1. New Halton Levels of Need Framework Denise Roberts – Deputy Designated Nurse Mark Grady – Principal Children’s Officer

2. Background Original Halton Children’s Trust Levels of Need Framework developed in 2007.

3. Basis for Developing new Framework Research undertaken through Glyndwr University 2010-11 found: Distinction between levels (e.g. between 2 and 3a, or between 3a and 3b) blurred. Understanding of the Framework varies between agencies Number of cases at each level should gradually fall – not the case at present Framework a snapshot of partnership working in 2007, new Framework needed to reflect more embedded partnership working and current priorities.

4. Requirements of new Framework Fit for purpose for all agencies Supports and reflects current working practices Embedded in working practices in preparation for forthcoming inspections Flexible and fluid between levels Clear and understandable Focus on the child and family and ensuring the best outcomes for all

5. Process for Development Report on research approved by Halton Children’s Trust and Halton Safeguarding Children’s Board Multi-agency working group established Aim – to develop and launch a new Halton Levels of Need Framework to meet support the work of all partners from April 2013.

6. Milestones Multi-agency group met monthly led by Health and including representation from key stakeholders Action plan in place Mapping exercise undertaken Proposed Framework taken to consultation and to test against case studies – over 200 involved Approval of Framework from strategic bodies

7. Framework UNIVERSAL SERVICES Contact, assessment and support for all children and young people undertaken by any agency involved within Universal Services. LevelDefinition Universal Plus What – To provide first level of early additional support. Why – To ensure appropriate support, such as brief intervention or longer term input at the earliest stage, subject to on-going review. Multi-agency Planning What – Enhanced multi-agency support and planning. Why – To address identified, more complex needs. Multi-agency plan to protect from harm What – Statutory multi-agency planning and support Why – Child has high level needs, may have suffered from harm or is at risk of harm, or could be encountering issues of compromised care. There is no option but to intervene.

8. Design Concept

9. For more information Marketing materials – posters, leaflets and z-cards for professionals and parents/carers and young people. Supporting documents – More detail and agency-specific versions. Mark.grady@halton.gov.uk

10. 5 case studies For each case study, consider, discuss and decide which level of the Framework would be most appropriate Options are 0 – Universal Services 1 – Universal Plus 2 – Multi-agency Planning 3 – Multi-agency Plan to Protect from Harm Case Studies Exercise

11. Case Study 1 Health Visitor and Children’s Centre have been working with the family for 2 months to address basic care needs e.g. provision of food, clothing and bedding. Children are aged 4 and 2. Despite this no consistent improvement made and Mum now presents with substance misuse issue.

12. Q1. Which level? 0Universal Services 1Universal Plus 2Multi-agency planning 3Multi-agency plan to protect from harm

13. Multi-agency Planning Possible Indicators Despite intervention, child not making consistent progress. Parenting impacting on child and family life causing instability and inconsistency. Children/young people’s risk taking behaviour impacting on other areas of their life. Child/young person has caring responsibilities that are having a negative impact on their lives. Child/young person with mental health and emotional well- being and/or behavioural issues

14. Case Study 2 Police attend family home weekly due to Domestic Incidents Dad suffers from depression - self managed with substance misuse. 14 year old has presented at school with bruising to the top of his arm.

15. Q2. Which level? 0Universal Services 1Universal Plus 2Multi-agency planning 3Multi-agency plan to protect from harm

16. Multi-agency Plan to Protect from harm Possible Indicators Child/young person considered to be a ‘Child in Need’, due to complex problems and/or risk taking behaviour which result in significant risk of harm. This requires statutory support to maintain a reasonable standard of health and development. Children/young people with severe or complex needs, in relation to disability. Parent/carer has complex issues that significantly compromise care and impact on providing a safe environment for the child.

17. Case Study 3 Family appropriately accessing education services Toddler group accessed for youngest child at Brookvale Children’s Centre All immunisations up to date

18. Q3. Which level? 0Universal Services 1Universal Plus 2Multi-agency planning 3Multi-agency plan to protect from harm

19. Universal Services Possible Indicators Entitlement for all children and young people from services such as Health and Education, Children’s Centres and other early years or youth settings. Support received from family, friends and community networks.

20. Case Study 4 Family flags to school that 10 year old child is presenting with “bizarre behaviour at home”. For example, not responding to parents questions or comments staring fixedly into space at times. Family wants support to identify the next steps.

21. Q4. Which level? 0Universal Services 1Universal Plus 2Multi-agency planning 3Multi-agency plan to protect from harm

22. Universal Plus Possible Indicators Health issues which may impact on child’s development and wellbeing Child may display behaviour inappropriate to age and stage of development Requiring support to develop parenting skills to meet the child/children’s needs, including environmental factors. Family unable to access effective support services to meet specific needs Children/young people starting to have absences from school and prevent further escalation.

23. Case Study 5 13 year old child is persistently attending late for school – up to an hour on some days When questioned child states this is due to making sure 2 younger siblings get to school as well. Mum discloses child provides basic care for her and other children and sees no issue with this.

24. Q5. Which level? 0Universal Services 1Universal Plus 2Multi-agency planning 3Multi-agency plan to protect from harm

25. Multi-agency Planning Possible Indicators Despite intervention, child not making consistent progress. Parenting impacting on child and family life causing instability and inconsistency. Children/young people’s risk taking behaviour impacting on other areas of their life. Child/young person has caring responsibilities that are having a negative impact on their lives. Child/young person with mental health and emotional well- being and/or behavioural issues