2.1.4 Social Care Thresholds

SCOPE OF THIS CHAPTER

This chapter provides guidance about how thresholds affect the type of referrals accepted by Children’s Social Care and the main categories referrals fall into.

LONDON CHILD PROTECTION PROCEDURES

Section 6, Referral and Assessment of the London Child Protection Procedures

This is a new chapter for October 2010.

Introduction
Who is the Document for?
Referral Pathways and Services
Common Assessment Framework (CAF)
Child in Need / Section 17
Child Protection / Section 47
LA Children’s Social Care – Duties and Responsibilities
How to Decide Whether to Make a Referral
Local Contact Details for other Agencies / Services

Appendix 1 – London CP Procedures - The Difference between Sect 17 & Sect 47 Referrals

Appendix 2 - The London Continuum of Need (CAF Thresholds)

1. Introduction

The majority of children and young people in Lambeth have a number of basic needs that can be supported through a range of Universal Services. These services include education, early years, health, housing, youth services, leisure facilities and services provided by voluntary organisations. However, some children have more complex needs and may need access to specialist services (e.g. children’s Social Care) to support them.

Under the national Every Child Matters agenda, safeguarding children is everybody’s business. The range of services working with children and young people has expanded over the last 10 years and this has meant an increased number of referral pathways for services. This document provides guidance about how thresholds affect the type of referrals accepted by children’s Social Care, and the main categories referrals fall into.

In this document, “threshold” refers to the point at which LA children’s social care are likely to accept a referral for a child, young person or their family.

This guidance does not list specific criteria for receiving an assessment or service. Information about indicators for child protection responses are included in Section 6, Referral and Assessment of the London Child Protection Procedures 2007.

2. Who is the Document for?

This document has been prepared to help explain how children’s social care staff apply thresholds to referrals made to the service. The document also sets out the circumstances in which children’s Social Care are likely to provide services and, where the threshold for a service is not met, provide alternative options for the referrer (often through universal services).

This document is primarily targeted at professionals who are in regular / daily contact with children or families, and may have a concern about a child or young person. By basing the Lambeth threshold document on the London document, it can be clearly demonstrated that Lambeth thresholds are consistent with those operating in the rest of the London area.

This document has been agreed as guidance for all agencies working with children in Lambeth.

3. Referral Pathways and Services

Referrals to services regarding concerns about a child typically fall into three categories:

Early intervention and prevention – Common Assessment Framework referrals
Child In Need – Section 17 referrals
Child protection – Section 47 referrals

Section 17 and Section 47 referrals will be considered by children’s Social Care, but early intervention and prevention referrals will often be made to other services and not processed by the local authority (although the Local Authority does hold a list of cases that have been subject to a CAF).

Safeguarding and child protection work should always be underpinned by principles of working in partnership with families. In all cases, consent must be sought from parents / carers to share information as appropriate, although there are certain circumstances in which this consent is not required (e.g. where there is specific risk of harm to a child and sharing the information with the parents would place the child at further risk).

Social Care staff have no mandate to compel parents to undertake assessments or accept services, although there may be consequences for the family if recommended services or interventions are not taken up by parents / carers.

Referrals in to Social Care should be done by either carrying out a CAF or, if this is not appropriate, eg because of the urgency of the situation, by completing as much information as possible on a CAF form.

Telephone referrals should be made to a member of the Referral & Assessment Screening Team. The teams numbers are set out in Section 9, Local Contact Details for other Agencies / Services. All referrals should be followed up in writing within 48 hours.

4. Common Assessment Framework (CAF)

The Common Assessment Framework (CAF) is a holistic assessment of a child’s needs for services. It is a process for recognising signs that a child may have unmet needs that Universal Services cannot meet, and identifying and involving other agencies who may be able to support the child and/ or undertake specialist assessment. Central to its development is the principle that it is child/ young person centred, holistic and can be shared across professionals as appropriate. The term is also used to describe the format in which the assessment is recorded.

The CAF provides a common method of assessment across children’s services and local areas. It facilitates early identification of needs, leading to co-ordinated provision of services, involving a lead professional where appropriate, and sharing information to avoid the duplication of assessments.

The common assessment is designed for when:

There are concerns about how well a child is progressing in terms of their health, welfare, behaviour, progress in learning or any other aspect of their well-being
The child’s needs are unclear or broader than a single universal service can address

A common assessment should be completed when a professional in any agency has concerns that a child will not progress towards the five Every Child Matters priority outcomes (being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being) without additional services.

