The Innovation: Te Koopu Ora - A respite care service for young parents
Te Koopu Ora was a service for teenage parents, delivered from a whare in West Auckland. It included a day programme to develop parenting skills and to promote healthy lifestyles for parents and their pepi, and a short-term residential care programme for mothers and pepi.
The video was made by the evaluators of the programme and focuses on the overall performance of Te Koopu Ora. The objectives of the evaluation were two-fold: firstly to review stakeholder knowledge and experience of the services provided, and secondly to describe the lessons learned and the critical factors that would assist in future service development, implementation and identification of areas for improvement.
The evaluation conclusions and findings involved in-depth interviews with staff and whānau service users and included the results of internal satisfaction surveys undertaken mainly during delivery of the service.
Te Whanau o Waipareira – Te Koopu Ora
[Airini Tukerangi, Te Koopu Ora Evaluator] A, tena ra koutou katoa. Ko Moehau toku maunga. Ko Tikapa te moana. Ko Ngati Tamatera toku iwi. Ko Ngati Tamatera toku hapu. Ko Te Pai o Hauraki toku marae. Ko Hauraki te whenua. Ko Airini Tukerangi ahau. Ko au te evaluator mo Te Koopu Ora. Nga mihinui ki a koutou katoa.
What were the objectives?
So the objectives of the evaluation were two main folds: one was to review the stakeholder knowledge and experience of the service; and the second bit was to describe the lessons learned and the critical factors that would assist in the future service development, implementation and areas for improvement.
Now the evaluation focuses on the overall performance of Te Koopu Ora, and the development of the evaluation conclusions and findings within the report involved really in-depth interviews with team members that included service co-ordinators; service managers; guided focus groups and whanau service users; and the results of the internal satisfaction surveys, particularly conducted throughout the service delivery.
[Ngaire Harris, Whanau Ora Clinical Director] Kia ora, my name is Ngaire Harris and I’m the Whanau Ora Clinical Director. And I suppose the main thing that we’re talking about for the Ministry of Health and the evaluation of the service is the Waipareira way. The Whanau Waipareira was set up in the 80s and it was to bring together all of the groups out here in West Auckland: Maori Women’s Welfare, Maori Wardens, some of the Department of Internal Affairs and all of them came together with all of the issues to provide services.
So this particular service is for the teenage parents. It’s a respite service. And they had a home down the road at Epping Road. And it was an overnight, as well as a day programme. So the day programmes, you’ll get to see the mums and the babies and some of the fathers. We will have a look at some of the feedback. So it all hinges on Whanau Waipareira saw a need and addressed the need by this particular contract and service for Te Koopu Ora in a setting that was a respite home, and getting all the services from here over there to wrap around some of these parents.
[Kim Wi, Te Whanau o Waipareira Registered Nurse] Kia ora, my name is Kim Wi and I’m a Registered Nurse for Te Whanau o Waipareira. So Te Koopu Ora at Epping Road was a whare we had for young parents and their pepi that we delivered services like Tamariki Ora, which was Well Child checks as Plunket have. We have a lactation consultant there and breastfeeding classes there, so navigating and advocating for whanau to access those services was a big part of what I did there.
[Melissa Hadley, Breast Feeding Consultant] Kia ora, my name is Melissa Hadley. I work at Te Whanau o Waipareira Trust. I currently work in the Family / Whanau Support contract, Whanau Care / Child and Youth, and Ante-Natal Breast Feeding Workshops.
The mums had to be pregnant and they’d come for a two-hour session, and in that session they’d learn the basics of breast feeding to benefit some difficulties they may encounter, and also where to access help within our community. And we also linked up a lot of mums to the Mainly Music downstairs, which used to run straight after our Ante-Natal Breast Feeding Workshops.
The good thing about being at Te Koopu Ora, it was a nice central hub and there were mainly lots of teens – most of them were young mums. Lots of friendships were based out of that. A lot of people would say, word of mouth, bring their friends along who were pregnant and say “there’s an ante-natal breast feeding class here”.
