Child in Need - Levels of Intervention (LOI)

1. Children in Need

This chapter does not apply to children who are the subject of a Child Protection Plan. Where the child is subject to a Child Protection Plan, this will be done during an initial case conference and subsequent core group meetings. It will be reviewed by a Child Protection Review Conference. Please see the Gloucestershire Safeguarding Children Board Procedures in relation to the implementation of the Child Protection Plan.

The majority of children and young people have a number of common needs supported by their families and a range of universal services. Some children, whilst continuing to be supported through universal services, will have additional, more complex, or acute needs. These children require clear and well understood access pathways to a range of more targeted or specialist services.

To inform decision around pathways, Gloucestershire has a guide: "Children's Workforce Guidance for Levels of Intervention" (LOI). This compliments a model originally produced by the Children's Workforce Development Council's (CWDC) called 'Windscreen of Needs' (see below).

Diagram 1: The Windscreen

This supports more integrated working across a continuum of need. The LOI document highlights four levels of need for children and young people 0-18. This is only a guide to inform but not replace professional judgment to determine what is in the best interest of a child, young person and their family; discussions around thresholds to services will sometimes take place as they can be overlapping and need to be fluid. It is important that this is transparent so that professionals from all agencies are supported to identify a pathway most appropriate to meeting individual needs.

2. Levels

The model used to illustrate the different levels of children and Young people's needs in Gloucestershire is referred as the windscreen of needs for children and young people (see Diagram 1: The Windscreen). It recognises that children, young people and their families will have different levels of needs and that a family's needs may change over time. They agreed multi-agency thresholds are set out across four levels of needs which are:

2.1 Universal (level one of the windscreen above)

Every child requires universal services such as education and GP's, as well as love, care and protection by those with parental responsibility for them. (There are examples in the 'Universal' column of the LOI document). These are children who are doing good overall progress in all areas of their development and have their needs met without additional support.

2.2 Vulnerable - Early Help Single and Multi-Agency Approach: (level two of the Windscreen)

These are children and young people where some concerns are emerging and who may require additional support usually provided by professionals already involved with them as a single agency response, They may also require a multi-agency support to meet their additional needs. This may relate to their health, development, social skills or education. If ignored, these issues could lead to an escalation of needs. The practitioner (with the consent of the child/family) will consider making a request for support to the Early Help Allocation Meeting.

Whilst the provision of support by Early Help services at level 2 is consensual and based on voluntary engagement with families, a young person under the age of 16 who is considered to be of sufficient age and understanding to be competent to receive contraceptive advice without parental knowledge may give consent in their own right. Lack of consent from parents/carers may impact negatively on the child's level of needs and could lead to Early Help professionals having to re-evaluate the needs as more complex or in some circumstances acute. In most situations, however, the lack of consent would be overturned by the skilful approach of a nominated Lead Professional.

Regarding children with disabilities, Section 17 of the Children Act 1989 describes how a child with disabilities has a statutory identity as a 'Child in Need' (see Section 2.3, Complex - Child in Need) and if requested and appropriate to do so, the Local Authority would undertake a statutory assessment of need, usually by a social worker. Gloucestershire, however, offers a majority of children where there are no safeguarding concerns and no significant family complexities (as set out in the Eligibility Criteria) the opportunity of an Early Help assessment without Social Care involvement. This is in line with the Warwickshire Judgement and allows a professional who may already have been working with the family for some time, to undertake the assessment within Early Help. There is in Gloucestershire a choice of free and funded service providers available to meet the identified needs of children with disabilities. A Personal Budget can be granted when a child or young person's support needs cannot be met through the support from the community, the early help partnership or providers, without individual and additional funding, providing the child meets the eligibility criteria.

2.3 Complex - Child in Need: (level 3 of the Windscreen)

A child's needs are seen as complex when they are not fully met due to their range, depth or significance. They may prevent the child from achieving or maintaining a reasonable standard of health and development without the intervention of more specialist and intensive services from the Local Authority. Without this provision, It would be likely that, the child's health or development would be adversely affected or significantly impaired. An Early Help Assessment may have been completed but has been unsuccessful.

