Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...

 
Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
Public Health Briefing 2017
Holiday Kitchen and Public Health Outcomes
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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
•   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

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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.

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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’.

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
•   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)

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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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.
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Holiday Kitchen and Public Health Outcomes - Public Health Briefing 2017 1 - Accord Housing ...
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)

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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

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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.

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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.

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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

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• 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.

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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

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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.

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