Threshold Framework 2023
‘Accessing the Right Help at the Right Time’
Multi-agency guidance on the access criteria to help support children, young people, and families
Welcome to the multi-agency guidance on accessing the right help and support for children, young people, and their families at the right time.
The purpose of this document is to assist practitioners working with children across all agencies and organisations when they are required to make decisions about the safety and wellbeing of children and young people. In Staffordshire we want this to be a collaborative approach where we achieve the right help, at the right time and importantly from the right service and the right person to help.
All children and young people In Staffordshire have the right to be healthy, happy, safe and have the opportunity to achieve their full potential and this guidance for thresholds of need and intervention underpins the local vision to provide support for children and families at the earliest opportunity. It also includes specialist and statutory interventions when required to promote the welfare and safety of children and young people.
The guidance sets out which agencies and which levels of intervention may be needed to support families, to build on their strengths, promote resilience and positive outcomes for children, young people and their families whilst ensuring children and young people are protected from abuse and neglect.
The Threshold Framework ‘Accessing the Right Help at the Right Time’ is the overarching document for the whole of the children and young people’s workforce and should be used by practitioners to aid decision making but, not replace the conversations and curiosity we need to have when faced with concerns about a child or young person to determine the best next steps. All practitioners should use their safeguarding leads and conversations at the front door (SCAS) for support, guidance, and reflection and for those based in Education Settings, discussion with ESAS (Education Safeguarding Advice Service) .
The document is to support practitioners with thresholds and embraces Staffordshire’s model of relationship based working and restorative practice and should be read in conjunction with procedures which can be found here and Staffordshire’s Early Help Strategy.
Staffordshire has developed a continuum of need alongside some features we might expect to see in families across the continuum. It is a simple way of developing a shared understanding and explaining the approach across all our services and partnerships, ensuring a consistent approach is applied by all.
The model illustrates how we will respond to the requirements of children and families across four levels of need (Universal, Earliest Help, Targeted Early Help and Statutory /Specialist) and is a visual tool to help us share a common language to describe risk and needs.
The model cannot replace professional curiosity, judgement or decision making and should not be used as a checklist – the examples are provided by way of guidance and context. It should be used alongside professional judgement and form part of a wider discussion about how best to meet the needs of a specific child or family and support the consistency of response to children, young people, and their families.
We want to ensure the right and least intervention through the right service, at the right time by the right person. Children and young people can move across the levels of vulnerability according to their particular circumstances. We have four levels of need, the divisions between the levels should not be conceived as ‘hard and fast’. The presence of a single or multiple combination of factors, the age of the child and family strengths and protective factors will all need to be considered.
Universal – Level 1
Most children reach their full potential through the care of their families and communities. Universal Services are provided to all children and their families through community networks such as schools, primary healthcare, leisure services, voluntary and universal groups. Some examples may include supporting a child to:
Good physical and psychological health
Meeting developmental milestones
Attending health appointments and developmental checks, registered with GP
No substance abuse or inappropriate sexual activity
Secure attachments and relationships providing warmth praise and encouragement
Child’s basic needs are met – food, drink, clothing, medical and dental
Appropriate guidance, boundaries and development of values and behaviour
Good supportive relationship within the family and social and friendship networks
Accommodation is clean and has basic amenities and facilities
Access to community resources, GP, education and leisure facilities
Earliest Help – Level 2
Children with needs at the level of Earliest Help are best supported by those who already work with them such as health professionals, children’s centres, early years, school and college settings or, by organising additional support.
Most constructive conversations will start with the child and their family because something has been shared or observed about the welfare of a child. The value of the knowledge and trust that a professional already working with a family has must not be underestimated. Working with the child and their family to address worries as they arise, rather than waiting for concerns to escalate is appropriate for the majority of children and can ensure much needed consistency for a family. Providing encouragement, building on strengths, and sharing information with or about other services that might help are all key ingredients to promoting children’s wellbeing.
Staffordshire’s ambition is to provide consistent access to Early Help delivered by a co-ordinated partnership including the private, voluntary, and independent sector as well as statutory partners as soon as needs are identified. An Early Help Assessment can be used by all agencies to provide a holistic view of the needs within the family and can be used to inform statutory assessments where needs require targeted support / specialist intervention.
Role of the Lead worker
A lead worker can be from any agency and dedicated to a family to build an honest and productive relationship. We know that Early Help works best when those who know the family well or speak with them regularly act as the lead worker by acting as the point of contact for the family and working with a range of other agencies to support meeting the needs of children and their families. The lead worker is not responsible for doing everything for the child and their family, they help to bring others together to work with them.