A child in this situation may be defined in law (Section 17 of the Children Act 1989) as a 'Child In Need'. The Local Authority has a duty, If requested, to undertake a statutory assessment of need (single assessment), completed by a qualified practitioner, using the Framework for the Assessment of Children in Need and Their Families (2000). This practitioner would need appropriate professional qualifications, skills and knowledge (such as a Qualified Social Worker) to provide a thorough analysis of needs, but also to be able to identify through assessment when emerging concerns are indicating unmet 'acute' needs and a child being in need of protection. A Child in Need plan would be drawn up with the lead professional in most cases being a social worker.

Child in Need Eligibility for Assessment and Intervention by a Social Worker

A social worker will be allocated to complete a single assessment when the level of need is such that:

• Crisis management requires a co-ordinated response;
• Specialist collaborative working is required in response to problems of high complexity and severity;
• It is a Life threatening and/or an acute situation;
• Specialist settings are requested including: specialist residential provision within and out of the county boundary, hospital inpatient care, mother and baby units, assertive outreach, day centres. (would include disabled children and those with very complex needs who are provided with residential placements which include a social care element of funding within the commissioning i.e. CYPERN placements);
• It cannot currently be met at Early Help level without social care involvement. The current level of support will subsequently reduce when the needs have reduced and they can be met by Early Help services.

Disabled CYP Eligibility for Assessment and Intervention by a Social Worker

In relation to Children with disabilities, it may be appropriate to complete a statutory assessment of needs undertaken by a social worker and to start a Child In Need Plan. It is recognised that children with disabilities are often more vulnerable than other children, therefore the threshold for statutory assessment may be lower. Some broad circumstances indicating the need for statutory assessment include:

• Imminent danger of family breakdown;
• Sudden and catastrophic trauma resulting in need for urgent multi-agency input & co-ordination;
• Evaluating the level of risk;
• Carers/parents' capacity to parent impaired by health/mental health problems or substance misuse;
• Complex family needs impacting on the parent/carers' ability to care for the child;
• To ensure regular CiN reviews and monitoring of/response to risk;
• Child protection and children in Care.

Early Help assessments will be offered for disabled children with the exception of the group above. If the disabled child or families needs are outside of these domains but the request is formally made for a SW assessment on the consideration that an early help assessment won't be sufficient a SW assessment will be provided. Support arising from the assessment will be provided in the same way as the outcome of early help or statutory assessments.

2.4 Acute - Child in Need of Protection (fourth sector of the Windscreen)

Where circumstances have deteriorated to a point that a child may be at risk of significant harm, the Local Authority, with the assistance of partner agencies have a duty to protect that child. These children will always need an immediate referral to Children's Social Care and/or the Police. Practitioners need to follow local safeguarding guidance. Any acute needs would have to be identified immediately using a statutory assessment and immediate action taken. The child would be defined under Section 47 of the Children Act 1989 as a child in need of protection.

A decision that a child has suffered or is likely to suffer significant harm following a specific incident or event is often more straight forward than a situation where a child's needs have not been met over a period of time due to neglect. It is therefore important for practitioners to regularly refer to the Levels of Intervention document to understand and address the impact of unmet needs at this level.

When children with disabilities are subject to Child Protection Plans, it is again important to ensure that the individual needs of the child in relation to their disability are considered alongside the other elements of the Child Protection Plan. Failure to do so could increase vulnerability and risk.

3. The Child in Need Process

3.1 Child in Need Multi-Agency Meeting

Where it is anticipated that a package of family support may be required to meet the child's needs under Section 17 of the Children Act 1989, consent to share information and receive professional support must be obtained from the child's parent(s)/carer(s). A home visit to see the child and their parents should take place within 5 working days of a referral being received and an initial Child in Need Multi Agency Meeting is to be arranged within 10 to 15 days thereafter. An initial assessment of needs should be available for the meeting unless a more in depth single assessment is in progress (taking up to 45 days).

A Child in Need Multi Agency Meeting provides an opportunity for a child / young person and his or her parents/carers, together with key professionals, to discuss needs, outcomes and identify services to meet those needs. Any existing support plan (My Plan +…) are brought to the meeting for discussion. An initial plan of support is agreed between family and professionals, clarifies the pattern of visiting and by who. This is to ensure there will be no delay in the provision of support. The Child in Need Plan is SMART and proportionate to the needs of the family. It takes into account the child and family's views of the problem, their culture and identity.

All 'Child in Need Multi Agency Meetings' should be attended by the child / young person (depending on age and understanding), by their parents/carers and by professionals/agencies who are involved with the family and whose contribution is recommended to improve outcomes for the child/YP. The allocated Lead Professional (in most instances a Social Worker), in consultation with the child / young person, will consider how and who is best placed to represent their views and inform the plan if the child / young person does not attend.

