Category: Equality of Opportunity

Removing barriers, offering opportunities to service users

Extending our weight management support: Solihull

As 2015 draws to a close, we’re very pleased to announce a new project for Gateway that will be starting in the new year: a weight management programme commissioned by Solihull Council.

The service will be very similar to the Gateway Lighten Up service that we run in Birmingham, with a call centre to triage people and provide regular support phonecalls, but it will have a bigger focus on behaviour change interventions with face to face and phone support on offer.

adult obesity in Solihull
Click to view PDF showing adult obesity levels in Solihull (pic: Solihull Council)

Why Solihull? Well, we know obesity is an issue nationwide, and affects people across the country. In Solihull, the north of the Borough has a particularly high prevalence of obesity, at around 31.4% compared to 23% in England and 23.7% in the remainder of Solihull, so we’ll be working with people in the north Solihull areas – Fordbridge, Kingshurst, Chelmsley Wood, Bickenhill and Smith’s Wood – to reduce obesity rates.

We’ll be working predominantly with people who have a BMI of over 30, with a particular focus on people with learning disabilities, disabled people and their carers, people with mental health issues, people over 40 and recent ex smokers.

Thanks to our years of experience in Birmingham, we already have a good knowledge of what works and what doesn’t when it comes to weight management. Our experienced call centre staff are set up and ready to go – they have already undertaken Behaviour Change training in order to promote weight loss and retention in weight management services.

For each client in the new programme, we’ll look at the many options that are available locally, and work with them to provide tailored options that meet their specific needs. As well as offering access to weight loss groups, we will be aiming to improve people’s overall wellbeing, and our staff will be working with their clients to find ways in which the whole family can get involved.

Lighten Up team at work
The Gateway Lighten Up team at work

And, of course, each person will get “wraparound support” via regular phonecalls from our dedicated staff, as well as face to face behaviour change support.

Working in partnership with established organisations in the Solihull area, we’ll be able to offer people a range of physical activities (including EXTEND, Tai Chi and walking groups) that are accessible to everyone and easy to sustain. And there will be a strong emphasis on getting other family members involved, with activities like “cook and taste” sessions and dance classes.

For those people with more complex needs there will be specialist support on hand, including one to one support from a dietician.

We especially like the focus on using local providers, as this mirrors our social value principles of recruiting from local communities and providing sustainable opportunities that people can keep up, long after contracts have ceased.

One of Gateway’s key areas of expertise is working with vulnerable groups, and this contract will be focusing on the most vulnerable groups in the Solihull Borough, so we are pleased to have the opportunity to roll out and demonstrate our way of working outside of Birmingham.

We recognise that Local Authorities and Public Health Services will be facing greater financial pressures in coming years, and moving into a new geographical area allows us to show that our approach can work in a variety of different area types, allowing the most vulnerable or in-need communities to access services wherever they live. We’re very much looking forward to working in Solihull.

POWS: Benefiting Birmingham

Click for full size
The consultation on Birmingham City Council’s budget proposals for 2015-16, “Responding to the challenge, looking to the future”, closed this week, and the council is now considering the feedback that’s been received.

One of the services that always seems vulnerable to budget cuts is our Pregnancy Outreach Workers Service (POWS), so of course we prepared a detailed response as an organisation. We used data collected over the last six months to show how the POWs’ work is aligned with the priorities of the council, the Health and Wellbeing Board, and national guidelines.

However, we were also very keen for other views and comments, from outside the organisation, to be taken on board. So we spoke to current and former clients, as well as colleagues in partner organisations, to raise awareness of the consultation and the ways in which people could respond.

We were delighted to hear that comments were being sent in thick and fast from people who understand, as we do, the unique benefits that the POW service brings to the city.

Some of the comments, like this one from a local foodbank co-ordinator, were forwarded to us:

My name is Helen Pipe and I am the Foodbank co-ordinator at Birmingham Vineyard Church. I am writing to you to say that I believe that Gateway Family services Pregnancy Outreach Team should continue to be maintained. As a church we supply Gateway’s Pregnancy Outreach Workers with Foodbank bags containing food and toiletries for the vulnerable clients that they work with. Many of the pregnant women that they work with are in a crisis situation, with no access to funds and therefore food and provisions. The Pregnancy Outreach Workers play a crucial role in helping families through a difficult time. This a service that needs to continue working in our city.

