Milton Keynes Council s1

Children and Young People’s Service

The Family Support Approach Specialist Services Specialist Services

July 2010

Milton Keynes Council Children and Young People’s Service

1 1. Introduction

This Family Support Approach sets out the approach taken by Milton Keynes Council’s Children and Young People’s Services, in partnership with other agencies, to ensure that children and young people in Milton Keynes are brought up in safe and secure settings and in ways that give them the best opportunities to thrive and prosper.

This approach is the agreed policy of Milton Keynes Council and has been endorsed by Milton Keynes Safeguarding Children Board (July 2010), setting out how we respond to the needs of children and families where there are significant safeguarding concerns.

Milton Keynes Council already has in place guidance for providing effective support for children and families with additional needs, through the use of the common assessment framework and lead professional (See ‘Effective Support for Children & Families’ – MKC 2009). The Family Support approach is for those children and families with complex needs who fall into the ‘Intensive’ end of the windscreen (See Appendix 1), and particularly children who need intervention from children’s social care.

Our Family Support Approach has been written to help social work staff and managers in Children’s Social Care, and staff in partner services and agencies, adhere to the standards expected and understand how we measure these standards. This will help to ensure that we deliver the highest standards of service and good outcomes to children, young people and their families in line with Milton Keynes Children & Young People’s Plan.

It is important that families, staff and partners fully understand and endorse Milton Keynes family support approach. This requires us to articulate the approach clearly, demonstrate that it is safe and effective, up-to-date and fit for purpose. This is what this approach sets out to do.

Our Family Support Approach is related to the principles of the ‘Think Family Approach’ (1) which states there is ‘no wrong door’ for a family to gain appropriate support. Against a backdrop of rising prosperity and improved outcomes for the majority of families, there is a small minority of around 2% of families who experience multiple problems. Growing up in a family with multiple problems puts children at a higher risk of adverse outcomes. These families with multiple problems can exert a heavy cost upon public services as well as the wider community. If we are to reach out to families at risk we need to identify and make use of opportunities to build tailored, flexible and holistic services that work with the whole family and can turn lives around dramatically.

2. Principles

In all our activities with children and their families, the child’s welfare is of paramount concern. Children are entitled to protection from significant harm through abuse, neglect or exploitation. All situations where child abuse is suspected or alleged should be investigated and assessed thoroughly without delay. Where assessment 2 indicates a child may be suffering significant harm, effective family support plans or child protection plans will be developed and implemented to safeguard the child.

There are unique advantages for children experiencing family life in their own birth family and in most circumstances children’s needs are best met by being cared for within their immediate or extended families. Children should be supported within their own family, with the assistance of family support services when necessary, unless there are clear reasons why this might not be consistent with their safety and wellbeing.

Social Work is about enabling positive change in families and communities to promote the best possible outcomes for children and young people. The social work task is one of deploying a range of methodologies to help people in a system (such as a family) find effective ways of solving identified problems, and thereby improving their lives.

The development of a working partnership with parents is usually the most effective route to meeting children’s needs and maximising participation is encouraged whenever possible. This includes working honestly and openly with families and children. Services should acknowledge and respect the contribution of parents, carers and other family members, involve them in decisions about their children and recognise when they need support. We need to acknowledge parents and carers strengths and creative potential to develop solutions to the problems they face. Sometimes, services seem to ‘encircle’ families and subject them to successive assessments and ‘signposting’ processes. The key is to understand the family’s situation from their own perspective and through coordinated support help them to meet their children’s needs more effectively. We seek to provide parents access to therapeutic support, which aims to unlock barriers in becoming an effective parent.

In Milton Keynes we have a rich diversity of families. By family, we mean any form of social organisation where one or more adults live with children and/ or have responsibility for their upbringing and welfare. This includes wider family members who may live elsewhere but provide support. We recognise that families come in many shapes and sizes with many differences. There is no preferred model for family, rather the test is that the developmental and well being needs of all the children are met. In all our work with children we must protect and promote their cultural inheritance, religious and ethnic identity and support them with any issues of identity around disability or sexual orientation of any family members. Services must demonstrate that they model mutual respect and meet a child’s cultural and religious requirements within a framework that encourages children to maximise the social and educational opportunities available to them.

