Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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Learning, Food and Play for families when they need it most Holiday Kitchen offers programmes of family wellbeing activities and healthy communal meals for pre and primary aged children and their families during school holidays periods. Co-delivered by staff and volunteers in community-based venues, it positively responds to risks of food poverty, social isolation, safeguarding, debt, physical inactivity, poor mental health and learning loss which are most acute during summer breaks. Based on family learning and play principles, it focuses on supporting vulnerable and at risk families in low income neighbourhoods to thrive. This briefing examines the evidence base Holiday Kitchen has gathered over the last three years of the value its holiday food and activities play in addressing health inequalities amongst low income and vulnerable families with pre and primary school aged children, and briefly explores the its positive contribution to support Prevention and Early Help work. 1. Wider Context of child nutrition, mental health and enrichment activities Much of our current health policy for children is driven by an emphasis on eating, maintaining a healthy weight through physical activity and the emotional and mental health of parents and children. Healthy Start is committed to supporting children in the first years of life. Free School meals i then offers 1.7 million pupils a free nutritious meal every school day, helping them do better in school, eat healthily and saving families up to £400 per child a year. Improving children’s diets and levels of physical activity are primary aims of Childhood Obesity: a plan for action (2016) ii and as part of this, it is expected that a Healthy Rating system for schools will be introduced with the support of Ofsted. This builds on the work achieved by the School Food Plan iii to support head teachers to improve food in their schools with the aim of boosting pupil wellbeing and academic attainment. Mental health has been given equal status with physical health following the publication in 2013 of ‘Closing the Gap: Priorities for essential change in mental health’ (Social Care, Local Government and Care Partnership Directorate, 2014) and ‘Future in mind – promoting, protecting and improving our children and young people’s mental health and wellbeing’ (2015). Positive participation in education is recognised to support and protect children’s wellbeing. Yet time out of school and nursery in the form of school holidays make up 13 weeks or 25 percent of a child’s year. During this time, there is a growing recognition that low-income and vulnerable children’s disproportionately face a series of risks, in a range of key areas as illustrated in Figure 1, including food poverty ivv. This can result in financial, emotional, nutritional, safeguarding, educational and/or social challenges that can demand costly crisis intervention and notably have longer-term impacts on health, educational attainment and wider family employment. Over the last few years, key steps have been taken to investigate and respond to the risks and opportunities school holidays present: • 2014 an All-Party Group of MPs and peers vi argued that tackling holiday hunger and the development of food and enrichment programmes during holiday times was needed. vii • 2015 the All-Party Parliamentary Group for School Food establishing a Holiday Hunger Task Group viii 2
• 2016 a short mapping survey in the UK showed over 400 organisationsix active in delivering food-based holiday schemes to provide children with a free healthy meal along with a range of physical activities; learning opportunities; enrichment and creative opportunities. • 2017 the Welsh Government announces £500,000 fund to support Holiday Food and Fun activities x • 2017 the London Mayor’s Fund launches Kitchen Social with the aim to help 330 community organisations develop a healthy food and social offer during the school holidays. xi Figure 1: Heightened risk for low-income and vulnerable families during holiday periods How does food poverty affect families? • Less varied dietary patterns • Less fresh fruit, wholemeal bread, meat and oily fish • Lower nutrient intakes than richer households • Parents/carers skip meals • Pregnant women have poor diets – more low birth weight babies and less likely to breastfeed • Children grow less well, and are more likely to be obsese • Children come to school hungry, less able to learn and benefit from school (Based on national and local surveys of food and dietary intake – Dowler, et al) 2. Holiday Kitchen Holiday Kitchen xii aims to mitigate the holiday time risks for low-income and vulnerable families with pre and primary school aged children. The programme recognises that a nutritious diet and continued and safe learning opportunities throughout the year are some key cornerstones upon which wider education and wellbeing outcomes 3