This comment came in from a former commissioner:

I am saddened to hear of the threat to decommission. The POW service was positively evaluated by B’ham University through a randomised control trial. […] The POW service offer a unique service to women during pregnancy and often gain access to hard to reach families who do not always access professional services. The POW service is able to offer upstream interventions to families and therefore reduce poor downstream outcome.

We have also been very happy to hear how keen our clients and former clients have been to respond to the consultation. Many sent emails and text messages, like the one above, with their thoughts on the POW service and how it had helped them.

Finally, in case you were in any doubt of the ways in which POWs support people every day, here are just two of the women that one POW, Shazia, supported last week. Daba is glad someone can go with her to antenatal classes, and Bolagia is grateful for Shazia’s one-to-one advice about looking after her new baby. It’s obvious that both are becoming more confident and independent thanks to POWS.

Find out more about the 2015-16 budget consultation here, and about
other consultations, including the current Third Sector Strategy consultation, here.

Two Ticks: positive about people with disabilities

Gateway Family Services has recently applied for, and been accepted to, the Jobcentre Plus “Two Ticks – Positive About People with Disabilities” scheme.

Two TicksIt means we have made a public commitment to being positive about employing disabled people, and shows our existing employees that we value their contribution and will treat them fairly if they become disabled.

It also means that you’ll be seeing the Two Ticks symbol a lot more from now on – on our stationery, our website, our newsletter and any job or volunteer adverts!

Why employ people with disabilities?

Nearly seven million people of working age are disabled or have a long term health condition. Historically there has been a significant gap between the proportion of people with disabilities employed compared to non-disabled people. This is despite it being against the law to treat a person less favourably than someone else because they have a disability – whether that’s at recruitment, in relation to pay or conditions, or when selecting for redundancy.

Gateway would like to encourage and support applications for jobs from people with disabilities, to create a workforce that reflects the diverse range of people that we serve.

We’d also like to be able to retain, or support into alternative employment, any of our current employees who become disabled whilst working for us.

Our commitment

In order to achieve the Two Ticks, we have made formal commitments to the following five areas:

  1. To interview all disabled candidates who meet the minimum requirement of the job and to consider them on their abilities. This is now included in our Shortlisting and Recruitment Policies.
  2. To discuss with disabled employees, at any time but at least once a year, what we can do to make sure they can develop and use their abilities. This should be included in their one to ones and appraisals.
  3. To make every effort, should an employee become disabled, to make sure they stay in employment.
  4. To take action to ensure that all employees develop the appropriate level of disability awareness to make these commitments work. This is now included in our mandatory equality training.
  5. To review these commitments every year, to assess what has been achieved and plan ways to improve on them – and to let employees and Jobcentre Plus know about progress and future plans. This will be included in our Annual Business Plan from now on.

As an organisation we have always aimed to be positive about everyone’s abilities, and – as we talked about to some extent in last week’s blog post, Fair doesn’t mean equal – to make sure that everyone is able to participate fully. By applying for – and achieving – the Two Ticks, we’re happy to say we have simply formalised many of the things we already do.

Fair doesn’t mean equal

I was sent this picture by a member of our Board. They’d seen it on Twitter. I think she liked it for the simplicity of the message it gave.


Most people would agree that equality is a fine thing. Enabling any individual to participate at the same level is essential to any sort of functioning society. However it only works if everyone is able to reach that level – or, as in the case of the picture, to look over the barrier and see what everyone else can.

This resonated with me as I think it sums up our ethos.

Equal is good but it isn’t always enough on its own. Gateway has always been about bridging the gap, recognising that there are people who aren’t ready or able – for justifiable reasons – to participate at the same level.

Gateway has always been about giving people that metaphorical “leg up”. In our Articles of Association, we committed to “providing assistance in overcoming barriers”. It was one of our founding principles and remains key to everything we do.

Our approach is to look at the individual and, with them, make the call on what they need to be able to participate.