Children are entitled to be listened to and respected as individuals. Children are entitled to participate, as fully as their age and understanding enables them, in decisions that affect them. We are committed to ensuring children’s views and their individual needs are fully considered when making decisions that affect their lives.

Services for children in need should be provided by the least intrusive method of intervention possible, consistent with safeguarding and promoting a child’s wellbeing. The feasibility of a voluntary agreement should always be considered before seeking a legal order. Family support services are available both to children in need and children who are at risk of significant harm.

3 Disabled children should have the same rights as other children and the above principles apply equally to them.

3. Background

The Children Act 2004 has provided a legislative framework for developing more effective and accessible services focused around the needs of children, young people and families. The Government's aim is for every child, whatever their background or their circumstances, to have the support they need to:

 Be healthy  Stay safe  Enjoy and achieve  Make a positive contribution  Achieve economic well-being

These five outcomes are universal ambitions for every child and young person, whatever their background or circumstances. Improving outcomes for all children and young people must underpin all service planning and delivery within children's services – and partnership arrangements with other agencies. Improving outcomes also involves narrowing the gap between disadvantaged children and their peers.

As part of the programme to meet children’s needs, several areas of improvement have been identified:

 More integrated, accessible and personalised services built around the needs of children and young people, not around professional or service boundaries  Shift to prevention and improved focus on safeguarding and promoting the welfare of all children  Workforce reform to ensure sufficient, suitably trained staff. All staff working with children will have a common core of knowledge and understanding about children's needs and increased understanding and trust between professionals  Development of the Common Assessment Framework, team around the child and lead professionals  Promotion of the ‘think family’ approach enabling all services in contact with a family to work in a more coordinated and ‘family’ centred manner

Children’s social care provides specialist services under the Children Act 1989 in relation to children in need, child protection and children in care. The Children Act 2004 gives a duty to both safeguard and promote the welfare of children. Responsibilities for safeguarding children are set out in ‘Working Together to Safeguard Children’, DCSF 2010.

4 4. Family Support in Milton Keynes

In Milton Keynes over the last ten years, children’s social care has, with its partners, developed a strong ethos and practice of ‘Family Support’. Family Support can be defined as:

Effective and focused interventions with families, where children are at risk of suffering significant harm or of coming into care, to change parenting behaviour to make children safe, healthy and able to enjoy and achieve. Family Support seeks to produce sustained change – better parenting and more secure attachment for the child.

Children's Social Care has a statutory responsibility to ensure the safeguarding of children and young people, particularly within their own family. This responsibility is often referred to as Child Protection. Children's Social Care also has responsibility for promoting well being for children who need safeguarding and for children in need. Thus effective safeguarding, child protection and promoting well being are the purpose and aims of Children's Social Care. Family Support in Milton Keynes is the term for the broad methodology used to achieve these aims.

Family support is about getting alongside a family, understanding the situation from their perspective and helping them identify the key issues which lead to the compromising of children’s needs. Family support promotes holistic approaches with the family enabling them to express their own opinions and tell their own story. The family need to be included from the outset in the interventions used and participate in settings goals and evaluating what has been achieved.

In the often stressful, high risk and highly active environment that is children’s social care it is all too easy to lose sight of our purpose and our values. This is often illustrated by a tendency to behave in punitive, risk averse ways towards some of the most vulnerable children and families in our society. In our work with families we need to stop, listen and think about what has been said and the meaning this has for the child’s welfare.

High quality assessment based on listening to family members, gathering information including from observation and from other agencies and practitioners, analysing that information, taking into account social and cultural issues, formulating and testing hypotheses in order to develop a robust care plan centred round the children’s needs is essential to the delivery of effective family support. Such assessment needs to be undertaken in a way that focuses on strengths and protective factors as well as weaknesses and risks, and the social worker must show positive regard in their interaction with all family members.