The CAF Pre-Assessment Checklist is a quick form that reflects the 5 ECM Outcomes, designed to help practitioners identify and document an initial concern, and/or determine the level of the concern.

Completing a common assessment should:

Enable the professional to identify the child’s needs
Provide a structure for systematic gathering and recording of information
Record evidence of concerns and a baseline for measuring progress in addressing them
Provide a framework for a discussion with LA children’s social care regarding an Initial Assessment or Core Assessment or to another service for a specialist assessment

Completing a common assessment can also provide a standardised written referral proforma to support a telephone referral.

Appendix 2 - The London Continuum of Need (CAF Thresholds) of this guidance provides a list of levels of need and their characteristics. It is important to note that this list is not exhaustive, but included for illustrative purposes only.

Where there is an immediate need to protect a child, professionals must contact children’s Social Care and/or the police directly and make a referral, rather than completing a Common Assessment.

See Mobility and Young London: Integrated Working without Boundaries (the London CAF protocol for more information about the operation of the CAF across London. The Protocol represents an agreement by local authorities and partners delivering children’s services in London to set in place consistent standards of service for all children, young people and families with identified additional needs, where some responses may need to be accessed via services not in their authority of residence. It also addresses cases where services need to be provided across LA boundaries, and represents an agreement to work collaboratively, to compromise when required and to be flexible with regard to current strategies: ensuring that children and young people remain at the heart of any engagement, support and intervention.

5. Child in Need / Section 17

Section 17 of the Children Act 1989 places a general duty on every local authority to safeguard and promote the welfare of children who are need within their area. Children’s Social Care must, so far as is consistent with this duty, promote the upbringing of children in need by their families, through provision of a range and level of services appropriate to the child’s needs.

The Children Act 1989 states that a child shall be considered “in need” if:

S/he is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision of services by a local authority
Their health or development is likely to be significantly impaired, or further impaired, without the provision of such services; and/or
S/he is disabled

Before referring a child to children's Social Care under section 17, professionals should in most cases, ensure that a CAF has been completed (with a lead professional identified where appropriate), and that a referral has been made to the appropriate specialist services. A section 17 referral to children's Social Care should be made if these initial attempts to improve the situation have been unsuccessful, accompanied by evidence of the actions taken to date. Although it is normally expected that a CAF will have been completed, a referral can be accepted without the CAF process having been completed where it is clear that the case already meets the criteria for a child in need. (see continuum chart). In these cases the referral should be made using the CAF form, but the CAF process does not need to be followed. See Section 3: Referral Pathways and Services.

6. Child Protection / Section 47

Section 47 of the Children Act 1989 requires the local authority to make enquiries to enable it to decide whether action is required to safeguard and promote the well-being of the child. Children’s Social Care will carry out a Core Assessment as a means of conducting the Section 47 Enquiries.

The purpose of the Core Assessment is to determine whether the child is suffering, or likely to suffer, Significant Harm and to assess whether action is required to safeguard and promote the child’s welfare. Health, education and other services have a statutory duty to help children’s Social Care to carry out the Section 47 enquiry. Social Workers will work with the police in the case of a criminal investigation.

7. LA Children’s Social Care – Duties and Responsibilities

The children’s Social Care service operates under a strict legal framework, and it is this legal framework that dictates which cases must be accepted from referral and assessed, and what services can be offered or provided to children, young people and their families.

Children’s Social Care determines the level of need for children by a process of assessment based on the Framework for the Assessment of Children in Need and their Families (2000). The assessment looks at the child’s developmental needs, parenting capacity of their carers, and family and environmental factors.

Children’s Social Care uses thresholds to consider whether a referral will be accepted, whether an assessment will be undertaken, and what services will be offered or provided. This way, they can ensure that help is targeted at those children who are most vulnerable, and that any decisions made about services are consistent.

Once a referral is accepted, staff will carry out an assessment to identify the child’s level of need and risk, and decide on an appropriate plan of action and services to be offered depending on this assessment.

When a referral is below their threshold, children’s Social Care will provide referrers with information on more suitable resources and pass the referral to other services where appropriate. Referring professionals should receive a feedback card setting out the outcome of the referral and the reasons for it.