are built. Its vision is for families to be supported to thrive throughout the year. At its heart is a focus on improving the public’s health and reducing health inequalities. Using a simple formula of holiday learning, food and play for families when they need it most, Holiday Kitchen works to address these holiday challenges in targeted neighbourhoods and settings. Built upon the National Economic Foundation’s Five Ways to Wellbeing principles xiii , it co-delivers diverse and creative free eight day family wellbeing programmes spread across 2-4 week holiday periods. Working in close partnership with community settings including children’s centres, domestic violence refuges, faith and community centres, Holiday Kitchen offers family focused learning activities, active outdoor play, family support, and communal breakfasts and lunches, catering to families with pre and primary school children. These programmes are not a form of child care and parents and carers are actively encouraged to participate and support their children throughout. Programme Thematic Focus and Public Health Holiday Kitchen focus is on three key areas where holiday risks are most pronounced: • Holiday nutrition: Holiday Kitchen aims to improve participants’ access to nutritious meals and experience of nutritious food during school holidays when Free School Meals (FSM) are unavailable, food bank referrals spike and there is a food poverty premium based not only on reduced consumption of fresh fruit, vegetables and oily fish, but the over consumption of convenience ‘junk’ food and drinks high in sugar, salt and fats. Through informative and hands-on experiences of healthy food, including through experimental ‘make and taste’ games and fun family cookery activities alongside communally shared nutritious meals, the programme supports empowering choice in nutrition experience, knowledge and related health behaviours for parents/carers and children. • Relationships: Supporting and strengthening family relationships is central to the psychological wellbeing and the functioning of family units. When families with limited resources experience stress, positive family bonding can be affected and contribute to poor mental health outcomes, low self-esteem and a lack of confidence. Social isolation and poor peer relationships can similarly impact on children and families’ social inclusion, participation and sense of self agency within communities. Holiday Kitchen focuses on supporting relationships through fun, non-intrusive, practical family and group activities in safe and engaging environments. While enabling social and emotional learning through creative interaction, the programme also embraces multi- agency working and signposting to ensure that families are appropriately supported. In so doing Holiday Kitchen also contributes to child and vulnerable adult safeguarding and related Early Help interventions associated with the Support For Families and Troubled Families agendas (Ofsted, 2015; Department for Education 2016). • Positive holiday activities: For low-income and vulnerable families holidays can result in isolation, inactivity and emotional stress. Opportunities for learning, socialising and playing significantly contract relative to more affluent families and term-time periods. Learning loss has been attributed to holiday periods (Campbell et al, 2015) which may exacerbate the attainment gap between children eligible for Free School Meals and their more affluent peers. Holiday Kitchen is committed to providing active and enriching family learning activities focused around life skills (including play) and healthy lifestyles 4
that families can replicate and/or build upon independently beyond the confines of the programme on a limited budget. The related outcomes of improved school readiness, improved safeguarding and reduced opportunity gaps in social participation, improved physical activity, nutrition knowledge, reduced food poverty, improved mental health and family functioning are mapped out in the programme’s Theory of Change for stakeholder groups (See Appendix 2). Fig 2: Holiday Kitchen Summer Programme 3. Background The programme was pioneered by the Accord Group xiv a West Midlands social housing and care provider in 2013. Since then it has received support from Family Action, a national family support charity, BBC Children in Need, the Children’s Food Trust, Birmingham City Council, Birmingham City University, Fareshare, the Greater Manchester Social Housing Partnership alongside numerous community based agencies who have either run programmes and/or facilitated activity sessions. 5