Family support is not about colluding with a family and focusing on parents’ needs rather than the children. Family support involves a clear and unambiguous approach with key concerns discussed and evaluated at the outset of contact and the establishment of plans with the family to promote better approaches to children’s needs. Safeguarding children and promoting their welfare is at the heart of family support. This robust approach, being open and honest with parents/carers while remaining empathetic is sometimes termed ‘authoritative social work’ (2).

This overall approach to Family Support is endorsed by the White Paper, ‘Care Matters – Time for Change’ 2007 and subsequent policy and legislation. 5 “ In response to the Care Matters Green Paper, many children and young people told us they would prefer to remain with their birth parents or wider family rather than come into care and that they wanted services to facilitate this wherever possible. ….care by a relative should be considered before any decision is made that a child should come into care. It is essential that services are designed to identify early those families who need support, including children in need of safeguarding, in order to prevent the need for children to enter care.

“This approach…needs to be a sophisticated one, with a range of services made available to support families as and when they need it. These will include intensive interventions where family difficulties are complex and enduring; better access to support care and short-term breaks; tailored support for adults whose own difficulties are impacting on their ability to parent……” (Chapter 2, p30)

Similarly, the Public Law Outline from the Ministry of Justice with regard to child care proceedings, seeks to “…encourage early intervention to find resolutions before cases reach court…(and)...ensure applications are only made after all safe, appropriate alternatives have been fully explored.”

5. Implementing Family Support

We know that the needs of the families we support are hugely diverse and that our responses must be tailored to individual need and family circumstances. However, there are clearly some very striking and frequently presenting features in family support work. Adult behaviours and health are central to understanding parenting capacity which is often limited to a greater or lesser extent by parental mental ill health, learning difficulties and drug and alcohol misuse. These behaviours can lead to dysfunctional and chaotic family circumstances which result in the neglect of children’s needs.

We need to develop our response in particular to these circumstances, through a more multi-professional skills mix in our services (e.g. the inclusion of adult primary mental health and substance misuse workers) and, in particular, a robust and tested methodological approach. We also need to establish more effective working relationships with our adult social care and other Community Well Being colleagues given the centrality of understanding a child or young person’s needs in the context of both the parent/ child relationship and the parent’s own needs. (3)

With some families support must be long term. The level of family dysfunction within the families who come to our attention is often very entrenched and quick fix solutions will not work. We need to stabilise a family’s situation and then consider how best to approach long term change where that is consistent with the welfare of the children. Sometimes we need to accept that parents will not or cannot change but, particularly where attachments are strong, make a decision that the best we can do is provide continued support to maintain children within those familial networks. Critical to our assessment of children’s needs is an understanding of the importance of emotional warmth and positive attachment and the role this plays in predictions of future positive outcome.

6 To deliver this approach, children’s social care has developed resources to provide seven day a week family advice and support and intensive family support (that is, rapid response service to prevent breakdown of families). The Intensive Support Service works with families whose children are on the edge of care and/or who are on Child Protection Plans. Families are provided regular support, sometimes daily, and in tandem the parents are provided therapeutic support to try to unlock the blockages to parenting effectively. Three Primary Mental Health Practitioners employed by CSC work intensively with parents on issues identified. Clear plans of work are identified and reviewed on a regular basis to ensure intervention is successful. Should there be agreement that progress is not being made evidence can be provided from the intervention to demonstrate that all avenues have been tried to support the child in the home environment.

We also provide specialist child-minding and home care for families in difficulty; support with parenting and child-care through family centres and our early intervention centre; and support care through fostering during the daytime and for overnight breaks. This spectrum of services has been developed over time and operates according to the following key principles:

 Partnership with parents and children and other key players (school, health, etc) – listening to everyone’s views  Empowering of children and families to find own solutions  Clear contract, solution focused, time limited and evaluated  Based on an agreed plan that identifies goals and expectations on all  Evidence-based behavioural approach focused on developing skills within the family system  Practical help based on problems identified in here and now  Established effective methods such as Webster Stratton  With built in evaluation from participants

Family support services are provided as a response to children in need or children at risk of significant harm. Unless, there are child protection concerns we would normally expect that the child and family will have been involved in a voluntary plan under the Common Assessment Framework (CAF) (see: ‘Effective Support for Children and Families’ Dec 09) to try and resolve any concerns, prior to a referral for children’s social care specialist services.

