Early Help Needs Assessment

Commissioning Unit

1 Version published 1st August 2014 Contents page

Introduction 3

Main findings and recommendations 4

Demographic Profile of Haringey 8

Key risk factors which predict early help 10

Social Care Front Door 11

Contacts and referrals by presenting issue to Social Care 11

Terminology around neglect and domestic violence 12

Contacts made to Children’s Social Care by presenting issue and age range 13

Contacts to Children’s Social Care which led to no further action (NFA) 15

The main presenting issues at point of contact which crossed the threshold for social care intervention 15

Population Estimates for Haringey 16

Early Years (0-5) including pre-natal17

Access to children’s centres 19

Mortality Rate 19

Low birth weight 19

Early access to maternity services 20

Breastfeeding 20

Childhood obesity20

Deprivation and Child Poverty 21

Families in receipt of out of work benefits or tax credits 22

Free school meals 23

Lone parent families with dependent children 24

Unstable housing including overcrowding, being in temporary accommodation and homelessness 24

Mental health 25

Substance Misuse (drug and alcohol) 26

Drug 27

Alcohol 28

2 Version published 1st August 2014 Teenage pregnancy 29

Violence against Women and girls (domestic violence) 30

Crime and antisocial behaviour 34

Not being in education, employment or training 36

Disabilities (physical/cognitive/emotional)37

Low aspirations 39

Young carers 40

Analysis of early help based on 2012/13 data 40

Evidence of what works from a best practice perspective 41

What provision currently exists and what the gaps are 41

Appendix 1 43

3 Version published 1st August 2014 Introduction This document covers

 An analysis of need1 at a population level based on the key risk factors which affect health and wellbeing of children and young people. This includes reviewing the needs which led to the demand for Children’s Social Care services, as an indicator of expressed need which could have been met earlier on in the child’s life.

 Identification of hotpots and vulnerable or key groups as priorities for targeted early help and prevention.

 Identification of services which demonstrate a clear impact on improving outcomes for children and families including enhancing resilience.

The following data and resources were used: Social Care data, Domestic Violence 2012/13 Strategic Assessment, Haringey Health and Wellbeing Strategy (2012-15), housing data, Child Poverty Strategy (2013-15), Early Help Needs Analysis, Impower, Big Lottery Fund Needs Assessment (January 2014), Joint Strategic Needs Assessment (2012), Common Assessment Framework data (report 2012-13), Children’s Centre review (2013,Tribal), Community Safety Strategic Assessment (2012/13), Mental health and behaviour in schools; departmental advice for school staff (June 2014 DoE), Tottenham Social Regeneration Indicators, SEN Placement Report (July 2014), Domestic and Gender Based Violence Mapping Audit of Haringey’s Statutory Services (February 2014), and data from the Strategy & Business Intelligence Unit.

1 Within Haringey, needs have been categorised by tiers. Tier 1 refers to children not in need of CAF, tier 2a/b refers to vulnerable children with 1 or 2 additional needs which require CAF and targeted service provision, Tier 3 is defined as vulnerable child with multiple complex needs requiring CAF and targeted provision. Tier 4 – vulnerable child meeting threshold for social care. The needs analysis presents finding based on a review of data for tiers 1-4.

4 Version published 1st August 2014 It is acknowledged that many of our Third Sector providers have carried out their own needs analyses on the communities they represent. This data does not form part of the current needs assessment.

Main findings and recommendations

 The main presenting issues at the point of contact to Social Care were broadly the same issues that crossed the threshold for a referral and subsequent assessment. These issues were violence against women and girls, offending rates, physical abuse/neglect, housing, the need for more family support, parental illness (physical/mental) and parental substance misuse. Support around behavioural issues was a key trend among families with children over 10 years.

 The main presenting issues to Social Care is set out in table 1 below by families with children under 4 years, 4-9 years, 10-15 years and 16 years and above.

Table 1 Presenting issue to social care among families with children by age range

0-3 years 4-9 years

Domestic Violence Physical Abuse/neglect

Physical Abuse/neglect Domestic Violence

Housing issues Parental illness- Mental/physical health & substance misuse Parental illness-Mental/physical Health & substance misuse Housing issues

Pre-birth concerns Family support

Family support Parental Alcohol/substance misuse

10-15 years 16+ years

Physical Abuse/neglect Offending behaviour

Domestic Violence Housing issues

Behavioural issues Behavioural issues

Missing person Physical Abuse/neglect

Parental illness (mental/physical) Missing person

5 Version published 1st August 2014 Family support Victim of crime

Sexual Abuse

Offending behaviour

Victim of crime

 The early identification of neglect (which includes physical harm/abuse according to the legal definition of neglect) is associated with issues such as domestic violence, mental health and substance misuse. Ofsted Inspection report (July 2014) identified the need to pick up chronic neglect more quickly and provide services in a timely way.

 Deprivation is a key causal factor given its relationship to early access to maternity provision, EYFS performance, domestic violence offence rates, crime, attendance at Children’s Centre, breast feeding, birth weight, SEN, eligibility for free school meals, worklessness households, obesity/overweight at 4-5 years, parental health (mental/physical), living in social housing and educational attainment.

 The centre and east of Haringey are associated with higher rates of deprivation and also correspond to higher population density. The following areas are identified from the data; Seven Sisters, White Hart Lane, Northumberland Park, Noel Park, Bruce Grove, Tottenham Hale and Tottenham Green.

 Children in lone parent households are more likely to live in poverty with Northumberland Park more likely to have higher numbers of lone parents residing than any other ward.

 Residents from most ethnic minority groups are generally more likely to be deprived in terms of socio-economic status. Greater support needs to be provided in particular to families with children from the following communities: White Irish Travellers, Somalis, Kurdish, Kosovan and Turkish.

 Early Help cases presenting with mental health and substance misuse issues are more likely to have domestic violence present given the relationship between these Toxic Trio.

 Domestic Violence offence rates are more likely to be higher in lower income areas with the trend showing the east of the borough having greater prevalence rates. In the 12 months to December 2013, Tottenham Hale,

6 Version published 1st August 2014 Northumberland Park and Bruce Grove three wards accounted for over a quarter (27%) of all recorded DV offences.

 Perpetrators of domestic violence are more likely to be young males between 18-34 years and are over-represented among the Black Caribbean, White Other and White British communities.

 Perpetrators of Violence against Women and Girls are more likely to have substance and/or mental health issues.

 There is a need to reduce violence against Women and girls and physical abuse/neglect particularly among families with children under 15 years especially 0- 4 years as a key vulnerable group. Hotspots due to the high numbers of children under three years include Seven Sisters and Tottenham Green.

 Violence against women and girls (or domestic violence as it has been referred to in the report) is more likely to be experienced among young women 16-24 years, pregnant teenage mothers, as well as those that present with long-term illness or disability.

 Greater dissemination of information about early help and other services among families with children of all ages was identified as a key need for families with children of all ages.

 As Police were the key agency in terms of contacts made to Social Care, more work needs to be done with this agency as part of the early help strategy.

 Children living in the wards of Seven Sisters, Northumberland Park and Bruce Grove may need to be given additional support in order to reduce the gap in achievement from Key Stage 2 to Key Stage 4.

 There is a link between crime/anti-social behaviour and violence against women and girls, mental health and substance misuse.

 Hotspots for crime include Noel Park, Tottenham Green, Northumberland Park, Tottenham Hale and Bruce Grove. Residents from BME communities are more likely to reside in these areas and are overrepresented in crime data whether as victim or perpetrator. Transport hubs are also particular hotspots for crime related behaviour.

 Offenders are more likely to re-offend within the six months after initial sentence.

 Greater targeting of services to Northumberland Park, White Hart Lane, Seven Sisters, Tottenham Green and Tottenham Hale which have more than

7 Version published 1st August 2014 50% of households on benefits and correspond roughly to the largest proportion of children under five years in the borough.

 Greater targeting of provision for families with children under 5 years in North and South of the borough with optimal outreach via children’s centre settings focusing on hotspot areas of Seven Sisters followed by Northumberland Park, Tottenham Hale, Bruce Grove, Tottenham Green and St Ann’s.

 Given the link between Mental Health and deprivation, there may be a need to ensure that the east and centre of the borough are particularly targeted for improving mental health (especially that of parents) and include specific work with parents who present with a dual diagnosis of mental health and substance misuse.

 Children of parents or carers who misuse drugs or alcohol are more likely to develop misuse/ and or mental health problems themselves.

 Vulnerable groups at risk for substance misuse include young offenders, LAC, care leavers, children affected by parental substance misuse and/or domestic violence, homeless young people, young people in gangs or at risk of recruitment, excludes and persistent truants and young people at risk of sexual exploitation.

 Poor child mental health is correlated with having a long-term illness/disability or SEN, being a young offender, having parents with mental health and/or substance misuse issues. Children aged 11-16 years of age from Black ethnic groups are especially vulnerable.

 Common mental health disorders in children are conduct disorder, anxiety disorder, attention deficit hyperactivity disorder and depression.

 Not being in education, employment or training is more likely to be experienced by males aged 18-19 years with over-representation among White Irish, White British, White and Black Caribbean, Black Caribbean and Other White.

 NEET is more likely to be associated with persistent absence or exclusion from school, being a teenage parent, Looked after Child as well as being a young offender.

 White Hart Lane, Tottenham Green and Northumberland Park have the highest proportion of NEET.

 The proportion of care leavers in education, employment or training has decreased from 63% in March 2013 to 47% as of March 2014.

8 Version published 1st August 2014  Substance misuse is a particular concern given the link to other issues such as NEET, teenage pregnancy, mental health, offending and late access to maternity provision. The impact of parental substance misuse on child is more likely to see children at risk of presenting with other social and emotional problems such as self-harm, offending and familial issues.

 Hotspots for overcrowded housing include Wood Green and Northumberland Park with Black and Minority Ethnic groups more likely to be living in temporary accommodation.

 Wood Green has the highest number of children and young people under 18 years living in overcrowded households followed by Northumberland Park.

 Enabling more families to access family support to increase their parenting and coping self-efficacy beliefs.

 Behavioural issues for children aged 10 years or above and also presenting with other risk factors in this report is a priority for targeting and support through the Early Help Framework. Disruptive or withdrawn behaviours could be symptomatic of an underlying mental health problem and may escalate into offending behaviour and expulsion from school which impacts on young person’s life chances.

 More targeted support for young people who are at risk of becoming offenders, victims of crime or engaging in risky behaviour.

 Bruce Grove, Tottenham Green and Harringay have the highest teenage conception rates.