Some people just need a bit of support and encouragement to actually get on with things. Others need us to build their confidence before they can see for themselves how competent they actually are.

But some people are a distance away from participating fully. It’s going to take more time and effort, but we’re in it together and we’ll help them all we can. If it’s possible, and they want it, we’ll help them get there.

What is fairness?

So what does it mean to be fair? The Oxford Dictionary says, ” treating people equally without favouritism or discrimination”. But sometimes, it’s clear someone is in need of more help. Sometimes, responding to a need requires “positive discrimination”.

The picture of the children looking over the barrier is beautiful in its simplicity. The one on the right is tantalisingly close. They know something exciting is happening as they can hear it but, frustratingly, they can’t quite see. They need that little bit of extra help to participate.

Likewise, in wider society, some people need us to discriminate in their favour – to build their resilience and confidence – to enable them to participate.

I’m worried that what I see as “fairness” – giving extra help, or making exceptions for someone based on their individual need – is sometimes seen as somehow less credible, or “soft”. But why? The help – like the extra step in the picture – is so easy to provide. No one is disadvantaged by it, no one is put out, and you could argue that we all benefit, because more people are living a fuller life.

Assessing needs, not judging behaviour

So can we say, then, that fairness means giving people the help they deserve? And that treating them differently is OK if it gets them to where they need to be – to the same place as everyone else?

I never thought I’d be saying the same thing as David Cameron, but in his Conservative conference speech in 2010 he said, “fairness means giving people what they deserve”. Great! How reassuring. Maybe we could even find some common ground.

But no, it falls away, as he continues, “and what people deserve depends on how they behave.” So, suddenly, it’s become a trade. The discrimination that Mr Cameron shows here is not a positive one, but a moral one, based on a judgement of someone’s behaviour.

At Gateway, our job is not to make any moral judgements, but to help those who need it in a way that is most likely to have the biggest benefit to them.

chris and amyTake home visits from our Health Trainer service. Most people are happy to meet their Health Trainer at the GP surgery, Children’s Centre, or local cafe, but some request a home visit.

However, it’s recently been suggested that the only people who should get a home visit are those who are housebound. The idea is that anyone else should be able to come to us, and if they don’t want to, they are clearly not committed enough to embark on a behaviour change process.

That, to me, sounds like a needless moral judgement. There’s a feeling that we are being “soft” and somehow disempowering the individual by agreeing to visit them at home.

If we stopped home visits, loads of people wouldn’t engage – and that’s not because they’re not committed, it’s because they’ve not got the bus fare, they’ve got three small kids at home, they’re embarrassed about how they look, or they’re anxious about going into a new situation, because they’re low and haven’t been out of the house for weeks because their relationship broke down, or they were bereaved, or they lost their job… there are a hundred valid reasons.

If we go to see someone at home it might just mean that someone who wouldn’t otherwise engage at all puts their trust in us and starts to do whatever it is they need to do. Our Health Trainers are skilled. They know the ideal is for the person to leave the comfort of home and engage more fully, and in most cases they gradually encourage them to do just that.

And who’s disadvantaged? We’re not – we’re happy to do home visits! The individual isn’t, as they are in their preferred environment. And the Commissioner is satisfied, as we’ve reached someone who would otherwise have disengaged.

It’s a simple fact that some people do just need a bit of extra help – a “leg up” – to get to where everyone else is. It isn’t just fair to offer it – it’s our responsibility.

“I’m a different person!” – Sarah’s Training To Care success

awardsAt tonight’s Gala, we’re presenting awards to some of our clients who have achieved successes during the previous year.

Training To Care Manager Michelle Bluck has nominated trainee Sarah Greening for an award because of her hard work and achievements on the course so far.

Training To Care is a gateway for people who want a caring career, offering them the qualifications and experience they need in order to apply for NHS jobs. It offers people with little or no work experience the chance to earn money and gain experience as they train towards a formal qualification in Health and Social Care.

Everyone receiving their first qualification will get a High Achiever award at the Gala, but Michelle nominated Sarah for a separate award because, of all our trainees, she felt Sarah has grown the most.

