SCOPE OF THIS CHAPTER
This chapter provides a guide for practitioners and managers, in every agency, who work, or come into contact with children, young people and their families where there may be low level or emerging needs.
RELATED CHAPTERS AND DOCUMENTS
Derby City and Derbyshire Thresholds Document (Documents Library, Guidance Documents)
Derby and Derbyshire Escalation Policy and Process (Documents Library, Guidance Documents)
Documents for use by practitioners when completing Early Help Assessments, including the Family Safety Advice Guidance, can be found in the Documents Library, Assessment Tools.
In July 2017, Section 8, Escalating Concerns and Differences in Professional Opinion, was updated to include a new subsection on Professional Meetings.
The new subsection explains how professional meetings can be useful including to share information and to help determine the direction of a case or the plan for a child/young person. They can also be a useful way of resolving uncertainty and can be helpful when working with complex family concerns and/or extensive professionals/networks.
Guidance is also provided in relation to informing families about the professional meeting and the decisions and recommendations that were made. In line with other multi-agency meetings, professional meetings should be chaired by an appropriate person, have minutes taken along with clear actions/recommendations and review timescales.
The Family Safety Advice Guidance which was written to support practitioners when completing the "Your family's safety advice" section of the Early Help Assessment has also been rewritten.
- Services for Children and their Families and Thresholds for Intervention
- How do I know whether there are Low Level or Emerging Needs?
- Using the Early Help Assessment to Identify Support and Services
- Obtaining Advice and using the Early Help Assessment
- Engaging with Families and Sharing Information
- Providing Services for Low Level and Emerging Needs
- Escalating Concerns and Differences in Professional Opinion
This chapter outlines the arrangements for:
- The provision of Early Help for families and children with low level or emerging needs;
- How families may be helped;
- How services may be accessed; and
- When Children's Social Care need to become involved and how this transition should be made.
It also sets out how practitioners and managers can assess and identify children's needs in partnership with them and their families, and how to work together to obtain the resources and services that are needed.
There are differences between Derby and Derbyshire in terms of systems and services, and ongoing development in both; these are outlined in Section 5, Obtaining Advice and Using the Early Help Assessment.
Arrangements for supporting children and the families in Derby and Derbyshire have been established to help at an early stage to meet the low level and emerging needs of children; these are co-ordinated via the Early Help Assessment process, identification of a Lead Professional and single or integrated Multi-Agency support.
2. Services for Children and their Families and Thresholds for Intervention
There is a range of early help support that is provided for children, young people and their families. This support is provided via both universal and targeted services.
The majority of children and young people will have low level needs that can be supported through a range of universal services. These services include:
- Health services such as GP's, Midwifery, Health Visiting and School Nursing;
- Nurseries and playgroups;
- Schools and Colleges;
- Children's Centres;
- Community, sport and leisure facilities;
- Housing; and
- Play and Youth Services.
However the changing nature of needs of the child or parent often means that the level of support required is likely to vary. This can be linked to the developmental stages of the child, challenges for parents (such as parental mental ill health / substance misuse / domestic abuse) and factors that impact on the family (such as unemployment / bereavement / isolation / lack of support networks). Assessment of a child's needs is therefore a dynamic, continuous process rather than a single event and practitioners should be alert to changes which might require a re-assessment of needs.
Early help should be provided to address any emerging needs and consists of co-ordinated support from universal and targeted services. Examples of agencies providing targeted services include:
- Health services such as Child and Adolescent Mental Health Services (CAMHS);
- Multi-Agency Team's (MAT's);
- Youth Offending Service (YOS);
- Services for disabled children such as The Lighthouse or Spirelodge;
- Voluntary and community sector organisations e.g. Homestart or Safe and Sound; and
- Specialist educational services and establishments.
Many universal and specialist services are also able to provide a targeted response.
Practitioners are expected to use the Early Help Assessment including the Early Help Pre-Assessment Checklist and Request for Support Form to help identify low level or emerging needs.
Consideration must be made of the particular circumstances that increase a child's vulnerability such as their age, disability, special educational needs, previous experience of abuse, legal status, family circumstances including mental ill health, substance use / misuse, domestic abuse, social isolation, and anti-social / offending behaviour, or if the child is a young carer. The positive or negative impact of religious or cultural belief should also be taken into account. Where a child has complex needs or is suffering or likely to suffer Significant Harm, a referral should be made to Children's Social Care, Making a Referral to Social Care Procedure.