To enable programme fidelity, the Accord Group offers a core support package to delivery partners, including: • A structured, quality assured and evaluated eight day holiday programme; • A toolkit to support planning and delivery, including recommended activities and a quality assurance self-assessment tool; • Training for service delivery coordinators • Budget and financial guidance; • Communication and marketing resources; • Project sponsorship and resources where possible. 4. Evidence, Impact and Social Value Since 2013 Holiday Kitchen has co-delivered over 16,000 activity days with meals through local and national partners, to 2138 participants in the West Midlands and Greater Manchester. Throughout, the programme has collected and disseminated social impact evaluation data in partnership with participants, academics and community engagement practitioners. Between 2014 and 2016 Planning for Real xv - experts in community engagement - worked alongside partners from the Accord Group, Family Action and Birmingham City University to explore the social impact of Holiday Kitchen in relation to the above core objectives. xvi The Planning for Real Unit took the lead in designing bespoke evaluation tools and materials to use with the children and families who attended the Holiday Kitchen. The Planning for Real ethos is that techniques should be highly visual, tactile, participatory and community-led and this approach underpinned the design of the evaluation activities. The Unit also carried out a ‘light-touch’ SROI analysis of one of the delivery venues in order to explore how investment has been returned upon in 2014 and through a Sandwell case- study in 2015. 2014 Learning Birmingham City University conclusions of the initial evaluation based on 2300 meals and activity days across eleven sites indicate that Holiday Kitchen is a promisingly effective programme for meeting the needs of low-income children and families during holiday periods and, relationally, in addressing the Child Poverty agenda laid out in the 2010 Child Poverty Act. In particular the evaluation showed that Holiday Kitchen met the following short term aims for children xvii: • Reduced opportunity gap • Increased physical activity • Improved opportunities for family bonding and learning outside the home • Improved nutrition 6
High levels of emotional stress and strain at home were reported by many of the parents in their evaluations of Holiday Kitchen 2014 (‘I felt very stressed at home and was struggling’) and some offered clear insights into how attending Holiday Kitchen with their children gave them the chance to relax and enjoy some family time. For example: ‘I feel very happy now as I am able to have fun with my kids rather than worry about everyday stress. I feel more able to bond with my children and have more fun with them.’ ‘Holiday Kitchen has helped calm me down and focus on my children. It has also helped my kids make friends.’ There is also evidence that the short term aim of ‘Increased exposure to reading and language development’ was partially met through the vocabulary building aspects of activities, and that the ‘Money, fun and games’ sessions may have led to an ‘Increased awareness of illegal money lending’. Notably, over a third of the participant cohort had visited a foodbank in the preceding twelve months, with a similar percentage in receipt of additional support through health and/or education providers. Dress up & play day Swings after Change4Life adventure day Fruit Kebabs 2015 Learning Based on the success of the 2014 Holiday Kitchen, 23 community settings were recruited to deliver the programme over the summer of 2015 - twelve in the Greater Manchester area, ten in the West Midlands and one in Lincolnshire. Exploring the programme’s wellbeing benefits using a shortened Warwick and Edinburgh Mental Wellbeing Scale xviii as part of the 2015 Holiday Kitchen evaluation, the West Midlands programme found: • 69 percent of 42 respondents said their child’s mood had improved ‘quite a lot’ or a ‘great deal’ through Holiday Kitchen participation. • 87 percent of parents/carers said their children had benefitted from joining in with other children, and 74 percent of parents/carers said that their child had ‘enjoyed being helpful to others’. • 66 percent of parent/carers said that they ‘have been feeling more relaxed’; and 67 percent stated that Holiday Kitchen has helped them to ‘feel better about myself’. 7