Family support requires able and skilled practitioners. The role of a social worker is a challenging one, requiring a range of complex skills and a sound knowledge base from which to practice. Of paramount importance are the skills and knowledge required to carry out high quality assessments and implement effective interventions with families. Social workers must possess an understanding of both the physical and emotional development of children and young people, have the ability to make positive relationships with families and other professionals and possess strong report writing and oral skills. Social workers also need to be confident, articulate, professional and energetic, and possess emotional resilience and determination.

Family support is most effective when undertaken with support from other professionals and services with specialist knowledge and skills. Social workers need to work with and respect the skills brought by Child and Adolescent Mental Health services (CAMHS), health visitors, educational psychologists, children’s centres and 7 services involved in supporting parents who can all contribute to effective family support.

Family support will be most effective when we are able to adopt a ‘Think Family’ approach, bringing the skills of those professionals from mental health, learning disability and housing and similar services, who are working with adult family members, together with children’s services to work holistically with the family as a unit.

Early Years services and children’s centres have a significant contribution to make in providing both child care and parenting advice and support to families in need. Specialist family support will work very closely with Early Years to ensure that resources are used effectively to maximise support available to families in need.

Where we do need to bring children into the care system, the quicker they return, the higher the chance of successful reunification. We must always ensure that, consistent with the child’s safety and well being, we try everything we can to get children back home.

However, we must remain aware that some adult’s present serious risk to children and in these circumstances the concept of danger emerges. The ability to assess risk accurately is crucial and the ability to act immediately is vital. Protective factors and the strengths of families need to be emphasised in every instance, but in high risk scenarios, a child’s welfare and safety is always paramount. Whilst we want to give a clear message that we are in the business of supporting families, child protection takes priority every time.

6. Family Support Process

The children and family are at the centre of the process. Some key ways of engaging families are to ask the following simple questions, which will also assist the family to identify their needs and how they could be met by ongoing support. The family are encouraged to discuss their needs in terms of the risks these generate for their children.

1. What is worrying you about your child / the situation? 2. What would you like to change / what would make a difference? 3. Who could help you with this? 4. What do you feel you need to do (to create this change/ make things different)?

At the core of Family Support is the multi-agency Family Support (Child in Need) Plan. A family support meeting will develop a plan to support the family to address the perceived difficulties in an honest and open way. Normally a family support meeting will follow either an initial or core assessment, following referral to children’s social care. The meeting will agree a plan, what each service will provide, what parents/ carers agree to do, what monitoring arrangements will be and when the review meeting will be held.

Family support meetings and subsequent plans will not just address safequarding and parenting issues, but also look more holistically at the wider needs of the child in terms of health, education and positive activities. Family support is about bringing 8 change in families, enabling parents to parent effectively by focusing on the needs of the child.

Prior to the production of the Family Support Plan, in every new and existing case where there is a possible safeguarding issue the social worker will always consult with a child protection co-ordinator to consider whether a family support plan is appropriate or whether the level of concerns and degree of inter-agency working required warrants a more formal child protection plan (see ‘levels of intervention’ below). This discussion and its outcome will always be recorded. Consultation will also occur following the production of a family support plan.

Families will be encouraged to review their progress at family support review meetings and this will be recorded in the family support review notes. Family support will end once risk issues are minimised and families have established a more consistent approach to meeting their children’s needs. Where families are consistently not achieving targets and significant risk continues, a Core Assessment will be undertaken to determine what additional intervention is needed and whether child protection processes are necessary. Normally a Family Support Plan should not continue more than twelve months, with a review every three months.

The strength of the Family Support ethos in Milton Keynes is that it empowers the family to generate their own solutions without the stigma of the Child Protection process. The success of the family support process is also dependent on the multi agency commitment to attend family support meetings, contribute to family support plans and develop a culture of open and honest dialogue with fellow practitioners from partner agencies and with families.