The Lead Professional should agree with the child / young person and their parents/carers who will attend prior to arrangements being made for the meeting.

It will be important for this meeting to identify a suitable place for the child / young person and his or her family. Consideration must be given to transport, timing of the meeting and any child care issues. For school age children the meeting should be held outside of school time, wherever possible, to facilitate attendance by the child/YP.

The first Child in Need Multi Agency Meeting will be convened and chaired by the allocated Lead Professional. Through discussion with the Line Manager, consideration will be given to new or newly qualified staff being supported by a Senior Practitioner or Manager at the initial meeting.

A note of the meeting will be taken. This record will be copied to those involved, including the child / young person and parent/s who will need to sign their agreement. The Signed record of the notes will be placed on the child/young person's electronic file.

Factors such as refusal of consent for certain agencies or absent parents to attend Child in Need Multi Agency meetings much be assessed and evaluated in the context of the child / young person's experiences, the level of risk and likelihood impact for the child and the family.

3.2 Child in Need Plan

A Child In Need Plan will be developed within the Child In Need Multi Agency Meeting. This will include the views of the child/young person where appropriate and the views of all other significant parties.

The Child In Need Plan must identify the Lead Professional, any resources or services that will be needed to achieve the planned outcomes with the agreed timescales and who is responsible for which action.

In particular the Child In Need Plan should:

1. Describe the identified needs of the child/young person and their family, having considered any cultural and diversity needs;
2. Include specific, achievable, realistic, timely and child-focused outcomes intended to promote and safeguard the welfare of the child;
3. Include realistic strategies, services and actions to achieved the planned outcomes;
4. Formulate the risks and contingency plan;
5. Identify the role and responsibilities of professionals, including the nature and frequency of contact and visits by all professionals with children/young people and family members;
6. Agree dates whereby the Plan will be reviewed and how long the plan would last. A plan is expected to be in place for a period of 3 months; A plan should not end without a CiN review being arranged.

The Chair of the Child In Need Multi Agency Meeting is responsible for the distribution of the Child In Need Plan. This should be provided to the child/young person (where appropriate), to the parents and other agencies or professionals involved in this process.

3.3 Review of Child in Need Plan

The purpose of the Review is to ensure that the objectives are being achieved within a set timescale. The review will discuss what impact the CiN plan has on the child and their family, the reasons why, and how the outcomes should be achieved.

Review meetings will be conducted at intervals agreed at the initial CIN meeting with the first review meeting being held within a maximum of 4 weeks from the referral. For DCYP it may be appropriate for the time intervals between CiN reviews to be longer. This should be agreed and recorded at the review. When a CiN plan follows a CP plan, the closing child protection case conference should outline the CiN plan and the core group should meet soon after the CP plan has ended to start the CiN review process (within 4 weeks). Unless in exceptional circumstances requiring service lead approval, a CiN plan following a CP plan would be reviewed at least twice before transferring/ending. On the other hand, after a CiN plan has been regularly reviewed for several months (7 months) with little or no positive impact, a manager should be asked to chair the following CiN review and consider stepping down or stepping up depending on the level of needs and risk to the child.

The outcome of a Review will be either:

1. That the child is no longer a Child in Need requiring Children's Social Care Services and interventions, which will result in a recommendation to the team manager that the case should be closed although the child may continue to receive services from a single agency or under a multi-agency Early Help plan not involving social care;
2. That the child continues to be a Child in Need who requires a multi-agency plan and the involvement of a social care team. An updated single assessment may be required;
3. That the child appears to be at risk of significant harm resulting in the need for a strategy discussion / meeting and further assessments under S17 or S47 of the Children Act. The social care team manager is informed immediately and the file is updated accordingly;
4. That the child continues to be a Child in Need under S17. The parents are now refusing to engage with the child in need plan and the threshold for S47 enquiry is not met. This may result in a recommendation made to the social care team manager to end the CiN plan. Non engagement of parents should not however be the reason for withdrawing professional support to a child in need and the impact of withdrawing services should be discussed in relation to the welfare of the child and recorded.

When a Child in Need Plan is amended during a CiN review meeting, the Lead Professional should circulate a copy of the amended Plan to the child, parent / carer and other involved agencies / professionals.