All practitioners should be supported with professional training, and be able to obtain advice in their workplace, so they can identify situations where the circumstances in the family are getting worse and are likely to affect the development or well being of the child. They must also be able to distinguish those situations that are so serious that urgent action is needed.
Agencies and practitioners must refer to the Derby City and Derbyshire Thresholds Document (see Documents Library, Guidance Documents Section) to help them in their decision making about thresholds for early help services and Local Authority Children's Social Care.
3. How do I know whether there are Low Level or Emerging Needs?
Parents, carers, children and young people may tell us that they require support, or practitioners may identify emerging needs and that services might be required as there are concerns about the child. In such cases practitioners would expect to have an open discussion with the parents / carers and child about the support and services that might help and agree how they would be accessed.
Where need is relatively low, individual services and universal services may be able to meet these needs, take swift action and prevent needs escalating. In these circumstances they should use the Early Help Pre-Assessment Checklist and Request for Support Form (available in the Documents Library, Assessment Tools) to identify and document low level needs. This may identify that an Early Help Assessment is needed and the action to be taken.
Where there are emerging needs and the child or parent are likely to require co-ordinated support from a range of Early Help services, or where there are concerns for a child's well-being or a child's needs are not clear, not known or not being met, practitioners should discuss the use of the Early Help Assessment with the child and/or their parents / carers.
4. Using the Early Help Assessment to Identify Support and Services
The Early Help Assessment consists of:
- An Early Help Pre-Assessment Checklist and Request for Support Form to identify and document low level needs or to help decide when an Early Help Assessment may be needed;
- A process to enable practitioners in the children and young people's workforce to undertake an Early Help Assessment and then act on the result;
- A team around the family (TAF) meeting to share information and co-ordinate responses either before or after completion of the Early Help Assessment form;
- A standard form to record an Early Help Assessment;
- A TAF action plan and review form.
Unless there are serious concerns that a child is suffering or likely to suffer abuse and maltreatment, practitioners should use an Early Help Assessment to start the process of understanding the needs and strengths of the child and the parent / carers. The aim should be to be complete the Early Help Assessment with 10 working days.
This will make sure that an in depth understanding of the child and their family's needs and strengths are understood at the earliest opportunity and increases the likelihood that the most effective decisions are made to improve the situation for the child and their family.
Some services as a result of statutory or other requirements will have different assessment models i.e. Youth Offending Service and Child and Adolescent Mental Health Services (CAMHS). In these cases the assessment used is likely to be that of the agency rather than the Early Help Assessment.
Where needs are relatively low level, individual services and universal services may be able to meet these needs, take swift action and prevent those needs escalating. The Early Help Pre-Assessment Checklist and Request for Support Form can be completed to help identify and document low level needs and any action to be taken. This can include when an Early Help Assessment may be needed. In cases where there are only low level needs the early help single agency action plan, or an agency action plan, should be completed and reviewed as appropriate. Where involvement is required from one other agency a completed Early Help Pre-Assessment Checklist and Request for Support Form should be submitted, with consent from the family, to the agency able to provide the requested support.
Some services, especially adult services, may have only very limited information. In these circumstances they should use the Early Help Pre-Assessment Checklist and Request for Support Form to identify and document needs. The completed form, with the consent of the family, can then be used to request early help services, including those from Multi-Agency Teams (MAT's). Depending on the nature of the needs and concerns this may lead to the completion of an Early Help Assessment. The service requesting the support will then be part of the Team Around the Family (see below).
Where an agency could complete an Early Help Assessment they should take the necessary steps to progress this.
5. Obtaining Advice and using the Early Help Assessment
Where there are emerging needs the practitioner should first establish whether the child has an identified Lead Professional within another service, for example a Health Visitor, a Teacher or a Social Worker, by contacting the relevant Locality Single Point of Access Clerk. If so, they should liaise with that individual with regard to the child's current needs and services provided (as below).
Where there is no identified lead professional, they should commence an Early Help Assessment with support from their agency. This will involve speaking with the child, parents / carers and other involved professionals to gather information and seek to understand what this means for the child and family, usually by means of a "Team around the Family" (TAF) meeting. They should consider both the needs / strengths of the child and, where appropriate, the needs of the parent / carer (such as those who have mental health needs).
