APPENDIX 2 What This Guide Does

APPENDIX 2 What This Guide Does

APPENDIX 2
What this guide does

This guide follows the assessment dimensions and areas of the National Framework for the Assessment of Children in Need and the Wales CAF, the common assessment framework used in the Team around the Child. This guide should be read in conjunction with the TAC Wrexham guide will help practitioners to assess the child’s level of need and know when to contact Children’s Safeguarding and Support for advice and when to make a referral. It therefore covers:

  • The child’s development
  • The parents and carers
  • The family and environment

It established thresholds for levels of need at 3 and 4 and for each assessment area givesexamples of issues faced by childrenand their family toassist practitioners in their assessment of the relevant level. It does not cover every possible example in each assessment area. Not all children with needs assessed at tier 3 automatically require a service from Safeguarding and Support; other agencies may be better placed to provide appropriate support. Some guidance is offered to practitioners about alternatives.

The child may have a tier 3 need in one assessment area, but if the above apply and the child’s other needs are at tier 2, then the TAC can be used. If the practitioner identifies that the child has tier 3 needsin more than one assessment area, is concerned that a child may be suffering or at risk of significant harm or that a serious crime has been or may be committed, they should ring Children’s Safeguarding and Support for advice by contacting the Child and Family Assessment Team (CAFAT, Grosvenor Road)

Professional Judgement

When identifying the level of need of child practitioners should

  • use their own professional judgement, taking advice where necessary
  • always consider not only the difficulties faced by the child but the child and family’s strengths as well
  • always consider the impact of the child’s situation upon their health and well-being

Don’t forget – if you are concerned about a child, whatever you decide to do, you need the child / family’s consent to share information if you do not actually have a child protection concern

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Assessment Framework/CAF Diagram

CAF AND NATIONAL ASSESSMENT FRAMEWORK TRIANGLE

Consider all he dimensions of the CAF triangle when discussing the child or young person’s situation

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Child’s Development

HEALTH
Wales CAF/ National Assessment Framework Assessment areas

General health including dental; Physical development; Impact of disability; Immunisations

EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should contact one of the following :
  • The GP
  • The school nurse
  • The health visitor / Surestart / Flying Start team
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support.
The child’s health / wellbeing / development is significantly impaired by (or impairment indicated by)
  • Consistently failing to reach their developmental milestones and where concerns exist about their parent’s ability to care for them
  • Developmental milestones unlikely to be met
  • Overweight/underweight/enuresis – for example weight gain falling 2 centile ranges or more
  • Some chronic health problems
  • Concerns about developmental progress e.g. overweight / underweight / enuresis
  • Very limited / restricted diet
  • Learning significantly affected by health problems
  • Significant and persistent dental decay
  • Frequently missing routine and non-routine health appointments
  • Frequent periods of illness unexplained by a recognised medical condition
  • Chronic or persistent substance and alcohol misuse
  • Unsafe sexual activity
  • Conception/termination
  • Experiencing chronic ill health or diagnosed with a terminal illness
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
Clear allegation of harm
Actual serious injury/harm
Serious or persistent risk of injury/harm
Growth faltering and there is no ‘organic’ cause identified.
Parents refusing medical care
Development significantly impaired due to parenting
Lack of food linked to neglect
Sexual exploitation
Heavy end substance misuse

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Learning and education
Wales CAF Assessment areas:
Understanding; reasoning and problem solving; Attention span and concentration; Progress and achievements; Participation in learning, education and employment
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should (depending on age of the child) contact one of the following:
  • Careers Wales
  • Job Centre Plus
  • The learning provider
  • The child’s school
  • The Early Years Team

For staff in schools

  • The education social worker
  • The educational psychology service
  • Education support staff
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support.
The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
Progress
  • Non-existent support in place for children who do not show engagement in play or learning opportunities
  • No interests/skills displayed
  • Intervention measures not making any difference and no progress or change taking place
  • Physical and communication skills do not appear to be progressing normally
  • Caring responsibilities that affect their intellectual / educational development
  • Significant difficulties in understanding and using language in comparison with age and general abilities
  • Inadequate progress despite School Action / School Action + statement
Participation
  • Exclusion from nursery or school for behavioural reasons and is at risk of permanent exclusion
  • Irregular attendance has become established
  • Reluctance of parents and carers to address non-attendance
  • Non school-attendance procedures are ineffective
  • Ongoing interventions required to maintain attendance
  • Severe attendance problems (final warning letter)
  • Severe difficulties sustaining home/school relationships
  • Regular fixed term exclusions

Special Needs

  • Severe or moderate learning difficulties
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
As level 3 but with the addition of indicators from other aspects of the child’s development, parents and carers or family and environment at level 4

