4.3 Early Help Assessment Framework in Knowsley

1. Foreword

This is a key document which will help us implement the Early Help Assessment Framework across all partner agencies in Knowsley. The ability to undertake one assessment and use this across agencies will ensure compliance with Government guidance and legislation around joined up services and a focus on prevention and early intervention for children, young people and their families. Importantly, it will help us to protect children and young people and give clarity on thresholds and roles and responsibilities for all agencies. This is an important Government driver for improving services and we all have responsibility for making this work.

We see the implementation of the Early Help Assessment Framework as a key priority in Knowsley and welcome the opportunity to strengthen our partnership working and our joint responsibility for planning and delivering services for children, young people and families across the Borough.

The document sets out the Early Help Assessment Framework procedures, gives helpful case studies and sets out useful information on the role of the Lead Professional. I hope you find the document useful and thank you for supporting our vision to improve outcomes for children and young people in Knowsley.

2. Summary/Introduction

Following the death of Victoria Climbie and the subsequent inquiry by Lord Laming, the government revised its legislation regarding the safeguarding of children (Children Act 2004) and introduced the 'Every Child Matters – Change for Children' agenda. This legislation states that no single agency has the responsibility to ensure a child/young person's needs are met and that a co-ordinated, multi-agency approach from every Practitioner working with that child/ young person is essential to ensure needs are met.

As such, Knowsley is developing its services to provide more effective, earlier interventions for its children and young people to ensure that they can achieve the 5 outcomes:

• Be Healthy;
• Stay Safe;
• Enjoy and Achieve;
• Achieve Economic Well-being;
• Make a Positive Contribution.

The model's objective is to provide Practitioners with a framework for delivering services to children, young people and their families by:

• Providing a framework for co-ordinated multi agency working to support children in achieving their full potential across the 5 outcomes;
• Focusing on the early identification of children with additional support needs and provide appropriate, timely and co-ordinated interventions;
• Minimising duplication in service delivery whilst maximising the efficiency of local resources;
• Promoting a shared responsibility between all services working with children/young people and their families to ensure needs are met;
• Creating a common language and clear procedures for integrated working across all services;
• Recognise that children and their families have differing levels of need. Service delivery should be developed to meet these needs, including preventative services.

3. Early Help Assessment Framework in Knowsley

Early help means providing support as soon as a problem emerges at any point in a child's life, it can prevent further problems arising.

Any child may benefit from early help, but practitioners should, in particular, be alert to the potential need for early help for a child who:

• Is disabled and has specific additional needs;
• Has special educational needs (whether or not they have a statutory Education, Health and Care Plan);
• Is a young carer;
• Is showing signs of being drawn in to anti-social or criminal behaviour, including gang involvement and association with organised crime groups;
• Is frequently missing/goes missing from care or from home;
• Is at risk of modern slavery, trafficking or exploitation;
• Is at risk of being radicalised or exploited;
• Is in a family circumstance presenting challenges for the child, such as drug and alcohol misuse, adult mental health issues and domestic abuse;
• Is misusing drugs or alcohol themselves;
• Has returned home to their family from care;
• Is a privately fostered child.

The agencies in Knowsley have agreements in place such as the Knowsley Model of Children in Need Threshold (see below) and the Knowsley Engaging Families Toolkit, which provide effective ways to identify emerging problems and potential unmet needs for individual children and families as well as clear guidance and procedures for all professionals, including those in universal services and those providing services to adults with children. The provision of early help services should form part of a continuum of support to respond to the different levels of need of individual children and families.

The Early Help Assessment Framework (EHAF) is a key part of delivering frontline services that are integrated and focused around the needs of children and young people, supporting them to achieve their full potential across the 5 outcomes. The EHAF is a standardised approach to conducting an assessment of a child's additional needs and deciding how those needs should be met. The process will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a child's needs and strengths, taking into account the role of parents, carers and environmental factors on their development. Practitioners will then be better placed to agree, with the child and family, about what support is appropriate. The EHAF will also help to improve integrated working by promoting co-ordinated service provision.