In the event that advice and support is required to progress the Early Help Assessment, the practitioner should contact the Early Help Advisor based in their locality. They can also assist with the coordination of practitioners from different agencies to establish the team around the family (TAF) meetings.
Further information about the Early Help Assessment in Derby can be found in the Guidance for Completing an Early Help Assessment document (see Documents Library, Assessments Tools).
If a practitioner requires advice, wishes to explore ways of engaging children and families in early help or discuss whether the threshold for a referral to Local Authority MAT or Children's Social Care met; they should call the Children's Services Professional Consultation Line. If the concerns/issues raised indicate that there is reasonable cause to suspect that a child is suffering or is likely to suffer, significant harm, the LA Team Manager will record the contact and advise the practitioner to contact First Contact Team to make a referral.
See the Derby City Consultation Line Leaflet for Professionals for more information on the service (see Documents Library, Leaflets).
Staff in the Local Authority Multi-Agency Teams (MATs), Integrated Disabled Children's Service (IDCS) and integrated / co-located teams will have the opportunity for informal consultation with Social Workers in their localities.
If emerging needs are identified by the completion of an Early Help Assessment and it is likely that services are needed from other agencies, then the assessment and action plan can be submitted to other services requesting their input, with the consent of the family.
If a complex package of support is needed, or if services are required from a Multi-Agency Team, or to make a non-urgent referral to Children's Social Care, completed Early Help Assessments (or other relevant assessments) can be submitted to the weekly Vulnerable Children's Meeting by the practitioner who has completed the assessment. They should be sent to the Single Point of Access Clerk in the relevant locality or at the Lighthouse for a child with a significant disability.
On completion of an Early Help Assessment, other appropriate assessment or assessment by Children's Social Care Reception team, the Vulnerable Children's Meeting will make a decision about allocation to the most appropriate practitioner or service for further assessment and action. In some cases there will be no need for MAT or Children's Social Care involvement and a referral to other services will best meet the needs of the child, or a decision made that no action is needed at that time.
In Derbyshire, professionals working with children and families can access the Starting Point Consultation and Advice Service. The service operates Monday to Friday from 08:00 – 18:00, and is staffed by Senior Practitioners and qualified Social Workers. Starting Point can offer advice on how to engage with children and families, dealing with difficult and challenging issues, how to achieve elusive outcomes, etc. This service complements, but does not replace, established lines of advice that exist within organisations, for example, discussions for health service staff with their named nurses.
Where there are low level needs or emerging needs the practitioner should complete a Starting Point Request for Support Form. Please note if you are aware the child already has an allocated MAT worker or Social Worker please do not fill out this form and liaise directly with the allocated worker.
If you are unsure about whether a threshold is met please call the Starting Point Consultation and Advice Service.
Starting Point receive all Initial Contacts where there is a request for general advice, information or a service for a child who may be a child with emerging or complex / serious needs. Information is shared with the Police and health services to ensure that families receive the right help at the right time.
In cases where there is no identified Lead Professional within the Multi-Agency Team, Starting Point may provide information and advice or re-direction to other services. This action will be informed by any history of previous involvement with the child and family.
An Initial Contact will be created for all other cases where it is judged the child may have emerging or complex needs. This Initial Contact will be then passed to the Senior Practitioner within Starting Point for screening.
The Senior Practitioner will decide whether an Early Help Assessment and planning process should be commenced or continued through the Lead Professional.
The Senior Practitioner will, within 24 hours, decide whether the child requires:
- The Early Help Assessment and planning process to be commenced or continued through the Lead Professional within the MAT teams;
- No further action;
- A referral to Children's Social Care for an assessment by a Social Worker.
Starting Point will direct the Initial Contact / Referral to the appropriate team and advise the referrer of the outcome within 24 hours.
If an Early Help Assessment is recommended then the enquirer referral details will be passed onto the MAT in Derbyshire. Further information about the Early Help Assessment in Derbyshire can be found online on the Derbyshire County Council website.