8. How to Decide Whether to Make a Referral

It is important to be clear about the purpose and intended outcome of the referral. Using the information in Section 3, Referral Pathways and Services, and the Appendix, it is helpful to consider the three main categories of referrals, and related levels of need, to consider where your concerns about a child or young person fit.

It can be very useful to consult with other professionals in the child’s network (such as health visitor, youth worker, teacher) if you have concerns. When the concern is around risk of harm to a child, you may want to speak to your own agency lead for child protection and safeguarding. Alternatively, you can speak with one of your local authority’s child protection advisers or a duty social worker about a referral.

Professionals in all agencies have a responsibility to refer a child to children’s Social Care when it is believed or suspected that the child:

Has suffered Significant Harm; or
Is likely to suffer significant harm

9. Local Contact Details for other Agencies / Services

Screening Team ( For all New Referrals)	Tel: 0207 926 1772 0207 926 7856 0207 926 6586 0207 926 6583 0207 926 6010 0207 926 7868 Fax: 0207 926 6874
Screening Team Manager	Tel: 0207 926 1772
Referral & Assessment Team 1 - Team Manager	Tel: 0207 926 6512
Referral & Assessment Team 2 - Team Manager	Tel: 0207 926 7866
Referral & Assessment Team 3 - Team Manager	Tel: 0207 926 6522
Referral & Assessment Team 4 - Team Manager	Tel: 0207 926 5437

Appendix 1 – London CP Procedures - The Difference between Sect 17 & Sect 47 Referrals

Indicator Table

The table below is an indicator guide of the difference within LA children’s social care between a S47 Core Assessment and an Initial Assessment. This table is intended as a guide and is not exhaustive. Each local area will have their own arrangements for the Common Assessment Framework (see Section 6.2. The Common Assessment Framework) and the wider children in need population. See Section 5. Children in Specific Circumstances.

LA Children’s Social Care Assessments
Section 47 / Core Assessment	Initial Assessment
Any allegation of abuse or neglect or any suspicious injury in a pre- or non mobile child.	Allegation of physical assault with no visible or only minor injury (other than to a pre-or non mobile child).
Allegations or suspicions about a serious injury / sexual abuse to a child. See also Section 4.3. Recognition of Abuse and Neglect and Section 5.23. ICT-Based Forms of Abuse.	Any injury / incident triggering concern (e.g. a series of apparently accidental injuries or a minor non-accidental incident).
Two or more minor injuries in pre-mobile or non verbal babies or young children (including disabled children).	Any incident / injury triggering concern (e.g. a series of apparently accidental injuries or a minor non-accidental incident).
Inconsistent explanations or an admission about a clear non-accidental injury.
Repeated allegations or reasonable suspicions of non-accidental injury.	Repeatedly expressed minor concerns from one or more sources.
A child being traumatised, injured or neglected as a result of domestic violence. See also Section 5.11. Domestic Violence.	Level 3 Domestic Violence. See Safeguarding Children Abused through Domestic Violence (London Board, 2006) for the assessment of risk to a child.
Repeated allegations involving serious verbal threats and/or emotional abuse. See also Section 5.6. Bullying.	Allegation concerning serious verbal threats to children. Allegations of emotional abuse including that caused by minor domestic violence.
Allegations / reasonable suspicions of serious neglect. See also Section 4.3. Recognition of Abuse and Neglect.	Allegations of periodic neglect including insufficient supervision; poor hygiene, clothing or nutrition; failure to seek / attend treatment or appointments; age; young carers undertaking intimate personal care.
Medical referral of non-organic failure to thrive in under fives. See also Section 4.3. Recognition of Abuse and Neglect.
Direct allegation of sexual abuse made by child or abuser’s confession to such abuse. See also Section 4.3. Recognition of Abuse and Neglect, Section 5.39. Sexually Active Children and Section 5.40. Sexually Exploited Children.	Suspicions of sexual abuse (e.g. sexualised behaviour, medical concerns or referral by concerned relative, neighbour, carer).
Any allegation suggesting connections between sexually abused children in different families or more than one abuser. See also Section 5.23. ICT-based Forms of Abuse and Section 14. Organised and Complex Abuse
An individual (adult or child) posing a risk to children. See also Section 5.18. Harming Others and Section 13. Risk Management of Known Offenders.
Any suspicious injury or allegation involving a child subject of a current child protection plan or looked after by a local authority. See also Section 5.7. Custodial Settings for Children, Section 5.17. Foster Care and Section 5.37. Residential Care.
No available parent and child vulnerable to significant harm (e.g. an abandoned baby).	No available parent, child in need of accommodation and no specific risk if this need is met.
Suspicion that child has suffered or is at risk of significant harm due to fabricated or induced illness. See also Section 5.12. Fabricated or Induced Illness.
Child/ren subject of parental delusions. See also Section 5.29. Parental Mental Illness.
A child at risk of sexual exploitation or trafficking. See also Section 5.40. Sexually Exploited Children and Section 5.43. Trafficked and Exploited Children.
Registered sex offender or convicted violent offender subject to MAPPA moving into a household with under 18 year olds. See also Section 13. Risk Management of Known Offenders.
Pregnancy in a child aged under 13. See also Section 5.39. Sexually Active Children and Section 5.40. Sexually Exploited Children.
A child at risk of FGM, honour based violence or forced marriage. See also Section 5.13. Female Genital Mutilation, Section 5.15. Forced Marriage of a Child and Section 5.20. Honour Based Violence.

