Chapter Four

Early Prevention through to Referrals to Children’s Social Care

In this section:

Early prevention when there are child welfare concerns
Common Assessment Framework (CAF)
When to appoint a lead professional
Principles of common assessment framework/lead professional working
Referrals to children’s social care
How to refer
Safeguarding responsibilities and the duty to refer
The framework within which children’s social care responds to all referrals
Distinguishing between a referral for support (section 17) and protection (section 47)
Feedback to referrers
Special Situations: Referrals which cross Boundaries

Early Prevention when there are Child Welfare Concerns

4.1 Multi-agency working can make a unique contribution to preventative and early intervention services, because it has been shown to be the most effective way of addressing the wide range of risk factors that contribute to poorer outcomes for children and young people.

4.2 A web-based toolkit resource to support managers and practitioners delivering multi-agency services is available at: http://www.everychildmatters.gov.uk

The toolkit covers:

The benefits of multi-agency working
Success factors for effective multi-agency working
Practical advice on setting up services
Activities to help managers and practitioners work through some of the issues
Examples of effective practice from a number of areas
A common language glossary, exploring how practitioners from different backgrounds use common terms
An agency A-Z explaining the roles and responsibilities of different agencies

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4.3 Common Assessment Framework (CAF)

The Common Assessment Framework (CAF) is:

A “framework for helping practitioners assess children’s needs for services earlier and more effectively, develop a common understanding of those needs and agree a process for working together to meet those needs” and

"A shared assessment tool used across agencies in England” providing “A common method of assessment across all children’s services and across all local areas”. It aims to help early identification of needs, leading to co-ordinated provision of services, involving a lead professional where appropriate, and sharing information to avoid duplication of assessments. This also reduces the need for children or their families to re-tell their story to different practitioners.

It provides an easy to use assessment that is common across agencies. It supports better understanding and communication among practitioners; facilitates early intervention, speeds up service delivery and reduces the number and duration of different assessments.

4.4 CAF Functions

The CAF has the following primary and supporting functions:

Primary function

The CAF is an assessment of need resulting in an action plan.

Secondary functions:

The CAF is a standard means of exchange for information sharing.
It is an overview summary of current services provided (in situations not considered ‘complex’.
It provides a standard request for resources (‘referral’) format between a practitioner requesting a resource (CAF Assessor) and a provider of a resource (Specialist Provider).

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When to appoint a Lead Professional

4.5 The Lead Professional (LP) is the person responsible for co-ordinating the actions identified in the assessment process and being a single point of contact for children with additional needs being supported by more than one practitioner.

4.6 A Lead Professional should be appointed at the conclusion (Action Plan) of the CAF assessment process where the CAF has identified that the child has additional needs requiring an integrated response

4.7 A Lead Professional should not be appointed when:

Additional support can be provided from core mainstream staff working closely together
Where there is no integrated response needed from services and where the child / parent does not require support in managing different services

4.8 The Lead Professional has a set of functions to be carried out as part of the delivery of effective and integrated support. Whilst ensuring the children and parent remain central to any decisions the Lead Professional should perform the following functions and tasks:

Acting as single point of contact for child and parent
Co-ordinating the delivery of the actions agreed by the practitioners involved
Reduce overlap and inconsistency
Identify where additional services may need to be involved and put processes in place for brokering their involvement
Lead on reviewing CAF action plan
Support child through key transition points

4.9 Consequently, the Lead Professional needs to be kept aware of (but is not responsible for) any changes to the CAF assessment or action plan.

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4.10 Principles of Common Assessment Framework/Lead Professional working

Children & parents should be involved throughout
CAF cannot be undertaken without explicit agreement of the child and/or their parent.*
The views of the child and parent should be considered when agreeing Lead Professional
The parent is considered as a possible Lead Professional for their child in appropriate and defined circumstances
CAFs should promote information sharing and not replace the conversations between practitioners or families
CAF should be electronically enabled, i.e. computerisedpractitioners are individually accountable for what they enter on
CAF to the children and parents they are working with, to other practitioners and to their line managers and/or professional bodies
Wherever practicable CAF should replace current paperwork (so reducing duplication)
When to start a CAF is a matter of practitioner and professional judgement
CAF/LP work should support cross-boundary working arrangements

* Parental powers to control their children reduce as a child matures. The rights of parent give way to the child's right to make important decisions when 'he or she is of sufficient understanding and intelligence' to be able to make up his or her own mind. This is known as Fraser Competence.