Before coming to Gateway, Sarah had stayed at home for years, bringing up her son. “I knew I needed to get out and look for work, but I didn’t have the courage; I didn’t know how to start,” Sarah says. “When I saw this opportunity come up, I forced myself to go for it, even though I was really scared. Even when I got through the interview I didn’t think I’d be able to do the work. I’m a quiet person and I had to learn how to open up.”

Michelle says, “When Sarah arrived for interview it was clear that she believed in what she wanted, but she was nervous and underconfident. I can’t put my finger on why I felt she would do well, but I wanted to give her a chance.”

And here is Sarah later on that night accepting her award

Part of the reason that Training To Care is different is because of the employability work that Gateway does with trainees. Sarah knew that a caring role was right for her but needed some encouragement. With this extra support, her progress has been phenomenal.”I’m a different person!” she says. “I’ve gone from not working, and feeling worthless, to enjoying what I do so, so much. I’m going out, talking to people. I work four days a week, and by the end of my break I can’t wait to go back. It’s a responsible job; patients put their trust in you, so helping them has given me a lot of confidence.”

Michelle agrees. “Despite her initial shyness and underconfidence, the way she approaches people – her manner with the patients – is genuine and natural. And she’s not afraid to stand up for patients, to be an advocate,” she says. “Even the most awkward patients are asking for her by name now. She has a way of getting them to do what she needs them to do; thanking them for letting her work. She makes them feel like they’re doing her a favour!”

The job Sarah’s doing at Moseley Hall Hospital is a tough one. It includes personal care (bathing, toileting, feeding) and working with all ages, including older patients with dementia. So why did Sarah choose care work, rather than a shop or desk job? Like most of our trainees, she says it was a natural choice for her. “Everyone asks why I would want to do this – I mean, it’s hard work – but it seems obvious to me. I’ve always been a caring person. Some people think you can be ‘too nice’, so I thought I’d take it somewhere where it would be appreciated.”

In November, Sarah will receive her Level 2 City and Guilds diploma in Health and Social Care, and by the end of the year she’ll have 12 months of really valuable work experience, with excellent references. All Health and Social Care roles must have a percentage of qualified staff, so she’ll be highly employable.

“Considering she’s never had a job, I am continually surprised by Sarah’s work ethic and the way she applies herself,” says Michelle. “Her commitment is faultless – she’s never been late, or off sick. Both her teamwork and lone working are excellent and this is reflected in feedback from her supervisor, and in her one-to-ones, which are invariably positive. The more you throw at her, the more she absorbs – and the more she wants to absorb. She’s genuinely interested in the work and she even does her own research alongside the course. A caring role just seems to come naturally to her – it just flows.”

Preparing women in prison for work: Community Interpreting

We’ve recently finished a really interesting project, working with Drake Hall Prison in Staffordshire to offer a Community Interpreting qualification to women in prison.

The five day Level 2 Award in Preparation to Work in Community Interpreting was delivered by Gateway during May. Drake Hall already offers various vocational training courses through their link with Milton Keynes College, but this is the first opportunity the women will have had to gain an interpreting qualification.

Like the Community Interpreting course that we already run, this is a way for many of the women at Drake Hall to formalise a role that they’ve been doing informally for years. The prison is a designated centre for foreign nationals, so the prisoners include a high number of foreign language speakers.

Why work in prisons?

Gateway specialises in helping people from hard-to-reach communities to function more effectively in society. With the right investment and support, people can overcome all sorts of barriers to lead happier, more productive lives. Working with prisoners to support their rehabilitation by recognising their existing skills, and helping them to learn new ones, is a natural fit for Gateway.

For female prisoners especially, we can see how skills provision could have far-reaching benefits. Many of the women have children and want to be positive role models to them. With skills and qualifications, the women will be able to have a legitimate income and provide for their family. The self-esteem and confidence which comes from being able to do this will have an impact on the whole family.

The main barriers for course attendees in prison are their levels of self esteem and self confidence, which – understandably – can be especially low. Additionally, many of the women at Drake Hall, as foreign nationals, feel that they are stigmatised by other prisoners.

When we first visited Drake Hall, we asked the women to tell us how they felt about the future. Most said that they felt the available options would be extremely limited for them once they left prison. Inevitably, there was a general feeling that no-one will care about them or consider them for a job when they are released. Some have been completely disowned by their family after being convicted and won’t be able to return home to a supportive environment. They spoke about feeling like they are “at the bottom” of society.