• 57 percent of parents also reported that Holiday Kitchen has helped them ‘feel closer to other people’; and 66 percent of parents/carers also stated that they have become ‘quite a lot’ or a ‘great deal’ more interested in new things. Planting, Growing Eating activity day Fun with food This same study found the following nutritional benefits: • 75 percent of children enjoyed eating fruit and vegetable, 69 percent enjoyed making food and 78 percent reported enjoying trying new foods at Holiday Kitchen • 56 percent of parents and carers felt their families ate more healthily than normal at Holiday Kitchen • 88 percent of parents and carers felt more confident to make healthy meals/snacks for their children as a result of Holiday Kitchen • 31 percent increase in the number of families that identified their food at home as nutritionally ‘good’ to ‘excellent’ following the completion of the programme. • 22 percent of parents/carers said Holiday Kitchen ‘helped me eat regular meals’. What do you like most about eating at Holiday Kitchen? 90% 77% 78% 75% 80% 71% 69% 70% 63% 60% 49% 46% 50% 40% 30% 20% 10% 0% What children reported liking most about eating at Holiday Kitchen (from O’Connor et al 2016) 8
Relationship benefits from in the 2015 programme included: • 87 percent of parents/carers said their children had benefitted from joining in with other children, and 74 percent said that their child had ‘enjoyed being helpful to others’. • 33 percent increase in the number of families that reported that the quality of their family time was ‘good’ to ‘excellent following completion of the programme. • 38percent increase in families rating their socialising with people outside of their family between ‘good and excellent’ following Holiday Kitchen. • 33percent increase in number of parent/carer reporting feeling confident to do family activities with their children following programme. PHE West Midlands sponsored the follow-on study from the 2015 evaluation Sandwell Prevention and Early Help Case Study. Based on a small sample of in-depth qualitative interviews with commissioners, delivery staff and participant parents, the study focused on two measures: • Whether involvement in the programme resulted in sustained short/medium term outcomes for individuals • The social value and value for money of outcomes for individuals and statutory agencies. It found that over a three month period there appears to be a cost effective continuum of programme impact for some participants who have achieved medium term applied knowledge, and, in some cases, sustained behaviour change in relation to one or more of the programme’s key objectives: • improved nutrition • stronger relationships • engagement in positive learning activities. Sandwell Prevention and Early Help Case Study: Programme Cost Effectiveness Financial analysis indicates that the cost of the programme of less than £400 per family compares favourably with the cost of a group parenting course – £580(Unit Cost Database, 2015). Where a Holiday Kitchen programme is partly attributable to avoiding a CAF intervention, this would contribute towards a saving of £1493, the estimated cost/saving to Children’s Services of a CAF (Unit Cost Database, 2015). Where Holiday Kitchen contributes to a reduction in intensive support for families there is clear potential for cost savings to local authorities. Although there was some anecdotal evidence about Holiday Kitchen having contributed to changing support arrangements for families, the multitude of agencies involved in supporting families and the small sample size mean it would not be credible to claim this as a direct outcome of the programme. It is however important to note the potential value of the programme as a cost-effective option which could be included as part of integrated support services. Based on financial proxies for a range of medium term outcomes, the evaluation concludes that there is a ‘compelling case’ for an ‘invest to save investment in this type of programme’. (See Appendix 1 for details.) The full reported outcomes of these evaluations can be found on the Accord Group website. 9
2016 Learning During summer 2016 Holiday Kitchen delivered its largest number of programmes to a total of 738 people across 30 deliver sites. This resulted in a total of 7,454 delivery days with meals. Three programmes ran across Greater Manchester, and the remaining 27 concentrated in the West Midlands. In total 5328 meals were delivered in collaboration with Birmingham City Council through Birmingham Children’s Centres. From this delivery, Birmingham City Council gathered data from participant parent/carers through pre and post- programme surveys. Findings from these surveys include the following findings: Figure 3: Evaluation finds from 18 Birmingham sites Summer 2016 “Holiday kitchen provides an excellent opportunity for families on a budget to have quality family time. I've seen myself really struggling with finance, routine, limited screen time and feeding nutritious meals. And I have found holiday kitchen answers all that for me. There’s balanced and healthy meals, warm up exercise and outdoor activities, family outings, relaxing art and crafts for parent and child, thoughtful activities for children to learn about cultures, countries, nature, festivals, languages, and parent and child cooking activities as well. The staff and volunteers carry the flow of activities in a very safe and fun way”. (Parent feedback at a Children’s Centre) This has helped me to spend time with my child showing them there is more to food than chips. (Parent feedback from a Community Centre) Getting into a group like Holiday Kitchen has helped me and my family so very much as we had all lost confidence being inside 24/7. (Parent feedback from a community setting) 10
