Piki Te Ora

1 Evaluation of Piki Te Ora

How well placed is Piki Te Ora to contribute to children’s learning and promote their wellbeing?

Piki Te Ora is well placed to promote positive learning outcomes for children.

ERO's findings that support this overall judgement are summarised below.

Background

Piki Te Ora operates from the children's ward of Hawke's Bay Hospital. The service is operated by a team of four Hospital Play Specialists (HPS) and the playroom is licensed by the Ministry of Education to cater for 11 children under primary school entry age, including seven aged up to two years.

Hospital Play Specialists are part of multidisciplinary teams (MDT) that support children's development, learning and emotional wellbeing while they are hospitalised. They also contribute to the wider aspects of paediatric care, providing support at bed sides, for hospitalised children and their family and whānau members. All four HPS are registered teachers. The Service Director for Community Woman and Children has oversight of the management and operation of Piki Te Ora. The HPS team leader oversees day-to-day management of the service.

The service's philosophy emphasises the importance of building partnerships with families and whānau, celebrating diversity, and acknowledging Te Tiriti o Waitangi, Te Whāriki, and Te Whare Tapawhā.

The May 2016 ERO evaluation found that the service needed to improve in areas of governance and management, internal evaluation, assessment and the appraisal process. Progress has been made to address these areas.

The Review Findings

Hospital Play Specialists adopt respectful and inclusive practices to quickly establish rapport with children, families and whānau. Whakawhanaungatanga is highly valued to promote a sense of wellbeing within the hospital environment. Children and whānau respond positively to the sensitive and attentive care provided by the HPS. They demonstrate secure and trusting relationships.

Children and whānau benefit from the calm, natural outdoor play environment that provides a welcoming inclusive space to explore and relax. The playroom has been refreshed to reflect the dual heritages of Aotearoa/New Zealand. Appropriate resourcing for younger children has been sought to promote active and physical movement as required. HPS provide relevant activities to promote creativity, sensory play and problem solving. Children are well supported to engage in medical play to prepare them for medical procedures to reduce anxiety.

The service is committed to embedding te ao Māori concepts, tikanga and te reo Māori into children's learning experiences. HPS work collaboratively with whānau to provide culturally responsive support for their children. The Hawke’s Bay District Health Board (DHB) Māori Health Unit provides ongoing support as needed. Leaders have identified the need to improve the use of te reo Māori to further support Māori children's success.

A strength-based approach to assessment supports HPS to identify children’s interests, abilities and dispositions. Responsive and meaningful learning opportunities are provided at children's bedsides and in the playroom. Families' cultures, languages and identities are valued and acknowledged. HPS have access to external support to strengthen their understanding of Pacific cultures. Supporting children to make choices about their learning and making this more visible within documentation continues to be a strategic focus.

Hospital Play Specialists advocate and empower whānau and children as the experts of their own wellbeing to contribute to the development of a hospital-based curriculum. They work collaboratively with a multidisciplinary team to provide appropriate support that is responsive to the individual needs of each child and their family.

The DHB and the service have strengthened systems and processes to support consistent understanding and implementation of practice linked to legislative requirements of the play service. Several strategic projects have been successfully implemented to improve outcomes for children and whānau. HPS work collaboratively to improve the quality of the service. To further support ongoing improvement in practice, a priority is to embed the new appraisal process for HPS, linked to the Standards for the Teaching Profession.

Some work has been undertaken to improve leaders’ understanding of internal evaluation. Parent and whānau views are regularly sought and responded to. Further developing effective evaluation for improvement should support the team to report against achieving strategic goals, identify priorities for improvement and provide assurance that accountabilities have been met at governance level.

Key Next Steps

Priorities are to continue to:

• embed the HPS appraisal process
• strengthen the understanding and use of evaluation by HPS to improve outcomes for children and families
• extend the use of te reo Māori to further strengthen inclusive practice.