When to use the Common Assessment framework

4.11 A period of Common Assessment is best seen as an 'episode' - a process of assessment, resource provision and, ultimately, a resolution.

4.12 The CAF Episode begins when there is an initial identification of a child as having ‘additional need’.

4.13 The CAF Episode:

Can only start with the explicit agreement of the child / parent (depending on age and understanding of the child)
May include events such as reassessment (including modification of needs and/or strengths) or changes to the action plan
May include a request for, and provision of, resources

4.14 A CAF Episode should be considered (after consulting the child / parent and the child's practitioner network) whenever a practitioner believes that a child will not progress towards the five Every Child Matters outcomes without additional services (i.e. child has ‘additional needs’) and:

Needs are unclear or broader than the single service can address
Common assessment would help identify needs, and/or get other services to help meet them
Establishes if the identified additional needs are being met

For further guidance on supporting families within the Common Assessment Framework, please use the hyperlink to CAF Guidance.

4.15 A CAF Episode should not be started when there are child protection concerns, i.e. concerns that a child may be harmed or is at risk of being harmed. In such circumstances the appropriate course of action is to refer to children’s social care.

4.16 The remainder of this chapter concerns when and how referrals to children’s social care should be made and the range of responses which may follow.

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Referrals to Children’s Social Care

Considering What to Refer

4.17 Each agency must have its own initial process for responding to reported concerns about children. This should include quickly identifying:

What the concern is: - what indicates that the child/family is in need of support or protection
Evidence of the concern and its possible impact on the child
What the agency has done about the concern
The impact of actions taken already
Other relevant knowledge of the child and family

Concerns about a child or young person's welfare must always be recorded whether or not further action is taken

4.18 Agencies have a responsibility to be aware of the threshold criteria of children’s social care for their core business. However, if in doubt, they are welcome to consult with children’s social care regarding the appropriateness of referral. It is possible to seek advice without giving identifying information. It helps to be as clear as possible about what is expected of children’s social care. At the end of the conversation an agreement will be reached about whether this enquiry will proceed to a referral. If it appears that the concern does not reach the threshold for child protection, but may meet the threshold for providing children’s social care services, the referring agency has to seek the consent of the parents for initial assessment by children’s social care to proceed.

4.19 Where concerns may reach the threshold for child protection enquiries, issues of when and how to involve parents are more complex – and are fully addressed in chapter 5 paragraphs 5.30 to 5.39

4.20 Referrals may relate to children whose homes lie outside the boundary of the local authority in which they may be found e.g. children who attend schools or playgroup or are on holiday.

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How to Refer

4.21 New referrals and those on closed cases should be made to the children’s social care duty desk. Those for cases already allocated should be referred to the current social worker.

Contact Telephone Numbers.

It is vital that referrers provide as much information as possible about:

The nature of concerns
How and why those concerns have arisen
What appear to be the needs of the child and family, including any special needs arising from cultural, physical, psychological, medical and other factors if known, what other agencies and professionals are involved with the child and family
Whether there is any reason why the referrer's identity cannot be shared with the family (the assumption is that, in the case of professionals who refer, the family will be told who has referred)
Whether it is necessary to consider urgent action to ensure the child is safe from harm

4.22 All staff making a referral by phone must confirm the referral in writing by secure e-mail or fax within 24 hours. If the referrer has not received an acknowledgement within 3 working days, they should re-contact the Local Authority.

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Safeguarding responsibilities and the duty to refer

4.23 Any professional worker, whatever their role, has a responsibility to ensure that knowledge or suspicion of child abuse is referred to children’s social care or the police. This applies to those who work directly with children and to those who work with adults who may also be parents/carers or otherwise have contact with children.