Demographic Profile of Haringey

 Haringey is an exceptionally diverse and fast-changing borough with a population of 258,912. One in five of the population are aged between 0- 19 years (63,606). 18,337 are 0-4, 16,132 are 5-9, 14,919 are 10-14 and 14,216 are 15-19 years. There are higher numbers of 0-19 year olds in the east of the borough. The top 3 wards are Seven Sisters (5,170), Northumberland Park (4,784) and Tottenham Hale (4,708).  The borough has a relatively young population with almost a quarter under 20 years and 90.5% of the population aged less than 65 years. This is higher than the London and England and Wales averages (88.5% and 83.4% respectively). Following national trend, our population is ageing with 9.5% of pensionable age (65 years plus) with a projected increase to 10% by 2022 and to 13.5% by 2037.  Haringey is the 5th most ethnically diverse borough in the country. According to data extracted in January 2013 from the local School Census, the most common ethnic origin of school pupils in Haringey is

9 Version published 1st August 2014 White Other (29.2%) followed by White British (18.7%), Black African (16.6%) and Black Caribbean (9.2%) showing that nearly half of the residents come from Black and minority ethnic (BME) communities.  Nearly 81% of our school children are non-white British compared with the London average of 65% and England average of 23%.  Nearly half of the school population in the borough have a first language which is known or believed to be other than English (47.7%).  A small proportion (1.5%) of the 0-19 years population have a statement of special education needs (n=1055 pupils) which is slightly lower than the London proportion of 1.6% but higher than the England proportion of 1.4%. Of the 1055 pupils, 354 attend a Haringey special school. There are 4,696 pupils on School Action and a further 2,410 pupils on School Action Plus. Current data shows 1,451 children with a statement of SEN (July 2014).  A wide range of religious beliefs are practised in the borough, with Christianity (45%) and Muslim (21.5%) being the most common. Haringey also has high levels of people who state they have ‘no religion’ (25.1%) 2011 Census.  Male life expectancy is 78.7 years which is slightly below the London average of 79.3 years. The range extends from 82.6 years in Crouch End to 75.8 years in Bruce Grove. (GLA 2008-2012)  Female life expectancy is higher than for males; (83.9 years compared to 78.7 years for males). This is slightly above the London average of 83.5 years. The range extends from 87.3 in Highgate to 81.9 years in Bounds Green (GLA 2008-2012).  40.3% of Haringey households are Owner Occupier or Shared. This is lower than the London average of 49.5%. Nearly a third of residents live in private rented accommodation (31.4%) which is higher than the London average of 25%.  The total number of households based on 2011 data is 101,955 Social housing accounts for about 24% of households with the greatest concentration in White Hart Lane (49.9%), Northumberland Park (45.4%), Tottenham Green (38.7%), Tottenham Hale (33.7%) and Seven Sisters (28.6%).  The number of adults with a degree level or equivalent qualification (level 4) is above the London average (40.8% and 37.7% respectively). The number of adults with no qualification (17.8%) is similar to London.  There are 64 schools (including 8 academies and 2 free schools), 12 Secondary Schools (11 are mixed, 1 girls school, 4 academies) and 1 sixth form college. In addition, Haringey has 1 Further Education College, 4 special schools co-located with mainstream schools, 1 primary and 1 secondary Pupil Referral Unit, 1 Pupil Referral Unit for students with medical needs, and 17 Children’s Centres.  Haringey is the 4th most deprived borough in London and the 13th most deprived in the country. An estimated 21,595 (36.4%) children live in poverty, largely in the east of the borough. The borough stretches from the prosperous neighbourhood of Highgate in the west to Tottenham in the east, one of the most deprived areas in the country.  We have significant levels of homelessness; more than 3,000 households are officially in temporary accommodation, the highest in London. Just over 30% of households live in social housing with high concentrations in

10 Version published 1st August 2014 the east of the borough. The east of the borough is more densely populated than the west.  The Job Seeker Allowance (JSA) claimant count was 7,551 as of April 2014, or 4.1% of the total working age population (16-64); Haringey rates are significantly above the England (2.8%) and London rates (2.7%).  84% of CAFs were completed for children aged 11 years and under in 2012-13; of which 36% were completed for children less than 5 years. The proportion of CAFs was greater for children from 3-5 years (n=180) than for 0-3 year olds (n=143).

Key risk factors which predict early help

This section of the needs assessment provides information from desk research which indentified the key risk factors that lead to vulnerability for children and young people and their prevalence across Haringey.

Vulnerability is defined as threats to the wellbeing of families and children by individual, parental or family circumstances which impacts on their health and wellbeing.

The key risk factors are:  early years (0-5 years) including pre-natal,  deprivation and child poverty and its correlation to issues such as domestic violence  Unstable Housing  Mental health  Substance misuse (drug and alcohol)  Violence against Women and Girls (domestic violence as previously known)  Crime/Antisocial behaviour  Not in education, employment or training (NEET)  Disability (physical, cognitive and/or emotional)  Health and Lifestyle factors such as teenage pregnancy, being a lone parent

Other risk factors  Young carer

Social Care Front Door

At the end of March 2014, there were 511 LAC of which 4 were also subject to a child protection plan. A further 201 children were subject to a child protection plan but not looked after. An analysis of needs which led to demand for Children’s Social Care services was undertaken to identify what needs might have been met earlier on in the child’s life.

345 children who had a child protection conference during 2012/13 had ‘domestic violence’ flagged as a presenting need (66%).

11 Version published 1st August 2014 Table 2 Number of children who are Looked after and/or in receipt of Child Protection Plan

No. Of children

LAC 507

CP Plan 201

CPP and LAC 4

The CiN census for 2013/14 revealed that as of 31st March 2014, the majority of children who remained on Child Protection Plans were related to neglect (physical abuse and neglect) and emotional abuse.

Further analysis of data in terms of presenting issues identified during the assessment process revealed that domestic violence, neglect (which includes physical abuse) and mental health were predominant issues.

Contacts and referrals by presenting issue to Social Care

Domestic violence was a key issue in the contacts made to social care for children with the majority of these contacts were from the police (36%) in 2013/14 followed by Schools (7%). Refer to tables 3 and 4 below.

Domestic violence accounted for 20% of all contacts to children’s social care in 2013/14. This equates to 3 a day. The second most common presenting need was Neglect and physical abuse concerns (14%) with the need for information and advice making 10% of contacts for the same period.

Table 3 Contacts made to Social Care by referring agency for 2013/14

Numb Perce Source er nt Police 2046 36.1 School / Education Department 420 7.4 Other Local Authority 370 6.5

12 Version published 1st August 2014 Table 4 Contacts made to Social Care by presenting need in 2013/14

Count Contac Perce Presenting Need ts nt Domestic Violence 1178 20 Physical abuse/neglect 861 14 Need For Info 599 10 Housing issues 428 7 Need for family support 304 5 Parental illness –mental health 304 5 Behavioural issues 247 4 Offending behaviour 209 3.5 Total number of contacts 5816

Terminology around neglect and domestic violence

Neglect

The current criminal definition of child neglect covers physical harm only. Government have indicated that the 1933 criminal law on child neglect will include emotional and physical abuse. This change is proposed to be made through the introduction of the so called ‘Cinderella Law) before the next election. Therefore for the purpose of reporting, the current definition will remain around neglect and physical abuse as one category with emotional abuse as a separate category.

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs resulting in serious impairment of the child’s health and/or development. Neglect can be difficult to define as definitions are often based on personal perceptions of neglect including what good care looks like and what the child’s needs are.

Neglect may occur during pregnancy. Once the child is born, neglect may result in a parent or carer failing to providing adequate food, clothing or shelter, failing to protect a child from physical and emotional harm or danger, failing to ensure adequate supervision of care as well as failing to ensure access to appropriate medical care or treatment. It may also include unresponsiveness to a child’s basic emotional needs.

There is no single cause for neglect. Neglectful families experience a variety and combination of issues such as mental health, DV, substance use and poverty.

13 Version published 1st August 2014 Violence against women and girls

Currently the borough uses the term “domestic and gender based violence” to describe types of crime and abuse such as domestic and sexual violence. This is a confusing and an unusual term, and is not used elsewhere. The term “violence against women and girls” is used by many London boroughs and partnerships nationally (for instance HM Government Call to End Violence against women and Girls Strategy 2010). MOPAC have agreed the use of the terminology in their updated VAWG Strategy 2013-17.

The UN Declaration defines violence against women and girls as: “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.

It includes the following types of abuse and crimes:

 Sexual violence, abuse and exploitation  Sexual harassment and bullying  Stalking  Trafficking and forced prostitution  Domestic violence and abuse  Female genital mutilation  Forced marriage  Crime committed in the name of “honour”.

With regards to terminology, when reporting analyses of historical data, reference will be made to ‘domestic violence’ otherwise the term ‘violence against women and girls’ will be used.

Contacts made to Children’s Social Care by presenting issue and age range

For the year ending March 2014 there were 5816 contacts made to children’s social care which equates to 16 per day.

The need for information was a prevailing issue for families with children of all ages.

When data is examined by each age group in Table 5; we find that the main issues for families with children under 4 years were domestic violence, physical abuse/neglect, housing issues, parental illness (physical & mental) and pre-birth concerns. Family support didn’t rank very highly but is still noted as a key concern for families with very young children.

14 Version published 1st August 2014 For families with children from 4-9 years, the contacts to social care by presenting issues were broadly the same and included parental alcohol/substance misuse.

Among the older age ranges (10-15 years); physical abuse/neglect, domestic violence, parental illness (physical/mental) as well as behavioural issues were dominant presenting issues in terms of contacts made to social care. Sexual abuse was also an issue which emerged for this age range but wasn’t a key issue for families with children of 16 or above.

For families with children 16 years and above; offending behaviour, housing, behavioural issues, physical abuse/neglect and missing person were prevailing issues among the contacts made to social care for this age group.

Table 5 Contacts to Children’s Social Care by age range and issue from March 2013-October 2014

Presenting Need 16+ 10 to 15 4 to 9 0 to 3 Total Absence From School 2 6 1 0 9 Allegation Against A Professional 1 2 6 0 9 Behavioural Issues 55 52 26 7 140 Bullying 4 7 1 0 12 Child Alcohol/Drug Misuse 9 7 0 0 16 Child Has A Disability 10 17 21 10 58 Child Mental Health Issues 29 23 4 0 56 Contact Dispute 0 10 26 11 47 Domestic Violence 23 88 202 310 623 Emotional Abuse 2 8 18 9 37 Families With NRPF 1 11 25 29 66 Family Member Involved In Offending Behaviour 15 18 38 21 92 Housing Issues 60 34 68 58 220 Immigration 2 1 5 3 11 Low Income/Financial Support 3 3 2 7 15 Missing Person 34 43 6 0 83 Need For Family Support 24 33 35 36 128 Need For Info 50 89 131 81 351 Neglect 16 53 89 98 256 Offending Behaviour 64 29 4 3 100 Parental Alcohol/Drug Misuse 5 17 39 35 96 Parental Illness - Mental And Physical 12 41 75 62 190 Physical Abuse 35 63 86 31 215 Pre-Birth Concern 2 0 1 64 67 Sexual Abuse 7 28 23 10 68 Sexual Exploitation 11 12 6 5 34 UASC 19 1 0 0 20 Universal Services 4 7 7 13 31 Victim Of Crime 28 22 12 4 66

15 Version published 1st August 2014 Presenting Need 16+ 10 to 15 4 to 9 0 to 3 Total Other 9 11 12 4 36 Total 536 736 969 916 3157 Contacts to Children’s Social Care which led to no further action (NFA)

No further action (NFA) for a contact means that the case did not meet the threshold for social services and onward referral. When we look at the presenting needs in the table below, we find that more than one in five contacts (22%) to children’s social care for domestic violence did not result in any further action.

One in ten of contacts for offending behaviour did not lead to further involvement by social care. About 8 per cent of contacts for behavioural and housing issues did not result in further action being undertaken by social care. These are the issues that need to be identified early and addressed by tiers 1-3 services.

Table 6 Presenting issue to social care which led to no further action (NFA)

Number Percent Of NFA At Of NFA At Presenting Issue Contact Contact Domestic Violence 160 21.7 Offending Behaviour 72 9.8 Behavioural Issues 60 8.1 Housing Issues 59 8.0 Neglect 53 7.2

Interestingly 99% of all referrals made in 2013/14 had no previous referrals made to social care. It is difficult to infer from this but possibly suggests that appropriate signposting to relevant services at tiers 1-3 may have resolved issues for families as there were hardly any re-referrals.

The main presenting issues at point of contact which crossed the threshold for social care intervention

The conversation rates from contacts to assessment and from referrals to assessment by presenting issues were reviewed. Contact is a ‘contact received by children’s social services on a new or closed case’. Referral is defined as ‘contact that is deemed to need further children’s social services involvement’.

The data in Appendix 1 shows the main presenting issues at the point of contact were broadly the same issues that crossed the threshold for a referral and

16 Version published 1st August 2014 subsequent assessment. The presenting issues are domestic violence, physical abuse/neglect, housing, need for family support and parental illness (physical/mental health) as well as parental substance misuse.