Participating centres found that in delivering the programme and related outcomes around Holiday Kitchen’s three key thematic focus areas of holiday nutrition, relationships and activities, the programme enabled them to meet their own business plan objectives which are aligned with reducing health inequalities, supporting parenting and addressing child poverty as illustrated by Golden Hillock Children’s Centre illustration: Golden Hillock’s alignment of Holiday Kitchen outcomes align with children’s centre priorities Holiday Kitchen’s alignment to public health priorities may be further understood in relation to the findings from 27 settings that Birmingham City University consulted following summer 2016 delivery (Wade, 2016). This consultation was conducted with the programme lead for each delivery centre: Holiday Kitchen 2016 reached the families that needed it the most Holiday Kitchen 2016 has helped children access healthy holiday food 11
Holiday Kitchen 2016 has helped children positively strengthen relationships with their family Holiday Kitchen 2016 helped stimulate children’s interest in learning Holiday Kitchen 2016 attendance has improved the self-confidence of children 5. Health and Housing Holiday Kitchen demonstrates the added value of, and outcomes to be achieved, as a result of housing and health colleagues working together to tackle health and social inequalities. Social landlords are important players in local communities and are in a unique position to offer support to achieving healthier lifestyles. They understand the needs of their residents and often invest in interventions to support them in a range of public health related initiatives, for example improving diet and eating more healthily. 12
The Accord Group are frontrunners in this and received an award for the Best Tenant Support/Advice Programme category at the Housing Excellence Awards 2015 for their Holiday Kitchen work. These awards highlight and reward those who are leading the way in the social housing sector. 6. Troubled Families and Early Help Senior Government officials have previously recognised the potential for Holiday Kitchen principles to be integrated with other significant programmes of work such as “Troubled Families”. xix Improving the health of troubled families is critical and means addressing the wider factors that shape health by working with local partners, and improving access to mental, physical and other health services. It also means improving healthy lifestyles, particularly in relation to multiple lifestyle risks that can be found together, for example, poor diet and mental wellbeing. Improvements across lifestyle factors, in turn, improve self-esteem, social and economic functioning. xx Furthermore, a healthy childhood is an integral part in developing a child’s ability to learn. Earlier intervention to support better health and wellbeing provides an opportunity to break the cycle of poor outcomes for the future. Holiday Kitchen working with schools, Early Help hubs and related agencies can support the cost effective delivery of integrated services which can effectively address families’ needs during and beyond the 25 per cent of the year schools and state nurseries are on holiday. The Holiday Kitchen approach acknowledges that health challenges do not exist in isolation from other problems, and that holiday periods may offer not only threats but opportunities for improved wellbeing and behaviour changes. Those working on Holiday Kitchen programmes may be well placed to work with both their Troubled Families co-ordinators and Early Help lead officers through unobtrusive play based activities and communal meals to potentially improve outcomes for vulnerable families in an integrated manner throughout the year. Accord Domestic Violence Refuge Case Study A woman in the refuge has four children. Her eldest (TD) has been diagnosed with ADHDA and ASD. Cooking and the healthy food experience for this large family, with a busy routine was not high on the list of priorities for mum. She often cooked frozen foods for convenience and fruit and vegetables were not common in the family diet. The family did not experiment with foods; and generally sitting down and eating together was a rarity. This family were fairly new to refuge when the Holiday Kitchen Summer programme began. The siblings had