4.24 Where there is disagreement between clinicians/practitioners about the need to refer a child protection concern, each person retains a personal responsibility to refer if he/she remains concerned. See also Chapter 23: Resolving Professional Disagreements.

Where any professional has sufficient concern about possible child abuse to have advised a parent of their intention to make a referral, there should be no unilateral withdrawal of that referral. The full information should be considered in consultation with children’s social care.

4.25 Front-line staff in each of the agencies, who regularly come into contact with families, must ensure that in each new contact, basic information about the child is recorded. This must include the child's name, address and age, the name of the child's primary carer, the child's GP, and the name of the child's school if the child is of school age. Information should be sought to fill gaps in the basic information.

4.26 Where any professional establishes that a child of school age does not have a place in a school, he/she must alert the education authorities. Local authorities have named officers responsible for receiving details of children found missing from education, contacts as follows:

*Leicestershire*	*Deputy Service Manager, Access and Welfare*	0116 2658162
*Leicester*	*Principle Education Welfare Officer*	0116 2211260
*Rutland*	Team Leader Strategic Responsibilities for the Education of Vulnerable Children	0157 2758485

4.27 Key issues for those referring to bear in mind also include:

A child or young person's account about an allegation of abuse must be taken seriously
Any disclosures by a child, together with any questions asked and answers given, should be recorded contemporaneously where possible, or, if not, as soon as practicable after the event. This record should be made available to investigating agencies
There are precise guidelines surrounding the interviewing of children and alleged perpetrators, and staff specially trained to undertake this task. It is important, therefore, that the person to whom a child discloses information does not seek to investigate or question the child except to clarify what they have heard. This is particularly important in cases of sexual abuse
In taking any initial action the importance of preserving evidence must be remembered
Emergency action to protect a child or young person must never be delayed. This includes immediate medical intervention where necessary

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Responsibilities of Children’s Social Care

4.28 When a parent, professional or other person contacts children’s social care, it is the responsibility of the allocated or duty social worker to clarify with the referrer the full details of the child and other family details that are known.

4.29 The social worker will ascertain the nature of the concerns, whether they are regarding a child in need or whether there are concerns about abuse or neglect.

4.30 Anonymous referrals must be taken as seriously as other referrals.

4.31 At the end of the discussion both the referrer and the social worker should be clear about:

Whether action will be taken
What that action will be
By whom
Whether the referrer agrees with the planned action

4.32 This initial outcome must be recorded by children’s social care and by the referrer (if a professional from another agency). Social worker and manager must acknowledge receipt of a written referral and decide the next course of action within 1 working day.

Please refer to page 142 of Working Together to Safeguard Children 2006 WT flowchart (PDF doc, 1237 Kb)

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The Framework within which Children’s Social Care responds to all referrals

4.33 When any referral is received by children’s social care, a decision must be taken within 24 hours whether the child or young person requires an assessment. Where there is insufficient information provided to reach this initial decision, the referring agency may be asked to provide further details before the referral can be accepted.

4.34 Where the information provided indicates that the child's situation is within the remit of children’s social care, there are then 7 working days in which an initial assessment should be completed. This applies to all eligible referrals, whether or not there are child protection considerations.

4.35 Where there are child protection considerations, referrals are subject to an initial assessment to determine whether they should be responded to as children in need of support (Children Act 1989 Section 17) or children in need of protection (Children Act 1989 Section 47.

4.36 Children’s social care will use the initial work of the referring agency prior to referral to inform their assessment. Children’s social care is the lead agency for child protection enquiries and it is their responsibility to determine whether the situation requires assessment for support or a child protection enquiry.

4.37 In many situations a supportive approach and services will prevent child abuse or neglect developing. Where the referral indicates developing concerns about how well a family is managing the care of their child but does not indicate immediate danger, there will often not be recourse to the child protection procedures. Children’s social care may, however, agree that it is appropriate to continue an initial assessment of whether the child is in need of family support services.