In general, the conversation rates from contact to assessment were low but the conversation rates from referral to assessment were high suggesting that these presenting issues need to be the focus of early help in order to reduce the number of children presenting to social care with greater severity of these issues. For example, among families with children from 0-3 years, only one in five contacts (21%) presenting with domestic violence (DV) as an issue went on to assessment but 90% of referrals into social care for DV went on to assessment by Social Care.

Behavioural issues for children were a presenting need at social service for all ages especially for children aged 10 years or above coinciding with secondary school. A behavioural issue does not necessarily mean a child has a possible mental health problem but disruptive or withdrawn behaviours can be symptomatic of an underlying mental health problem and may escalate into offending behaviour and expulsion from school which impacts on young person’s life chances.

Among families with children from 10-15 years, only 8% of contacts led to an assessment but 87% of referrals for the same presenting issue led to an assessment. It suggests that there needs to be clearer pathways into appropriate services especially from schools about pupils and/or their families who are exposed to this risk factor and co-present with other risk factors mentioned in the needs assessment.

Similarly among families with children who are 16 years and older, housing issues accounted for two in five contacts to social care which went on to assessment but 82% of referrals into social care for housing issues led to further assessment.

There is a caveat in that the actual base numbers of contacts and referrals by presenting issue vary which affects the proportions but the general point of earlier intervention around these presenting issues remains valid.

The tables and graphs for each age group the number of contacts and referrals by presenting need and conversion rates from contact to assessment and referrals to assessment are found in Appendix 1 of this report.

Population Estimates for Haringey

Current population estimates are taken from GLA data (2013) with population estimates reported for 2014 and 2015. The inferences are based on 2014 data. Base tables are found in Appendix 1 of the report.

The GLA estimates shows that the largest proportion of children from 4-9 years inclusive reside in Seven Sisters followed (in descending order) by Northumberland Park, Tottenham Hale, Bruce Grove, White Hart Lane and St Ann’s.

17 Version published 1st August 2014 GLA population estimates data (which includes future year projections) identify the largest proportion of children from 10 – 15 years reside in Seven Sisters followed by White Hart Lane, Tottenham Hale, Northumberland Park, Tottenham Green, Bruce Grove, Fortis Green, West Green and Noel Park. Refer to Tables 12-14 inclusive in Appendix 1 for actual data.

The most number of young people aged 16 – 25 years inclusive reside in Tottenham Hale followed by Noel Park, Northumberland Park, St Ann’s, Seven Sister, Tottenham Green, Bruce Grove, Woodside, Bounds Green and Harringay. Refer to Table x in Appendix

Data for 0-3 population is found in the next section.

Early Years (0-5) including pre-natal

The most important years for a child’s survival, growth and development are prenatally through the transition to school, with the fastest period of growth occurring during the first three to four years of life when the child’s brain is rapidly growing and adapting to the environment.

A child’s early development score at 22 months is an accurate predictor of educational outcomes at age 26, which in turn is related to long-term health outcomes (Improving the public’s health; a resource for Local Authorities, Kings Fund, 2013).

Beginning with a healthy pregnancy, a safe birth and a strong bond between a baby and its parents is vital. While it has been acknowledged for some time that this phase strongly influences outcomes in later life, recent evidence reinforces the importance of early intervention to reduce the impact of stress in pregnancy and to promote attachment and this is particularly true for children born into disadvantaged circumstances. Many problems which occur later in life, and lead to enormous expenditure on service provision, arise because children did not receive appropriate support in their early years.

For the purpose of aiding identification of vulnerable families, the following indicators were explored; population by ward, access to children’s centres, mortality rates, CAFs initiated, low birth weight, early access to maternity provision, breastfeeding and childhood obesity.

The table below shows the 2013 GLA ward level population projections for 0-3 year olds. The highest number of children under 3 reside in Seven Sisters, followed closely by Northumberland Park, Tottenham Green, Tottenham Hale, Bruce Grove, St Ann’s, Woodside and White Hart Lane.

18 Version published 1st August 2014 Table 7 2013 GLA population projections for children 0-3 years for 2014 and 2015

Ranking based on Borough Ward Name Year total 0-3 years 2014 population Name data Haringey Alexandra 2014 665 Haringey Alexandra 2015 651 Haringey Bounds Green 2014 813 Haringey Bounds Green 2015 797 Haringey Bruce Grove 2014 984 5 Haringey Bruce Grove 2015 990 Haringey Crouch End 2014 674 Haringey Crouch End 2015 661 Haringey Fortis Green 2014 640 Haringey Fortis Green 2015 641 Haringey Harringay 2014 799 Haringey Harringay 2015 795 Haringey Highgate 2014 551 Haringey Highgate 2015 535 Haringey Hornsey 2014 745 Haringey Hornsey 2015 737 Haringey Muswell Hill 2014 553 Haringey Muswell Hill 2015 537 Haringey Noel Park 2014 800 Haringey Noel Park 2015 801 Haringey Northumberland Park 2014 1072 2 Haringey Northumberland Park 2015 1091 Haringey St Ann's 2014 903 6 Haringey St Ann's 2015 908 Haringey Seven Sisters 2014 1166 1 Haringey Seven Sisters 2015 1144 Haringey Stroud Green 2014 574 Haringey Stroud Green 2015 570 Haringey Tottenham Green 2014 1066 3 Haringey Tottenham Green 2015 1094 Haringey Tottenham Hale 2014 1064 4 Haringey Tottenham Hale 2015 1113 Haringey West Green 2014 750 Haringey West Green 2015 759 Haringey White Hart Lane 2014 840 8 Haringey White Hart Lane 2015 848 Haringey Woodside 2014 880 7 Haringey Woodside 2015 882

19 Version published 1st August 2014 Access to children’s centres

A review of children’s centres and attached childcare by Cordis Bright (June 2013) identified that Haringey Children’s Centres are limited in their capacity to identify and engage more vulnerable children and families. Constraints include existing staffing resource and limited identification and referral of more vulnerable children and families to Children’s Centres from other agencies.

The Children’s Centres with the lowest average attendance tended to have the lowest percentage of children (0-4 years) living in poverty. Activities specifically providing services for parents and carers showed higher levels of reach included antenatal/ postnatal/ midwife and employment or training provision.

Only half (51%) of the children living in the most deprived areas of the borough achieved a good level of development in the Early Years Foundation stage compared to 64% children living in other areas (Income deprivation Affecting Children Index -IDACI). The most deprived areas are in the east of the borough; in particular Northumberland Park, White Hart Lane, Seven Sisters, Tottenham Green and Tottenham Hale all of which have more than 50% of households on benefits and which correspond roughly to the largest proportion of children under five years in the borough.

In terms of CAFs generated in 2012/13, over a third (36%) of all CAFs were completed for children under five years while nearly half of CAFs completed were for children between 5-11 years (48%). Low numbers were undertaken in Early Years from both Children’s Centres and Early Years Health Professionals (n=77). This has been flagged as a cause for concern.

Mortality Rate

The perinatal mortality rate for 2009-11 for London was 7.9 per 1,000 births which is higher than the average for England (7.5 per 1,000 births). Haringey is above the London and England rates being at the higher end of the range 7.9-8.6 per 1,000 births. (source: PHE ChiMat using HES data).

The Infant mortality rate for Haringey is 4.66 per 1,000 live births which is higher than the London (4.34 per 1,000 live births) and England rates (4.29 per 1,000 live births).

Low birth weight

Low birth weight has been linked to increased instances of stillbirth, neonatal death, neurological abnormality, acute chronic illness, cardiovascular disease and hypertension in adult life.

The proportion of low birth weight term babies in 2011 was significantly higher in London (3.2%) than for England (2.8%). Haringey is just above the London top quartile (6.9% compared with 6.4%)

20 Version published 1st August 2014 The percentage of babies born with a low birth weight (under 2500g) reveal that White Hart Lane has the highest rate (12.3%) followed by Northumberland Park (11.5%) and St Ann’s (11.3%).

Early access to maternity services

Of the 19 wards in Haringey, Bruce Grove has the lowest proportion of women booking early (under 13 weeks); White Hart Lane the 3rd lowest; Northumberland Park the 4th and Tottenham Hale the 5th lowest. In terms of other characteristics women aged under 20 and Black African women living in the east of the borough are most likely to book late for antenatal care. The following characteristics also increase the probability of late booking:

o Women who are substance misusers (including drugs and/or alcohol)

o Recent migrants, refugees, asylum seekers, and women with little or no English

o Young women aged under 20 years

o Women experiencing domestic violence and abuse

Breastfeeding

Department of Health guidance states that babies should be exclusively breastfed until 6 months of age. When looking at exclusive breastfeeding, White Hart Lane ward has the lowest exclusive breastfeeding rate in Haringey at 30.3%; Bruce Grove has the 3rd lowest rate; Northumberland Park the 4th lowest and Tottenham Hale the 6th lowest.

Exclusive breastfeeding is highest in wards in the west of Haringey; the highest rate is in Alexandra ward at 67.4%. There is real inequality in breastfeeding rates across Haringey with exclusive breastfeeding rates in west Haringey wards more than double those in the four identified wards.

Childhood obesity

In Haringey, about one in five children aged 4-5 years are overweight or obese (22.7%) compared with the London top quartile (19.6%).

Children in Reception year (age 4/5) and Year 6 (age 10/11) are measured every year as part of the National Child Measurement Programme.

Data from the Tottenham Social Regeneration Indicators show that Tottenham Hale has the highest proportion of pupils 4-5 years who are overweight or obese in Haringey (36.2%), followed by White Hart Lane (31.3%), Tottenham Green (30.7%)and Bruce Grove (30.6%).

21 Version published 1st August 2014 Deprivation and Child Poverty

Health and life expectancy are still linked to social circumstances and child poverty. Poverty is associated with a higher risk of illness and premature death and the effects on health may persist throughout the life course. In addition, poverty has significant consequences in terms of both the physical health of preschool children and their wider functioning (e.g. language development).

Haringey is one of the most deprived authorities in the country, ranking 13 out of 326 (where 1 is most deprived) English Local Authorities. It is the 4th most deprived borough in London after Hackney, Newham and Tower Hamlets. The east of the borough and the north east in particular has more LSOAs within the most deprived 20% in England (80 out of 144 LSOAs in Haringey).

Based on review of data of LSOA across England, Child Poverty statistics and also from the Tottenham Social Regeneration Indictors (Strategy & Business Intelligence), the most deprived wards are Northumberland Park followed by White Hart Lane, Tottenham Green, Tottenham Hale and Bruce Grove.

Child Poverty

The Child Poverty Act 2010 outlines several different measures of poverty. The most commonly used proxy measure at a local level is the proportion of children in families in receipt of out of work benefits, or in receipt of tax credits where their reported income is less than 60% of median income. Using this definition Haringey has seen a 10% fall in the percentage of children living in poverty since 2007.

In 2011, there were 19,205 children (nearly one in three) living in poverty in Haringey (32%). This is the 9th highest child poverty rate in London and the 14th highest across England GLA intelligence (2013) Child in poverty update.

Children living in poverty are likely to be in the east of the borough. The three wards with the highest child poverty rates are: White Hart Lane (45.0%), Northumberland Park (47.7%) and Noel Park (42.7%). Tottenham Hale, Tottenham Green and Hornsey have also significant levels of poverty affecting children.

22 Version published 1st August 2014 Figure 1 Identification of wards in Haringey by Index of Multiple Deprivation from most deprived to least deprived

Families in receipt of out of work benefits or tax credits

When data was examined for families in receipt of benefits or classed as workless households, more than one in four children (28.0%) live in a household where no adult is in work; this is below the London (28.2%) and England (32.6%) averages. 7.2% of Haringey Households have no adult in work and dependent children; this is higher than London (4.2%) and England (5.7%).