Family Support is also enhanced by the use of Family Group Conferencing (FGC), a voluntary approach that engages with wider families to support them to find solutions and build on their strength as a family to support other family members. FGCs have resulted in innovative solutions for children that keep them within their wider family without the need for formal child protection plans or care proceedings. They can be used at any stage from initial assessment to during care proceedings. FGCs are not the only way of engaging the wider family and social workers are encouraged to engage with wider family members to explore solutions.

More information about levels of need and thresholds can be found in Appendix 1.

7. Effective Methods and Interventions

The child is often the bearer of the problem, but working with and supporting a child in isolation from his or her home/school system rarely produces positive results. The critical importance of engagement with those others within the system of the child is recognised. Failure to include the system of concern in a holistic fashion minimises meaningful and sustainable change and frustrates the child’s efforts in making sense of his or her life experiences. We must shift the focus of intervention - not problem children, but problem systems - and specify the more targeted interventions which really make a difference.

In engaging with the child‘s wider system, we need to be clear about which methodologies and approaches are likely to be most effective in producing sustained 9 change – better parenting and more secure attachment for the child. Systemic Family Therapy, Social Learning Theory and Webster-Stratton programmes are grounded in an evidence base which demonstrates they work. These approaches have a generic name – ‘systemic practice’. It is systemic practice that informs Family Support in Milton Keynes.

‘ Systemic practice’ entails collaborative and respectful working, inviting the family and all the members of the family and practitioner system (including the professionals and others in the child’s wider system - from family, to school, to other services) to join in finding a solution to the presenting difficulty. The family includes the extended family and those from the wider support network.

In this way professionals are not seen to have all the answers, but instead look to the family’s own understanding and particular knowledge of what is not working and help them to identify and use their own skills to create a way forward. By listening to the voices of parents/carers and children and those involved in their lives, we can provide a context in which families gain confidence to rely on their own strengths and resilience to find a solution.

The most critical aspect of any work is engagement, which flows from a “can-do, optimistic outlook”, finding a way around complex and stuck systems, demonstrating an ability to look for positive framings, openings and possibilities, to be unflappable, and to assume “we can do something”. The approaches below all contain the following elements of systemic practice.

 Systemic Family Therapy attempts to identify the problems and relationships, ideas and attitudes of all the family to get an idea about what is going on for the whole family. Once these areas are clear, the practitioner(s) will sometimes attempt to shift the problem(s), attitudes, relationships, to a position that is more beneficial, less damaging, or simply more realistic. They may do this in a number of ways; education; homework tasks; experimentation (e.g. suggesting that the family try behaving or relating in a different way); recreating the families’ realities. Problematic behaviours and relationships may be considered as normal and realistic for the individuals in that particular system. We need to work with the family and assist them to recreate their realities to accommodate more acceptable and supporting behaviours. In essence – the focus is on the system, as opposed to the individual.

 Social learning theory is a theory to explain how people learn behaviour. People learn through observing others' behaviour. If people observe positive, desired outcomes in the observed behaviour, they are more likely to model, imitate, and adopt the behaviour themselves. Leading on from outcomes - reinforcement creates an expectation, which as a result strengthens an individual’s particular behaviour. (Reciprocal causation with three variables: the person, the behaviour and the environment – each influencing the other, thus a continuous development and not static in nature)

 Professor Webster-Stratton, at the University of Washington, Seattle developed the Incredible Years (IY) Series over the last 30 years. It comprises three linked programmes for children, teachers, and parents. All of the programmes have been rigorously researched and have demonstrated 10 positive results that have been replicated by independent researchers. This evidence has demonstrated the effectiveness of these programmes in both preventing and treating conduct problems among children aged two to eight years and increasing their social competence.

 Solution focused intervention is about helping a parent or family focus on their strengths through positive reframing. This means encouraging an individual to develop positive coping strategies in specific situations. These are identified by the worker with the family and tested out using a set plan which is followed through and reviewed in a set time span. This approach works well where the family have the emotional space and strength to complete this work. Sometimes preliminary reflective life story work is needed.

