SCOPE OF THIS CHAPTER
This chapter guidance is on providing Early Help and undertaking Early Help Assessments (EHA's) with children, young people and their families.
Please see Derby Safeguarding Children Board website for further information on the Early Help Assessment and related documents.
This guidance was reviewed in May 2016 and updated as required.
- Introduction and Derby City Early Help Assessment Flowchart
- Services for Children and their Families and Thresholds for Intervention
- The Early Help Assessment (EHA)
- When to do an Early Help Assessment
- When not to do an Early Help Assessment
- Lead Professional
- Multi-Agency Teams (MAT's)
- Working with an Early Help Assessment Completed by Another Practitioner
- Seeking Consent to Share Early Help Assessment Information
- Sharing Information from the EHA Discussion without Consent
- Parents Who do Not Wish to Work in Partnership and Disguised Compliance
- Differences in Opinion
1. Introduction and Derby City Early Help Assessment Flowchart
This chapter outlines arrangements for the provision of Early Help to families and children with low level or emerging/additional needs. It describes how families may be helped and how services may be accessed, including when Children's Social Care need to become involved and how this transition should be made. It sets out how practitioners and managers can assess and identify children's needs in partnership with families, and how to work together to obtain resources and services that are needed.
This document summarises the principles and processes specific to Early Help in Derby City.
Arrangements for supporting children and their families in Derby with low level and emerging/additional needs are co-ordinated by the Early Help Assessment process, the identification of a lead professional and provision of single or integrated multi-agency support.
For the process to follow when requesting an early help service, see the Derby Early Help Assessment Flowchart.
2. Services for Children and their Families and Thresholds for Intervention
A range of Early Help support is available for children, young people and their families. This support is provided through a range of universal and targeted services. The majority of children and young people will have low level needs that can be supported by universal services which 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;
The changing nature of needs of the child or parent means the level of support required is likely to vary. This can be linked to the developmental stage of the child, challenges for parents (i.e. parental mental ill health/substance misuse/domestic violence and abuse) and factors that impact on the family (i.e. bereavement/unemployment/lack of support network/s). Assessment of a child's needs is therefore dynamic and continuous and practitioners should be alert to changes which might require re-assessment of needs.
Early Help should be provided to meet emerging and additional 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 Teams (MAT's);
- Youth Offending Service;
- Services for disabled children (Lighthouse);
- Voluntary and community sector organisations, for example, Homestart or Safe and Sound;
- Specialist education 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/additional needs. These documents are available from the Derby Safeguarding Children Board website.
Consideration must be made of circumstances that increase a child's vulnerability i.e. age, disability, special educational needs, previous experience of abuse, family circumstances including mental ill health, substance use/misuse, domestic violence and abuse, social isolation, anti-social/offending behaviour or if the child is a young carer. 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 (see Derby City Council Reception First Contact Team Flow Chart).
All practitioners should be provided with professional training and be able to obtain advice in their workplace to help identify situations where the circumstances in the family are getting worse and are likely to affect the development or well being of the child, and situations that are so serious that urgent action is needed.
Agencies and practitioners must refer to the Derby City and Derbyshire Thresholds Guidance to help them in their decision making about thresholds for Early Help services and Children's Social Care.
Parents/carers, children and young people may tell us that they require support, or practitioners may identify emerging/additional needs and that services might be required. In such cases practitioners would be expected to have an open discussion with parents/carers, and the child, about the support and services that might help and agree how they will be accessed.
Where need is relatively low, individual and universal services may be able to meet these needs and prevent needs escalating. In these circumstances they should use the Early Help Pre assessment checklist and Request for Support form to identify and document low level needs. This may identify that an Early Help Assessment is needed and the action to be taken.
3. The Early Help Assessment (EHA)
The Early Help Assessment (EHA) was developed to ensure an on-going focus on preventing things from going wrong in children's lives in the first place. The EHA should capture a child's needs, decide how those needs should be met and ensure improved outcomes for the child. The EHA consists of:
- An Early Help Pre assessment checklist and Request for Support form which is used 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 act on the result;
- A team around the family (TAF) meeting framework which will help to share information and coordinate responses either before or after completion of the Early Help Assessment form;
- A standardised 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 Early Help Assessment should be completed within 10 working days.
The assessment can be completed by any practitioner who is involved with the child. It provides a holistic assessment of the child's needs in the context of the individual, the family and the community and encourages information sharing between practitioners in partnership with the child and their family.
If the completed EHA indicates that a child has needs that require services from more than one practitioner, a Lead Professional will become the person responsible for:
- Providing a single point of contact to support the child and family in accessing services;
- Ensuring that children and families get appropriate services when needed, which are well planned, regularly reviewed and effectively delivered;
- Reduce overlap and inconsistency between practitioners.
