A range of early help support is provided for children, young people and their families in Derby. This support is provided via a range of universal and targeted services. Early help services aim to provide advice and/or intervene where there is evidence of emerging needs with the objective of preventing escalation to higher level services such as placements in care, child protection work or entry into the criminal justice system, which have a profound cost financially and socially.
This guidance is for practitioners based in early help services to ensure consistency and quality in relation to the delivery of early help services across the three locality teams in the city.
2. Early Help
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;
- Children's Centres;
- Voluntary and community sector organisations e.g. Homestart or Safe and Sound;
The Derby City and Derbyshire Safeguarding Children Boards thresholds document provides an outline of examples of Early Help:
- Poor nutrition or inadequate clothing, poor home conditions or risk of homelessness;
- Low level self harm or substance misuse;
- Family circumstances which present challenges for a child or unborn baby i.e. parental substance misuse, mental health problems or low level domestic abuse;
- Poor attendance, disengagement or at risk of exclusion from school or post 16 education, training or employment;
- Disabilities (low level needs) or health needs (chronic);
- Significant behavioural difficulties, or involvement in, or risk of, offending;
- Teenage pregnancy and parenthood, including the risk of early parenthood;
- A young carer who appears to be coping;
- Low level risk of child sexual exploitation or are beginning to go "missing";
- Parental conflict or lack of parental support/boundaries
All agencies are expected to use the Early Help Assessment to request support and help identify low level or emerging needs.
Where a child has complex needs, a referral should be made to Children's Social Care, although MAT's also work with level 3 cases. The Derby City and Derbyshire Safeguarding Board thresholds document outlines examples of level 3 needs as detailed below:
- Children with a disability (medium/high level needs) or significant mental health needs;
- Who are aged 16 plus and are homeless;
- At medium risk of child sexual exploitation or are persistently "missing";
- Who are young carers and are not coping and/or with unmet needs;
- Whose parents are experiencing difficulty in providing a reasonable standard of parenting, including parents who have a physical or learning disability, have mental ill health issues, are seriously ill or misuse substances (this includes unborn babies);
- Living in a situation where there is repeated or serious domestic violence (this includes unborn babies) or are age 16/17 and are a victim/perpetrator of domestic abuse;
- Living in families where there is a likelihood of family breakdown;
- Whose behaviour has been sexually harmful;
- Who are living in a private fostering arrangement;
- Where early intervention attempts to improve the situation have been unsuccessful.
Agencies and practitioners must refer to the Derby City and Derbyshire Thresholds Document to help them in their decision making about thresholds for early help services and Local Authority Children's Social Care. It is likely that decisions as regards whether cases meet the Early Help or Complex Needs threshold are made in the weekly Vulnerable Children Meeting (VCM). The level of work will primarily be decided based on the needs of the child and guidance contained within the thresholds document. The VCM will also be the forum where decisions will be made as regards which agencies such cases are allocated to.
The levels of need contained within the thresholds document are as follows:
- Low level needs where individual services and universal service are able to address the child's needs;
- Emerging needs where a range of early help services are required co-ordinated through an early help assessment;
- Complex or serious needs where assessment and help is likely to be required as a child in need (section 17 of the Children Act 1989) or that they require accommodation (section 20 Children Act 1989);
- Child protection concerns where a child requires immediate protection and urgent action because there is reasonable cause to suspect that the child is suffering, or likely to suffer, significant harm, and enquiries are to be made and the child assessed under section 47 of the Children Act (1989). This may include consideration about whether a child can safely remain at home.
3. How do I know when there is emerging need?
Parents, carers, children and young people may tell us they require support, or practitioners may identify emerging needs and that services might be required, as there are concerns about a child. In such cases, practitioners would be expected to have an open discussion with the parents/carers and child about the support and services that might help and agree how they will 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, practitioners 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 subsequent action that needs 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. MAT Interventions
Where the above criteria for MAT's is met and it is assessed that the MAT worker is best placed to deliver a piece/s of work, MAT workers will be allocated to undertake specific piece/s of work as outlined below.
The MAT worker will arrange and co-ordinate a Team around the Family (TAF) meeting with professionals from other agencies and the family within 6 weeks of allocation.
The assessment (either early help or single assessment) must be used as the basis of identifying the current needs and risks associated with the family and the basis of an outcome focused and specific, measureable, achievable, realistic and time bound, multi-agency plan to be agreed with the family. This work will then be delivered to the family by the agencies involved in the TAF.
All cases MUST have an initial progression of change tool (these include spider-graphs and Graded-care Profile, where neglect/poor care is a case feature), completed by the allocated MAT worker in partnership with the family before the first TAF meeting to benchmark where the family are in relation to needs at the start of an intervention.
Early help practitioners must also meet with the family prior to the first TAF meeting to agree a contract between the worker and family. Practitioners must use the standard early help contract, which outlines the role parametres of early help practitioners and what both parties can expect during an early help intervention. This must be signed by the family and saved on the families' electronic file.
The progression of change tool must be reviewed before each TAF review meeting by the allocated MAT worker so that this can be used as a basis for discussion on progress made (or not) in the TAF review meeting.
Early help practitioners will ensure that sessions with families are planned and focused and are based on the goals in the TAF plan/s, rather than being 'visits' or reactive (to perceived crisis). All sessions must be recorded using the PARA model:
TAF review meetings must be held on a regular basis, i.e. no longer than 12 weeks. All agencies working with that family must attend. The Lead Professional (LP) in such cases may not necessarily be the MAT worker. The meeting must be focused on reviewing the progress made against the TAF plan, which MUST be the tool used to drive such meetings. The TAF plan MUST be reviewed and updated at each TAF review meeting.
The progression of change tool must also be reviewed at the termination of an intervention to ensure there is clarity as regards what has been achieved/what has changed. Furthermore, the 'How Was It for You?' form must be completed with the family at the end of intervention.
The maximum length of time a MAT case should remain open is 12 months. This is sufficient time to deliver specific pieces of work to a family. The focus of early help is on short but intensive pieces of work that provide families with the skills to be able to deal with future difficulties.
It is imperative that work is delivered based on principals of empowerment that challenges families but equally equips them with the skills that negate the need to rely on agency involvement at a later point, should they face any further difficulties.
There will be circumstances where cases may need to remain open longer than 12 months due to statutory duties, or the exceptional circumstances of the case, i.e. homeless 16 and 17 year olds who are classified as Children in Need under Section 17 of the Children Act 1989.
In these circumstances, the practitioner must raise these cases with their line manager in supervision in order to get management sign off to keep the case open for longer for 12 months.
In these circumstances, managers must look at the case on the database to check:
- The quality of the plan;
- Whether there is drift in the case;
- Whether the case needs to remain open and if it does, agree a timeline with the practitioner as to when that case will close.
Team Managers must discuss all such cases with their Head of Service (HOS) in their regular supervision sessions, so that HOS's can maintain an overview of all cases in their locality that have remained open over 12 months.
Cases should be closed where:
- The goals (contained within the TAF plan/review plan) relating to the early help practitioner have been completed;
- Where no progress against the TAF plan is being made and there is no assessed or identified risk of significant harm;
- Where the family no loner want to engage in the voluntary service and there is no risk of significant harm;
- Where risk escalates and there is no scope for Early Help services to remain involved in the case.