There are a range of other parenting approaches which engage with families and help parents develop a more authoritative approach to parenting, whilst developing play and having fun with emotional warmth. Parenting services in Milton Keynes offer ‘Mellow Parenting’, ‘Strengthening Families’, ‘Families & Schools Together’, Human Givens, Triple P, a wide range of interventions that support systemic social care practice.

8. Participation and Evaluation

It is important that family support in children’s social care is monitored and evaluated to ensure that it remains effective for the children and families who participate in it. Children and families should be involved at all stages of the family support process – in the assessment, developing the care plan and in its review.

We will develop ways of setting baselines at the outset of family support and then involve the family at mid and end points in evaluating what has been achieved and what has changed. Evaluation needs to be collected and recorded in a systematic way so the effectiveness of the service can be measured and so that we can learn from families using the service how it can be approved.

We will ensure that family support plans are well recorded on ICS, with clear objectives, and subsequently robustly audited to discover whether objectives have been achieved. Supervision and file audit are important parts of the process to ensure that intervention is having a positive impact, that progress is constantly evaluated by the worker, and decisions are made based on well recorded evidence and analysis, with a clear rationale.

We will ensure that training and personal development support are available to practitioners to learn the skills required to deliver effective family support, to engage with the child and the family and to evaluate the effectiveness of the intervention.

11 Conclusion

The Family Support Approach sets out the approach taken by professional staff in Milton Keynes Council CYPS Specialist Services and key partners such as community health, police and schools in working with children and families with intensive needs. This approach can be characterised by working with children and families, listening to their concerns and perceptions, and focusing on the whole system in which a child and family are located to identify solutions and bring about change.

This approach requires skilled, confident and authoritative social workers and colleague professionals who have the time, the support and the resources to work with complex family dynamics, keeping the needs and well being of the child at the centre of all their work.

Family support must be flexible, adaptable and creative, and we must have effective evaluation of what we do, informed by the recipients of the service, that is children and their families.

References

1. ‘Reaching Out, Think Family, Analysis and Themes from the Families at Risk Review’ (2008) Cabinet Office, Social Exclusion Task Force

2. Serious Case Review, Baby Peter’ (2009) Executive Summary, LSCB Haringey

3. ‘Crossing Bridges’ (2000) Falkov, Adrian

12 Levels of need in children and young people’s services and children’s social care

This paper links the Levels of Need (Thresholds) agreed by Milton Keynes Safeguarding Children Board and by MK Children’s Trust, which apply across children’s services and in particular for Children’s Social Care in relation to children in need and to children who may suffer significant harm, to the children’s social care assessment process and the different interventions available.

Levels of need are sometimes referred to as ‘thresholds’. Thresholds imply a gate- keeping process or a step to get over in order to access services. ‘Levels of Need’ is a more neutral term which implies that interventions are tailored to the needs of the child or young person at whatever level these needs are present.

1. Levels of Need for Children and Young People’s Services

The Levels of Need for Children and Young People’s Services are stated in the document ‘Effective Support for Children and Families’ (2009), which is guidance on the Common Assessment Framework and Team around the Child/Lead Professional process. There are four levels of need: Universal; Additional; Considerable and Intensive. The details of these levels of need, including indicators of levels of need, and the conceptual model (Windscreen) are in Appendix 1.

2. Children’s Social Care Referral and Assessment Process

The Children’s Social Care Service is responsible for the Council’s implementation of the Children Act 1989, in particular with reference to children in need and section 47 (child protection) enquiries which concern children who may be or are likely to suffer significant harm.

Children’s Social Care duties, along with those of other statutory partners in particular the Health Service and the Police, are set out in further Government guidance in particular the ‘Assessment Framework’ 2000 and ‘Working Together’ 2006. These arrangements in each local area are scrutinised by the Local Safeguarding Children Board – in Milton Keynes this is the Milton Keynes Safeguarding Children Board (MKSCB). Milton Keynes Safeguarding Children Board has a website which contains the full multi-agency safeguarding procedures and other information at mkscb.org

Before referral to Children’s Social Care, unless the referral concerns a child who may be or is likely to suffer significant harm, the referring agency is expected to have undertaken a Common Assessment (CAF) with the family which has led to some planned preventative intervention and support. This might include a Team around the Child meeting (see Effective Support for Children and Families). This is a voluntary process which begins with discussion with the family.