6. Engaging with Families and Sharing Information
Working in partnership with children, parents/carers and families
Accurate information and a clear understanding of what is happening to a child within their family and community are vital to any assessment. The usual and most effective way to achieve this is by engaging children and parents in the process of assessment, reaching a shared view of family strengths, what needs to change the potential impact on the child and family if these changes don't happen and what support is needed, and jointly planning any required next steps.
All practitioners should expect to work in partnership with children and parents and this includes agreement about sharing information. Some families may not recognise difficulties, may be reluctant to engage, may avoid contact or even be hostile. It is important that practitioners use their skills to engage with all families through a variety of means and are persistent in these attempts. Practitioners should appropriately share information with each other in such situations in order to maximise their chances of engagement and/or to agree a lead role for someone who may have been able to establish contact.
Involving children and young people
It is essential that the child is seen and listened to and their wishes and feelings considered, whatever their method of communication, when enquiries are carried out into their welfare. Engaging with and listening to what children and young people have to say about what is happening to them in their lives, should be the cornerstone of effective intervention and support. There may be circumstances where the information from the child or young person will inform the nature of further action and will take place prior to the matter being raised with the parent or carer.
In all situations the overriding consideration as to whether to share information should be the safety and welfare of the child.
Obtaining parental, or where appropriate the child's consent to information being shared, should be a first consideration when practitioners first have contact with a child and/or their family. Written consent to share information should be sought wherever possible. A lack of consent should never compromise the safety or welfare of a child. However, consideration should be given to seeking the views of the parent/child as to why consent may be being withheld in line with their human rights.
A practitioner should record their decision and the reasons for it, whether or not they decide to share information. If the decision is to share, a practitioner should record what information was shared and with whom. They should also record any consultations and views sought which were undertaken as part of the process.
For further information please see:
- Derby and Derbyshire Safeguarding Children Boards' Information Sharing Agreement and Guidance for Practitioners (see Documents Library, Guidance Documents); and
- Information sharing - Advice for Practitioners Providing Safeguarding Services to Children, Young People, Parents and Carers (Department for Education, March 2015).
7. Providing Services for Low Level and Emerging Needs
Team around the Family (TAF)
Where a Multi-Agency response is required, the team around the family (TAF) brings together practitioners from across different services that work together to co-ordinate and deliver an integrated package of support to meet the needs identified during the Early Help Assessment process. Working with the family, they will agree an action plan to describe the outcomes agreed and support to be provided or actions taken, by whom and within what timescale.
The assessment and TAF action plan are regularly reviewed by the TAF to monitor the progress towards the agreed outcomes. The review identifies any unmet or additional needs for the child or young person and should ensure a smooth transition between universal, targeted and specialist services. Reviews should usually take place at 6 weekly intervals but may be more or less frequent depending on needs.
Where a child has been in receipt of specialist services, and that service is coming to an end but transition to the early help process is needed it is the responsibility of the specialist service to convene an appropriate meeting to ensure a smooth transition.
Practitioners should follow their own agency procedures with regards to recording, but the plan and assessment should be shared documents.
The Lead Professional in Derby and Derbyshire
The lead professional is the person responsible for co-ordinating the actions identified in the assessment process, including any review TAF meetings. They are a single point of contact for children and young people with emerging needs who are supported by more than one practitioner within a team around the family.
The lead professional can be any practitioner working within the team around the family and should be the most appropriate person to act in the role at that time. The lead professional should be ideally someone with an established relationship with the family. In cases where The Lighthouse or Spirelodge (disabled children's services) or the Youth Offending Service are involved, it is likely that that the practitioner from these services will be the lead professional.
If the child becomes subject of a statutory service such as Children's Social Care, the lead professional responsibility will transfer to the relevant specialist service.
Disagreements about the most appropriate person to be the lead professional should be addressed using the Derby and Derbyshire Escalation Policy and Process (see Documents Library, Guidance Documents).
Multi-Agency Teams (MATS)
In both Derby and Derbyshire, the Multi-Agency Teams will work at an early stage to help parents and carers meet the emerging needs of children and young people. They are also able to work with children and their family's following a period of specialist intervention when continued support is required.
The Multi-Agency Teams are all locality based and consist of a number of services and linked practitioners. They may include:
- Social Care Workers;
- Education Welfare Officers;
- Youth Workers;
- Health practitioners such as Mental Health Workers, Community Midwife's, School Nurses and Health Visitors;
- Youth Offending Service officers;
- Children's Centre staff; and
- Personal Advisors.