not yet formed any friendships with other children and so the programme offered the opportunity for them to engage with and have fun with other children within the refuge setting. The eldest child experienced attachment disorders and regularly displayed difficult behaviour. Staff facilitating the programme set about introducing themselves to each family to get an idea of individual likes and dislikes of food, as well as their experience of cooking and eating different foods. Staff noted that TD was incredibly enthusiastic, not only to get involved and cook but to learn new ways to cook with different types of food. TD took a real interest in cooking and the way in which fresh ingredients can be turned into a delicious meal. 13
Attending the programme gave TD and her siblings a great experience of spending time with one another in a setting where they were able to prepare and cook fresh home-made meals. This time allowed the siblings to talk to one-another and have fun preparing their own meal. All siblings agreed to be responsible for different elements of the cooking and responded well to each other’s instructions. Holiday Kitchen gave the opportunity for TD to spend quality time building towards a healthy relationship with her siblings in a different setting. During Holiday Kitchen TD did not display any outbreaks of challenging behaviour. Towards the end of the programme TD’s mother stated “I’ve seen some huge changes in her self-esteem and outlook of living in refuge”. Since the Holiday Kitchen programme has finished, TD’s peer group has extended and her friendships have grown. This has given her a great deal of satisfaction and comfort. Staff feel that it is clear that Holiday Kitchen qualitatively contributed towards the children in this family’s holiday-nutrition as well as having a medium-term positive impact on their peer and family relationships. 7. Social Marketing Change 4 Life xxi is one of the most instantly recognisable brands in health improvement. It enjoys high levels of trust and involvement from both the public and private sectors. The ambition is to create a movement in which everyone in society plays their part, helping to create changes to those behaviours that can help people lead healthier lives. To support this ambition Holiday Kitchen promotes Change 4 Life messages as part of its activity programme and with stakeholders to strengthen messages around healthy eating and lifestyles. Holiday Kitchen also maximises opportunities to promote and incorporate other relevant social marketing programmes including Start 4 Life the national campaign that offers healthy tips and advice for pregnant women, new parents and families as well. Holiday Kitchen can also make their clients aware of other relevant schemes such as Healthy Start, the UK-wide government scheme to improve the health of low-income pregnant women and families on benefits and tax credits. 8. Scaling up community based public health and wellbeing outcomes As a reminder the PHOF “Healthy lives, healthy people: Improving outcomes and supporting transparency” xxii set out a vision for public health a set of desired outcomes and the indicators to help us understand how well public health is being improved and protected. The focus is on achieving positive health outcomes for the population and reducing inequalities in health. The PHOF sets the context for the system, from local to national level and describes the broad range of opportunities to improve and protect health across the life course and to reduce inequalities in health that still persist. The outcomes reflect a focus not only on how long people live, but on how well they live at all stages of life. Supporting indicators help focus on those things that matter most to the public’s health and which we know will help improve outcomes. These are: • Improving the wider determinants of health 14
• Health improvement • Health protection • Healthcare public health and preventing premature mortality. Local partners are required to consider the ‘family’ of community centred approaches to improve health and wellbeing in their areas (Public Health England, 2015). The Holiday Kitchen commitment to promoting health and wellbeing for participating families within community settings falls in line with the NHS England/Public Health England (PHE) position on community based health interventions. In so doing it also aligns to several of PHE’s priority areas, including: Ensuring every child has the best start in life; mental & physical health; reduction of health inequality; place based health; building community health assets and contributes to support PHOF Domain 1: Improving the wider determinants of health and Domain 2: Health Improvement – particularly in relation to addressing health inequality. If the investment in Holiday Kitchen is considered in relation