The Job Seeker Allowance (JSA) claimant count was 7,551 at April 2014, or 4.1% of the total working age population (16-64); Haringey rates are significantly above the London (2.8%) and England (2.7%) rates.

The number of households claiming Job Seekers Allowance in May 2013 shows that nearly one in ten people from Northumberland Park claimed JSA (9.2%). This is the highest rate in London. JSA claimant data for Tottenham Hale (6.8%), Tottenham Green (6.7%) and Bruce Grove (6.6%) are the 8 th , 9 th and 10 th highest rates in London respectively. In addition, data for the 18-24 age cohort revealed that Haringey has a higher number of this age group in receipt of JSA than London (6.4% compared with 4.7%).

23 Version published 1st August 2014 When data on out of work benefits claimed was reviewed for 18-64 year olds, Haringey exceeds the average rates across London (13.4% compared with 10.4%).

In Haringey, Northumberland Park had more residents claiming out of work benefits (27.8%) followed by Tottenham Hale (21.7%), Bruce Grove (21.2%), White Hart Lane (21.4%), Tottenham Green (21.1%) and West Green (18.7%).

The proportion of children from 0-19 years who live in households that claim council tax benefits is over half (52.1%). The eastern part of Seven Sisters ward has a high concentration of children living in workless families claiming Housing Benefit and Council Tax Benefit (75.5%) followed by Northumberland Park (69.9% of 0-19 year olds living in households) and Hornsey (42.2%)

People from most ethnic minority groups are generally more deprived in terms of socio-economic status, and poverty (APHO Ethnicity and health). Knowing the percentage of the population which are BME can help with the planning of services.

The largest BME groups which are most likely to be on housing benefit (HB) and with children attending Haringey schools are White Irish Travellers, Somalis, Kurdish, Kosovan and Turkish.

4,950 people moved to Haringey from overseas (ONS 2009/10).This is 21.9 per 1000 of the population (13th highest rate in London).

The largest number of registrations for national insurance locally over the last three years has come from people from Poland, Hungary and Bulgaria. The number of asylum seekers supported in accommodation was 190 at March 2011 (latest figures from the Home Office).

Free school meals

Free school meals was reviewed as another indicator of child poverty as children who are eligible achieve lower levels than those not eligible for FSM at Foundation Stage, Key Stage 2 and GCSE.

The proportion of children entitled to free school meals is higher in Haringey for children in primary and secondary schools. Over one in four children are eligible for free school meals in primary (26.4%) compared with the national average of 18%. A third of children are entitled to free school meals in secondary schools (32.6%) which is above the national average of 15.1%.

87% of children eligible for free school meals live in the east, with the highest numbers in Northumberland Park, Tottenham Hale and Hornsey wards.

24 Version published 1st August 2014 Lone parent families with dependent children

According to the Child Poverty Strategy, nearly three quarters of children in poverty are living in lone parent households (72.6%). Lone parents head up 27 per cent of all households with dependent children in Haringey which is a much higher proportion than for both London (21 per cent) and England (17 per cent). There are more lone parents in Northumberland Park ward than any other ward (n=1045).

Being in work is a buffer against depression as lone mothers who stay at home are more likely to suffer from depression.

Unstable housing including overcrowding, being in temporary accommodation and homelessness

Overcrowding is defined here as households with at least one room less than the number required for the household. Research demonstrates the link between overcrowded conditions and children’s ill-health. Living in substandard housing can have a profound impact on a child’s physical and mental development with implications for both their immediate and future life chances.

4.7%of children and young people from 0-18 year olds live in overcrowded households (2,443 children). Wood Green has the highest proportion of children and young people aged 0-18 years living in overcrowded households (8.6%) followed by Northumberland Park (8.1%) and Stroud Green (5.3%). West Green also has significant numbers of children lived in overcrowded households.

Haringey has significant levels of homelessness with just under 3000 homeless households living in temporary accommodation, among the highest in the country (Community Safety Strategic Assessment 2012-13). Nearly one in three of the borough’s households are living in social housing but there is a marked difference across wards in terms of the proportion of households in social housing. In the west, one in five households are living in social housing compared with areas in the east such as Tottenham with 40% living in social housing. White Hart Lane and Northumberland Park have particularly high levels of social housing (55% and 53% respectively).

4,190 children live in temporary accommodation. This represents 8.0% of the total number of children. 94% of households in temporary accommodation (TA) have dependent children (as of July 2014). The majority of households in temporary accommodation are lone parent families (73%).

There are higher levels of benefit dependency for those living in temporary accommodation with only one in three households in paid employment (31%). Working households in temporary accommodation are generally low paid and depend on working tax credit and housing benefit to supplement their earnings. Of those in temporary accommodation, over half were in receipt of JSA/Income support benefits (58%) and over one in 10 families living in temporary accommodation were receiving disability benefits.

25 Version published 1st August 2014 Black and Minority Ethnic (BME) households are overrepresented in TA with Black African households making up 22% of families in TA.

Mental health

Children and young people living in Haringey are potentially at greater risk of developing mental health problems than those living in both London and England as a whole.

Socio-economic factors play a significant role in the development of mental health problems and with high rates of deprivation and unemployment, particularly in the centre and east of the borough; certain groups of children and young people living in Haringey are at greater risk.

Children of parents with mental health problems are also at risk of experiencing mental ill health; levels of mental illness in adults in Haringey are nearly twice the national average. Common mental health disorders in children are conduct disorder, anxiety disorder, attention deficit hyperactivity disorder and depression (source: Child and Adolescent mental health survey 2004).

In Haringey, hospital admissions for mental health disorders in children 0-17 years were higher than the London average (87.1 per 100,000) and England rate (87.6 per 100,000). The Haringey figures cite 89.3 per 100,000 (source: Public Health England Chimat).

Hospital admissions as a result of self-harm in young people aged 10-24 years were lower in Haringey (199.4 per 100,000) compared with London (201.0 per 100,000) and England (346.3 per 100,000), Public Health England CHIMAT.

In view of the strong link between deprivation and mental health problems in children and young people, it is likely that prevalence rates are higher in the centre and east of the borough.

Children with long term physical illness/disability as well as those children who have a statement of special education needs are especially vulnerable to mental ill health. Children with mental ill health are three times more likely than other children to have special education needs.

Young offenders are also at high risk of suffering mental ill health; it is estimated that up to 40 per cent of young people in the youth justice system have mental ill health. Comparison of prevalence rates among young people in custody with young people in the general population show that young people in custody are at least five times

26 Version published 1st August 2014 more likely to be identified with learning disabilities , at least four times more likely to be dyslexic, about nine times more likely to have communication disorders (60-90% compared with 5-7% among young people in the general population), and are twice as likely to have had traumatic brain injury and fetal alcohol syndrome compared with young people in the general population.

Children and young people who have a parent with mental ill health are at greater risk of mental ill health themselves. Local data from GP registers (Quality and Outcomes Framework) suggest that 1.5 per cent of Haringey’s adult population have a mental health problem which is almost twice the national rate of 0.8 per cent.

Children aged 11 to 16 years from Black ethnic groups have a higher prevalence of mental health problems than other groups. Over 28 per cent of children living in Haringey are from Black ethnic groups.

Current data from CAMHS as of March 2014 confirm the trend for the majority of referrals into CAMHS for children and young people aged 10-18 years; 40% of children referred into CAMHS tier 3 were 10-14 years old. About one in five referrals were made for children age 5-9 years and nearly a third (31%) were referred into CAMHS among the 15-18 year age range.

A greater number of boys were referred in the 5-9 age group which bucks the trend for other age groups in which there was a greater number of girls referred among 0- 4, 10-14 and 15-18 years.

The greatest numbers of referrals were from General Practitioners, equating to 45%. Local Authority referrals were mainly from Education (24%) and Social Services (14%).

Substance Misuse (drug and alcohol)

Children of parents or carers who misuse drugs or alcohol are more likely to develop misuse and/or mental health problems themselves (ACMD, 2003; DfES, 2005). These comprise a set of risk-taking behaviours, which along with other risk factors (e.g. social deprivation) may lead to other risk taking (e.g. unprotected sex) and criminal behaviour.

In 2012/13, around one in seven (14%) of adult clients who presented to drug treatment were living with children. This was higher in alcohol treatment where a little over one in four (26%) were living with children. This gives some indication of the potential hidden harm that local children and young people may be experiencing

27 Version published 1st August 2014 because of parental substance misuse. Reaching those parents who are not in contact with, or have dropped out of treatment, is a priority.

The majority of young people who seek help for substance misuse have other emotional or social problems, such as self-harming, offending and family issues. Studies have shown that young people from more than one vulnerable group are more at risk of drug or alcohol misuse (DfES: 2005; The NHS Information Centre, 2011). The groups at risk are:

 Young offenders

 Looked after children

 Care leavers

 Children affected by parental substance misuse

 Children affected by domestic violence and abuse

 Homeless young people

 Young people at risk from sexual exploitation

 Young people in gangs or at risk of gang recruitment

 Excludees and persistent truants

NTA’s analysis (2012/13) revealed that the proportion of parents receiving treatment in Haringey was one of the highest in London with 166 children and 110 parents seen by Cosmic, the agency that provides support for children affected by parental substance misuse.

Data from Haringey adult drug treatment services in 2012-13 indicated that the adult treatment population experienced a range of social issues:

 Housing problems were reported by almost one in three (30%) new clients - over one in ten (12%) had no fixed abode.

 One in seven (14%) adults were drug treatment clients who came via the criminal justice system

 Nearly one in three (31%) adults had a dual diagnosis, a term used to describe a co-existing mental health and substance misuse problem

 Only one in seven (14%) adult clients were in employment at the start of their treatment

28 Version published 1st August 2014 In terms of children; the number of referrals to specialist drug or alcohol treatment from services who may be in contact with vulnerable young people, including Looked After Children and CAMHS is low (4%) compared to nationally (17%). The majority of referrals for vulnerable young people to specialist treatment come from the Youth Offending Service - 41% compared to 34% nationally.

Data from Public Health England suggest an increasing trend among young people being treated for substance misuse over 2011/12 and 2012/13. Almost half of the referrals in 2012/13 came from Education Services (48%) followed by Youth Justice Services (31%) and Families, friends or self-referral (9%).There were comparatively low numbers of referrals from Children and families services (6%).

Recent performance data for 2012-13 reveals that 171 young people between 13-21 years were treated for substance misuse. Of this sample, nearly half of the young people in treatment were White British or White other (49%). About one in 5 young people in treatment was Black other (22%) while just over one in 10 were Black Caribbean (11%).

In Haringey, there are a larger proportion of girls 0-17 years in treatment (39%) compared to the National average for females in treatment (34%).

Among the age group sampled, most of the service users were at the younger end of the 13-21 year age range with nearly three quarters aged between 13-15 years (72%). The main drugs of choice remain cannabis and alcohol.

Alcohol

The exact prevalence of drug and alcohol misuse amongst children and young people and the need for substance misuse interventions is difficult to establish both at a local and national level. This is partly due to the hidden nature of such use and also due to the lack of early identification of substance misuse in universal and, to a lesser extent, targeted services (Haringey Drug and Alcohol Action Team, 2010).

It is estimated that there were 32.7 alcohol related hospital admissions per 100,000 among the 0-18 population in Haringey (Local Alcohol Profiles for England 2013). Note that the accuracy of alcohol admission rates is affected by how hospitals clinically record this data which remains variable. One in 3 referrals to specialist treatment came from the youth offending service and 1 in 4 from education services in 2012/13.

According to a local survey (Haringey Council and NHS Haringey, 2009) of primary school pupils aged 10-11(sample size n=656), 8 per cent of boys and 3 per cent of

29 Version published 1st August 2014 girls reported having drunk an alcoholic drink in the week before the survey but most pupils (91%) did not drink alcohol.