We know that it’s common for attendance to drop over the duration of a course at Drake Hall. Usually this is down to a lack of self-esteem and the inability of prisoners to see the potential benefits of training. However, we can see that many of the women at the prison – particularly the foreign nationals – have language skills and the life experience to be good interpreters, so we tried to communicate this as much as possible.

Delivering the course

Course tutor Sarah Clay

Initially, eight women enrolled on the course, but more joined as word spread. Ten women finished the course and all achieved their Level 2.

Course leader Sarah Clay said, “It was a privilege to teach a group of learners who, by the second session, no longer felt nervous or suspicious, but were enthusiastic about learning new knowledge and skills.

“Throughout the course individuals were keen to share their experiences and to listen and learn from the formal teaching as well as each other. We had many ferocious yet productive discussions.

“I was also very impressed with the way that the women supported each other, demonstrating excellent team working skills. All overcame nerves and brought their learning together to perform effectively in an assessed role play, during which they were the interpreter.

“Learners listened excitedly on the last day when the Governor talked about his ideas for how they might utilise their skills within and outside of Drake Hall.”

Nine marked the course delivery as “excellent” and one as “good”. This selection of comments from the evaluation forms at the end of the course showed just how much of a positive impact the training had had:

Hopefully I can one day become a interpreter for someone and I can show off my talent


Everything was useful … not only in the course, in life and resettlement as well


[I hope] to continue with this line of work when I leave prison. I have gained more confidence and my speaking skills will develop as I work professionally on a regular basis


The role plays and scenarios were useful which gave me confidence.


A really good course, very useful and made me feel like my language skills are useful! Can we do the next level?

Paul Newton, Governor of Drake Hall thinks that something like this could make a real difference. “I’m always looking for new ideas. Not only does this give the women a confidence boost by being able to gain a valuable qualification it also makes the most of skills they already have – maybe they just didn’t realise it.

“A wealth of abilities exist in our establishment, so what a great opportunity to sell a positive message about a prison and the resources held inside.”

The future for our Community Interpreting courses

Currently, anyone in Birmingham can apply to do a Gateway course and go onto our books as a qualified Community Interpreter. So in the future, we are hoping to extend the service further afield and employ some of the Drake Hall trainees.

We have also started to have discussions with the prison about developing an online – or call centre based – interpreting service, which would enable remote working. Drake Hall prison already runs a call centre and a distribution centre, so this could be another beneficial addition for them. The prisoners would gain work experience alongside a recognised qualification, whilst the prison would be able to offer enhanced interpreting services internally and commercial services externally.

Equipping women in prison with the tools they need to become productive members of society – practical as well as personal – is a vital service and one which we are really pleased to be able to provide.

Training To Care: saving the NHS money with local employment

Our Training To Care programme, which we launched in October in partnership with Birmingham Community Healthcare Trust, is continuing to provide benefits for everyone involved.

The aim of the course is to offer people the qualifications and experience they need in order to apply for NHS jobs – and to offer employers a pool of cost-effective, skilled, reliable staff.

Trainees are happy

The benefits to trainees are pretty straightforward. They’re offered the chance to get work experience in a caring role and train for a Level 2 City & Guilds Diploma in Health and Social Care, together with bespoke NHS training. Importantly, though, they earn a wage for the duration of the course. Gaining qualifications usually means a financial cost to the trainee, so this – unfortunately for the thousands of unqualified, unemployed people who would love a career in care – is a rare opportunity.

Around two thirds of our trainees were previously unemployed; some of them long term. Some had come from our volunteer programmes, working their way up the Skills Escalator. Most had some previous caring experience, but it wasn’t in a paid capacity, so it often didn’t count when it came to job applications and formal interviews. We counted it.

We believe that this combination of work experience, qualifications and payment gives the trainees everything they need to move forward and get a career in healthcare.

But there are many vital benefits to Birmingham Community Healthcare, and wider employers, as well.

Employers are happy too

Our aim is to provide healthcare employers with a valuable resource of reliable, enthusiastic, hard working and, ultimately, qualified staff who will save them money.