The teams have close links with their locality areas, the services within them and communities who live there.
8. Escalating Concerns and Differences in Professional Opinion
Insufficient progress, increasing or new concerns
It is essential to keep under review the changing picture of whether the circumstances and outcomes for the child are improving or not. The views of parents / carers and young people about whether the help is making a difference are important in this, as are the views of professionals and other objective measures. Where insufficient progress is made, or the situation deteriorates, consideration must be given in a timely way to the potential long term impact on the child, taking particular account of the age of the child, and whether a referral should be made to Social Care. In all cases drift and delay must be avoided.
Parents who do not wish to work in partnership and disguised compliance
An initial lack of co-operation may be resolved within a short space of time. Occasionally practitioners in all agencies will come across families who prove to be reluctant, resistant, and sometimes angry or hostile to their repeated efforts to engage with them. In extreme cases there can be intimidation, abuse, threats of violence and actual violence.
In other cases they may appear to engage with practitioners, but only superficially and with no real commitment on their part. The adults may also be focused on their own needs which can divert practitioners from a focus on the child.
If this arises, practitioners must seek advice from their manager or designated person to explicitly identify in a timely manner whether this parental behaviour is having a detrimental impact on the development of the child and together consider if other action might be necessary.
The behaviour may prevent or restrict opportunities to assess and observe the child in their own home. It may also restrict other sources of information from other practitioners or family members. It is important to explicitly work out and record what areas of assessment are difficult to achieve and why. The presence of violence or intimidation needs to be included in any assessment of risk to the child living in such an environment.
Insufficient cooperation and engagement of a parent / carer that impacts on the welfare of the child should be explicitly analysed to identify whether a referral should be made to Children's Social Care (see also Making a Referral to Social Care Procedure).
Differences in opinion
Practitioners should seek to agree the level of concern about a child. However it may be that individual may legitimately have a different perspective as to the seriousness of concerns. Differences in professional opinion about a child's needs and concerns must be resolved using the Derby and Derbyshire Escalation Policy and Process (see Documents Library, Guidance Documents). Any practitioner has a responsibility to refer to Social Care if they consider the threshold is met and a child is suffering or likely to suffer significant harm.
It is good practice to involve parents/carers, children and young people in multi-agency meetings, however there are occasions when it is may not be appropriate to involve them.
Professional meetings provide an opportunity for professionals involved with a family to come together not only to share information, but also to help determine the direction of a case and the plan for a child/young person. They may be held to resolve uncertainty and are helpful where there are particularly complex family concerns, with extensive professionals/networks. Professional meetings can lead to staff being able to challenge families (especially where there is disguised compliance, hostility and resistance) and one another openly and effectively.
Where professional meetings take place, they should be focused on outcomes for the child and family and form part of a continuous process of assessment, planning, implementation and review across all levels of need, including early help.
Any practitioner can request a professional meeting however they should only be held after careful consideration is given to the need to exclude the family from the meeting. In most cases the family should be informed by the practitioner arranging the meeting that it is to take place. However, where this would be against the best interests of the child/young person, the family need not be informed in which case all invited agencies should be aware of this decision; see Derby and Derbyshire Safeguarding Children Boards' Information Sharing Agreement and Guidance for Practitioners (via Documents Library, Guidance Documents). Where decisions and recommendations have been made without family members being present they should be communicated to the family as soon as possible afterwards unless to do so would put the child at additional risk.
The reasons for the professional meeting and the decision to inform the family or not, should be documented within agency records and other agencies informed. Similar to other multi-agency meetings, professional meetings should be chaired by an appropriate person, have minutes taken along with clear actions/recommendations and review timescales.
Where there are differences in opinion about the need for a professional meeting, the outcome of a meeting or other issues, practitioners should refer to the Derby City and Derbyshire Escalation Policy and Process (see Documents Library, Guidance Documents).
Referrals to Social Care
Practitioners should refer to the Derby City and Derbyshire Thresholds Document (see Documents Library, Guidance Documents) to support their decision making about escalating any concerns to other agencies including Children's Social Care. Serious or complex needs and child protection concerns should be referred to Children's Social Care, see Making a Referral to Social Care Procedure.