Whilst the family will have one main lead worker helping to link them with appropriate support, successful Early Help requires a partnership response. This is often achieved through multi-agency ‘Team Around the Family’, or ‘Restorative Circle’ meetings, working WITH families, not doing TO families, known as a strengths-based ‘restorative approach’ which promotes a culture of inclusion and support which enables children to achieve their best outcomes, builds resilience and enhances problem solving skills. We know that not one person has all the answers so this process helps everyone, including the family to find solutions that will help make a difference.
The Early Help Assessment is the tool which is used to coordinate and bring together different agencies who may be working with the family.
Children and their families at this level will be seeking support to improve their circumstances and may have one, or a range of needs which may increase in complexity, and could include:
Worries about diet, hygiene or clothing
Not being taken to health and other appointments
Not reaching developmental milestones
Few opportunities for play or socialisation
Substance use or concerns
Mental health concerns
Poor school attendance or exclusion
Special educational needs
Disengagement from education, training or employment post 16
Difficulties with peer group or adult relationships
Some evidence of inappropriate responses and behaviours
Finds it difficult to cope with anger, frustration and upset
Disruptive or anti-social behaviour
Disability requiring support services
Complex health needs
Vulnerable to exploitation
Parental conflict or lack of parental support or boundaries
Parental engagement with services is poor
Parent is struggling to provide adequate care
Unrealistic parental expectations
Child perceived to be a ‘problem’ by parents
Minor to moderate mental health issues
Parental drug and alcohol use
History of co-sleeping with previous children
Lack of parental stimulation or interaction
Parental conflict, domestic disputes impacting on the children
Has experienced loss of a significant adult through bereavement or separation
Parents struggle without support or resources as the result of mental health or learning difficulties
Family is socially isolated
Involvement in or risk of offending
Poor access to universal services
Care Coordination for a Child with Disabilities
Neglect can be notoriously difficult to recognise, particularly when it presents as low level (see level 2 indicators). But it is important for professionals to understand and observe the cumulative effect low level neglect can have on children, particularly those who are non-verbal, and are therefore unable to tell us how they feel and what life is like for them (their daily lived experience).
Learning from local reviews, including those outlined in the National Child Safeguarding Practice Review Panel’s Annual Reports demonstrates that many children have suffered abuse through neglectful parenting, which has taken place over many months, sometimes years, with no or little effective support to prevent further harm or abuse. This often results in a significant event that causes serious harm and can include head trauma or fractures. Sadly some children may die as a result of serious harm.
Being alert and responsive to the voice of the child and using the tools available to you such as early help or the Graded Care Profile 2 (GCP2), helps you to build a picture of a child’s daily lived experience but more importantly ensures you, along with others if necessary, are able to target the right help at the right time, and prevent or reduce further harm. (Definition page 108 Working Together 2018)
For further literature on neglect and GCP2 please refer to either the SSCB website, or the NSPCC website. Training is also provided by the SSCB. Please keep yourself up to date by saving the link to the Learning Zone to your favourites.
For more information about neglect visit http://staffsscb.org.uk/children-and-families/parents-and-carers/concerned-about-a-child-or-young-person/
Targeted Early Help -Level 3
Children and Young People at this level have diverse and complex needs and targeted, multi-agency support services are required and should be supported by a clear co-ordinated action plan coordinated by a lead worker without the need for statutory social work intervention.
What to do next?
Talk to the child and their family about your concerns and seek parental agreement, or consent from the young person themselves to carry out an Early Help Assessment.
The lead worker should engage the family and other professionals to coordinate support. If the support needed for the family is more than the lead worker can organise effectively the Family Practitioner Service can work consensually with the family in a more intensive way alongside other professionals. Referral to the Family Practitioner teams is by way of a conversation with SCAS (details below) and a conversation with the team to discuss the best way for the child and their family’s needs to be met.
Staffordshire’s ambition is to provide consistent access to Early Help delivered by a co-ordinated partnership including the private, voluntary, and independent sector as well as statutory partners as soon as needs are identified. An Early Help Assessment can be used by all agencies to provide a holistic view of the needs within the family and can be used to inform statutory assessments where needs require targeted support or specialist intervention.
Needs at this level will include:
Child has some serious or recurring health problem (s) which are not treated, or badly managed
Regularly misses appointments for serious medical conditions or treatment
Developmental milestones are not being met due to parental care
Regular substance misuse
Lack of food
‘Unsafe’ sexual activity
Child has a significant disability
Mental health issues emerging e.g., conduct disorder, ADHD, anxiety, depression, eating disorder, self-harming
Parent / carer is failing to provide consistently adequate care
Parents have found it difficult to care for previous child or young person
Domestic abuse, coercion, or control in the home
Parent’s mental health problems or substance misuse affect care of child or young person
Non-compliance of parents or carers with services
Child has no positive relationships
Child has multiple carers; may have no significant relationship to any of them
Child at risk of Female Genital Mutilation and other harmful traditional or cultural practices, Forced Marriage, or Honour Based Abuse where a protective parent is engaging with targeted services to seek protection
Child at risk of Modern Slavery and, or Human Trafficking but parents are accessing support and services
Family has serious physical and mental health difficulties impacting on their child
Community is hostile to family
Emerging involvement in gang or other activities which risks future exploitation
Young person displays physical violence towards parents
Statutory /Specialist Services -Level 4
A small proportion of children and young people will have more acute needs and be supported by Staffordshire District Operational teams. This may include children who are unlikely to reach or maintain a satisfactory level of mental or physical health or development, or their health and development will be significantly impaired, without the provision of services.