The pre-employment training that Gateway and the Healthcare trust offers is specially tailored to the roles offered – so this, in addition to the previous experience of caring for family that many trainees have, enables them to hit the ground running when they arrive on site. Several supervisors of the bedded units who have offered placements to Gateway trainees have mentioned that the ability to “mould” trainees into a role has been useful.

Clare Gadd, Clinical Team Leader at The Sheldon Unit, says “it makes a real difference to have two more members of the team who were able to join us and get up and running quickly, and of course, it has the added financial benefit of removing the cost burden of using agency staff.”

Gateway’s specialist support also helps to give a smooth transition for the long-term unemployed people who are returning to work. This extra support and employability training means that the retention rate – in an industry that has a traditionally high turnover – is much better (80% in this programme to date). The process also means that employers have additional administrative help, as Gateway managers are on hand to provide extra support to trainees during their placement.

Trainees’ stories

Trainees Roza, Charlotte and Judith are working at Moseley Hall Hospital, a specialist stroke and brain injury rehabilitation centre.


Roza had been working in hospitality and came to Gateway some time ago to work as an interpreter before applying for the Training To Care programme. Although she didn’t have formal care experience, she has cared for her sister, who has Down’s Syndrome.

Roza says: “I was very happy with the support and training that Gateway offered me as an interpreter, so when I saw the opportunity to move into care work with the same level of support, I jumped at the chance.

“The work is very rewarding. It’s nice when you go onto the ward and people are pleased to see you. Watching people recover and helping them learn to walk again is really satisfying. Every day I feel better and get more confident about work.”


Roza, Charlotte and Judith
Trainees (L-R: Roza, Charlotte and Judith)
Charlotte had done a few different jobs – in hotels, bars, shops and warehouses – but always wanted a career in care. Her mum is ill so she has some informal experience, but it never seemed to be enough to get a foot in the door. She said, “I’d been trying for years to get into care work, but you can’t just walk into it. Even if an advert says ‘no experience required’, you’ll lose out if someone with any experience at all applies. Some jobs even require payment up front for checks before you can start. It’s not easy.

“In the past I’ve done lots of jobs but working in a caring role like this just feels really natural to me. The supervisors give me lots of praise, which is really encouraging. I’m getting loads of experience and learning something new every day.”

Charlotte’s supervisor, Annmarie Rumble, says: “Charlotte was quite quiet at the start but it feels like she’s really blossomed. She’s grown in confidence and is now able to work under her own steam. She’s really good with the patients; she has a caring and calm nature which is just what they need. She’s particularly good at calming them if they get upset.

“Sometimes when younger people come to us to start work they can be a bit unprepared for the sorts of tasks they may have to do. Charlotte was prepared prior to starting placement and adapted very quickly to what she was expected to do. She is a highly valued member of the team.”


Judith started with Gateway as a volunteer befriender. “I like to help people, which is why I was a befriender, and later an interpreter, with Gateway. I really enjoy this work. I’m not always comfortable with new people but here we see new people every day, so it’s given me a lot more confidence. As trainees, we are paired with a nurse, but I’m finding that I can do more and more on my own.

“It’s not so much the medical side of the job that appeals to me; it’s everything around it. My mum and dad passed away in hospital and I wasn’t able to be with them, so I see this as paying something back. If I can be there for someone who doesn’t have anyone and who’d otherwise be isolated – if I can have a chat with them, and cheer them up – then I know that I have done a good job.”

From unemployment to care work: breaking the cycle

In October we introduced our Training To Care programme. It’s a gateway for people who want a caring career, offering them the qualifications and experience they need in order to apply for NHS jobs.

Being able to earn money and get work experience while you train is – unfortunately – a rare opportunity. Usually, people relying on benefits would not able to gain formal qualifications without losing money.

Three months on, we’ve already put 18 staff into placements, with more due to start next week, and the feedback from placement supervisors has been incredibly positive.

The trainees

In this video, trainees Lynne and Yvonne talk about their backgrounds in care – including Yvonne’s experience caring for family members – and how they’re finding the scheme so far. (Apologies for the sound – we recorded this during a hailstorm so we’ve added some subtitles!)

