Early Help (EH) and Neglect Briefing Note


The NSPCC’s annual report ‘How Safe Are Our Children?’ compiles the most robust and up to date child protection data. It states:

In Bolton, there is a good multi-agency framework to tackle neglect at all levels. This briefing note focuses on how we can support families before neglect becomes a serious issue and crosses the social care threshold.

·  Early Help (EH) is providing support as soon as a need emerges

·  Prevention is about intervening before something becomes a major problem

Consider the following issues when using the Early Help Process:

It is reasonable to assume that few parents will know about the Early Help process and may feel apprehensive about what it involves. Some may feel criticised and that professionals are taking control over their lives. Although it may seem inappropriate to use the term ‘neglect’ at this point, it is important to be open and transparent with families about your concerns, but also about your aspirations that the situation can improve. Be clear that you will be working ‘with parents’ and not ‘doing to them’. There is a significant relationship between the effective engagement of parents and improved outcomes.

Be clear that using the EH process is about providing help as soon as needs emerge and to stop things from getting worse. It is really important to take the time to explain what Early Help can offer. Make sure that you give a copy of the Early Help leaflet to help explain. Copies can be collected from the Integrated Working Team (01204 331392/4).

Evidence based tools can help you to gather information and focus on what you are concerned about. They can also be a practical way to start conversations that some families might find challenging. (See page 4 for suggested tools).

When completing the assessment - consider:

Child development section:

·  Describe how the child is developing in relation to your expectations of a typical child of this age? – include areas of strength as well as where the child lags behind their peers

·  How does the child view themselves? Does their family life impact on their social relationships? Is their behaviour challenging? Include their views

·  Identify where the home environment may impact on their development in relation to health, physical development or speech, language and communication

·  Identify the impact of reduced participation/attendance in education is having on their learning

Parents and Carers section:

·  The child’s perspective and experience – in what way are their basic care needs being met or not met? How does this affect them now and how might it impact on them in the future? Have you spoken to/observed the child and recorded/considered their words?

·  Is there anything about parents’ own childhood or their current support needs that has an impact on their ability to parent their children?

·  Parental/child relationships and attachment

·  How much do parents want things to improve? – Are they able to achieve this?

·  How well do parents work with services – has this been better or worse in the past?

Family and the wider environment section:

·  Are there other family members that can or are supporting the family or could be having a detrimental effect

·  Housing and environment – is there any positive or negative impact on the children?

Understanding the information gathered from the assessment

Firstly, check that all the information you have gathered and discussed with the family and other professionals provides a clear, balanced, accurate and relevant picture. Does it describe how it affects the children – both positively and negatively? From this picture, it should be clear what needs to change and what support is needed to make this happen, how you will be able to describe what positive change looks like. If you can be clear about this, then action planning, expectations of family members and how progress can be measured will be easier for everyone.

Make sure / Are clear

Action Planning

·  Identify the goals you are trying to achieve as identified above, what actions need to be taken and by whom and what the timescale is

·  Practical support from workers can help make ‘quick wins’

·  Set a date to review progress – how quickly you review will depend on your level of concern, but in cases where you have concerns about neglect, this should be no longer than 10 weeks

Reviewing:

·  Has change happened? Sometimes a stepped approach is needed and small steps to improvement can be measured, however this cannot be allowed to drift

·  Can change be sustained?

·  Is there evidence of positive engagement with families?

·  Do you need to reconsider the level of risk or revise your plan?

·  Have you discussed the plan and progress with your manager?

TOOLS

A Day in the Life of Child/Parent

Day in the Life – a tool to understand, from a child’s perspective what life is like on a daily basis, who provides care, who takes responsibility, highlighting areas of strength and concern. Sometimes it is useful to use a clock to go through the whole day. Areas of anxiety and concern often happen in the evening and at night when no-one may see the child. The same activity can be undertaken with parents to see if their account matches the child’s.

Three Houses Tool

To ascertain children’s views about their House of Worries, House of Good Things and House of Dreams.

My World Triangle

Using the My World Triangle allows practitioners to consider systematically:

How the child or young person is growing and developing

What the child or young person needs from the people who look after him or her

The impact of the child or young person’s wider world of family friends and community

Graded Care Profile

This is an assessment tool to help practitioners identify when a child is at risk of neglect.

Graded Care Profile identifies strength and weaknesses across 4 key areas:

These four areas are subdivided into topics and scored from one being the best to five with the greatest concern.

Adverse Childhood Experiences Questionnaire

Adverse childhood experiences (ACEs) include but are not limited to: Use of this questionnaire can help parents acknowledge that they themselves have experienced events which will have impacted upon them and indicate support may be helpful for them in developing parenting skills.

Themes arising from Multi-Agency Neglect Audit July 2017

Strengths:

·  Assessments showed that practitioners had a clear understanding of the ways in which different forms of neglect affect children and took into account family history and the cumulative impact of neglect

·  There is evidence in all of the assessments of agencies working together to share information to ensure a holistic assessment of the child and their parents

·  Some use was evident of tools and/or research to support direct work with the child and family and the analysis in the Child and Family Assessment; including the Graded Care Profile, 3 Houses and ‘Day in the Life’

·  In the majority of cases the key partners attended multi-agency meetings regularly and consistently

·  It is clear that thresholds to access assessments and services from social care are understood and applied consistently

Areas requiring further improvement:

·  There remains a challenge in using the Early Help Assessment and Plan when neglect is an emerging issue for a child

·  The use of tools to understand the nature of neglect and its impact on children within a sibling group are not consistently being used

·  Understanding and responding to resistance from children and parents remains a challenge; there is little evidence that the resistance is assessed or explored in order to evaluate the underlying causes or to develop strategies to respond

·  The impact on children of bereavement or loss of contact with a significant adult in their life did not inform the assessment

·  In sibling groups there can be a tendency to focus on the child with most overt and presenting risk and this means the impact, risks and experiences of the other children get lost

·  Understanding children’s culture and diversity remains a gap and an area where perhaps practitioners struggle to understand what and how to explore these issues

·  Plans were felt not to be of good enough quality

·  Where the presenting risks to children are complex and high and interventions are not working, multi-agency groups appear to struggle to evaluate why interventions are not effective and the default response is to input even more services

·  Where there has been drift there is no recorded evidence of challenge from other practitioners

·  Practitioners rarely see neglect and its impact in adolescent children unless this is associated with the needs of a younger sibling or by the child’s own high risk behaviour, such as persistently missing, anti-social behaviour, aggression and violence

If your assessment identifies a risk of significant harm to the child(ren), the Early Help Assessment should be completed or reviewed and shared with the MASSS team after contacting them by phone on 01204 331500. When completing the EHA, the “Is this significant harm?” tool on the BSCB website could be used, to help to specifically identify your concerns.

06/10/2017 Page 4 of 4