[Chloe Scanlan, new mother] Kia ora, my name is Chloe and my baby is Ivy and she’s five months old. I’ve been using the services at Te Koopu house since I was hapu, and the service I used was the breast feeding workshop. When I first started the workshop I was scared and wasn’t quite sure if I wanted to do breast feeding, as a lot of my family and friends didn’t breast feed. So I had no prior knowledge of what it was about and how to do it. But when I came to the workshop, they taught me a lot about the importance and the benefits it would be for my baby, and the techniques that I could use.
They made me feel comfortable and I asked so many questions and they knew the answers as they were mothers themselves, which also helped me to trust them with the information that they had. The breast feeding workshop not only helped me but it also helped my partner as he learned the importance as well, and that he learned how to support me. They also gave me details of other people that I could contact after birth once I had baby, and those people were amazing.
[Fender Maeva, new father] Kia ora, my name is Fender Maeva. I am 22 years old and I am a young father. The workshop I took was the breast feeding workshop. Me and my fiancé did it together and it’s a good thing because I got to learn the whole concept of breast feeding. And it taught me how to support her in breast feeding and stuff like that so it’s a really good thing and I really recommend it to all the young fathers out there.
[Melissa Hadley] If we were to do anything different next time, it’s probably just try and encourage more mums to come. Come along and be part of the group, yeah and take part in the services that are available to them.
[Jessica Kaulima, Playgroup Organiser] Hi, my name is Jessica and I run the young parents’ playgroup here. I’m a single mum of four children: my eldest is 9, I have an 8 year old, a 2 year old, and 28 days.
How do you rate your experience with the staff?
I found the staff very kind and helpful. They helped me with whatever I needed, whether it was housing, food, or just a shoulder to lean on.
[Chloe Scanlan] I kept in contact with Melissa and Sarah once baby was born and they just kept continuing to support me and to help me. Their guidance and support was awesome and I’d recommend it to any of the young mothers that would come through Waipareira and using their services. They’re amazing people and they’re just so knowledgeable and the things that they taught me will help me with my baby, as I’m still breast feeding today and will continue to do so for as long as I can.
Kahutoroa Mataia Tukerangi, Kuia and Te Whanau o Waipareira Kaumatua Roopu
Tena ra koutou katoa i tau nei i raro i te tuanui o tenei whare. Tena koutou. Ko Kahutoroa Mataia Tukerangi toku ingoa. No Hauraki ahau. Ko Tikapa te moana. Ko Moehau te maunga. Ko Te Pai o Hauraki te marae. Ko Ngati Tamatera te iwi. Ko Tainui te waka. Ko Mauratu te tangata. No reira, tena koutou, tena koutou katoa.
[What was your role as Kuia?]
To support them is to give them advice when they are not certain, to come forward and seek out the kaumatua kuia – or the kaumatua men if they have to – but most of all, is to get advice from them and then report back. If there are any differences, they can go and find that with the doctors and the nurses of the Waipareira.
[Elaine Porter, Te Koopu Ora Co-ordinator] My name is Elaine Porter and I was the co-ordinator at Te Koopu Ora, a programme for mothers and their pepe, and fathers and their pepe. It’s forming relationships with the mothers and fathers, and watching them interact with their children. And watching them, it was encouraging them to do the parenting and ask the questions if they needed to ask about the role of parents or how they could do this better. They also were very keen on education and knowing the right things to feed their baby or the right programmes to attend. They were very, very interactive and very proactive, a lot of the mothers.
What I found worked for the young parents is that they’re to establish what they see is important, and then you guide them. It’s really important that they drive the programme because there’s so many programmes out there that is driven by research and what should happen, but each generation is different – and they see things through how they’ve been brought up. They parent how they parent. So if you can combine that with some teachings on good parenting or positive parenting, that’s really positive for them, it’s really helpful.
One to one is really better than a large number of parents in a classroom. It’s better to go one to one in a home environment – in their environment or here – as long as you establish a trusting and bonding… bond and trust is the two things I found were really important.
What tips / experience could you give to future parenting co-ordinators?
Demonstrate what I was teaching. If you’re coaching them then demonstrate it. If you’re asking them to eat differently, well then together in their home or your home, demonstrate what you’re teaching. Not just teach and there’s no action to it because they actually receive it more. And they learn from watching you. Most of them would learn from watching.
