Levels of Need Threshold Guidance Audit for frontline staff
Total survey respondents / 246
1. Do you know how to access the levels of need guidance?
Number of respondents / Per cent of respondents
Yes / 189 / 78%
No / 53 / 22%
Total respondents / 242 / 100%
Not answered / 4

Of the respondents that answered “NO” to this question 66% were from the Police

2. Do you use the levels of need guidance to inform contacts/referrals made to Multi Agency Safeguarding Hub (MASH) where you have concerns for the welfare or safety of a child?
Number of respondents / Per cent of respondents
Yes / 137 / 56%
No / 31 / 13%
I have not made any contacts/referrals / 77 / 31%
Total respondents / 245 / 100%
Not answered / 1

64 % of those who responded to this question with “NO” were Police, however most of the responses referenced using their own internal assessment tools

WVT were undertaking their own staff survey when HSCB commissioned this piece of work, they asked the following two question which have been included here.
Are you familiar with the levels of need guidance?
Yes / 92 / 61.74%
No / 47 / 31.54%
N/A / 10 / 6.71%
Total / 149
Do you use the levels of need guidance to inform referrals to the MASH?
Yes / 86 / 58.90%
No / 43 / 29.45%
N/A / 17 / 11.64%
Total / 146


3. Have you used any other tools to access risk and support a contact/referral to MASH?
Number of respondents / Per cent of respondents
Yes / 60 / 25%
No / 179 / 75%
Total respondents / 239 / 100%
Not answered / 7
4. Please detail which other tools you have used?
·  Assessing Families in complex child care situations
·  Asset (youth justice national assessment tool)
·  Barnardo's DVRIM
·  Barnardo's DVRIM
·  Bernardo's D/V tool
·  CAADA- risk
·  CAF
·  CAF
·  CAF assessments Brookes Traffic Light
·  child referral form
·  Child referrals via OIS and crimes raised
·  CO1 through Police systems
·  CSE DV RIM
·  CSE tool
·  CSE toolkit/ assessment
·  DASH
·  DASH ARMS Risk assessments
·  direct contact with social services
·  Discussion with Safeguarding team (Caron Shelley / Hazel Blankney)
·  DV RIM for domestic abuse Child Sexual Exploration risk assessment tool CAF Families First
·  DVRIM
·  DVRIM
·  Education officer in the Mash team and the safeguarding website for Herefordshire.
·  Education Safeguarding Support and Advice - seeking clarification and support by speaking directly with Anne-Marie Kemp (MASH Education Officer).
·  Experience
·  Experience a d training received in house
·  Family assessment framework Home conditions survey
·  graded care profile
·  Have not yet needed to use any tools. Although it was useful to be shown how to use the level needs within the safeguarding lead training and how to fill out a referral form.
·  Health needs assessment.
·  home conditions toxic triangle and shemmings and shemmings triangle
·  home conditions assessment
·  Home conditions assessment neglect - graded care profile assessment of needs promotional guide Solihull approach
·  Home conditions assessment. DV assessment scale -CADDA Graded care profile
·  I don't use other tools but I will consider previous decisions and responses to help me interpret the levels of need guidance.
·  I have picked up the phone to talk to a member of the MASH team to ascertain level of concern and best course of action.
·  I use West Mercia Women's Aid's internal Safeguarding Officers to support me is assessing risk and making a referral/ contact with MASH.
·  In house safeguarding guidance and info share with our in house safeguarding officer who will assess if referral needed
·  Information on prevent/signs/checklists - what to look for.
·  internal safe guarding team
·  Local Policing systems.
·  MAG meeting
·  mash team and attended mag meetings
·  Not applicable' or 'No' (6)
·  Named safeguarding Nurse.
·  Neglect Tool Assessment and Adult Attachment Interview
·  OASys assessment, information from police or other partnership agencies
·  Only professional knowledge gathered over 20 years in the Police.
·  Own organisation tools.
·  Phone call to MASH team to discuss case first hand. Often this helps to refine the decision making process about making a referral.
·  Police knowledge Knowledge of criminal law common sense
·  police systems
·  pre-birth planning meeting template Through MAG discussions with colleagues and contact Alison Feher or Lyn Renton advice
·  Risk an Resilience and DVRIM
·  Risk and resilience Neglect
·  Risk and Resilience tool
·  Risk assessment Matrix
·  RISK MANAGEMENT PLANS WITHIN POLICE SYSTEMS
·  sometime look at NSPCC guides for various types of abuse as they contain good guidance of signs symptoms for specific things such as burns or bites etc.
·  supervision tool risk and resilience
·  The Referrals come from MASH so I have not had to use a tool.
·  triangle
·  Video walk through of the scene where the child was living.
·  We ring and seek advice from Duty social worker
·  Working Together; CA
5. Have you received feedback on the outcome of contacts/referrals you made?
Number of respondents / Per cent of respondents
Yes, for all / 44 / 21%
Yes, for some / 90 / 42%
No, not for any / 80 / 37%
Total respondents / 214 / 100%
Not answered / 32

Of the 80 who responded to this question with “No, not for any” 48 of these indicated that they had not made a contact / referral

6. Has the feedback you have received included an explanation of how the contact/referral did or did not meet a particular level of need?
Number of respondents / Per cent of respondents
Yes, for all / 29 / 14%
Yes, for some / 65 / 32%
No, not for any / 109 / 54%
Total respondents / 203 / 100%
Not answered / 43

Of the 109 who responded to this question with “No, not for any” 45 of these indicated that they had not made a contact / referral