These are children and young people whose needs are more complex, based on a range of needs and depth or significance of the needs. They are at risk of social or educational exclusion. Their health, welfare, social or educational development is being impaired and life chances will be impaired without the provision of additional services and are otherwise known as Children in Need.
Other children and young people may require an immediate referral to Staffordshire Childrens Services (SCAS) for an assessment to be completed to better understand their needs. These are children and families with increasingly complex needs, those children who are at risk of or suffering significant harm. The Children Act 1989 introduced the concept of significant harm as the threshold that justifies compulsory intervention in family life in the best interest of children and gives local authorities a duty to make enquiries.
Significant harm would include:
- Children at immediate risk of significant harm including physical, sexual, emotional harm and neglect
- Children with unexplained injuries, suspicious injuries or where there is inconsistent explanation of the injury
- Children from families experiencing a crisis likely to result in an imminent break down of care arrangements
- Where there are serious concerns regarding the risk of significant harm to an unborn baby
- Children who are remanded or otherwise in Custody
- Children who disclose abuse
- Vulnerable children who are left alone or otherwise subject to neglect
Where there are concerns about a child’s welfare a referral should be made to children’s services and this includes referrals about children in specialist settings such as the secure estate or those who are in health authority funded beds in Private Hospitals. There is also an increasing awareness of extra familial threats to children in respect of Child Criminal and Sexual exploitation, trafficking, and modern-day slavery.
The threats posed to children’s mental health and wellbeing by exposure to social media and the internet are well known and the risk of children being abused online.
Professionals should wherever possible, discuss concerns with the family and, where possible seek the family’s agreement to making a referral unless this may, either by delay or the behavioural response it prompts or for any other reason, place the child at increased likelihood of suffering Significant Harm.
A decision by any professional not to seek parental permission before making a referral to Children’s Social Care Services (SCAS) should be approved by their manager where possible, recorded and the reasons given.
Where a parent has agreed to a referral, this must be recorded and confirmed as part of the referral.
Where the parent is consulted and refuses to give permission for the referral, further advice and, or approval should be sought from a manager or the Designated Senior Person or Named Professional, unless to do so would cause undue delay. The outcome of the consultation and any further advice should be fully recorded.
After taking full account of parent’s wishes, if it is still considered that there is a need for a referral:
- The reason for proceeding without parental agreement must be recorded.
- The Children’s Services team (SCAS) should be told that the parent has withheld her or his permission.
- The parent should be contacted by the referring professional to inform her or him that after considering their wishes, a referral has been made.
Staffordshire’s Families and Communities Directorate have implemented a Restorative Practice Model across the system. This is about how we work with children and families but also how we work with each other and our partners.
What Does It Mean?
Restorative Practice is a relationship and strength-based approach that embodies a set of core beliefs and principles which are built on mutual respect and trust. This provides a foundation to ensure that professionals are working in partnership “with” parents, carers and families to appropriately meet their needs, and that this is taking place in a safe way. By using these approaches, we will provide staff with a range of language, behaviours and tools that strengthen their relationships with children, young people, and families, empowering them to share responsibility by using a solution-focused approach, which supports positive change
This includes being explicit about the ‘bottom-line’ to safeguard or protect a child, using a ‘high challenge’ and ‘high support’ approach, which builds on strong relationship-based practice between children, families, and professionals. Therefore, achieving sustainable change and reducing the likelihood of dependency on professional services the fundamental unifying hypothesis of restorative practices is that “human beings are happier, more cooperative and productive, and more likely to make positive changes in their behaviour when those in positions of authority do things with them, rather than to them or for them.”
Staffordshire New referrals for children who meet the threshold for Level 3 and Level 4 who are not known or are currently closed to children’s services, should ideally be made by phone: Staffordshire Children’s Advice and Support (SCAS) 0300 111 8007 8.30am – 5.00pm Monday to Thursday 8.30am- 4.30pm Friday EDS (out of hours) Tel No. 0345 604 2886 Or email: firstname.lastname@example.org
Disagreements over the handling of concerns can impact negatively on positive working relationships and consequently on the ability to safeguard and promote the welfare of children. All agencies are responsible for ensuring that their staff are supported and know how to appropriately escalate inter-agency concerns and disagreements about a child or young person’s well-being. Staffordshire Safeguarding Board has a published escalation procedure which can be found here.