Within Knowsley, four levels of need have been identified and defined:

Examples of each level are shown below:

Children, young people and their families can require support at any of the above levels and may move up and down levels dependent on their needs.

Level 1 - Universal

Children at Level 1 should be able to reach their full potential across the 5 outcomes. If a Practitioner identifies a need at this level it is likely that a referral/appointment would be made internally or to another single agency that would address this need, but practitioners may find it useful in helping identify specific needs at this level to use an EHAF. 

Examples of low level support would include offering advice and support, sign posting and referral on to other universal agencies.

Level 2 – Need for Support

At this level issues can be resolved by accessing appropriate support from available services (see Case Study 2a). If the full needs of the child are not clear an Assessment (see Appendix 1: Knowsley Early Help Assessment for Children, Young People and Families) could be completed at this level to assist in accurately identifying support required (see Case Study 2b below).

At this level, Practitioners should be able to provide assistance, advice and information. It should also be possible to offer specialist support and involve other agencies as appropriate. However if the support provided does not meet the needs of the child/young person and further intervention from other agencies is required, then the family support /EHAF model should be followed.

If the Practitioner decides that an EHAF is required then he/she should take the following steps:

Step 1 – In order to find out who else may be working with a child, young person or family, the Practitioner should do a background information search on the Early Help Module (expected Summer 2016).  As an interim measure, the Practitioner may contact the Early Help Team who will conduct a search on EHM. (Tel no 0151 443 4092/4707). 

This search will highlight:

1. Whether an EHAF already exists and/or whether issues and concerns have been raised previously;
2. Which services are currently or have been involved with the family.

Step 2 – Depending on the outcome of the search, the Practitioner has three options:

1. If the background information search identifies that the child has a Lead Practitioner or an EHA a in place, the Practitioner should contact the relevant Practitioner leading on the case to share his/her own concerns (see Case Study 2c); or
2. If the background information search identifies that the child or young person is already well known to services and is receiving uncoordinated support, the Practitioner should call a multi-agency Team Around the Family (TAF) meeting (see Appendix 2: Early Help – Team around the Family Meetings Template) with all those involved, including the family. The Practitioner is responsible for organising and chairing the meeting and also inviting the appropriate service providers. The meeting will serve to co-ordinate the response from all services and enable the relevant Practitioners to work closely with the family to share information and plan interventions, creating a Multi-agency Support Plan (See Case Study 2d and 2e).  Practitioners with limited experience of TAF processes can call on the assistance of the Early Help Team (0151 443 4092) who will advise on the process and offer hands-on support where practical;
3. If the background information search identifies that the child or young person is NOT well known to services, apart from universal services, and there is no existing or recent assessment information available, the Practitioner should initiate an Early Help  Assessment (in document form pending access to EHM). (See Case Study 2b). If the Practitioner is confident with the assessment and knows which services could offer support to the family, the Practitioner can move straight to completing the EHAF and call a TAF meeting to create a Multi-agency Support Plan. This meeting should decide on the level of support required in relation to the Threshold Document and identify a different Lead Professional if this is appropriate;
4. If reviews of service interventions at TAF meetings show that progress is being made and the child's/young person's needs are being met, he/she may move down to less intensive support from Universal Services for example.  If more time is needed to meet the family's needs then Early Help should continue to be provided by the Lead Professional and partners until it is agreed that needs have been met as far as possible, support is no longer required due to progress, or an escalation of support is required (including to Children's Social Care).
   
   

Level 3 – Child Welfare Concern

N.B BEST practice dictates that consent should be sought for the sharing of information.   Practitioners can share information without parental consent if they feel this is in the best interest of the child.

At this level, Section 17(1) of the Children Act (1989) states that it is the general duty of each local authority:

• To safeguard and promote the welfare of the children within their area who are in need; and
• So far as is consistent with that duty, to promote the upbringing of such children by their families by providing a range and level of services appropriate to those children's needs.

A child is taken to be in need if:

1. 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 for him of services by a Local Authority;
2. His health and development is likely to be significantly impaired or further impaired without the provision for him of such services; or
3. He is disabled.