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Emotional development and behaviour
Wales CAF Assessment areas:

Temperament; Response to stress; Appropriate self control; Coping strategies; Lifestyle; Anti-social behaviour

EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should contact one of the following :
  • refer the child through EMARS to mental / emotional health services
  • contact the support staff in school / behaviour support service
  • refer to YOS (prevention service)
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support.
The child’s health / wellbeing / development is significantly impaired by (or impairment indicated by)
  • Severe difficulties coping and adjusting following emotional upheaval, e.g. domestic violence, bereavement, family breakdown
  • Mental health issues emerging – conduct disorder, ADHD, autism, anxiety, eating disorders behaviour
  • Disruptive/challenging behaviour at school or in the neighbourhood
  • Cruelty to pets/animals
  • Behaviour is sufficiently extreme to place them at risk of removal from home
  • Persistent and serious self-harming
  • Alienates self from school and peers through extremes of behaviour
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • As level 3 but with the addition of indicators from other aspects of the child’s development, parents and carers or family and environment at level 4
  • Sexual behaviour being of concern to all professionals and others involved with the child - not receptive to advice from professionals
  • Self Harming likely to have a serious effect on the child or young person’s health or well being
  • Child or young Person is missing from home regularly or for long periods

Self image
Wales CAF Assessment areas:
Views and feelings about themselves; Sense of belonging and acceptance by family; Peers and wider society; Experience of discrimination
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should contact one of the following :
  • School
  • The health visitor / Surestart / Flying Start team
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support.
The child’s health / wellbeing / development is significantly impaired by (or impairment indicated by)
  • Demonstrating significantly low self-esteem in a range of situations
  • Evidence of significantly poor standards of hygiene
  • Self image distorted and maybe demonstrating fear of persecution
  • Self-image being affected by significant caring responsibilities within the home
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • As level 3 but with the addition of indicators from other aspects of the child’s development, parents and carers or family and environment at level 4

Family and Social Relationships
Wales CAF Assessment areas:
Quality of relationship with parents or carers and siblings; Friendship patterns with peers and other significant people
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners might contact one of the following first :
  • YOS (prevention service)
  • The school
  • or make a referral to mental/emotional health services via EMARS
Safeguarding and support should be contacted if there is a risk of imminent family breakdown
The child’s health / wellbeing / development is significantly impaired by (or impairment indicated by)
  • Relationship with family experienced as negative, critical or rejecting
  • Family no longer wanting to care for child
  • Family experiencing a crisis likely to result in the breakdown of care arrangements
  • Inability to sustain appropriate peer relationships
  • Unresolved issues arising from parents divorce/death or parent / carer
  • The child and its peers being involved in challenging behaviour
  • Conflict in relationships
  • The child having been previously been looked after by a local authority
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • Sexual activities between siblings
  • Inappropriate sexualised behaviour between peers
  • Suffering physical, emotional or sexual harm or neglect
  • Child abandoned by their carer.

Social presentation
Wales CAF Assessment areas:
Understanding of how appearance, behaviour and any impairment are seen by others; Appropriateness of dress for age, gender, culture and religion; Personal hygiene
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should contact one of the following :
  • Support staff at the child’s school
  • A youth worker (older child)
  • The health visitor (younger child)
The child health and disability team within Children’s Safeguarding and Support
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support. The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
  • Child’s personal hygiene and appearance having an impact on the number of friends the child has
  • Unable to discriminate and likely to put self at risk
  • Severe disability – relies on others to meet needs
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • Child persistently watchful and wary in all settings
  • Child or young person’s presentation suggests misuse of drugs or alcohol and parents or carers are not responding appropriately.
  • Sexually precautious behaviour places child at risk of abuse or exploitation

Self-care skills
Wales CAF Assessment areas:
Acquisition of practical, emotional and communication skills necessary for increasing independence (taking account of the impact of any impairment)
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners should contact one of the following:
  • Refer into CAMHS / emotional / mental health support services
  • Contact Surestart / Flying Start / health visitor for the younger child
Following involvement of one of these practitioners a decision may be made to refer to Children’s Safeguarding and Support
The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
Independence
  • Child prematurely taking care of self at a level that is inappropriate
  • The child is being impaired from developing age appropriate skills to assist them in becoming independent.
  • Appearance reflects poor care
  • Persistent inappropriate risk-taking
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • As level 3 but with the addition of indicators from other aspects of the child’s development, parents and carers or family and environment at level 4