Management Assurance on Legal Requirements

Before the review, the staff and management of Piki Te Ora completed an ERO Hospital-based Education and Care Assurance Statement and Self-Audit Checklist. In these documents they attested that they have taken all reasonable steps to meet their legal obligations related to:

• curriculum

• premises and facilities

• health and safety practices

• governance, management and administration.

During the review, ERO looked at the service’s systems for managing the following areas that have a potentially high impact on children's wellbeing:

• emotional safety (including positive guidance and child protection)

• physical safety (including supervision; sleep procedures; accidents; medication; hygiene; excursion policies and procedures)

• suitable staffing (including qualification levels; police vetting; teacher registration; ratios)

• evacuation procedures and practices for fire and earthquake.

All early childhood services are required to promote children's health and safety and to regularly review their compliance with legal requirements.

Phil Cowie

Director Review and Improvement Services Central

Central Region

5 November 2019

The Purpose of ERO Reports

The Education Review Office (ERO) is the government department that, as part of its work, reviews early childhood services throughout Aotearoa New Zealand. ERO’s reports provide information for parents and communities about each service’s strengths and next steps for development. ERO’s bicultural evaluation framework Ngā Pou Here is described in SECTION 3 of this report. Early childhood services are partners in the review process and are expected to make use of the review findings to enhance children's wellbeing and learning.

2 Information about the Early Childhood Service

3 General Information about Hospital-based Service Reviews

ERO’s Evaluation Framework

ERO’s overarching question for a hospital-based service education review is ‘How well placed is this service to contribute to children’s learning and promote their wellbeing?’

ERO focuses on the following factors as described in the bicultural framework Ngā Pou Here:

• Pou Whakahaere– how the service determines its vision, philosophy and direction to contribute to children’s learning and promote their wellbeing
• Pou Ārahi– how leadership is enacted to contribute to children’s learning and promote their wellbeing
• Mātauranga– whose knowledge is valued and how the curriculum is designed to contribute to children’s learning and promote their wellbeing
• Tikanga whakaako– how approaches to teaching and learning respond to diversity, contribute to children’s learning and promote their wellbeing

Within these areas ERO considers the effectiveness ofarotake– self review and ofwhanaungatanga– partnerships with parents and whānau.

ERO evaluates how well placed a service is to sustain good practice and make ongoing improvements for the benefit of all children at the service.

A focus for the government is that all children have an opportunity to benefit from quality early childhood education. ERO will report on how well each service responds to children who are Māori, Pacific, have diverse needs, and are up to two years of age.

For more information about the framework and Ngā Pou Here refer to the methodology for ERO reviews in Hospital-based Education and Care Services.

ERO’s Overall Judgement

The overall judgement that ERO makes will depend on how well the service promotes positive learning outcomes for children. The categories are:

• Very well placed

• Well placed

• Requires further development

• Not well placed

ERO has developed criteria for each category. These are available on ERO’s website.

Review Coverage

ERO reviews are tailored to each service’s context and performance, within the overarching review framework. The aim is to provide information on aspects that contribute to children’s learning and wellbeing and are useful to the service.

1 Evaluation of Piki Te Ora

How well placed is Piki Te Ora to promote positive learning outcomes for children?

ERO's findings that support this overall judgement are summarised below.

Background

Piki Te Ora operates from the children's ward of Hawke's Bay Hospital. The service is operated by a team of four Hospital Play Specialists (HPS) and the playroom is licensed by the Ministry of Education to cater for 11 children under primary school entry age, including up to seven aged under two years.

HPS are part of multidisciplinary teams (MDT) that support children's development, learning and emotional wellbeing while they are hospitalised. They also contribute to the wider aspects of paediatric care, providing support at bed sides, for hospitalised children of primary and secondary school age and their family and whānau members. All four HPS are registered teachers. Two are registered play therapists and long-term Hawkes Bay District Health Board (DHB) employees. Two, including the team leader, have been appointed in the last two years and are in training for their HPS registration.