Children’s Social Care receives referrals from other agencies and from the public regarding children in need and children in need of protection. All referrals and subsequent work are entered on to the Integrated Children’s System (ICS), the services complete electronic records system. Children’s Social Care must gather

13 information from the referrer and others to determine whether an initial assessment (brief) is required. The target for completion of initial assessments, including information from other agencies, is seven days.

The initial assessment may lead to a child in need (family) support plan or, if the situation is complex, a core assessment in much more depth may be required. A core assessment has a target for completion of 35 days including much more detailed information from other agencies and detailed exploration into family background and dynamics and the needs of the children. A core assessment will lead to a children in need (family) support plan or other action as is deemed necessary.

Whenever there are child protection concerns a ‘section 47 enquiry’ is undertaken. This will involve liaison with police and other agencies and will include a strategy discussion, usually in the form of a meeting, to decide on and plan the actions needed. An assessment of the child’s circumstances including risks and needs is undertaken following the strategy meeting. This may lead to a decision that there are no concerns, to a voluntary child in need plan, or to some form of statutory intervention and/or to an initial child protection conference. If a child protection conference is required, the target is that this happens within fifteen days of the strategy meeting.

Where children in need (family support) plan has not successfully improved parenting to protect children from significant harm, a strategy meeting is convened and a decision may be taken in consultation with the Child Protection Coordinator to proceed to a multi-agency Initial Child Protection Conference. If the conference agrees, a child protection plan is put in place. Should the circumstances of the child/young person not improve or where a serious incident occurs, a decision may be made to apply to the Court for care proceedings. The first step in this process is usually an application for an interim care order.

Below are the agreed Milton Keynes safeguarding indicators of levels of need which might suggest the level of intervention required.

3. Children’s Social Care and Safeguarding (Child Protection) Levels of Need

1 A contact is the first point at which all requests for a service, advice or information and notifications are received.

2 A referral is a request to Children’s Social Care for a service. Where a referral can be dealt with by the provision of appropriate advice, information, signposting to other services, or problem solving without the need for further assessment, this will be an appropriate response. Where there are child in need concerns it is appropriate to ask any professional referrer whether they have considered a Common Assessment Framework (CAF).

3 An initial assessment is a brief assessment to gather further information about the child’s circumstances. The assessment is carried out to determine whether a child is in need, whether they require any services to meet that need or whether more detailed assessments need to be undertaken. An initial assessment can be

14 used to assess the needs of disabled children and the support needs of their parents/ carers.

4 A core assessment is an in depth assessment which addresses all aspects of the needs and strengths of a child and the capacity of parents to meet these needs. It follows from an initial assessment or from a Section 47 enquiry strategy meeting or child protection conference.

5 A Section 47 enquiry is undertaken where a child may be suffering or is likely to suffer significant harm. This is done in accord with ‘Working Together’ 2006 and MKSCB multi-agency safeguarding procedures. This will involve a strategy meeting which may lead to a child protection conference or to a core assessment depending on the circumstances.

6 The social worker is encouraged to consult with a child protection co- ordinator at any point in the process from referral to initial or core assessment and throughout the implementation of the child in need or child protection care plan. Consultation with the child protection co-ordinators is available to discuss any safeguarding concerns and seek their independent advice. Consultation can be used to discuss the need for a child protection conference. In deciding the way forward, the team manager will take into account the advice of the child protection co-ordinator

7 An initial child protection conference will normally be held:

 Where the section 47 enquiry has found the concerns are substantiated and that the child may continue to suffer, or be at risk of suffering significant harm

 Where a child who is subject to a child protection plan in another authority moves permanently into Milton Keynes

 Where a child in need (family support) plan is in place and the professionals involved agree that there is a likelihood of significant harm (including neglect) which the plan has not been able to effectively address. In these circumstances a strategy meeting will be convened first.