Appendix 2 - The London Continuum of Need

Integrated Working Without Boundaries – the London Common Assessment Framework (CAF) Protocol (Young London Matters, 2009, Annex 2a: The London Continuum of Need (CAF thresholds).

Annex 2 - CAF Thresholds

1.0 Introduction

The purpose of this chapter is to outline common risk triggers for beginning a common assessment and to introduce the London Continuum of Need model. This model was developed in consultation with local authorities and key local, regional and national partners. We recognise that some local authorities may have more detailed level descriptors. The London Continuum does not provide an exhaustive list of all the possible scenarios and practitioners should always use their professional judgement.

The London Continuum establishes a consistent approach for:

Four levels of need and corresponding service intervention
Beginning the CAF process

This will facilitate swift and easy access to appropriate services and help remove barriers to cross authority integrated service delivery.

It is acknowledged that children may move from one level of need to another and agencies (including Universal Services) may offer support for needs at more than one level.

The London Continuum model does not guarantee service provision by particular agencies at each level as there may be restricting factors such as:

Specific service criteria related to the agency’s specialist area of work
Previous interventions
Geographical location
Age limits
Time limited provision, e.g. only available during school term

The London Continuum builds from the four levels of need:

Level 1

No identified additional needs. Response services are universal services.

Level 2 - (Low risk to Vulnerable)

Child’s needs are not clear, not known or not being met. This is the threshold for beginning a common assessment. Response services are universal support services and/or targeted services.

Level 3 - Complex

Complex needs likely to require longer term intervention from statutory and/or specialist services. High level additional unmet needs – this will usually require a targeted integrated response, which will usually include a specialist or statutory service. This is also the threshold for a Child in Need which will require Children’s Social Care intervention.

Level 4 - Acute

Acute needs, requiring statutory intensive support. This in particular includes the threshold for child protection which will require Children’s Social Care intervention.

(Please note The London Continuum of needs within this annex represents the level descriptors. Detailed risk and resilience factors relating to specific policy areas are provided at the end of this document and also can be accessed on the Young London Matters website).

The London Continuum identifies a set of risk and resilience triggers and levels of need and has been established in consultation with London Local Authorities and those organisations listed within the Protocol. Due to the expert opinion and policy advice utilised in developing the London Continuum, authorities may choose to consider a review of their thresholds and or align these with the London Continuum.

When there is an immediate need to protect a child because they are being harmed or at risk of harm the practitioner must contact the local authority Children’s Social Care and/or police directly and make a telephone referral. All practitioners must follow the referral process in their local borough and follow up a verbal referral with a written referral. In some local authorities the common assessment is the accepted mode for a written referral. For cross authority working use the method identified by your Local Safeguarding Children Board.

The London Continuum of Need should be read alongside the London Child Protection Procedure..

Click here to view:

The London Continuum Chart: Level 1

The London Continuum Chart: Level 2

The London Continuum Chart: Level 3

The London Continuum Chart: Level 4

The London Continuum of Need model was developed in consultation with local authorities and key local, regional and national partners. It should be noted that some local authorities have more detailed level descriptors than are set out within this annex. The London Continuum does not provide an exhaustive list of all the possible scenarios and practitioners should always use their professional judgement.

The London Continuum of Need is available to download here.

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