Parents and Carers

BASIC CARE
Wales CAF Assessment areas:
Providing for the child or young person’s physical needs (food, drink warmth and shelter); Appropriate medical and dental care; Ensuring appropriate clothing and adequate personal hygiene
EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners might
  • Contact Safeguarding and Support for advice
  • Refer to Surestart / Flying Start / health visitor
The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
  • Significant concern about prospective parenting ability, resulting in the need for a pre-birth assessment.
  • Parents’ previous history of struggling to care for child or sibling.
  • Parents may not be able to provide care for physical or intellectual or social reasons
  • Inability to recognise health needs for self or child such that the child’s health and development likely to be significantly impaired
  • Parent is struggling or unable to provide adequate care or meet the child’s needs
  • Multiple births/several children aged under 4 severely impacting upon the family’s ability to cope
  • Parental reluctance to engage with required services (for example concealed pregnancy, a history of not engaging with ante-natal and post-natal care)
  • The child frequently being taken to casualty or GP, suffering from accidental injuries
  • The child not receiving or following treatment for a recognised medical condition
  • The child being rarely clean or appearing poorly cared for
  • The child being mostly undressed and the home cold
  • Parents showing little warmth
  • Haphazard supervision
  • Parents are unable to care adequately for a child with disabilities
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • Basic care is rarely consistent
  • Parents have seriously abused/neglected the child
  • Previous child has been removed from parents care and no further risk assessment has been completed
  • Parents own needs means they cannot keep child safe
  • Parents to do not recognise or accept danger and do not protect child/ young person from harm

Ensuring safety

Wales CAF Assessment areas:
Ensuring child or young person is adequately protected from harm; Contact with unsafe adults and children;

Self harm; Hazards and dangers inside and outside the home

EXAMPLES OF TIER 3 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners might
  • Contact Safeguarding and Supportfor advice
  • Refer to Surestart / Flying Start
  • Contact the police
The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
  • History of violence between the adults in the household
  • The child never being encouraged to meet or play with other children
  • Continued deteriorating attachment issues between parent/carer and child
  • The child having experienced several different changes of primary carer; changes of carer continue (eg child moves back and forth between relatives/parents)
  • Inadequate supervision of children / children being minded by inappropriate adults or inappropriate older children
  • The child being exposed to unsafe adults or unsafe behaviour by adults
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • As level 3 but with the addition of indicators from other aspects of the child’s development, parents and carers or family and environment at level 4
  • Recent History of violence between the adults in the household
  • Children missing from home for prolonged periods

Emotional Warmth

Wales CAF Assessment areas:
Ensuring child or young person has secure, stable and affectionate relationships; Providing praise and encouragement

Appropriate sensitivity and responsiveness to child or young person’s need

EXAMPLES OF TIER 3 AND ABOVE AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners might
  • Contact Safeguarding and Support for advice
  • Refer to Surestart / Flying Start
  • Refer to CAMHS
The child’s health / wellbeing / development is significantly impaired by (or impairment indicated by)
  • Child receiving erratic or inconsistent care
  • Parents’ own emotional needs compromising those of their child
  • Child having multiple carers but no significant relationship to any of them
  • Lack of attachment in relationship with parent
  • Lack of emotional warmth, warm physical contact or comfort
  • The child being encouraged by another adult to take a negative view of a parent
  • Parent undermining the child and / or the child’s relationships with others
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • Parents inconsistent highly critical or apathetic towards child together with a lack of warmth resulting in emotional abuse.
  • Family life so chaotic that there is a lack of basic routines to ensure child’s needs are met.
  • Child has no one to care for them
  • Child has multiple carers resulting in no consistency and stability in their care arrangements

Stimulation

Wales CAF Assessment areas:
Responding and encouraging child or young person’s learning; Joining in play; Promoting learning opportunities;

Ensuring school attendance

EXAMPLES OF TIER 3 AND ABOVE AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT MAY BE APPROPRIATE.
If this is the only domain in which ‘Tier 3 and above’ needs are recorded, practitioners might
  • Contact Safeguarding and Support for Advice
  • Refer to Surestart / Flying Start
  • Secure support / advice for the parents
  • Contact the school support staff
The child’s health / well-being / development is significantly impaired by (or impairment indicated by)
  • No constructive leisure time or guided play that would lead to the child’s healthy development
  • Parents encourage school non-attendance
  • No contact between the school and the child’s family
  • Child receiving little stimulation
  • A child with a learning disability has no individual education plan
  • The child having frequent unexplained absences from school and numerous unscheduled changes of school
/ EXAMPLES OF TIER 4 AND ABOVE WHERE A REFERRAL TO CHILDREN’S SAFEGUARDING AND SUPPORT IS NECESSARY
  • The child is receiving no relevant stimulation appropriate for age
  • The child is exposed to pornography or other exploitative/harming material

Guidance and Boundaries

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