15 per cent of pupils had drunk alcohol in the week before the survey and 7 per cent had been drunk. 7 per cent of year 10 boys and 2 per cent of year 10 girls had drunk over the advised weekly limit for adult females of 14 units (Haringey Council and NHS Haringey, 2009).

The lack of consistent screening, recording and the overall low number of onward referrals to the specialist substance misuse services, means that local specialist treatment data is likely to be an underestimate of the prevalence of substance misuse amongst vulnerable young people locally.

The lower than expected referral rates from Social Care and the CAMHS services (4%) locally suggest that substance misuse is not systematically screened and addressed and that therefore opportunities for early intervention are being missed. Self referrals to the substance misuse services are also lower than nationally which points to issues around accessibility and publicity of services.

The proportionally higher rate of referrals from the youth offending service, on the other hand, is likely to do with the low numbers coming via other services than a higher prevalence of substance misuse in that service, however, conversely it could also indicate that it is only when young people are in contact with the criminal justice system that their substance misuse is being identified.

Teenage pregnancy

A need has been identified to join up sexual health work streams with young people and the substance misuse agenda - particularly in the light of Haringey’s high teenage pregnancy rates compared to London and England averages.

Haringey has a rate of under 18 conceptions of 36.2 per 1000 (Impower 2013) which is higher than the London rate (34.3 per 1000) and England rate (30.9 per 1000). Haringey is fifth highest borough for teenage pregnancy rates behind Lewisham, Barking & Dagenham, Greenwich and Lambeth (source: ONS).

In terms of wards, Bruce Grove, Tottenham Green and Harringay have the highest teenage conception rates.

The study, Teenage Pregnancy in England, by the Centre for Analysis of Youth Transition, highlighted that the girls most at risk of pregnancy before 18 were those:

30 Version published 1st August 2014  Eligible for free school meals

 Persistently absent from school

 Making slower progress than expected academic progress between key stages 2 and 3(ages 11-14) (Crawford et al, 2013).

Other risk factors are:

 Being in care or a care leaver

 Experiencing sexual abuse and exploitation

 Alcohol use and misuse

 Having had a previous pregnancy

Research evidence identified key risk factors which are known to increase the likelihood of teenage pregnancy. These are risky behaviours; education-related factors and family and social circumstances.

Risky behaviours include early onset of sexual activity, poor contraceptive use, mental health/conduct disorder/involvement in crime, repeat abortions, teenage motherhood, alcohol and substance misuse

Education-related factors including leaving school at 16 with no qualifications, disengagement from school, low educational attainment and poor attendance at school.

Family/background factors including parental aspirations, ethnicity, daughter of a teenage mother, being in care or a care leaver. Data on mothers giving birth under age 19, identified from the 2001 Census, show rates of teenage motherhood are significantly higher among mothers of ‘Mixed White and Black Caribbean’, ‘Other Black’ and ‘Black Caribbean’ ethnicity. ‘White British’ mothers are also overrepresented among teenage mothers, while all Asian ethnic groups are under- represented.

Violence against Women and girls (domestic violence)

Data presented in this needs assessment on the incidence and prevalence of domestic violence needs to be considered in the context of information that shows who and where people are more likely to report domestic violence.

31 Version published 1st August 2014 Research shows that this issue is significantly under-reported. Domestic violence is more likely to be kept secret; disclosure will usually happen either during immediate crisis when the police are needed or may emerge after a long process of reflection. It is difficult to accurately calculate in terms of incidence and prevalence as domestic violence is a phenomenon that is NOT confined to a particular group, type of people or to a particular geographical area. The data in this section should be read with this caveat in mind.

Violence against women and girls is defined as ‘ Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse: psychological, physical, sexual, financial, and emotional’.

Crime Survey of England and Wales, (CSEW) produces prevalence figures but have difficulty encouraging full disclosure. It makes it difficult therefore to estimate accurately the prevalence of the issue.

There is a high correlation between the domestic violence (DV) offence rates and areas of deprivation as there are higher DV rates in low income areas and declining domestic violence offence rates associated with higher income and education areas. This picture is synonymous with police recorded data and data from agencies supporting people seeking refuge from DV.

Domestic violence offences account for 35% of all violence against the person (2011-2012 data). A significant majority of DV offences are in the east of the borough. Northumberland Park, Bruce grove and Tottenham hale have the highest numbers in the borough.

Data on female hospital admissions for assault can be used as a proxy for Violence against Women and Girls where more serious injury is caused. Admission figures confirm the trend for higher reporting for the east of the borough.

However it is important to note that Alexandra, Highgate and Stroud Green wards have DV rates as a proportion of all violent offences which are higher than the Haringey average of 33%. Research suggests that generally, some victims with a higher socioeconomic status are reluctant to involve the authorities.

Data from Haringey domestic violence Strategic Assessment (2012/13) incorporates police recorded crime data. There were 1,774 DV offences in the twelve months to December 2013, a modest increase of 6% (92 additional offences) compared to 2012. This represents a significant fall in the rate of increase compared to 2012 which saw a 19% annual increase. DV across London followed a similar increase

32 Version published 1st August 2014 over the last 24 months (2011/12 and 2012/13) but increased only by 6 % annually per year.

A significant majority (78%) of recorded DV offences are in the east of the borough. In the 12 months to December 2013, Tottenham Hale was the worst affected ward (n=133 offences) followed by Northumberland Park (n=123 offences) and Bruce Grove (n=105 offences). Collectively these three wards account for over a quarter (27%) of all recorded DV offences. Wood Green (Noel Park) also had high numbers of DV offences.

Victims of domestic violence are more likely to be identified among Black Caribbean, followed closely by White British and White other populations. Women are more likely to experience domestic abuse compared with males (7% compared with 5% of males). Domestic Violence victims are mostly aged between 21-30 years. More than one in three of DV victims have been the victim of another offence in the previous twelve months (2011-12 data). Other ethnicities which are more likely to be victims are Polish, Lithuanian and Romanian nationals.

Data based on analysis of offenders for domestic violence commencing community sentences between October 2011 and September 2012 revealed the profile of perpetrators were more likely to be male (93%) of which 60% were young men between 18-34 years. Ex-partner (42.1%) and husband (33/2%) are the most likely relationship between victim and perpetrator. In terms of ethnicity, Black Caribbean, White Other and White British are over-represented in this group compared to the ethnic composition of Haringey.

Among the offender cohort, two thirds were flagged as having mental health problems (67%), more than a third had alcohol misuse problems (38%) and about one in two had substance misuse problems.

The LSOA covering Campsbourne estate in Hornsey is the only one in the west with a rate greater than the borough average. The lower offending rates seen in the west do not mean DV is not happening there; rather they highlight the possible issue of under-reporting associated with DV, especially in more affluent areas.

The top 3 wards for DV repeat offences comprising 30% of all repeats are Northumberland Park (75 repeat offences), Tottenham Hale (70) and Bruce Grove (66). Two thirds of all DV offences in White Hart Lane (66%) and West Green (65%) are repeats; Bruce Grove (63%), Harringay (62%) and Northumberland Park (61%) also have high percentages of repeats.

33 Version published 1st August 2014 Out of the 77 venues identified as having 5 or more repeat offences, Tottenham Hale had the vast majority with 23, more than double the rates for Seven Sisters and Harringay with 11 and 10 repeat offences respectively; possibly indicating areas where victimisation is most acute. Interestingly, despite its high offending rate and repeat percentage, Northumberland Park had no venues with 5 or more offences. This implies that multiple offending is more dispersed throughout the ward rather than being spatially fixed.

Haringey’s seasonal peaks over the last two years (2011-12 and 2012-13) are during the summer and autumn periods, with the average daily number of offences peaking in October.

This is generally linked to the warmer weather and longer daylight hours resulting in increased levels of socialising and associated drinking. There are also popular celebrations and bank holidays (Halloween, Bonfire Night, Christmas and New Year) during these periods that contribute. November and December recorded the highest monthly increases of 26% and 38% respectively.

Fig 2 Reported Domestic Violence offences by Lower Super Output Area (LSOA) across Haringey (for the year ending December 2013)

The key risk factor for being a victim of all forms of domestic and gender based violence is being female. Other risk factors of domestic violence are:

34 Version published 1st August 2014  age (women in younger age groups, in particular 16-24 year-olds are at greatest risk; this is also a risk factor for experiencing sexual violence)  Ex-partner (42.1%) and husband (33.2%) is the most likely relationship between victim and perpetrator  pregnancy (the greatest risk is for teenage mothers and during the period just after a woman has given birth (Harrykissoon et al. 2002)  long-term illness or disability (women and men with a long-term illness or disability were almost twice as likely to experience DV as others)  being in a lesbian, gay or bisexual relationship (Home Office 2010a)  Over two thirds of offenders flagged with DV issues are identified as having mental health issues and half of offenders were recorded as having a substance misuse issue.

Different forms of gender based violence can intersect, for example a perpetrator of domestic violence against his wife could also perpetrate ‘honour’-based abuse against his (female or male) children. Those most at risk of female genital mutilation, ‘honour’- based abuse and forced marriage are girls under the age of 18. At the Whittington FGM service in 2012-13, 96 women were recorded to have undergone FGM.

Crime and antisocial behaviour

The overall violent crime rate is below the London average. The more serious types of violent crime account for nearly half of all crime in Haringey (47% compared to 40% in London).

Forty one per cent of all crime is committed in five wards: Noel Park, Tottenham Green, Northumberland Park, Tottenham Hale and Bruce Grove. Primary crime hotspots are focused on two main town centres in Wood Green and Tottenham.

Offenders are more likely to be males, in the age group 18-24 years with Black Caribbean and Black African Groups more likely than average to be offenders. Low aspirations are a risk factor which increases likelihood of becoming an offender.

Almost a third of offenders are identified as having mental ill health. Drug misuse is particularly associated with crime; 30% of offenders have alcohol misuse linked to their offending.

Data for 2012/13 (Community Safety Strategic Assessment 2012/13) revealed that there were 350 young offenders in Haringey who are highly over-represented for

35 Version published 1st August 2014 serious crimes accounting for almost 10% of offences. The youth offending rate is 49.5% which is much higher than the London average of 40.5%. Nearly half (45%) of young offenders aged 10-17 years re-offend within a year which is higher than London rates and other boroughs.

An assessment of offenders by Community Safety in 2014 showed that for 1,046 offenders who commenced probation this year, four out of ten violent offenders are between 25-34 years while about one in three are in the 18-24 age range. At least 20% of offenders have alcohol misuse linked to their offending with nearly one in four having mental health issues identified by probation (24%).

At least 37% of offenders are unemployed but this figure may be much higher. The re- offending rate for adults is 35.5% compared to a London average of 33.5% (Oct 09 to Sept 10). However the offending rate for young people is extremely high (44.7%) compared to the London average of 37.9% (Oct 09 to Sept 10).

Haringey has the second highest proportion of female offenders under statutory supervision across all London Boroughs.

Tottenham Social Regeneration Indicators reveal that Haringey’s performance figures for crimes which are a basket of key neighbourhood crimes comprising violence with injury, robbery, burglary, vandalism (criminal damage), theft from the person, theft of motor vehicles and theft from motor vehicles are higher than the London median (49.3% compared with 29%). Within Haringey, the wards with the highest figures for the above neighbourhood crimes are Northumberland Park (62%), closely followed by Tottenham Green (61.8%), and Tottenham Hale (50.3%).

The majority of those accused of knife and gun crime are aged between 15 and 24 years. Fifty-eight per cent of those accused of offences linked to gangs are between 15 and 17 years. The rates of violence with injury are higher in Haringey compared with the London Top Quartile data (8.6 compared with 5.3). Hotspots in Haringey are Tottenham Green, Noel Park, Northumberland Park and Tottenham Hale.

Domestic violence accounts for over a third of all violent crime.