An acting service director for the DHB has oversight of the management and operation of Piki Te Ora. The HPS team leader oversees day-to-day management of the service.

The service's philosophy emphasises the importance of building partnerships with families and whānau, celebrating diversity, and acknowledging Te Tiriti o Waitangi and Te Whāriki, the early childhood curriculum, to support children's learning and wellbeing.

The September 2011 ERO review found that self review, HPS appraisal and bicultural practice needed strengthening. Progress has been variable.

The Review Findings

The philosophy is evident in practice. HPS are highly responsive to the needs of children and their families and whānau. They are skilled at quickly establishing rapport, engagement and trust. The needs and wellbeing of all family members are considered. Parents' aspirations for their children's wellbeing are sought and respected. The practice of identifying a primary HPS for individual children promotes the development of close relationships. These in turn impact positively on children's wellbeing as they transition into hospital or if they are long-term patients.

HPS are committed to culturally responsive practice. They seek support from the DHB cultural representatives to ensure their practice is appropriate. Te ao Māori is well understood by some of the HPS team who provide support for others and lead an authentic approach to working with whānau Māori. HPS are keen to continue to explore Tātaiako: Cultural Competencies for Teachers of Māori Learners to support their practice.

While children can access a range of learning materials in the playroom, adequate and ongoing resourcing continues to be a challenge. Upgrading the learning environment has been identified as a long-term strategic priority. Plans are in place to improve the outdoor area to better meet the needs of whānau and children. Further consideration should be given to provision for:

• the range of different age groups using the playroom

• non-mobile children

• opportunities for sustained floor play

• reflection of diverse cultures in the environment

• celebration of children's learning, wellbeing and achievements in wall displays.

The curriculum is suitably defined by children's interests, learning and medical needs as well as whānau input and aspirations. The psychosocial assessment process is used effectively to inform initial and ongoing planning for individual children's wellbeing. HPS record children's learning experiences through narrative and photos. These may be shared with whānau and other early childhood services attended by individuals, or become part of MDT notes. HPS agree that their approach to assessment for learning, particularly for children hospitalised for long periods, could be strengthened. A next step should be for HPS to better integrate and make visible in learning records, the documents and thinking that underpin both their health and education practices such as:Te Whāriki; Te Whare Tapa Wha, the Māori health model; and Play Specialist theory.

HPS are a well-established team, proactive in identifying priorities and advocating for families. Professional development opportunities are sought and valued. Networking with other HPS is in place. The Piki Te Ora annual and strategic plans provide direction for priority aspects of practice. Identifying desired outcomes should support improved monitoring of progress, decisions about next steps and a more strategic basis for reporting to managers.

A highly reflective and improvement-focused approach characterises HPS practice. Monthly meetings with managers enable them to share their ideas and concerns. Support to develop HPS understanding and use of internal evaluation should be sought to promote a more effective approach to planning for improvement and sustaining good practice over time.

A new appraisal process is in place linked to professional teacher requirements and the HPS role. The approach requires further development to support endorsement of HPS Practising Teacher Certificates and to promote ongoing improvement to their practice.

A well-defined governance and management framework identifies reporting lines and roles of personnel. However, managers do not adequately plan for sustainability in relation to the quality of the service and teacher capability. The development of upto-date expectations about service delivery linked to educational outcomes for children is a vital next step. Documented guidelines should support consistent understanding and implementation of practice linked to legislative requirements and the work of the play service. Managers and HPS should regularly evaluate practice in relation to expectations to help them identify priorities for development and provide assurance at governance level that accountabilities are being met.

Key Next Steps

Managers should seek support for HPS to help them develop:

• their understanding and use of internal evaluation

• assessment practice that is more closely linked to the principles of Te Whāriki.

Managers should also:

• define and clarify expectations for service delivery to support ongoing internal evaluation and improvement, quality assurance and understanding of HPS roles and responsibilities

• further improve the HPS appraisal process to sustain and strengthen the quality of teaching.