Therefore, at this level it is likely that the child/young person will already be known to services due to the complexity of their presenting needs. This should be identified through an Early Help Assessment.

Many concerns about children/young people can be reduced at this stage by appropriately matching need to services.  Practitioners working with a child or young person with presenting needs at Level 3 should therefore follow their internal procedures. For example; contacting the Lead Safeguarding Person in their organisation with a view to seeking further advice and guidance.

If an Early Help Assessment (see Appendix 1: Knowsley Early Help Assessment for Children, Young People and Families) identifies the potential needs for services from the Children & Families' Division, the completed EHA must be shared with the Children & Families' Division at the point of contact, and consent sought from the child's parent/person with parental responsibilities.

At this point the Children & Families' Division/Local Children & Families' Social Work Team would consider the child's identified needs and whether or not it is appropriate to undertake a Single Assessment.

In addition Working Together to Safeguard Children has introduced the concept of Contextual Safeguarding which recognises that as well as threats to the welfare of children from within their families, children may be vulnerable to abuse or exploitation from outside their families. These extra-familial threats might arise at school and other educational establishments, from within peer groups, or more widely from within the wider community and/or online. These threats can take a variety of different forms and children can be vulnerable to multiple threats, including: exploitation by criminal gangs and organised crime groups such as county lines; trafficking, online abuse; sexual exploitation and the influences of extremism leading to radicalisation.

Level 4 – Need for protection

A child in need of protection will be assessed under Section 47 of the Children Act 1989 which states:

Where a Local Authority:

1. Is informed that a child who lives, or is found, in their area:
   1. is the subject of an emergency protection order; or
   2. is in police protection; or
2. Has reasonable cause to suspect that a child who lives or is found in their area, is suffering or is likely to suffer, Significant Harm, the authority shall make, or cause to be made such inquiries as they consider necessary to enable them to decide whether they should take an action to safeguard or promote the child's welfare.

Therefore, many children and young people at this level will have their needs met through existing Safeguarding procedures for multi-disciplinary working. (See Multi Agency Safeguarding Hub (MASH) Procedure). If safeguarding procedures are in place, but some of the child's needs are not being met, Practitioners should identify the statutory Lead Practitioner and the concerns should be re-directed appropriately. (See Case Study 4a and 4b). It is not appropriate for children and young people at this level to be discussed at a Service Allocation Meeting.

In the unlikely event that a child is assessed to be at Level 4 but is not currently receiving a service, (e.g. those with acute illness, mental health needs, complex disability), the procedures outlined at Level 2 and Level 3 should be followed to identify needs and take appropriate action. However, if a child/young person is identified as being at risk of significant/immediate harm, Practitioners should not follow the procedures set out for Levels 2 & 3. They should immediately make a direct referral to the local area Children & Families Social Work Team and follow up with an EHA within 48 hours if appropriate.

Once the child/young person is making progress and is moving towards achieving their full potential across the 5 Outcomes, he/she may move down to an appropriate level. At lower levels, the child's/young person's needs will be monitored closely through both specialist support and Multi-agency Meetings.

4. EHAF Procedure within Knowsley

The EHAF exists to support children, young people and their families. It will help to ensure that children and young people receive the right support at an early stage, as a preventative measure. As the EHA  is a shared assessment, overseen by  single practitioner but including the contributions of others, it will also prevent families having to repeat the same story to different practitioners. 

Having identified that a child has additional need(s), practitioners must decide whether this need can be met via a referral to a single external agency or whether the needs are more complex, requiring referral to two or more teams. If the presenting needs can be met by a single agency then existing referral procedures can be used and there is no need for an EHA. However if the presenting needs require support from two or more teams then the EHA must be completed and the following process followed:

• Use the EHM when available, to check if an EHA already exists and support is in place;
• If an EHAF already exists, the practitioner should contact the Lead Practitioner to discuss the issues. If the practitioner has access to EHM and they could request permission to contribute the EHM episode and become part of the TAF process making contributions to ongoing review and assessments;
• If an EHAF does not exist then an EHA should be completed with the child and/or family. At this time informed consent must be obtained to share the information with other teams/agencies;
• If not created on EHM, the completed EHA must be logged centrally with the Early Help Assessment Manager who will record on EHM that an EHA and support are in place; 
• The Lead Practitioners must co-ordinate the actions of the multi-agency teams plan and ensure that it is reviewed in a timely manner (suggested maximum of 6-8 weeks);
• At this review, it may be decided that the child's needs have been met and the EHA and can be closed. At this point the EHA must be closed on the EHM system;
• Consent should be regularly reviewed as the family also has the right to withdraw consent at any stage. If this was to happen the Practitioner should follow their own internal procedures but recorded on EHM;
• If during discussion with the child/young person/family it has been identified that an EHA cannot go ahead due to lack of engagement with the family and the Practitioner is of the view that the child/young person may be at risk of Significant Harm. The Practitioner should speak with his/her local named Safeguarding Person.

See Early Help Assessment Framework Process Chart.

5. Consent

It is important that professionals are aware the Data Protection Act 2018 and the UK GDPR place duties on organisations and individuals to process personal information fairly and lawfully and to keep the information they hold safe and secure. The Data Protection Act 2018 contains 'safeguarding of children and individuals at risk' as a processing condition that allows practitioners to share information. This includes allowing practitioners to share information without consent, if it is not possible to gain consent, it cannot be reasonably expected that a practitioner gains consent, or if to gain consent would place a child at risk.

Note: The Data Protection Act 2018 and UK GDPR do not prevent, or limit, the sharing of information for the purposes of keeping children safe. Fears about sharing information must not be allowed to stand in the way of the need to promote the welfare and protect the safety of children. See Information Sharing Procedure.

Consent is the key to successful information sharing and central to the EHAF process as without the family's consent the EHA process cannot proceed.  As such, it is essential that children, young people and their family understand the EHAF process and how their information will be shared between agencies.

Throughout the process, Practitioners should discuss the issue of consent with the family and explain why it may be necessary for agencies to share information. The Practitioner should be clear about what information is likely to be collected, how it will be used, who it will be shared with and why. Children, young people and their families may agree only to partial consent, specifying what information may be shared and with whom. The individual's wishes should be respected, unless a child is at risk of harm.

There are some circumstances in which it would be appropriate to share information without consent, such as:

• The disclosure prevents the child/young person from committing a criminal offence or places the Practitioner at risk of collusion;
• The child/young person is at risk of significant harm or harming someone else;
• The information is required as part of a legal proceeding;
• Information is requested by the police as part of a criminal investigation;
• In any other circumstance where public interest overrides the need to keep information confidential.

When decisions are made to share information without consent, the reasons for doing so should be recorded and the family should be made aware (if this does not place the child at increased risk of harm).

Working with young people and consent

Although the EHAF process focuses on the need to share information and the importance of including the whole family in assessment, Knowsley recognises that young people may not always want to involve their families in decision making. As such, procedures have been established to allow young people to consent to the EHAF process alone if they are of sufficient maturity and development (see below).

When working with a young person it is important to encourage them to discuss issues with their parents/carers, however this may not always be appropriate. At this point, depending on the young person's needs, it should be explained that only limited support may be offered to meet their needs as many services work with the whole family. However, the young person should be reassured that the appropriate services will work with him/her and respect their wishes if they are deemed to be 'Fraser Competent.'

A young person (12 years and over), who has the capacity to understand and make their own decisions, may give (or refuse) consent to sharing information. In these circumstances the young person is deemed to be 'Fraser Competent'.

• A child has sufficient understanding if they can:
• Understand the question being asked of them;
• Have a reasonable understanding of: what information might be shared; reasons for sharing the information;
• Implications of sharing/not sharing the information;
• Appreciate and consider alternative courses of action;
• Weigh up one aspect of the situation against another;
• Express a clear personal view on the matter;
• Keep a reasonable consistency in their views.

Any child below the age of 16yrs can give consent when they reach the necessary maturity and intelligence to understand fully the intervention proposed and the consequences of their decision. However the Practitioner must consider the fact that intelligence and the ability to understand will vary greatly for every child, so the decision of 'Fraser Competency' must be carefully considered. If a child is deemed 'Fraser Competent' after receiving all appropriate information regarding the intervention, then the consent (or refusal to consent) is valid.