The 10-17 year age group are more likely to engage in crime, gang related offences and crime involving personal robbery. 58% of those accused of gang-related offences

36 Version published 1st August 2014 are aged 15-17. The majority of people involved in gangs live in Tottenham and Wood Green. (Data for Oct 2011 - Sep 2012.)

Hotspots for residential ASB, dumping, noise complaints and reported domestic violence are areas with high density housing, particularly large housing estates.

The top 5 wards for ASB calls are Noel Park, Tottenham Green, Northumberland Park, Tottenham Hale and St. Ann’s, all situated in the east which also have far higher concentrations of people from black and ethnic minority backgrounds. In addition to high ASB incidents, these top 5 wards correspond to areas of highest deprivation in the borough.

The data shows that across anti social behaviour types, as both perpetrators and victims, Black and Ethnic Minorities are over represented. White British and 27% of ASB perpetrators are White British; 22% are White Other and 16% are Black Caribbean – highly overrepresented compared to their population size. By sex, women are 61% of ASB victims.

Across vulnerable groups, 10% of ASB incidents are alcohol related, with 20% of incidents that are youth related involving alcohol. More than one in five ( 21%) of incidents involve drugs with almost half of incidents involving young people being drugs related; 5% of incidents are mental health related; 4% of incidents are hate crime related (15 race and 6 homophobic).

Haringey’s Community Safety Partnership data 2013 reveals lower levels of violent offending, with serious youth crime offending down by a quarter in 2012/13 compared to the previous year.

Not being in education, employment or training

Data from the Audit Commission (2010) revealed that factors which contribute to being a NEET are in order of importance; low levels of education, pregnant, substance misuse, being a carer, immigrant background, disability and having parents who have experienced unemployment.

The positive association between education and health is well documented. Low income is a strong predictor of low educational performance. This feeds into disadvantage in adulthood and transmits poverty across generations. A primary cause of child poverty is a lack of opportunities among parents with low skills and low

37 Version published 1st August 2014 qualifications. (The Health & Wellbeing of children and young people in London: an evidence based resource, Public Health England, June 2014).

In 2013, 43%of NEETs were aged between 18-19 year olds; of which over half (57%) were male. Over represented ethnic groups are White Irish, White British, White and Black Caribbean, Black Caribbean and Other White.

There are 4.3% of children and young people (under 18 years) that are not in education employment or training as of June 2014. London has one in four young people between 16-24 years who is unemployed. Haringey is in the top five boroughs for NEET behind Southwark and Lambeth (Public Health England, June 2014, the Health & Wellbeing of children and young people in London).

Four in ten young people who were not in education, employment or training (44%) _ were persistently absent from school and/or had been excluded from school permanently or more than once on a fixed term basis at secondary school.

T he proportion of care leavers in education, training and employment has deteriorated from 63% in March 2013 to 47% in March 2014.

In addition as of June 2014, nearly one in ten 16-19 year olds (9%) are not accounted for or known in terms of their NEET status. This may mask the true number of NEETs.

White Hart Lane, Northumberland Park and Tottenham Green have the highest number of young people who are not in education, employment or training.

Gypsy and Traveller children experience low levels of attainment and access to secondary education. School attendance by Irish Traveller pupils in Haringey is below the national average. There are a significant number of GRT children missing education (especially Roma).

There are 591 children in care. Nearly a third (30%) of young people aged 16 years or above who are in care or care leavers are not in education, employment of training. In June 2013, 39% of teenage mothers were NEET and of youth offenders, one in four was not in education, employment or training.

Disabilities (physical/cognitive/emotional)

The current placement report (July 2014) reveals that since 2009 there has been a rising trend in the number of children with statements across the borough. There are

38 Version published 1st August 2014 1,451 children with statements in Haringey, the highest recorded in six years due to an increasing 0-19 years population, an increase in the staying-on rate of 16-19 age group as a result of provision at Haringey 6th form centre and an increase in the number of younger people receiving a statement. The average age of a child with a statement is 5-6 years old. The average age for having a statement has decreased since 2009 when the average age was 9/10 years of age.

Since 2009, the numbers of children diagnosed of autism has increased in both the primary and secondary school sector. Other primary needs have remained stable with the exception of Speech, Language and Communication which has also increased in terms of number of children diagnosed since 2009.

A current assessment of SEN provision across the borough shows that over a third of all provision (35%) caters for children with autism. There is a significant number of education places for children with physical difficulties (19% of places) followed closely by severe learning difficulties (17%) and hearing impairment (14%). Note that places means places at Special Schools, Sixth Forum and Resource Bases.

Between January 2013 and January 2014, the number of children accessing independent out of borough specialist provision has increased; of this cohort, 30% are for autism followed by provision that focuses on behaviour, emotional and social difficulty (24%) and provision for moderate learning disabilities (20%).

There are abound 53 children and young people who attend Orthodox Jewish specialist provision out of borough. In addition, Haringey has 82 children and young people with complex needs whose needs are met out of borough; this may be due to the complexity of needs, parental preference or a lack of provision in borough.

There are 54 children in care with statements of special education needs who are in placements outside Haringey.

Families of children with special educational needs are more likely to be on Housing Benefit (between 47- 48%) than those who are not SEN (36.4%). This is also true for free school meals with more families who have children with special education needs likely to be in receipt of free school meals that those families who are not SEN.

125 disabled parents with dependent children are known to social services. Nearly half of the disabled parents (n=60) live in Tottenham.

39 Version published 1st August 2014 A report on CAF for 2012-13 revealed that over twice as many assessments were made in relation to boys compared with girls who have Special Education needs; 600 compared to 297 but this gender split is in line with national SEN picture.

Low aspirations

The proportion of residents with no qualifications is highest in Tottenham with nearly one in four (23.4%) without qualifications compared with 17.8% across Haringey as a whole.

Only half (51%) of the children living in the most deprived areas of the borough achieved a good level of development in the Early Years Foundation stage compared to 64% children living in other areas (Income deprivation Affecting Children Index -IDACI).

2013 data on Key Stage 1 achievement in reading, writing, science and maths shows that the highest attainment for all subjects was found among pupils living in Alexandra, Crouch End, Stroud Green and Muswell Hill wards. Pupils living in wards of Northumberland Park, Tottenham Hale, Bruce Grove and Harringay were less likely to achieve at least Level 2B in reading, writing, maths and science.

Data for Key Stage 2 shows that three quarters of children in Haringey achieved level 4+ at Key Stage 2 which is below the London median of (79%). Within Haringey, over half of children living in St Ann’s ward achieved the KS2 level 4+ attainment level.

Interestingly, when data for Seven Sisters, Northumberland Park and Bruce Grove is reviewed, more children at Key Stage 2 reached level 4+ (77.5%, 67.7% and 75.4% respectively) but the proportion of children reaching Key Stage 4 (five plus GCSEs A*- C) declines. While the statistics for KS4 may be affected by other factors such as population in-flow (that is new arrivals into the wards), it seems reasonable to suggest that children moving from KS2 to KS4 within the wards of Seven Sisters, Northumberland Park and Bruce Grove may need to be given additional support in order to reduce the gap in achievement.

In terms of achieving the expected levels for Key Stage 4 which is 5+ GCSE A*-C including England and Maths; current data reveals that more than three-fifths of Haringey children achieved this level (63.5%) which is almost equivalent to the London median of 64.5%.

40 Version published 1st August 2014 Among families where children are eligible for free school meals, the attainment gap widens when compared to families who are not eligible. From the analysis earlier in the report, we recall that Northumberland Park and Tottenham Hale in the east of the borough were areas that had the highest numbers of families eligible for free school meals.

Young carers

Local data is available from April – December 2013 shows 77 young carers known to CYPS in Haringey of which 30 were 10-12 years, 26 were 13-18 years and the remainder between 5-9 years. This is likely to be an under-estimate as the JSNA (2012) projected maybe four times as many young carers living in Haringey i.e. 2892 rather than the 723 originally recorded in the 2001 census.

The Joint Children’s Commissioning Group for young people aged 11+ identified CAMHS, transition, lifestyle issues (sexual health, substance misuse, physical activity) and youth provision as priorities for this cohort.

Being a young carer as we see earlier is more likely to have a negative impact on academic attainment in that young carers may be more likely to have low aspirations.

Analysis of early help based on 2012/13 data

The greatest number of CAFs were generated in the South network (n=351, 2012-13 data) compared with the North Network (n=317) and West Networks (n=230). 84% of CAFs were completed for children aged 11 years and younger. Just over 1 in 10 young people aged 11-18 years received a CAF (15%).

There seems to be an over-representation of Black Caribbean, Black Other and Black African groups among CAFs undertaken by ethnic grouping with this ethnic cohort accounting for 38% of CAFs generated. White British accounted for over 1 in 5 CAFs generated (22%) and White other accounted for at least one in ten CAFs generated (17%).

In terms of where CAFS are generated; the majority were undertaken in schools (n=610 for 2012-13). Social Workers generated a high proportion of CAFS (n=130) which is likely to include the possibility that inappropriate referrals to First Response did not meet the threshold and were re-directed.

41 Version published 1st August 2014 The majority of CAFs were allocated to Educational Psychology Service (n=208) followed by Family Support (n=143) and Speech, Language and Communication Service (n=143).

Evidence of what works from a best practice perspective

Graham Allen’s report (Early Intervention; the next steps), in 2011 presented a list of 19 top programmes from a global review of the literature in which 72 programmes were evaluated and organised into three levels. Level 1 was comprised of the top 19 interventions followed by Level 2 which consisted of three 3 programmes and level 3 which was comprised of the remaining 50 programmes evaluated.

Building on the work of the Allen Review, in July 2014, the Early Intervention Foundation published recommended programmes across nine key domains (see bullet points below). It evaluated costs and benefits, implementation and effectiveness of the programmes.

 Mental health  Substance misuse  Child maltreatment  Risky sexual behaviour  School and employment  Obesity & physical health  Crime, violence & antisocial behaviour  Early child development

 Contexts of child development

The guidebook provides details of 50 programmes that have been successfully implemented in the UK. These details were obtained from other clearinghouses that have rigorously reviewed thousands of interventions and assessed the strength their

42 Version published 1st August 2014 evidence against a set of internationally recognised standards. EIF aim to add to this list of ‘First 50’.

The programmes were identified on the strength of their evidence, the age of their target population and the outcomes they hope to achieve for their community and are listed in Table 15 in the Appendix.

What provision currently exists and what the gaps are

Mapping is currently underway to identify ‘how much’ commissioned activity is currently provided and this will be mapped against need to identify possible gaps.

We know in terms of domestic violence for instance that we need more community- based, voluntary programme for domestic violence perpetrators as well as therapeutic service for children and young people affected by domestic violence both during and post crisis.

Further information on gaps will be informed by the use of commissioned services in the Early Help Framework and what needs emerge around the types of services needed.

43 Version published 1st August 2014 Appendix 1

Table 8 The proportion of contacts and referrals going to assessment by presenting need for families with children from 0-3 years.