The principles

The lack of funded opportunities for those who want to get into care work has been reflected in the demand for places on the scheme; we’ve been inundated with CVs and requests for information. This means we’ve had to become really adept at seeing people’s potential when they come to interview.

All of our trainees have some caring experience, even if that experience is informal. We believe that caring for family members, and all the emotional and practical skills that it entails, is just as important as formal training as a background for care work.

The training

Gateway delivers a City and Guilds Diploma in Health and Social Care at Level 2. Trainees also receive training from the NHS that includes things like conflict resolution, manual handling, safeguarding, governance, health and safety and communications.

personal-care-traineesThe training is bespoke, so it offers trainees some extra support – which we find leads to extra confidence. Trainees bond as a team, which gives them more self-reliance – and they take that with them to their placement. Some of the trainees are based at the same units, so they are able to support each other on site, too.

The feedback so far

Clare Gadd is Clinical Team Leader at The Sheldon Unit. She manages two members of Gateway staff at the Unit who undertake palliative care. She says, “We have two members of Gateway staff working as part of the team and, after a period of induction, they have both settled into the routines and expectations of the job well. We have a lot of very dependent patients, and their contribution has been invaluable.

“It makes a real difference to have two more members of the team who were able to join us and get up and running quickly, and of course, it has the added financial benefit of removing the cost burden of using agency staff,” Clare continues. “Considering the members get a year’s support and development working towards achieving a professional qualification, the scheme provides a positive outcome for all involved.”

So far we have had a very good retention rate. Typically, employers report a higher drop-out rate for people who are new to work, or who have been out of work for a long time, but we haven’t found this to be the case in our groups. Turnover in health and social care roles is traditionally very high, so we hope that the extra support and personalised training that we offer will help with retention rates in the NHS going forward.

Gateway’s “skills escalator” takes Farzana to the top

farzanaWe were thrilled to find out this week that two of our Pregnancy Outreach Workers have been accepted to begin degree courses in Nursing.  For both Lynette and Farzana this has been a long term ambition  and the culmination of a long journey, as Farzana explains…

Farzana joined us six years ago as a Pregnancy Outreach Worker (POW), but her story starts years before that, when she took a level one Community Family Worker (CFW) course with Gateway.

“It’s been a long term ambition of mine to get into nursing, but I was a housewife with four kids – there was no way I was going to be able to study full time,” says Farzana.

“When I saw the Gateway Community Family Worker course being advertised, I jumped at it. Studying one day a week at a local Children’s Centre meant that I could fit it in to my routine. There were assignments and modules, but I could fit them around my family life.”

It took Farzana three years to do the CFW levels one, two and three. After completing the level three qualification, she applied for a role as a POW and joined Gateway full time. But she continued studying and working towards her life goal.

“Whilst working as a POW, Gateway offered me a secondment to do a foundation degree, followed by a BA Honours, so I’ve been working and studying for the last six years.

“It’s been really tough but I wouldn’t have been able to do it if it wasn’t for Gateway; they’ve given me a great opportunity. I’m not just gaining valuable, real life experience in the community, working with vulnerable families, but I’ve been able to carry on with my education and do what I’ve always wanted to do.”

Farzana is a great example of everything we mean when we talk about our “Skills Escalator”. Helping people to get through the different stages they need to access their chosen career is one of the initial and key concepts of Gateway. We feel that, by spending six years getting first-hand experience whilst studying, Farzana will have a more rounded understanding which will equip her well for her role as a nurse.

Nursing is degree based, which can narrow the entry for people who take a non-traditional route. Giving up work to study would financially exclude many people,

Farzana is now in a position to study nursing full time and she’s been accepted onto a nursing course at Birmingham City University.

“Usually you work somewhere for six years and that’s it. Working for Gateway is completely different – they’ve given me 100% support with my career and I’ve really got something back. It’s like a ladder that you can step onto – and if you want to climb to the top you can.”

Watch Farzana talking about her achievements:

The importance of investing in maternal mental health

mother-babyOur staff  support pregnant women with complex social factors  but why are the POWs  needed?  Simply put…our  clients  are vulnerable, but not vulnerable enough to get statutory support.