Young people should also have a say in who will act as their Lead Practitioner. Provided they have the skills and knowledge, any Practitioner may be requested to act as a Lead Practitioner, meaning that those who specifically work with young people, such as a Youth Worker or a Connexions Personal Adviser, could take on this role. The young person should feel comfortable with the Practitioner and able to express their opinions, knowing that the Practitioner will work in partnership with them to ensure their needs are met.

6. The Team Around the Family Meeting (TAF)

The Practitioner who completes the EHAF with a family should call a Multi-agency meeting. These meetings are a way in which to co-ordinate the delivery of services to a family. Attended by the family and representatives from each service working with that family, these meetings will ensure that children/young people are receiving the support they need and that the family is involved in the decision making process.

(See Appendix 2: Early Help – Team around the Family Meetings Template).

The Practitioner who has completed the EHA is responsible for:

• Convening the meeting;
• Inviting the child/young person/family and Practitioners working with the family to attend;
• Ensuring that the family have consented, fully understand the process and are able to contribute to the proceedings;
• Sharing information;
• Agreeing actions for the Multi-agency Support Plan.

It should be a requirement of this meeting that a Lead Practitioner is appointed and agreed upon in consultation with the multi-agency team and the family. This does not need to be the person who has completed the EHA but the Lead Professional will assume responsibility for the EHA and subsequent planning and review. (See Section 7, Lead Practitioner).

To ensure that services are delivered in a timely, co-ordinated manner, the Practitioners involved in EHA support  should complete meetings and reviews within the following recommended time frames:

• TAF meetings should be held within 15 working days of completing an EHA. It may be appropriate to convene a TAF to inform the completion of the EHA however;
• Multi-agency support plans need to be reviewed approximately every 6-8 weeks (maximum suggested time lapse of 3 months).

7. Lead Practitioner

The Practitioner who completes the EHA is responsible for convening the initial TAF Meeting. It is at this meeting that a Lead Practitioner will be appointed. This decision is made in agreement with the multi-agency team and the child/young person/family, based on the ability of the Practitioner to coordinate services that meet the needs of the family.

The responsibilities of the Lead Practitioner include:

• Acting as a single point of contact for the child/young person/family;
• Acting as an advocate for the family, ensuring that their needs are being met and that they are kept informed of progress, so that they may contribute to proceedings;
• Ensuring that children, young people and families get appropriate interventions and that these are well planned, reviewed and effective.

When a Lead Practitioner has been assigned they are responsible for:

• Keeping an overview of what is to happen;
• Monitoring progress on behalf of the group;
• Keeping track of plans and timescales, ensuring regular reviews, calling and chairing further meetings;
• Making sure all Practitioners involved know what they need to do.
• Making sure the family are aware of information sharing;
• Being the first contact for any new Practitioner;
• Being the first contact for the family or young person.

Although the Lead Practitioner will be the main point of contact for the family, each service represented on the Multi-agency Support Plan will have shared responsibility for the outcomes and service delivery within their own agency. The Lead Practitioner is NOT responsible or accountable for the quality of services delivered by other agencies. 

8. Conclusion

The EHA model provides a framework to develop effective multi-agency working. All Practitioners, regardless of their role, should be working to the same procedure.

By providing a common language around levels of need and clear guidance on the EHA process, Practitioners should be able to clearly identify a child's/young person's needs and be able to offer the relevant services to support them. Monitoring this service provision will provide Knowsley with an up to date needs analysis, allowing gaps in service provision to be identified. As such, these processes can be utilised to inform future commissioning decisions.

Following this model will help to ensure that services within Knowsley not only meet the requirements of the Children Act 2004 but also co-operate to improve the outcomes for children and young people within the Borough.

9. Glossary of Terms

Appendices

Appendix 1: Knowsley Early Help Assessment for Children, Young People and Families

Appendix 2: Early Help – Team around the Family Meetings Template