44 Version published 1st August 2014 % contacts % referrals No of No of Presenting Need going to going to Contacts Referrals assessment assessment DOMESTIC VIOLENCE 653 21% 325 90% NEGLECT 209 20% 71 82% NEED FOR INFO 166 1% 5 40% HOUSING ISSUES 143 11% 19 89% PARENTAL ILLNESS- MENTAL HEALTH 123 29% 52 98% PRE-BIRTH CONCERN 123 29% 58 90% NEED FOR FAMILY SUPPORT 103 21% 45 87% PHYSICAL ABUSE 77 40% 45 87% PARENTAL ALCOHOL/DRUG MISUSE 76 24% 35 74% FAMILIES WITH NRPF 64 30% 36 97% FAMILY MEMBER INVOLVED IN OFFENDING BEHAVIOUR 52 8% 14 71% CONTACT DISPUTE 30 0% 1 0% SEXUAL ABUSE 23 26% 10 90% BEHAVIOURAL ISSUES 21 10% 2 100% Other 167 14% 49 63% CHILD HAS A DISABILITY 18 33% 6 100% UNIVERSAL SERVICES 18 0% 2 0% OFFENDING BEHAVIOUR 17 6% 1 100% EMOTIONAL ABUSE 16 19% 7 86% VICTIM OF CRIME 16 0% 0 0% PARENTAL ILLNESS- PHYSICAL ILLNESS 12 25% 5 100% REQUEST FOR TRANSFER TO SAFEGUARDING TEAM 12 8% 11 9% LOW INCOME/FINANCIAL SUPPORT 11 18% 4 100%

45 Version published 1st August 2014 % contacts % referrals No of No of Presenting Need going to going to Contacts Referrals assessment assessment SEXUAL EXPLOITATION 7 43% 4 75% IMMIGRATION 6 33% 3 100% UNEXPECTED CHILD DEATH 6 0% 0 0% MISSING PERSON 4 0% 0 0% PARENTAL ILLNESS- LEARNING DISABILITY 4 0% 1 0% CHILD ALCOHOL/DRUG MISUSE 3 33% 1 100% SIGN POSTING 3 0% 0 0% ALLEGATION AGAINST A PROFESSIONAL 2 0% 0 0% BELIEF CENTRED ABUSE 2 0% 0 0% PRIVATE FOSTERING 2 0% 1 0% (blank) 2 0% 0 0% BULLYING 1 0% 0 0% CHILD MENTAL HEALTH ISSUES 1 0% 0 0% DEATH OF A PARENT/CARER 1 0% 0 0% IMMEDIATE PROTECTION REQUIRED 1 100% 1 100% S7 / S37 REPORT 1 0% 1 0% UASC 1 0% 1 0% Grand Total 2030 19% 767 86%

Graph 1 The percentage of contacts and referrals to Social Care which proceed to assessment for families with children from 0-3 years.

46 Version published 1st August 2014 Table 9 The proportion of contacts and referrals going to assessment by presenting need for families with children from 4-9 years.

47 Version published 1st August 2014 % contacts % referrals No of No of Presenting Need going to going to Contacts Referrals assessment assessment

DOMESTIC VIOLENCE 336 18% 126 87% NEED FOR INFO 243 1% 3 67% PHYSICAL ABUSE 168 57% 125 87% NEGLECT 146 27% 69 83% PARENTAL ILLNESS- MENTAL HEALTH 113 24% 32 94%

HOUSING ISSUES 112 11% 19 79% NEED FOR FAMILY SUPPORT 80 19% 28 82% PARENTAL ALCOHOL/DRUG MISUSE 64 28% 24 92% SEXUAL ABUSE 48 29% 27 67% BEHAVIOURAL ISSUES 47 4% 2 100% FAMILY MEMBER INVOLVED IN OFFENDING BEHAVIOUR 45 9% 10 70% CHILD HAS A DISABILITY 39 79% 31 100% CONTACT DISPUTE 38 0% 0 0% FAMILIES WITH NRPF 31 39% 19 95% EMOTIONAL ABUSE 28 21% 11 100% Other 133 18% 42 67% VICTIM OF CRIME 17 6% 1 100% MISSING PERSON 16 6% 2 100% PARENTAL ILLNESS- PHYSICAL ILLNESS 12 33% 5 100% OFFENDING BEHAVIOUR 11 9% 4 50% ALLEGATION AGAINST A PROFESSIONAL 10 20% 2 100% REQUEST FOR TRANSFER TO SAFEGUARDING TEAM 9 44% 9 44%

PRIVATE FOSTERING 8 25% 7 29% SEXUAL EXPLOITATION 8 38% 4 75% LOW INCOME/FINANCIAL SUPPORT 6 17% 1 100% UNIVERSAL SERVICES 6 17% 1 100%

ABSENCE FROM SCHOOL 5 20% 1 100% IMMIGRATION 5 0% 1 100% CHILD MENTAL HEALTH ISSUES 4 50% 2 100% DEATH OF A PARENT/CARER 4 25% 1 100% S7 / S37 REPORT 4 0% 1 0% (blank) 4 0% 0 0% UNEXPECTED CHILD DEATH 2 0% 0 0% BELIEF CENTRED ABUSE 1 0% 0 0% BULLYING 1 0% 0 0% Grand Total 1671 22% 568 85%

Graph 2 The percentage of contacts and referrals to Social Care which proceed to assessment by 4-9 years.

49 Version published 1st August 2014 Table 10 The proportion of contacts and referrals going to assessment by presenting need for families with children from 10-15 years.

DOMESTIC VIOLENCE 156 19% 49 90% NEED FOR INFO 133 0% 1 0% BEHAVIOURAL ISSUES 119 8% 15 87% PHYSICAL ABUSE 119 63% 102 85% MISSING PERSON 94 4% 6 83% OFFENDING BEHAVIOUR 94 5% 13 62% NEGLECT 91 41% 51 90% NEED FOR FAMILY SUPPORT 81 27% 29 86% HOUSING ISSUES 64 14% 9 100% PARENTAL ILLNESS- MENTAL HEALTH 56 20% 17 94% CHILD MENTAL HEALTH ISSUES 50 12% 10 70% VICTIM OF CRIME 49 2% 2 50% SEXUAL ABUSE 46 46% 30 90% CHILD HAS A DISABILITY 33 85% 28 100% FAMILY MEMBER INVOLVED IN OFFENDING BEHAVIOUR 29 10% 5 80% SEXUAL EXPLOITATION 25 28% 14 93% PARENTAL ALCOHOL/DRUG MISUSE 23 17% 7 100% EMOTIONAL ABUSE 19 47% 9 100% CHILD ALCOHOL/DRUG MISUSE 16 13% 2 100% Other 112 17% 42 57% FAMILIES WITH NRPF 15 47% 9 100% REQUEST FOR TRANSFER TO SAFEGUARDING TEAM 14 43% 12 50% CONTACT DISPUTE 13 8% 1 100% BULLYING 10 0% 1 0% UASC 9 22% 4 100% UNIVERSAL SERVICES 9 0% 0 0% ABSENCE FROM SCHOOL 8 0% 1 0% PRIVATE FOSTERING 8 0% 9 0% LOW INCOME/FINANCIAL SUPPORT 6 0% 0 0% PARENTAL ILLNESS-PHYSICAL ILLNESS 4 25% 2 100% PRE-BIRTH CONCERN 3 33% 1 100% ALLEGATION AGAINST A PROFESSIONAL 2 0% 0 0% DEATH OF A PARENT/CARER 2 50% 1 100%

PARENTAL ILLNESS- LEARNING DISABILITY 2 0% 0 0% REMANDED INTO LA CARE 2 0% 1 0% UNAUTHORISED ABSENCE 2 0% 0 0% FEMALE GENITALIA MUTILATION 1 0% 0 0% S7 / S37 REPORT 1 0% 0 0% SELF HARM/ATTEMPTED SUICIDE 1 0% 0 0% Grand Total 1409 22% 442 85%

Graph 3 The percentage of contacts and referrals to Social Care which proceed to assessment by 10-15 years.

52 Version published 1st August 2014 53 Version published 1st August 2014 Table 11 The proportion of contacts and referrals going to assessment by presenting need for families with children from 16years and above.

% contacts % referrals No of No of Presenting Need going to going to Contacts Referrals assessment assessment

HOUSING ISSUES 109 41% 72 82% OFFENDING BEHAVIOUR 87 6% 7 71% BEHAVIOURAL ISSUES 60 7% 7 86%

MISSING PERSON 57 0% 3 67%

NEED FOR INFO 57 2% 2 50%

NEED FOR FAMILY SUPPORT 40 15% 13 69%

PHYSICAL ABUSE 40 48% 29 79%

CHILD MENTAL HEALTH ISSUES 38 11% 5 100%

VICTIM OF CRIME 34 6% 5 80% DOMESTIC VIOLENCE 33 15% 11 100% UASC 31 39% 25 92% CHILD ALCOHOL/DRUG MISUSE 15 27% 4 100% SEXUAL EXPLOITATION 14 7% 5 60% CHILD HAS A DISABILITY 12 75% 9 100%

PARENTAL ILLNESS- MENTAL HEALTH 12 8% 1 100% NEGLECT 11 27% 4 100% SEXUAL ABUSE 10 10% 4 50%

FAMILY MEMBER INVOLVED IN OFFENDING BEHAVIOUR 9 33% 3 100% Other 37 22% 13 85% PARENTAL ALCOHOL/DRUG MISUSE 5 0% 0 0% FAMILIES WITH NRPF 4 50% 3 100% IMMIGRATION 4 0% 1 0% EMOTIONAL ABUSE 3 67% 3 100% LOW INCOME/FINANCIAL SUPPORT 3 0% 1 0% PRE-BIRTH CONCERN 3 0% 0 0% BELIEF CENTRED ABUSE 2 0% 0 0% BULLYING 2 0% 0 0% SIGN POSTING 2 0% 0 0% UNIVERSAL SERVICES 2 50% 1 100% (blank) 2 0% 0 0% ABSENCE FROM SCHOOL 1 0% 0 0% ALLEGATION AGAINST A PROFESSIONAL 1 100% 1 100% DEATH OF A PARENT/CARER 1 0% 1 100% PRIVATE FOSTERING 1 100% 1 100% REMANDED INTO LA CARE 1 100% 1 100% Grand Total 706 19% 222 83%

55 Version published 1st August 2014 Graph 4 The percentage of contacts and referrals to Social Care which proceed to assessment by 16 years and above

Ward Name Year Total Ranking Muswell Hill 2014 685 Muswell Hill 2015 691 Alexandra 2014 972 7 Highgate 2014 682 Alexandra 2015 967 Stroud Green 2014 715 Highgate 2015 711 Stroud Green 2015 735 Crouch End 2014 811 Crouch End 2015 845 Fortis Green 2014 929 8 Hornsey 2014 837 Fortis Green 2015 920 Hornsey 2015 848 White Hart Lane 2014 1208 5 Harringay 2014 792 White Hart Lane 2015 1186 Harringay 2015 818 Bounds Green 2014 918 Bounds Green 2015 943 Noel Park 2014 929 8 Noel Park 2015 958 Bruce Grove 2014 1261 Northumberland Park 2014 1491 2 Bruce Grove 2015 1269 4 Northumberland Park 2015 1497 Woodside 2014 1047 Woodside 2015 1065 St Ann's 2014 1057 6 St Ann's 2015 1088 Seven Sisters 2014 1634 1 Seven Sisters 2015 1613 Tottenham Hale 2014 1419 3 Tottenham Hale 2015 1462

Ward Name Year total ranking Harringay 2015 523 Harringay 2014 540 Highgate 2015 554 Crouch End 2015 575 Highgate 2014 576 Crouch End 2014 584 Stroud Green 2015 591 Stroud Green 2014 614 Muswell Hill 2015 650 Muswell Hill 2014 660 Hornsey 2015 746 Hornsey 2014 751 Bounds Green 2015 807 Bounds Green 2014 820 St Ann's 2014 831 St Ann's 2015 843 Alexandra 2014 844 Alexandra 2015 845 West Green 2015 865 Woodside 2015 880 Woodside 2014 888 10 Noel Park 2014 898 9 West Green 2014 902 Fortis Green 2015 964 Fortis Green 2014 970 7 Bruce Grove 2015 1014 6 Bruce Grove 2014 1023 Tottenham Green 2014 1023 5 Tottenham Green 2015 1029 Northumberland Park 2015 1226 Northumberland Park 2014 1228 4 Tottenham Hale 2014 1278 3 Tottenham Hale 2015 1284 White Hart Lane 2015 1306 White Hart Lane 2014 1346 2 Seven Sisters 2014 1427 1 Seven Sisters 2015 1456