An NSPCC report from June this year found that:

The wellbeing of more than one in 10 newborn* babies in England could be improved if all new mothers with mental illness had equal access to good services

Mental health problems – including depression, anxiety, post-traumatic stress disorder and schizophrenia – can begin or escalate when a woman is pregnant or in her child’s first year.

They can have a damaging effect on family life, and in the worst cases, impact on babies’ health and welfare.

Evidence shows that the vast majority of these illnesses are preventable and treatable, and with the right support, the negative effects on families can be avoided.

This echoes our findings and the feedback from our Pregnancy Outreach Workers.

So why are so many pregnant women slipping through the cracks? Because they are medically low risk.

In safeguarding terms, a “vulnerable adult” tends to mean an adult who is vulnerable to abuse or exploitation, and much of the advice is directed towards care of the elderly. If a pregnant woman or mother doesn’t meet the criteria for a vulnerable adult – in other words if she is not suffering direct physical or emotional abuse, or neglect – then she doesn’t get support. She is seen as having adequate mental capacity and able to cope alone.

There are services are designed to support the mother but don’t always come through (eg  pregnant women are supposed to see a health visitor but, in our experience, many don’t). A shocking 73% of maternity services do not have a mental health midwife.

This list of risk factors for poor mental health, taken from NHS Scotland’s Early Years website, is typical of the “middle ground” that our more complex clients occupy.

  • experience of poverty and deprivation
  • experience of gender based violence
  • experience of stigma or discrimination
  • living in isolation
  • having been in care
  • alcohol and substance misuse
  • being a teenage mother

Despite all these factors – these pregnant women are not considered vulnerable by definition.

Danni*, one of our more complex clients, already has two children in care, and received Pregnancy Outreach support for her most recent pregnancy. POW manager Michelle explains, “Lack of support in the past means that Danni has continued to lead a chaotic lifestyle and to have more children. This time round, she’s had extended support from a POW, but she still is not engaging with Social Workers. She feels that they are only there to take her children away and judge her. She misses appointments, saying, ‘I feel like a failure’ and ‘what’s the point, you’re taking my kids off me.’

“Like an unfortunate number of women, Danni is ‘vulnerable… but does not meet the criteria of a vulnerable adult,” Michelle continues. “She’s been told by doctors that she’s not clinically depressed, so the support available is limited. If she’s not engaging – missing appointments with her drug worker, for example – no-one chases it up. When anything happens – like recently, when her access to her children was reduced – she’s quick to relapse.”

In fact, most of the safeguarding advice given to support workers for new mothers is based around the child. A mother who has a chaotic lifestyle or a drug dependency is seen not as someone in need of support herself, but as an abuser of a vulnerable child.   We absolutely know that the safety of children is paramount, what we recognise is that it is not only them that need protection and support.

In other words, there is a gap between social services’ concern for the unborn child, and concern for “vulnerable adults”. Many of our clients occupy this space. 213 of the clients we are supporting at the moment have identified mental health issues and 126 are experiencing domestic violence.

Children in care

We’re seeing how unaddressed  maternal mental health issues can lead to more children in care, and there is a cycle attached to this.  We are recognising a missed opportunity to break a vicious cycle.  The lack of support at such a crucial time means that many vulnerable women return to a chaotic lifestyle lost in a gap between services.

In fact, at this vital time, all sorts of support that parents had been receiving – for example, access to a family support worker – is actually withdrawn. Parents on parenting courses  lose their place on the course when they lose care of their child. The implication is that the mother of a child who’s been taken into care is no longer a parent and no longer requires support.

Far too many children are in the Local Authority care and there is a plan to move children into more stable environments through adoption. Surely there must be an equal priority to help pregnant women be fit mothers to take care of their own children? The vast majority want to, and are devastated when this is not possible. A common response is to get pregnant again, and so the cycle starts over.

The POWs are able to create solid, structured mental health support for the mother. They help create the conditions suitable for children to be brought into a family and to strengthen the maternal bond.

This is why I’d like to see the sort of support that Gateway POWs offer – dependable emotional support and practical advice – to become the mainstream.

*names have been changed