4.38 In those situations where children’s social care becomes involved to assess family support needs, it will normally be expected that agencies will have taken responsibility to assess the needs of the child and explored other routes to support the family, both voluntary and statutory, before a referral to children’s social care.

4.39 Where the concerns quickly indicate that the child may be suffering or is likely to suffer significant harm, the initial assessment may be brief and the decision is taken to move to a child protection enquiry under these Procedures. This also begins a core assessment.

Please refer to chapter 5: Child Protection Enquiries, including medical assessments

4.40 When children’s social care receive a referral which constitutes or may constitute a criminal offence, they will discuss the case with the police at the earliest opportunity. All Section 47 enquiries and many Section 17 referrals involve a criminal offence or suspicion of a criminal offence.

4.41 If the referral is about Under Age Sexual activity, please refer to Chapter 21: Managing Reports of Under Age Sexual Activity

4.42 It may be necessary to take emergency action to safeguard the child; this should be preceded by an immediate strategy meeting / discussion between the police, LA children’s social care and other relevant agencies.

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Distinguishing Between a Referral for Support (Section 17) and Protection (Section 47)

4.43 When considering whether the referring situation is one that requires support (Section 17) or child protection enquiry (Section 47 enquiry) the following factors will be taken into account. They do not carry equal weight and are examples only. They are not an exhaustive list, and are subject to professional judgement.

4.44 Family Support (Section 17) Assessment: The following circumstances may prompt a family support assessment rather than a child protection enquiry:

Minor bruising other than to a non-mobile baby or child
Minor injury as a result of inappropriate chastisement where there is no significant history of previous concerns
Minor injury caused by a sibling who is not an adult
Minor injury as a result of a dispute between parent and teenager
Parent genuinely remorseful/keen to deal differently, in the context of a relatively minor, out of character, act of abuse
Neglect has obvious cause with which parent is asking for help to change
Minor injury resulting from poor supervision

4.45 However, the following additional factors may add sufficient concern to indicate that a child protection enquiry is more appropriate, even in the previously listed circumstances:

Child is very young or very vulnerable
Where there is an emerging pattern of minor injuries
Where parental problems of mental illness, drinking or drug use and domestic violence co-exist
Where there are incidents of domestic violence
The above factors are not a check list and not a substitute for professional judgement about the individual circumstances of each situation.

4.46 Important: Remember too that any assault, however minor, is a criminal offence, even if children’s social care judge that there is insufficient to suspect significant harm to the child. Children’s social care will discuss with the police in deciding what to do. More often than not this will entail an initial assessment by the police who will then decide whether they need to remain involved.

4.47 Child Protection enquiries (Section 47) enquiries: A child protection enquiry will almost certainly be indicated where the following apply:

An allegation of sexual abuse
Any injury, however minor, to a non mobile baby or child
Alleged or suspected serious physical injury
Less serious injuries or assaults where there have been previous concerns regarding abuse or ill-treatment
Suspicion of fabricated or induced illness. Please refer to Chapter 14 - Fabricated or Induced Illness (FII)
Neglect is serious, and standards of living for adults are markedly better than for the child
Repeat of neglect after family support services have been given previously
Injury/treatment is sadistic/brutal (i.e. pain/distress caused deliberately and giving the adult satisfaction)
Where children are the subject of parental delusions, or are targets for parental aggression, rejection or neglect for pathological reasons
There is no consistent explanation/no admission of what is clearly abuse
Domestic violence where the child has been injured, even if inadvertently

The management of child protection enquiries and related criminal investigations is set out in detail in Chapter 5.

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Feedback to Referrers

4.48 Feedback should always be provided to the referrer even if no action is to be taken. If the referrer is a member of the public, this should be done in a way consistent with respecting confidentiality of the child. Feedback to a professional who refers should be in writing.

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Special Situations: Referrals which cross Boundaries

4.49 Leicestershire, Leicester City and Rutland children living near the boundaries of other authorities may come into contact with agencies based outside Leicestershire and Rutland. Similarly children from other local authorities may come into contact with agencies in Leicester, Leicestershire or Rutland.