58 Version published 1st August 2014 Table 14 2013 GLA population projections for young people 16-25 years for 2014 and 2015

Ward Name Year Total Ranking Alexandra 2014 1305 Alexandra 2015 1328 Bounds Green 2014 1934 9 Bounds Green 2015 1933 Bruce Grove 2014 2131 7 Bruce Grove 2015 2115 Crouch End 2014 964 Crouch End 2015 981 Fortis Green 2014 1522 Fortis Green 2015 1560 Harringay 2014 1815 10 Harringay 2015 1792 Highgate 2014 1261 Highgate 2015 1312 Hornsey 2014 1570 Hornsey 2015 1597 Muswell Hill 2014 1097 Muswell Hill 2015 1111 Noel Park 2014 2444 2 Noel Park 2015 2436 Northumberland Park 2014 2393 3 Northumberland Park 2015 2436 Seven Sisters 2014 2315 5 Seven Sisters 2015 2322 St Ann's 2014 2380 4 St Ann's 2015 2377 Stroud Green 2014 1191 Stroud Green 2015 1199 Tottenham Green 2014 2277 6 Tottenham Green 2015 2297 Tottenham Hale 2014 3423 1 Tottenham Hale 2015 3481 West Green 2014 2172 West Green 2015 2186 White Hart Lane 2014 2406 White Hart Lane 2015 2482 Woodside 2014 1973 8 Woodside 2015 1901

59 Version published 1st August 2014 Table 15 Early Intervention Foundation Summary of Evaluation of programme from 4-1 (most effective to least effective)

Description of each EIF ranking of impact by programme

EIF Description Description of Evidence or rationale for programme ratin of evidence programme g

Multiple high-quality evaluations (RCT/QED) with Consistently consistently positive impact across populations and Established 4 Effective environments

Single high-quality (RCT/QED) with positive impact Initial Effective 3

Lower-quality evaluation (not RCT or QED) showing Formative Potentially Effective 2 better outcomes for programme participants

Logic model and testable features, but not current Non-existent Theory-Based 1 evidence of outcomes or impact

No logic model, testable features, or current Unspecified 0 evidence of outcomes or impact

Evidence from at least one high-quality evaluation Negative Ineffective/harmful - (RCT/QED) indicating null or negative impact

Programmes not yet rated, including those rated by evidence bodies whose standards are not yet mapped to the EIF standards, and submissions from providers or local areas of innovative or promising TBD TBD ? interventions

Rating (High - Low)

RATING OF 4

Botvin LifeSkills Training (LST)

Age: 12-18 Rating: 1 2 3 4 Assessed by: NREPP, OJP, Blueprints, RAND, Child Trends, Coalition for EBP Outcomes: Prevent substance misuse; Prevent crime, violence & antisocial behaviour

60 Version published 1st August 2014 RATING OF 4

Families and Schools Together (FAST)

Age: 3-11 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, OJP, C4EO, NREPP, Project Oracle, AIFS Outcomes: Enhance school achievement & employment; The family and the home; Prevent crime, violence & antisocial behaviour

Family Nurse Partnership (FNP)

Age: <0-2 Rating: 1 2 3 4 Assessed by: Blueprints, OJP, NREPP, Commissioning Toolkit, RAND, Coalition for EBP Outcomes: Enhance school achievement & employment; Positive early child development; The family and the home; Prevent risky sexual behaviour & teen pregnancy; Prevent substance misuse ; Prevent child maltreatment; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Functional Family Therapy (FFT)

Age: 10-18 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, OJP, CEBC, Blueprints Outcomes: The family and the home; Prevent substance misuse ; Prevent crime, violence & antisocial behaviour

Incredible Years BASIC Preschool Programme

Age: 3-5 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, OJP, NREPP, RAND, CEBC Outcomes: Positive early child development; The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Multidimensional Family Therapy (MDFT)

Age: 13-18 Rating: 1 2 3 4 Assessed by: OJP, NREPP, CEBC, Child Trends

61 Version published 1st August 2014 Outcomes: Enhance school achievement & employment; The family and the home; Prevent substance misuse ; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

RATING OF 4

Multidimensional Treatment Foster Care - Adolescent (MTFC-A)

Age: 10-17 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, CEBC Outcomes: Enhance school achievement & employment; The family and the home; Prevent risky sexual behaviour & teen pregnancy; Prevent crime, violence & antisocial behaviour

Multisystemic Therapy (MST)

Age: 12-17 Rating: 1 2 3 4 Assessed by: OJP, RAND, Blueprints, CEBC, Commissioning Toolkit Outcomes: The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Multisystemic Therapy for Problem Sexual Behaviour (MST-PSB)

Age: 11-18 Rating: 1 2 3 4 Assessed by: OJP, CEBC, NREPP, Commissioning Toolkit Outcomes: Enhance school achievement & employment; The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Positive Action

Age: 6-17 Rating: 1 2 3 4 Assessed by: Blueprints, Child Trends, NREPP Outcomes: Enhance school achievement & employment; Prevent risky sexual behaviour & teen pregnancy; Prevent substance misuse ; Prevent crime, violence & antisocial behaviour

Promoting Alternative THinking Strategies (PATHS)

Age: 3-11

62 Version published 1st August 2014 Rating: 1 2 3 4 Assessed by: OJP, NREPP, Blueprints, Child Trends Outcomes: Enhance school achievement & employment; Support children's mental health & well-being

RATING OF 4

Standard and Group Triple P (Level 4)

Age: 1-12 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: The family and the home; Prevent crime, violence & antisocial behaviour

Stepping Stones Triple P

Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)

Age: 3-18 Rating: 1 2 3 4 Assessed by: OJP, NREPP, CEBC Outcomes: The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

RATING OF 3

Adolescents Coping with Depression (ACWD)

Age: 15-18 Rating: 1 2 3 4 Assessed by: NREPP, Blueprints, Child Trends, RAND

63 Version published 1st August 2014 Outcomes: Support children's mental health & well-being

Bright Bodies

Age: 5-18 Rating: 1 2 3 4 Assessed by: Blueprints, Child Trends Outcomes: Prevent obesity & promote healthy physical development

Family Foundations

Age: <0-2 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, NREPP, Blueprints, RAND Outcomes: Positive early child development; The family and the home RATING OF 3

Good Behaviour Game (GBG)

Age: 6-10 Rating: 1 2 3 4 Assessed by: OJP, NREPP, Blueprints Outcomes: Prevent risky sexual behaviour & teen pregnancy; Prevent substance misuse ; Prevent crime, violence & antisocial behaviour

Helping the Noncompliant Child (HNC)

Age: 3-8 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, CEBC Outcomes: Positive early child development; The family and the home; Prevent crime, violence & antisocial behaviour

Incredible Years Child Training Programme (Dinosaur Curriculum)

Age: 2-8 Rating: 1 2 3 4 Assessed by: Blueprints Outcomes: Positive early child development; The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Incredible Years School Age Basic Programme

Age: 6-12 Rating: 1 2 3 4

64 Version published 1st August 2014 Assessed by: Commissioning Toolkit, OJP, NREPP, RAND, CEBC Outcomes: Enhance school achievement & employment; The family and the home; Prevent crime, violence & antisocial behaviour

Incredible Years Teacher Classroom Management

Age: 3-8 Rating: 1 2 3 4 Assessed by: Blueprints Outcomes: Enhance school achievement & employment; Prevent crime, violence & antisocial behaviour

RATING OF 3

Incredible Years Toddler Basic Programme

Age: 1-3 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, NREPP, RAND, CEBC Outcomes: Positive early child development; The family and the home; Prevent crime, violence & antisocial behaviour

Keeping Foster and Kinship Parents Trained and Supported (KEEP)

Age: 5-12 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: The family and the home; Prevent child maltreatment; Prevent crime, violence & antisocial behaviour

Lifestyle Triple P (Level 5 - Group)

Age: 5-10 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: The family and the home; Prevent obesity & promote healthy physical development

65 Version published 1st August 2014 Multidimensional Treatment Foster Care - Preschool/Preventive (MTFC-P)

Age: 6-8 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, CEBC Outcomes: Prevent obesity & promote healthy physical development; Positive early child development; The family and the home; Prevent child maltreatment; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN)

Age: 5-18 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit, OJP, CEBC Outcomes: The family and the home; Prevent child maltreatment; Support children's mental health & well-being

RATING OF 3

New Beginnings (UK)

Age: 0-1 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: Positive early child development; The family and the home

New Forest Parenting Programme (NFPP)

Age: 3-11 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: Positive early child development; The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Olweus Bullying Prevention Programme (OBPP)

Age: 3-11 Rating: 1 2 3 4 Assessed by: Blueprints Outcomes: Prevent crime, violence & antisocial behaviour

66 Version published 1st August 2014 Parents Plus Adolescent

Parents Plus Children

Parents Plus Early Years

RATING OF 3

Parents as Partners in the UK

Age: 0-11 Rating: 1 2 3 4 Assessed by: CEBC Outcomes: The family and the home; Prevent crime, violence & antisocial behaviour

Pathways Triple P (Level 5)

Age: 0-12 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: The family and the home; Prevent child maltreatment; Prevent crime, violence & antisocial behaviour

67 Version published 1st August 2014 PreVenture

Age: 13-14 Rating: 1 2 3 4 Assessed by: NREPP, CAYT Outcomes: Prevent substance misuse

Primary Care and Discussion Groups Triple P (Level 3)

Reading Recovery

Age: 5-6 Rating: 1 2 3 4 Assessed by: RAND Outcomes: Enhance school achievement & employment

School Health and Alcohol Harm Reduction Project (SHAHRP)

Age: 13-15 Rating: 1 2 3 4 Assessed by: CAYT Outcomes: Prevent substance misuse

RATING OF 3

Strengthening Families Programme for Parents and Youth 10-14

Age: 10-14 Rating: 1 2 3 4 Assessed by: Blueprints, Commissioning Toolkit, CAYT, NREPP Outcomes: Enhance school achievement & employment; The family and the home; Prevent substance misuse ; Prevent crime, violence & antisocial behaviour

68 Version published 1st August 2014 Success for All

Age: 4-14 Rating: 1 2 3 4 Assessed by: Blueprints, Coalition for EBP, OJP, Child Trends Outcomes: Enhance school achievement & employment

Talk About Alcohol

Age: 11-18 Rating: 1 2 3 4 Assessed by: CAYT Outcomes: Prevent substance misuse

RATING OF 2

5 Pillars of Parenting

Born to move - Active Learner Project

Age: 0-5 Rating: 1 2 3 4 Assessed by: C4EO Outcomes: Positive early child development; The family and the home; Prevent obesity & promote healthy physical development

RATING OF 2

DrugAware

Age: 5-17 Rating: 1 2 3 4

69 Version published 1st August 2014 Assessed by: CAYT Outcomes: Prevent substance misuse

Mellow Parenting

Age: <0-5 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: Positive early child development; The family and the home; Prevent child maltreatment

Mentalization-based Treatment for Families (MBT-F)

Age: 7-16 Rating: 1 2 3 4 Assessed by: Commissioning Toolkit Outcomes: The family and the home; Prevent crime, violence & antisocial behaviour; Support children's mental health & well-being

Parents as First Teachers (Born to Learn) (PAFT)

Age: 0-3 Rating: 1 2 3 4 Assessed by: OJP, CEBC, RAND, NREPP, Commissioning Toolkit, Child Trends, C4EO Outcomes: Positive early child development; The family and the home

Standard Teen and Group Teen Triple P (Level 4)

RATING OF 1

Me+You=4Eva

Age: 8-13 Rating: 1 2 3 4 Assessed by: C4EO Outcomes: Prevent child maltreatment

70 Version published 1st August 2014 71 Version published 1st August 2014