Where it becomes clear a child/children has emerging/additional needs, the practitioner should first establish whether the child has an identified Lead Professional within another service, for example a Health Visitor or Social Worker, by contacting the relevant locality single point of access clerk (see Derby and Derbyshire SCBs' Procedures Manual, Local Contacts, Advice and Further Information). If so, they should liaise with that individual with regard to the child/children's needs and services provided.
Where there is no identified Lead Professional, they should commence an Early Help Assessment. This will involve speaking with the child, parents/carers and other professionals to gain information/seek to understand what this means for the child and family usually by means of a Team Around the Family (TAF) meeting.
The TAF brings together practitioners from different services that work together to co-ordinate and deliver integrated packages of support to meet the needs identified during the Early Help Assessment process. Working in partnership 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 timescales.
The assessment and TAF action plan are reviewed by the TAF to monitor 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 take place at a maximum of 12 but ideally every 6 weeks dependent upon need and risk.
Practitioners should follow their own agency procedures with regards to recording but the plan and assessment should be shared documents.
In the event that advice and support is required to progress the Early Help Assessment, the practitioner should contact an Early Help Advisor based in their locality (see Derby and Derbyshire SCBs' Procedures Manual, Local Contacts, Advice and Further Information). They can also assist with the coordination of practitioners from different agencies to establish the Team Around the Family meetings (TAF).
Further information about the Early Help Assessment is available from the Derby Safeguarding Children Board website.
Where the assessment indicates that the child has urgent or complex needs the EHA will feed into specialist assessment processes. The EHA is not to be used when concerns arise that a child may have suffered or is likely to suffer Significant Harm and an immediate response is required. In such circumstances, the practitioner must contact the First Contact Team. A contact will be recorded in these circumstances but will only progress to a referral if agreed by both the First Contact Team and the practitioner.
The lack of a completed EHA should never delay the start of a Section 47 Enquiry by Children's Social Care. Children with additional and/or emerging needs may require targeted support from education, health or other services. The EHA will be used to identify their needs and examples might include:
- Disruptive or anti-social behaviour;
- Involvement in or risk of offending;
- Poor attendance or exclusion from school;
- Experiencing bullying;
- Special educational needs;
- Disengagement from education, training or employment post-16;
- Poor nutrition;
- Substance misuse;
- Overt parental conflict or domestic violence and abuse;
- Lack of parental support/boundaries;
- Anxiety or depression;
- Housing issues;
- Pregnancy and parenthood.
4. When to do an Early Help Assessment
An Early Help Assessment (EHA) should be done at any time when it is believed a child has additional/emerging needs that may need to be met with a range of services. It is designed for use when:
- A practitioner is concerned about how well a child is progressing. This might include concerns about their health, welfare, behaviour, progress in learning or any other aspect of their well-being or they or their parent/s may have raised a concern with a practitioner;
- The needs are unclear, or broader than a single service can address; an Early Help Assessment would help identify the needs, and/or get other services to help meet them.
Concerns should be discussed with the child and/or their parent before deciding, with them, to carry out an EHA. The EHA Pre-Assessment Checklist (which can be downloaded from the link below) or the supporting tools for the EHA can be used to help judge whether one is appropriate. If concerns exist about more than one child in the same family, one EHA should be completed for all children in that family rather than individual assessments being completed for each child.
Generally practitioners working for, or on behalf of, agencies who are accountable for providing services, will carry out EHA's where:
- More information is required to assess the needs and plan services;
- The practitioner is in the best position to carry out the assessment.
At any time, whilst an Early Help Assessment is being carried out, or on its completion, it may become apparent that the child is unlikely to reach or maintain a satisfactory level of health or development without the provision of services. In such circumstances, the EHA should be presented to the Vulnerable Children's Meeting (VCM), through the locality Single Point of Access Clerk (SPA) to enable a decision to be taken regarding allocation and / or planning. Practitioners should ensure that they are clear as to the purpose of the involvement of the Children and Young People's Department and the services that are needed. For children with a significant disability, these should be sent to the IDCS at the Lighthouse.
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/or 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.
5. When not to do an Early Help Assessment
In the following circumstances an Early Help Assessment would not be required:
- There is no need to do an EHA for every child a practitioner works with. Children who are progressing well, or have needs that have already been identified, do not need one;
- An Early Help Assessment is not needed where it is obvious what the needs are, or a practitioner has already assessed them using the agency's assessment tool, and the practitioner's service can meet the full range of those needs;
- Where a service (as a result of statutory or other requirements) has different assessment models i.e. Youth Offending Service/CAMHS. In these circumstances, the assessment used is likely to be that of the agency rather than the Early Help Assessment;
- Where individual needs are relatively low level, individual 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 from one other agency is required a completed Early Help pre assessment checklist and request for support form should be submitted with the consent from the family, to the agency able to provide the requested support.
