Nanny state's first in ruin, made to change (9)
I believe the answer is:
nursemaid
'nanny' is the definition.
('nursemaid' can be a synonym of 'nanny')
'state's first in ruin made to change' is the wordplay.
'first' says to take the initial letters.
'in' means one lot of letters goes inside another.
'to change' is an anagram indicator.
The first letter of 'state' is 's'.
'ruin'+'made'='ruinmade'
'ruinmade' is an anagram of 'nuremaid'.
's' put within 'nuremaid' is 'NURSEMAID'.
(Other definitions for nursemaid that I've seen before include "child minder" , "female carer" , "Nanny" , "She may attend to babe" , "her charges are small" .)