Healthcare NHS Trust

Parents supporting parents

The programme uses a pro-active non-stigmatising approach that values prevention

Principles of partnership, equity and collaboration&

Maintaining safe standards of care

Confidence building and self-esteem&.

Important practice strategies

Parents who have been visited express a strong sense of being valued and supported&

Visiting guidelines and protocols

Further information

 

Parents supporting parents
The Community Mothers Programme is an innovative support programme where experienced mothers (called Community Mothers) offer informal support and useful information to other local parents with young children. Monthly home visits are offered as "one parent to another". They also offer parent led support groups in the most disadvantaged areas, which promote maternal mental well being during the first year of parenthood. Community Mums do not report back to professionals, but specially trained health visitors provide ongoing support, training and guidance.
 
The Community Mothers Programmes is about MOTHERS SUPPORTING MOTHERS (fathers are very much involved too). The programmes are about promoting positive health and developing early parenting skills, concentrating on primary and secondary prevention. There is a strong emphasis on inter-agency collaboration.
 
The programme was introduced into the UK in 1991 by Thameside Community Healthcare NHS Trust with the assistance of the Early Childhood Development Unit, Bristol University. It now operates independently. A committed team of Community Mothers now offers informal support and befriending within eight of the most disadvantaged areas of Thurrock, Essex.
 
The Thurrock Community Mothers Programme has gained two prestigious awards for outstanding achievements:
 
  • The Essex Area Child Protection Committee Award 1993  
  • A Regional Healthy Alliances Award 1995
  • A new sister programme, called the Breast Feeding Support Programme, introduced in 1995, operates on the same principles and improves low breast feeding rates in disadvantaged areas. This has also gained two prestigious awards:
  • The Thameside NHS Trust Gold Quality Award 1997
  • The Professional and Practice Development Nurse National Achievement Award 1997
 
The Community Mothers Programme operates on an international basis. Brenda Molloy, with a team of specially trained public health nurses, developed the first programme in Dublin in 1988, where there are now 170 Community Mothers visiting in 11 different health boards. The programme is now also well established in the Netherlands, Germany and the USA. Several other Community Mothers Programmes now operate in various areas of the United Kingdom.
 
Principles of partnership, equity and collaboration
The programme recognises that parents tend to seek social support from other parents about parenting and health issues. Lay people have a different perspective and the programmes create innovative health promotion approaches that are both user friendly and culturally relevant.
 
The support workers are representatives of their own communities and offer help from "within". They try to "hold back" on their own opinions and enable parents to "work through" their own difficulties.
 
Confidence building and self-esteem
Parenting is a very isolating and demanding job. Both parents need to feel confident in their new roles - particularly during the early years. In order to achieve this they need easy access to vital information about effective parenting and easily accessible support that promotes self-esteem. The Community Mothers share a wide range of humorous, cartoon illustrated information sheets with parents during each monthly home visit. These cartoons are a vital part of the programme because they provide useful and practical information about parenting, all areas of child development, and a wide range of health issues. Sharing the cartoons during each visit provides a focus for discussion and debate and generates new ideas for the parents to try out with their own children.
 
Community Mums praise parents for their achievements and encourage them to set their own monthly targets. They do not hand out advice, but work on an equal basis, offering suggestions and alternatives to enable parents to find solutions to their own difficulties.
 
&"We offer useful tips via informal cartoon information sheets and we pool ideas from other parents. If you make the parents feel good, that is then reflected on their own relationship and in turn, the health and development of the children"& [Community Mother]
 

Parents who have been visited express a strong sense of being valued and supported&

.."She [Community Mother] helped me to see all the good things I do with my son when other people made me feel a failure. Im not the worst mother in the world now. Im stronger and Im more realistic. I hope the future sees all us mums using our experience to help each other constructively."&
 

.The programme uses a pro-active non-stigmatising approach that values PREVENTION

Professionals spend a great deal of valuable time responding to crisis situations. Prevention has suffered because resources are so over stretched. By facilitating and supporting these community based support workers, early difficulties can be "nipped in the bud" before problems become entrenched and difficult to resolve. Offering non- stigmatising support to all local parents after they have a new baby spreads the "preventative net" far wider. A much wider population can be reached by developing these programmes than would be possible by health visitors working in isolation.
 