15 Milton Keynes Children’s Trust

1. A conceptual model for meeting children and young people’s needs

Up and down the country many local Children’s Trusts have found it useful to adopt a shared framework and conceptual model for all work with children and young people. The conceptual model (page 9) is a way of developing a shared understanding and explaining the Milton Keynes approach across all our services, to all practitioners and managers working with children and to children and families themselves. The model illustrates how we will respond to children and young people across four levels of need – Universal; Additional; Considerable; and Intensive.

At Level One - Universal, the child and their family have core needs that are best met through the provision of universal services - primarily health, schools and settings, early years and community/ leisure services.

At Level Two – Additional, the child and family’s needs can usually be met by the provision of extra help from one or two universal or targeted services. Discussion of the issues in an age appropriate way with the child and their family should take place and then a plan agreed. Where this involves two services, the discussion and the plan agreed are best recorded through the completion of a Common Assessment (CAF). The plan will identify the extra support to meet the additional needs. A Lead Professional (LP) or Team around the Child (TAC) meeting is not usually needed. The plan can be reviewed by the workers, child and family. Opportunities for disabled children; housing issues; behaviour problems at school; these are all indicators of where the CAF might be beneficially used at Level 2.

At Level Three – Considerable, the child and family’s needs are more complex and a multi-agency/disciplinary approach will meet them best. Again, discussion with the child and family is the first step, followed by completion of a CAF. A Team around the Child (TAC) meeting may well be the best way to organise support and services and a Lead Professional may be needed to co-ordinate services. Risk of exclusion; concerns about child development; persistent non-school attendance; danger of offending; these may all be indicators of where the targeted approach using TAC and LP is best used.

At Level Four – Intensive , the child is likely to be at risk of significant harm or their development will be seriously impaired if services are not provided. Referral should be made to services with the power to undertake statutory non-voluntary intervention and services with specialist skills, such as Children’s Social Care, Child & Adolescent Mental Health Service (CAMHS), and Youth Offending.

For more detailed information on the four levels, please see the next page and Section 5 - Indicators of Possible Need – pages 24 to 31.

16 Milton Keynes Children’s Trust - Levels of Need

Level 1 Health, schools and other open All children and young people who live in, Universal access services, along with or are found in, the area aged 18 or parents/ carers meet all needs under, whose needs are being adequately met by their parents/carers Level 2 Life chances may be impaired without services Additional (Example of concerns/services) Targeted Youth Services CAF School holiday provision for Children with additional needs who would (if more than disabled children benefit from extra help from agencies/ one service is Connexions services to make the best of their life needed) Early Support for Young children chances. with Disabilities Housing Advice and Support Concerns about learning Parents who through illness/ disability need help with child care TEXT Level 3 Life chances will be impaired without services Considerable (Example of concerns/services) Tier 2 CAMHS Children who are unlikely to reach or Platform 8 to 13 maintain a satisfactory level of health or CAF & LP & Targeted Youth Services development, or their health and TAC Speech and Language Therapy development will be impaired, without the Targeted Parenting Support provision of services. Short Breaks (disabled children) Children who are disabled and have Risk of exclusion complex needs. Homelessness prevention Children whose health or development is Persistent absence being impaired or there is a high risk of Where mental illness or impairment. substance abuse impair parenting Level 4 Risk of significant harm/ Children who have suffered or are likely removal from home/significant to suffer significant harm as a result of Intensive longer term impairment abuse or neglect (Example of concerns/services) Children with significant impairment of Initial and Child Protection function/learning and/or life limiting Core Children in Care illness Assessment, Youth Offending Children with challenging/self harming S47 Tier 3 & 4 CAMHS behaviour investigation Behaviour Partnership Children involved in crime/misuse of CP Strategy Health care for life limiting illness drugs at a significant level meeting

17 The Conceptual Model – ‘Windscreen’

Level 2 Level 3 CAF (if more than CAF, TAC, LP one service is needed)

Level 4 –refer to children’s social Level 1 care or other specialist If unsure assessment Consult