to the value of the outcomes it achieves over the short and medium term, a compelling case emerges for an ‘invest to save’ investment in this type of programme by Prevention and Early Help Teams. Such family learning, food and play activities could particular provide value for money and/or consolidate support plan outcomes for vulnerable families if offered through integrated prevention and early intervention services in the following key areas: • Early Years: Working with community providers and schools Holiday Kitchen could support ‘whole family’ school readiness. This may be especially pertinent around the transition stage when children start school and in the subsequent summers that follow EYFS during Key Stage 1. • Children and Young People: Working with parents, schools and community services the programme could support children’s and young people’s learning and development especially relating to learning loss during school holidays 1. Summer School programmes offered to targeted children transitioning from primary to secondary schools could be extended to offer opportunities for strengthening family wellbeing and improving holiday nutrition. • Social Care: Holiday Kitchen type programmes could holistically complement support plans for children including those associated with CAF, Children in Need and Child Protection, with an emphasis on strengthening relationships around the child. • Health Support: Holiday Kitchen type programmes could cost-effectively complement services that promote nutrition, active lifestyles and wellbeing in fun, inclusive and dynamic ways. • Targeted Family Support: Holiday Kitchen offers families supportive mainstream environments to strengthen basic life-skills in a non-intrusive manner. This could cost- effectively complement other family support services to ‘turn around’ families and prevent crises. • Children’s Specialist Support: Holiday Kitchen can complement specialist support to children including SEND, communication, psychological and mental health services by 1 See Campbell et al (2015) for further discussion on this within the Scottish context. 15
providing creative and safe opportunities to communicate, creatively engage and strengthen relationships. Through a closer integration of Holiday Kitchen type programmes with the above services, it is anticipated that Holiday Kitchen outcomes for vulnerable families would proportionately also be strengthened. With the appropriate commitment of multi-agency leadership these proposals could easily be integrated into the existing partnership delivery model. The co- ordination of programme development, training, marketing, funding, quality-assurance and evaluation needs investment to support local ownership that effectively reflects different cultural and community needs in delivery. The need to engage wider partners, including Public Health (PH), in further roll out and scaling up of these types of programmes is recognised. Given the positive evaluations to date, it is important system leaders in PH realise the potential of Holiday Kitchen in enabling progress towards achieving a surprisingly wide range PH outcomes and indicators as described in both the Public Health Outcomes Framework (PHOF) xxiiiand Children and Young People’s Health Outcomes. xxiv To date across the West Midlands, Holiday Kitchen has worked with a range of agencies including: • Agencies: Family Support Teams, School Liaison Officers, Food banks, NASS, Family Action, Community Groups, Police, Environmental Charities, Museum Services, DV Services, England Illegal Money Lending Team, Financial Inclusion Partnerships, Social Housing Providers, Kellogg’s, educational caterers. • Settings: Children’s Centres, Community Centres, Domestic Violence Refuges, Schools, and Youth Centres. • Geographic Scope: In addition to 27 Holiday Kitchen programmes in the West Midlands, other parts of the country have now taken up the PH opportunities afforded from working with Holiday Kitchen. Social Housing Providers across Greater Manchester co-delivered twelve programmes through thirteen housing associations in summer 2015 and a further three were evaluated in 2016. • Future: Working closely with Birmingham City Council, Fareshare, community settings and City Serve to skill up, strengthen and deliver Holiday Kitchen programmes through a collaborative working group in Birmingham over the next year. Brakes Meals and More programme has also committed to support ten setting in the West Midlands. 16
To be sustained, however, there remains a notable need for the following: • Strategic policy and practice guidance leadership • Links to and commitment from schools • Commitment of delivery partners and venues • Complementary links to community activity providers • Funds and resourcing 9. For More Information Dr Caroline Wolhuter Head of Social Inclusion Accord Group Email: Caroline.Wolhuter@ashrammoseleyha.org.uk or Twitter: @HolidayKitchen_ Briefing produced by: Karen Saunders, Health and Wellbeing Programme Lead, PHE West Midlands and Dr Caroline Wolhuter, Accord Group Acknowledgements: David Elliott, PHE West Midlands and Sian Every, Accord Group February 2017 17