4.50 In addition there are frequently occasions when a child or family known to agencies in Leicestershire, Leicester City or Rutland moves to an address in another area, or a child moves into the area of one of the three authorities from elsewhere.

4.51 Where a child is in contact with agencies from another authority, the following general arrangements should apply:

All cases of suspected child abuse will be dealt with according to the procedures of the authority in which the child ordinarily resides
Apart from any necessary action to afford immediate medical treatment and protection to the child, the case will be referred as soon as possible to the child's "home" children’s social care, who will conduct the investigation and ongoing work
Should the child or young person be temporarily resident in another authority, that authority is responsible for any initial investigation of child protection concerns
Where a child and/or family moves across an administrative boundary ALL agencies should ensure that the fact of the move, details of the child, and the basis for any concern, are passed on to their opposite number in the new authority
Where a child is subject to a statutory order to a local authority, that authority retains ultimate responsibility although the new authority may agree to act as agent. This agreement should be in writing
where a child is subject of a child protection plan, the originating authority retains responsibility until the new authority has held a conference and reached a decision on whether a child protection plan is appropriate. Please refer to Chapter 7: Core Groups and Child Protection Plans)
Where neither of the above apply, but where there are concerns which fall short of the need for a child protection plan, all agencies should consider:
Whether these concerns are sufficient to make it appropriate to pass information on about them, and
Whether information about the move should be done quickly rather than waiting for standard channels of information to be triggered, as these may be subject to some delay.
Where an agency has been working with a family which moves but there are no child protection concerns, the agency should consider what information should be passed on, having regard to issues of consent required to share information.

4.52 Where a children’s social care service provides help under Section 17 which involves providing or funding accommodation out of their own area, the placing authority does not relinquish responsibility for the case unless it is specifically and formally transferred to another local authority. In addition, the placing authority should consider whether it is in the child's best interests to advise the second authority of the placement, and should do so unless there are strong reasons not to. Special situations: Managing child Protection Referrals in Respect of Children Attending Hospital Outside Leicester, Leicestershire and Rutland

4.53 Leicester, Leicestershire and Rutland children and young people living near the boundaries of other authorities or requiring certain specialist medical treatment may attend at or be admitted to hospitals in neighbouring counties and the first suspicion of child abuse will sometimes arise in these locations.

4.54 Cross boundary working together requires liaison between professionals who may not have established working relationships. Procedures and working practices between different Health Authorities and different Local Authorities can also vary. These circumstances present particular challenges to effective communication and collaboration. Key factors are clarity about:

Where responsibility lies for responding in the first instance
Channels for subsequent communication

4.55 The designated child protection doctor and nurse for the health community will act as facilitators where communication and information sharing becomes difficult.

4.56 When concerns arise about the safety of a child in a hospital outside the jurisdiction of the three authorities subject to these procedures, hospital staff should follow their child protection procedures and refer the child to children’s social care in whose area the hospital is situated.

4.57 The children’s social care local to the hospital is responsible for responding to the child protection concern. When determining what action to take, it should liaise closely with the relevant “home” children’s social care within Leicester City, Leicestershire or Rutland.

4.58 There may be a need for immediate protective action because the child or young person’s removal from hospital would place him/her at risk of significant harm. Such action may be taken by the Police in the locality of the hospital. If an emergency protection order is to be sought, children’s social care in whose area the hospital is placed is normally expected to apply for the order.

4.59 It is expected that that there will be consultation between the two local authorities and agreement about what action to take, because future involvement with the child and family is the responsibility of the local authority in whose area the child is normally resident.

4.60 Where the child remains in hospital and child protection enquiries indicate the need for a child protection conference, responsibility for convening the conference lies with the child’s “home” authority. It may be that the venue for the conference will need to be at the hospital where the child is, to ensure the attendance of key medical and nursing personnel.

Disagreements About the Handling of Reported Concerns.

4.61 For disagreements over the handling of reported concerns please refer to:

Chapter 23: Resolving Professional Disagreements Related to the Safety of Children.

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