Management Assurance on Legal Requirements

Before the review, the staff and management of Piki Te Ora completed an ERO Centre Assurance Statement and Self-Audit Checklist. In these documents they attested that they have taken all reasonable steps to meet their legal obligations related to:

• curriculum

• premises and facilities

• health and safety practices

• governance, management and administration.

During the review, ERO looked at the service’s systems for managing the following areas that have a potentially high impact on children's wellbeing:

• emotional safety (including positive guidance and child protection)

• physical safety (including supervision; sleep procedures; accidents; medication; hygiene; excursion policies and procedures)

• suitable staffing (including qualification levels; police vetting; teacher registration; ratios)

• evacuation procedures and practices for fire and earthquake.

All early childhood services are required to promote children's health and safety and to regularly review their compliance with legal requirements.

ERO identified areas of non-compliance relating to governance and management. To meet requirements the service needs to:

• make detailed information about Ministry of Education funding and expenditure available for parents

• ensure that an ongoing process of internal evaluation is in place to help the service maintain and improve the quality of its education and care.

[Licensing Criteria for Hospital-based Education and Care Services 2008, GMA3, GMA6]

In order to improve current practice the service provider should ensure:

• legal requirements for hospital-based education and care are well understood by HPS and managers and that documentation and systems are developed to support ongoing compliance

• the annual budget clearly states staffing costs and leave entitlements, and professional development, equipment and operational allowances for the play service.

Next ERO Review

When is ERO likely to review the service again?

The next ERO review of Piki Te Ora will be in three years.

Joyce Gebbie

Deputy Chief Review Officer Central

10 May 2016

The Purpose of ERO Reports

The Education Review Office (ERO) is the government department that, as part of its work, reviews early childhood services throughout Aotearoa New Zealand. ERO’s reports provide information for parents and communities about each service’s strengths and next steps for development. ERO’s bicultural evaluation framework Ngā Pou Here is described in SECTION 3 of this report. Early childhood services are partners in the review process and are expected to make use of the review findings to enhance children's wellbeing and learning.

2 Information about the Early Childhood Service

3 General Information about Early Childhood Reviews

ERO’s Evaluation Framework

ERO’s overarching question for an early childhood education review is ‘How well placed is this service to promote positive learning outcomes for children?’ ERO focuses on the following factors as described in the bicultural framework Ngā Pou Here:

• Pou Whakahaere – how the service determines its vision, philosophy and direction to ensure positive outcomes for children
• Pou Ārahi – how leadership is enacted to enhance positive outcomes for children
• Mātauranga – whose knowledge is valued and how the curriculum is designed to achieve positive outcomes for children
• Tikanga whakaako – how approaches to teaching and learning respond to diversity and support positive outcomes for children.

Within these areas ERO considers the effectiveness of arotake – self review and of whanaungatanga – partnerships with parents and whānau.

ERO evaluates how well placed a service is to sustain good practice and make ongoing improvements for the benefit of all children at the service.

A focus for the government is that all children, especially priority learners, have an opportunity to benefit from quality early childhood education. ERO will report on how well each service promotes positive outcomes for all children, with a focus on children who are Māori, Pacific, have diverse needs, and are up to the age of two.

For more information about the framework and Ngā Pou Here refer to ERO’s Approach to Review in Early Childhood Services.

ERO’s Overall Judgement and Next Review

The overall judgement that ERO makes and the timing of the next review will depend on how well placed a service is to promote positive learning outcomes for children. The categories are:

• Very well placed – The next ERO review in four years
• Well placed – The next ERO review in three years
• Requires further development – The next ERO review within two years
• Not well placed - The next ERO review in consultation with the Ministry of Education

ERO has developed criteria for each category. These are available on ERO’s website.

Review Coverage

ERO reviews are tailored to each service’s context and performance, within the overarching review framework. The aim is to provide information on aspects that are central to positive outcomes for children and useful to the service.