Maintaining safe standards of care:
The work of the volunteers is in accordance with the Thameside NHS Trust volunteer policies and procedures. The role of the co-ordinator is crucial for ensuring safe standards of care and monitoring and clarifying the boundaries within which the programme operates:
 
A COMMUNITY MOTHERS CHARTER highlights the following practice boundaries:
> dont let parents become dependent on you
> dont lend money or do baby sitting
> never give advice about health or illness
> the absolute duty to protect a child being harmed
stresses confidentiality
 
Important practice strategies include:

Rigorous recruitment of volunteers. The volunteer mums are recruited very carefully. They are usually recommended via word of mouth by networking with a wide variety of local voluntary and statutory agencies. References and social service checks are undertaken and an in-depth interviewing procedure.

 

Providing guidance for undertaking home visits and group work.

 
The Community Mums use a form to assist them as they do a home visit. This helps them to keep each visit on track by guiding or prompting them through the visit, giving it a structure and some direction. It also reminds them to ask the parent to contact a health professional if they have any concerns about illness etc.
 
An important feature at the end of each visit is the setting of targets. These are practical ideas or things to try before the next visit and are set in accordance with issues discussed during the visit - often ideas from the cartoon information sheets. These targets are reviewed at the beginning of the next visit. Encouraging the parents to set themselves targets motivates them to put into practice their own ideas. The emphasis is always to point out the parents ongoing experience and achievements.
 
Vetting referrals. There is a tendency for some professionals to refer families that are causing them difficulties, rather than referring families at an early stage when they would benefit from preventative support. It is important to know if there are any child protection issues to be aware of, or any risk of violence to the community mother.
 
Vetting referrals. There is a tendency for some professionals to refer families that are causing them difficulties, rather than referring families at an early stage when they would benefit from preventative support. It is important to know if there are any child protection issues to be aware of, or any risk of violence to the community mother.
 
Informal monitoring. The health visitor co-ordinator visits each volunteer at home every two to three months. This gives the opportunity to talk through how things are going and any difficulties they are having on a one to one basis. The health visitor trainer occasionally accompanies the volunteers on home visits to guide and assist them in using the programme materials correctly.
 
Access to support and advice. Clear guidance is given on what to do and who to contact in the event of a crisis or concern about a child at risk or other urgent issue.
 
Providing clear, evidence based health and parenting information. The volunteers share cartoon-illustrated health and parenting information sheets with parents. These are used as an important focus for discussion and debate about key health and parenting issues. This forms a vital part of each visit.
 
Appropriate record keeping. The Community Mums do not keep formal records. However, the health visitor co-ordinator keeps records about who is being visited, how the visiting is progressing and any action taken in response to the issues raised by the Community Mums.
 

Inter-agency working and liaison with other professional and voluntary services. Services are mobilised in accordance with the wishes of parents being visited, in response to requests passed on by the Community Mums. In this way, vulnerable families gain increased access to many local services. A wide range of agencies is invited to contribute to ongoing informal training sessions. Several joint projects have been initiated.

 
Ongoing training and mutual support. Following initial individual training sessions, group training and support meetings operate on a two weekly basis. These provide a forum for ongoing learning and development and reinforcement of programme strategies and operating boundaries.
 
Child protection. Relevant information is passed on, on a need to know basis if there is a need to protect a child in danger. Each Community Mother has an absolute duty to contact the co-ordinator if she thinks a child is at risk of significant harm.
 
Visiting guidelines and protocols:
Each Community Mother signs a confidentiality clause when they are recruited to the programme.
They are given clear guidance about the importance of confidentiality before they start visiting:
No professional worker should convey any medical or any other information received in confidence from a client to a Community Mother without prior agreement of the client. Similarly, no Community mother should divulge any information to a professional without the clients prior consent.
 

However, where a Community Mother is concerned about a clients problem, this can be discussed anonymously with a professional so as to elicit the most appropriate course of action available.
The exception to the above guidelines is when a Community Mother suspects that a child is suffering significant harm. As protection of the child is paramount, it is understood that the Community Mother has an absolute duty to act on behalf of the child and contact the co-ordinator, who is then responsible for taking appropriate professional action.

For further information, contact -

Celia Suppiah or Mary Low
Community Development Specialist Nurses
Public Health Development Unit
Tilbury Health Centre
London Road
Tilbury
RM18 8EB
Tel. 01375 843241

 
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