7. Have you ever had to use the levels of need guidance to challenge the decision making on the outcome of a contact/referral?
Number of respondents / Per cent of respondents
Yes / 38 / 17%
No / 184 / 83%
Total respondents / 222 / 100%
Not answered / 24
8. If you felt the need to challenge the decision making process and outcome of a contact/referral, how have you approached this?
·  As a duty social worker in the MASH team we need to evidence the level of need at screening to explain the need for further assessment, the level of need is quoted in order to justify the decision. The team Manger may question this decision. The main areas that are challenged maybe between Level 3 (CAF level) and Level 4 that could benefit from being clarified more clearly in the Level of needs guidance to support decisions.
·  Assessed using the levels of need document and spoken to the duty manager for a discussion, escalating as appropriate
·  at child in need meeting using the levels of need guidance to highlight what the family were still unable to achieve
·  By following the guidance and using the escalation form though a lot doesn't apply to Heads as we do not have line managers. This is something I raised at improvement board MANY times
·  By speaking to education lead and relevant staff in MASH
·  CAF agencies do not appear to know their remit or of the thresholds; they are of the opinion CAF needs require input from a social worker. As other authorities there should be very few Cain children/families and those that need that level of support there is a need for a separate team to child protection.
·  Contact the MASH team - officer linked with schools
·  Contacted a senior member of staff- currently Jane Hoey
·  Direct contact with the MASH or Social Services
·  direct with social worker or social work team lead, with support and advice from NNSC or SNSC or using the escalation policy
·  Discuss it with my line manager, who would then address the issues with Children’s Team.
·  Discuss with named nurse, specialist nurses or team leader. Used escalation policy.
·  discussed with line manager
·  Discussed with my manager.
·  Discussion with safeguarding lead and team leader then escalated to social care via escalation policy.
·  Discussion with the relevant manager.
·  emails, discussion with safeguarding lead, used the trusts escalation policy
·  Escalation
·  Firstly by ringing to discuss and/or submitting any additional information that may have not been clear or If needed by use of escalation policy
·  Followed the escalation policy
·  Formal report via line supervisors outlining where I think the decision-making was flawed.
·  Have not needed to do so
·  I have approached Senior Practitioners, Team Managers and Service Managers informing my own Team Manager at the time of doing so for escalation of concern processes whereby I have felt that any inaction on my own referrals could have resulted in significant harm to a child.
·  I have had no input or training in this area. It is completely new to me.
·  I have not been in this situation. I would consult our safeguarding officer for advice.
·  I have use the levels of need to challenge social workers at meeting when it is felt that they want to step down and I disagree
·  I haven't had to.
·  I spoke to the manager involved in the decision making process directly.
·  I would contact the MASH team having referred to the levels of need.
·  I wrote a letter to Jo Davidson expressing my concern about the case.
·  Initially by contacting a MASH Manager and asking for decision to be reconsidered. When decision was still NFA, discussed at local MAG and taken back to MASH from there. Children concerned subsequently became subject to CP plans.
·  Lado was informed and a meeting arranged with Social Worker to discuss outcomes.
·  Letter
·  MASH team are very supportive and I would phone them if I felt the need to challenge the decision process.
·  Never challenged
·  Not applicable (16)
·  Not needed to.
·  phone call to social worker
·  Phone MASH team and contact 2gether safeguarding team for assistance
·  Professional disagreement process
·  Spoke to a MASH manager to request further investigation.
·  Spoken to the TM
·  Supervision with lead nurse for safeguarding.
·  Talked it through with safeguarding staff
·  Telephone
·  telephone and email contact to a social worker or manager or IRO
·  Telephone contact, early days of MASH. Referral reviewed by different social worker. Have previously included Kim Gristy in raising concerns about referrals /thresholds.
·  Through direct contact and then escalation through a team manager.
·  Through direct discussion with either the SW or SW team manager
·  through safeguarding team
·  Used the escalation policy.
·  Via Caron or Becks or Heather in MASH
·  via our own safeguarding lead
·  via own safeguarding team
·  via safeguarding lead and line manager
·  Via senior colleagues in CWB
·  via social worker for the case or team manager and also through supervision
·  We have contacted Mash and spoke to the team or to a manager. We know about the escalation policy.
·  We have used our school contact which was Kim Gristy and now Anne-Marie Kemp or else spoken to a social care manager.
·  Yes letter to heads of service.
9. Do you have any comments/experience to share with regards to the effective implementation of the levels of need guidance?
·  Any referral I’ve sent via MASH I have had a response from.
·  Application of levels of needs often seems inconsistent across families i.e. the decisions made about what support is given appear to vary according to professionals involved.
·  As above. From my experience I feel that Level of need cannot be used alone and should be used alongside risk tools depending on subject. E.g. If a referral has been made regarding domestic abuse the DV RIM tool can support the level of need to clarify a professional decision. I feel that this cannot be clarified with the level of need alone. Especially in regards to Level 3 and Level 4 that needs more clarification.
·  Behavioural problems within school are deemed to require SW input if they deem the child is a mainstream pupil and therefore not having special needs. School appear not to have a structure to challenge behavioural issues. There also appears to be a just in case thought process within Herfordshire and MASH are passing things through for a core assessment when a few phone calls would suffice to review the decision and record as information in case of further referrals.
·  External agencies as well as internal colleagues need to be more familiar with the levels of need and apply these before making referrals.
·  Feedback should be received for every referral made to the MASH team.
·  Guidance can sometimes make you feel that making a referral is pointless although you have the experience to know that something is not right and further intervention is needed although levels of need are not fully met.