Some services, especially adult services may only have very limited information and in such circumstances 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 be used to then request Early Help services including those from Multi-Agency Team's (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.
If an EHA is refused and the practitioner is concerned about the safety or welfare of a child, Derby and Derbyshire SCBs' Procedures should be followed. Lack of consent or cooperation should not prevent professionals meeting if the child's welfare needs are evident and the criteria for Social Care are not met.
6. Lead Professional
A Lead Professional is a practitioner who takes the lead role to coordinate provision and be a single point of contact for a child and their family, when a range of services are involved or an integrated response is required. On the completion of an Early Help Assessment that identifies that a range of services are required to meet the additional/emerging needs of a child, a Lead Professional will be identified to carry out the lead role.
Where a Social Care Single Assessment identifies that interagency work is required for a Child in Need, the Lead Professional role will be undertaken by a practitioner on behalf of the statutory agencies and will in some circumstances be a qualified social worker. It will be the responsibility of the Lead Professional to promote and facilitate effective working together by all agencies involved.
In cases where the Lighthouse (disabled children's services) or the Youth Offending Service are involved, it is likely 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 SCBs' Escalation Policy and Process.
When an Early Help Assessment has been finished, an EHA Monitoring Form must also be completed and submitted in line with the guidance contained within the EHA document set (attached within the EHA and supporting guidance). This will provide information to enable managers to understand which children, young people and families require additional support and help them to plan accordingly.
7. Multi-Agency Teams (MAT's)
MAT's will work at an early stage to help parents and carers meet the emerging and additional 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.
MAT's are locality based and consist of several services and linked practitioners. They may include:
- Education Welfare Officers;
- Youth Workers;
- Youth Offending Service Officers;
- Children's practitioners;
- Priority Families Officers;
- Early Help Advisers;
- Children's Centre Staff;
- Personal Advisers.
The teams have close links with their locality area, the services within them and communities who live there.
8. Working with an Early Help Assessment Completed by Another Practitioner
Practitioners working in a targeted specialist service, such as Children's Social Care, may receive an Early Help Assessment as part of the referral process. It will be important that the EHA is discussed with the practitioner who completed it to pool knowledge and expertise and reach a shared, better informed view of the child's needs. This may include discussion to ensure that the clinical reasoning for decisions taken and services provided are fully understood by all agencies.
If a practitioner is responsible for undertaking specialist assessments, including a Social Care Single Assessment, the Early Help Assessment should be used to inform the subsequent assessment. This should save the child/parent/s from needing to repeat themselves unnecessarily, help the practitioner be better informed and save time. However, it will be important to check that the information is accurate and up to date.
9. Seeking Consent to Share Early Help Assessment Information
In most circumstances practitioners should only record and share Early Help Assessment information with the informed consent of the child or parent. A practitioner should ensure they engage 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 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 practitioners engage with families through a variety of means and are persistent in these attempts. Practitioners should appropriately share with each other in such circumstances 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.
It is essential that the child is seen and listened to and their wishes and feelings considered, whatever their method of communication. Engaging with, and listening to, what children and young people say about what is happening to them 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.
10. Sharing Information from the EHA Discussion without Consent
Written consent to share information should be sought wherever possible; however 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 was shared and with whom. They should record any consultations and views sought which were undertaken as part of the process.
During the course of an Early Help discussion, a practitioner may gather information that they believe should be shared without consent (because consent has been refused or because it would be inappropriate to seek consent).
It is not possible to give guidance to cover every circumstance in which sharing of confidential information without consent will be justified. Practitioners must make a judgement on the facts of the individual case. Where a child is suffering or likely to suffer Significant Harm, or there is a risk of serious harm to adults, the public interest test will almost certainly be satisfied. However there will be other cases where practitioners will be justified in sharing some confidential information in order to make decisions on sharing further information or taking action - the information shared should be proportionate and there should be a pressing need to do so.
It is possible to identify some circumstances in which sharing confidential information without consent will normally be justified in the public interest. These are:
- Where, in the interest of the child, reasonable concerns identify that their health or development will be impaired without the provision of services;
- Where there is evidence that the child is suffering or is likely to suffer significant harm; or
- Where there is reasonable cause to believe that a child may be suffering or is likely to suffer significant harm; or
- To prevent significant harm arising to children and young people or serious harm to adults, including through the prevention, detection and prosecution of serious crime. See Derby and Derbyshire SCBs' Procedures.
In cases where the practitioner decides to share information without consent, they must record the reasons for doing so.
11. Parents Who do Not Wish to Work in Partnership and Disguised Compliance
An initial lack of cooperation may be resolved within a short space of time. In a few occasions 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 child/young person 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 engagement and co-operation 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.
12. Differences in Opinion
Practitioners should seek to agree the level of concern about a child. However it may be that individuals 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 SCBs' Escalation Policy and Process. 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.