[Chloe Scanlan] We used Te Koopu Ora’s facilities for my baby shower. They made us feel comfortable and the venue was awesome as it could hold a lot of us. A lot of my friends and family were hapu at the same time so we played games that would help all of us, even those that weren’t mothers. We did games such as changing nappies and bottle feeding and it taught us a lot about our own ways of doing things. But it was awesome as we could interact with each other. Not just for myself, but for the other mothers there and the ones that were hapu as well.
Young Parents Playgroup
[Jessica Kaulima] The group came about because me and a friend used to go a young mothers’ group and we decided to run one of our own. The highlights would be the young parents in our community getting to meet each other and the kids running around with each other and playing and being happy. Our day trips –we’ve been to the zoo, to Lollipops which we’ve really enjoyed. And also our fundraisers – we have raffled off meat packets and boxes of goodies, all sorts. And also we get delivered Fair Food, which is fruits and vegetables for our young parents to take home with them free.
We have a Facebook page – Youngparents Playgroup – and I set it up so young parents could interact with each other and friend each other on Facebook. And we also have week-by-week updates on what we’re doing for our playgroup, and I thought of it just as a good way to advertise for our playgroup.
Health and Nutrition
[Bella Te Pou, Public Health Waipareira Kaimahi] Kia ora, my name is Bella Te Pou. I work in Public Health, a team member. Our contract is based around physical activity, nutrition, Tupeka Kore which is smoking, AOD alcohol and drugs, Koiora Taiahi which is Well Child.
What did your programmes include?
The services we done at Te Koopu Ora with the mothers and the pepe was physical activity and nutrition. The physical activity was based around well-being with the mamas and the pepe. We did kick-boxing, boxing, sit-ups, push-ups and other circuit training. The nutrition was also based around mamas and the pepe on healthy eating and what our tamariki are eating and also the mamas.
How has Te Koopu Ora impacted your life?
[Jessica Kaulima] It was good to know that there were support systems for us young mothers and dads like Waipareira. It was good to get out and meet other people instead of being at home shut in a box all the time.
They helped me take the stress out of my life when I was pregnant. I was picked up every day and brought back to the house on their van. They used to give me lunch, provide a nice safe environment, and I actually really got to enjoy my pregnancy.
Elaine was like a second mother to me. She was always there to talk to. She was a very kind lady and I really loved her.
What keeps you passionate about Whanau Waipareira?
[Ngaire Harris] Te Koopu Ora was a service – it’s an innovation service about getting better outcomes for young parents. And why we’ve really invested in this is that – I’m a fifth-generation Whanau Waipareira person; came right through all these services as a young mother with a young family; and now I have a young daughter who has her young family coming through, and a niece who has used Te Koopu Ora services – which was a really fitting service for her as a mum and a new mum learning about all our services.
And just to let the other people know that if you want to have these services, we have been on a long journey. And these are some of the things that we’ve been making – the DVDs and in books – of our services and helping the journey for our whanau, because it’s all about whanau. Kia ora.
Evaluator’s key findings
[Airini Tukerangi] So just to actually go through the summary of the key findings – there are five significant key findings:
One of the main ones is basically the quality of the implementation. Now at the time of the establishment back in November in 2010, Te Koopu Ora was developed and implemented during a major transformation sector change in health. It marked the implementation of Whanau Ora policy. It well-mentioned intentioned Whanau Ora service provider, Te Whanau Waipareira, without a fully-developed Whanau Ora framework. These policy changes, in addition to developing an over-arching Whanau Ora model of care and delivery had significant impacts on the quality of the implementation of this particular service. Not having a clear Whanau Ora framework meant that the focus to redesign a service and systems which were being developed for the organisation, which subsequently led to gaps into the specific service design and implementation of Te Koopu Ora.
Lessons learned from this has seen the establishment of incubators and steering groups that has had a dedicated team and approach to an emergent service, with additional charged and mitigating emerging delivery matters. It requires a different lens to those of the core businesses, so this is actually a different kind of way of actually nurturing new and developing services.