Stakeholder Outcome Proxy Explanation Source of proxy £9,283 Moving from feeling unconfident to confident - based HACT wellbeing valuation - average value of increase in on specific survey question - I never feel useless - wellbeing for this outcome Change in strongly agree, agree, disagree, strongly disagree confidence for £,1195 Cost of confidence training, SROI conducted for Coventry's Local Enterprise and Growth young people per year Initiative (LEGI). http://www.globalvaluexchange.org/ www.emagister.co.uk/self_confidence_and_assertiveness_co Children urses-ec170022955.htm Improved nutrition £348 Average spend by families on fresh fruit and Family Spending Survey www.ons.gov.uk/ons vegetables per year £225 Cost of three lesson course on healthy eating SROI report ‘Gardening in Mind, Coventry and Warwickshire Mind, 2013’ - http://www.globalvaluexchange.org/ Improved physical £200 Annual cost of weekly sports session http://birmingham.gov.uk/strikesoccer health Increased physical £342 Average cost of yearly local gym membership Sandwell Leisure Trust - https://www.slt- activity leisure.co.uk/memberships £520 Average expenditure on social activities per family Expenditure and Food Survey taken from Global Value per annum Exchange database - http://www.globalvaluexchange.org/ Improved social £1,850 Member of social group HACT wellbeing valuation inclusion The average value of the increase to wellbeing resulting from regular attendance at a group Improved wellbeing £318 Improved self-confidence from revealed preference https://www.barnardos.org.uk/the_value_of_early_interventi – increased data for what individuals are prepared to pay for on.pdf - confidence confidence classes. Parent/carers £13,080 Move from low to high confidence HACT wellbeing valuation Improved family £257 Weight loss club membership https://welcome.weightwtchers.com knowledge of £800 Swapping takeaways for home cooking Change4Life - www.nhs.uk/Change4Life nutrition Improved £2,457 Able to obtain advice locally HACT wellbeing valuation knowledge of (If I needed advice about something I could go to budget recreational someone in my neighbourhood) activities Family relationships £2,629 Potential cost saving or value of resources http://qualitymatters.ie/wp- (parent-child) per reallocated content/uploads/2015/02/Building-Bridges-Restorative- positive change person Justice-SROI-Evaluation-2015.pdf Appendix 1: Examples of financial proxies for a range of HOLIDAY KITCHEN relevant medium term outcomes 18
Appendix 2: Holiday Kitchen Theory of Change 19
References i https://www.gov.uk/universal-infant-free-school-meals-guide-for-schools-and-local- authorities ii https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action/childhood- obesity-a-plan-for-action iii http://www.schoolfoodplan.com/ iv http://whatworksscotland.ac.uk/wp-content/uploads/2015/07/The-cost-of-school-holidays.pdf v https://www.northumbria.ac.uk/about-us/news-events/news/2015/07/research-reveals-impact- of-the-school-holidays-on-struggling-families/ vi http://www.publications.parliament.uk/pa/cm/cmallparty/register/hunger-and-food- poverty.htm vii https://foodpovertyinquiry.files.wordpress.com/2014/12/food-poverty-feeding-britain- final.pdf viii http://www.sharonhodgson.org/tags/holiday_hunger_task_group ix http://foodfoundation.org.uk/jumping-the-hurdle-of-holiday-hunger/ x http://www.bbc.co.uk/news/uk-wales-politics-38490966 xi http://www.mayorsfundforlondon.org.uk/kitchen-social-great-things-to-eat-and-do/ xii https://accordgroup.org.uk/about/projects-and-partnerships xiii http://www.neweconomics.org/projects/entry/five-ways-to-well-being xiv http://accordgroup.org.uk/ xv http://www.planningforreal.org.uk/what-is-pfr/ xvii http://www.planningforreal.org.uk/holiday-kitchen-evaluation-report-is-published/ xviii Tennant, R; Hiller, L; Fishwick, R; Platt, S; Joseph, S; Weich, S; Parkinson, J; Secker, J &Stewart-Brown, S; 2007. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation, in Health and Quality of Life Outcomes 2007, 5:63. xix https://www.gov.uk/government/policies/support-for-families and https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/66113/121214 _Working_with_troubled_families_FINAL_v2.pdf xxi http://www.nhs.uk/Change4Life/Pages/why-change-for-life.aspx xxii http://www.phoutcomes.info/ xxiii http://www.phoutcomes.info/ xxiv http://fingertips.phe.org.uk/profile/cyphof Wade, A (2016). Holiday Kitchen Programme 2016. C:SPACE, Birmingham City University. 20
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