The second point is the whanau access and utilisation to Te Koopu Ora. Through the formative stages of service implementation, changes to the Te Koopu Ora service showed an ongoing issue of low utilisation rates of the core services being delivered to young adults. And in particular, three nights of respite and up to 20 clients per day of the day services. This included participating in day programmes that were being delivered at the whare.
The third point was overall whanau satisfaction of the service. In-depth interviews with five Maori clients in the first two years of the implementation phase found on average each mother accessed the services at least five maternal support services within Te Whanau o Waipareira. This enabled and empowered whanau to build their resilience while improving the overall knowledge and access to the key services.
Overall, 95% of clients related the quality of service as ‘good’ or ‘excellent’. For feedback from the service users of Te Koopu Ora, claimed to have gained more knowledge of caring for, in some particular areas, a set of twins; being in a place that was mentally and physically spacious; and to actually addressing some of their personal goals around being a new mama; and/or specifically learning new parenting skills.
Some of the recurring comments included: it’s a restful, clean, tidy and friendly space; the staff are approachable; that it is clean, light and very friendly and a warm, peaceful environment; it was easy to access in terms of getting into the whare; and that the support and new skills were actually being constantly developed for new mamas.
The fourth area in terms of a significant finding was “how do we shape the future of this developing service?” So the original Te Koopu Ora services implemented in 2010 changed quite markedly in 2012 due to the significant number of internal and external changes, as I’ve alluded to previously. It’s within the innovation view that Te Koopu Ora changed to meet the changing needs of mums and their whanau.
Throughout the formative review of this service, a clear framework emerged based on an innovative Mata Ora model, which is a Te Whanau o Waipareira Trust model. This information, along with an emerging service model of delivering Whanau Ora allowed Te Koopu Ora a much stronger position. And it also enabled Te Koopu Ora to reach and succeed their ongoing development and integrating maternal and child health services in a Te Koopu Ora approach to wellbeing – a Whanau Ora wellbeing model.
So what might be the opportunities for further development, given that this was a pilot project? I’ve kind of identified five main significant points:
So one is to develop a key service performance indicator and implementing Waipareira internal information and monitoring frameworks. That’s one of the key points.
To increase the role of Whanau Waipareira wide range of practitioners and the education of Maori whanau. Now this approach actually embraces the whanau collective approach to wellbeing and development, and focuses on enabling a much wider client capacity. So that’s about teaching the whanau as a whole how to actually engage and to learn new skills.
The third point is a greater diversity in the type of data that was collected through the evaluation process. And that is around information about whanau relationships; collecting the right demographics; who and how are people related within a whare, including what are the significant relationships within that particular household.
A fourth area was to look at the increase, or at least maintain an ongoing client service feedback system. So this was really around our own internal satisfaction systems. This takes into consideration whanau engagement during the evaluation component, and also as you’re actually travelling through different service deliveries within the Whanau Ora type of service within the organisation.
Our last, but not least important point is basically “How do we develop and strengthen leadership within Te Koopu Ora?” And we certainly saw the major benefits of establishing a steering group, and to look at what were the overarching terms of reference for the steering group. There are major opportunities to co-create a collaborative greater and wider range of relationships with not only referring organisations, but the whole of the education agencies as a whole. So – koina te korero mo te evaluation, and those are the key points around the key findings. Tenei te mihi atu ki a koutou katoa. Kia ora.
I love Waipareira Trust.
About Te Whānau ō Waipareira Trust
Te Whānau ō Waipareira Trust is an Urban Māori Authority established in west Auckland in 1984. It was founded on the strength of its social, education, health, economic and spiritual indigenous self-determination agenda, ‘Mana Māori Motuhake’.
The Trust’s Whānau Centre in Henderson, is a one-stop-shop for access to Health, Education, Justice and Social Services, with over 60 services available to whānau. Whānau Centre also houses a medical clinic, dental surgery, physiotherapy clinic and a range of services from the Waitemata District Health Board.
6-8 Pioneer Street
Waitakere City, Auckland
PO Box 21 081, Henderson
Waitakere City, Auckland
Phone: 09 836 6683
Fax: 09 838 4314
Freephone: 0800 924 942
Disclaimer: This page and the innovation it accompanies do not represent the views of the Ministry of Health. The views represented are those of Te Whānau ō Waipareira Trust and the innovation piloted.