Early Help and
Neglect Strategy
2015 to 2017
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Contents
Section
Page
Foreword
3
Development of the Strategy
5
Introduction
6
Definition of Early Help
9
Vision
10
Why does Durham need an Early Help Strategy?
11
Early Help Across Durham’s continuum of need
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Levels of Need
18
Model: The Durham Staircase & Continuum of Need
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Cross Cutting Themes
21
Early Help: Progress to Date
22
Measuring the Impact
25
Commissioning
26
Governance and Accountability
27
Joint Action and Commissioning Plan
28
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Foreword
This strategy sets out our commitment to provide early help to combat neglect and its causes in
County Durham. All partners will identify need early and offer support to children and their
families that will make a positive difference to their lives.
It updates the Early Help Strategy 2014 and makes clear the direct link to neglect and hidden
harm (alcohol and substance misuse, domestic abuse and mental illness).
The Early Help and Neglect Strategy outlines our partnership commitment to deliver early timely
help to children, young people and their families in County Durham. It outlines our shared vision
and principles, our shared ambitions and objectives and how collectively we will deliver stronger
services, improve outcomes for people and reduce cost to our services and communities.
Early help is a key principle in a broad range of partnership work and has many cross cutting
themes and objectives. An effective early help and neglect strategy is not a static document, as
such this strategy and its implementation will be regularly reviewed and developed by Durham
Local Safeguarding Board (LSCB).
The Early Help and Neglect Strategy is for all those who work with or who have an interest in
the outcomes of children, young people and their families in County Durham.
Too many children and young people suffer the consequences of growing up in neglectful
circumstances. This blights their lives and condemns them to a future in which their ambitions
are unfulfilled. This strategy makes the strongest possible statement that we will work together
to find and address neglect and hidden harm in all its forms, so that families can thrive and
provide the environment for their children to reach their potential.
We believe, and our experience tells us, that by working with parents and children, by helping
them find solutions to their problems, the majority of families can provide a stable, loving home
for their children.
We also recognise that some families will not be able to make the changes required, despite
help and support. This strategy is supported by practice guidance for professionals to evaluate
parents’ capacity to change and ensure that there is robust, timely decision making to avoid the
damaging harm to children that neglect causes.
We understand that neglect often arises where other parental needs exist; in particular alcohol
and substance misuse, domestic abuse and mental illness. This strategy requires all partners to
work together to address these hidden harms and meet the whole range of needs families may
face, using a ‘Think Family’ approach.
I would like to thank all of our partners who have contributed to the development of this strategy.
It is based on a firm base of consultation and a great amount of support has been received
throughout. The updated Early Help and Neglect Strategy 2015 acknowledges the significant
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progress that has been made since the 2014 strategy was agreed and takes our partnership
forward to tackle the challenges that remain.
This updated strategy describes the continuation of our journey. Its shared vision and ambitions
and our commitment to ‘getting it right’ will continue throughout its implementation and across
all our partnerships.
Jane Geraghty
Independent Chair - Durham Local Safeguarding Board
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Development of the Strategy
The Early Help Strategy 2014 was developed through discussion and consultation with partners
across the County Durham Partnership. The wide range of views and feedback enabled us to
be confident that the strategy was taking us in the right direction and was consistent with our
ambitions of ensuring children, young people and adults who are parents and carers get the
right support at the earliest opportunity.
The Early Help Strategy 2014 was based on a sound evidence base relating to ‘what works’,
with the voices of children, young people and parents at its heart. Their views were sought
through commissioned work through Investing In Children as well as reference groups working
with groups of children and parents from within our existing services.
From this consultation we know that children and young people value;
 Trust, openness and honesty
 Being treated with respect
 Support for their parents as well as themselves
Partners and stakeholders views were gathered through a series of consultation workshops. In
addition Senior Management Teams; Services; reference groups; one to one’s; Community of
Learning Groups, Partnerships and Forums across County Durham all hosted Early Help
consultations. This information was collated and feedback from all consultation informed the
development of the first strategy.
The 2015 strategy has been updated by the Durham LSCB Early Help Sub Group with support
from the Local Early Help Forums and has used the work of the national Early Intervention
Foundation (EIF) to provide a comprehensive framework for action.
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Introduction
The majority of children and young people in County Durham will grow up and reach their
potential in a supportive environment.
However, some children, young people and their families face further difficulties and problems.
Additional help and support needs to be available at the earliest opportunity to stop these
challenges from escalating and negatively impacting on their future.
Evidence shows that the major issue facing children who need a Child Protection Plan is
neglect. By the time the situation has deteriorated to the point that protection is required,
children have often lived several years of their lives in these circumstances.
The aim of this strategy is to ensure that early signs of neglect and hidden harm are identified
and that help can be provided before the situation has escalated to child protection level. Very
often, neglect is driven by the unmet needs of parents - whether it is alcohol or substance
misuse, domestic abuse or mental health needs. Early help and intervention is essential to
reverse these issues.
Early help and intervention can range from appropriate advice and support and a single agency
response, through to the need for more coordinated, multi-agency and intensive support,
sometimes from specialist services. No matter what the cause of the need is, the sooner
support and intervention is provided, the better the outcomes for children and families.
In County Durham, we are well placed to move forward with the Early Help Strategy. Significant
progress has already been made in delivering timely early help and prevention services that
work well together. There is a well evidenced commitment set out across Durham’s Children,
Young People and Families Partnership and Durham LSCB to embed and promote Think
Family.
We will use this knowledge and commitment as a platform to embed early help, we will build on
what we know works and strengthen joint working across partners. By identifying needs and
providing support to children, young people and their families at the earliest possible stage,
outcomes will be improved and human and financial costs reduced.
When improvement does not result from the help and support provided, we recognise the need
to act decisively. This strategy will provide guidance for professionals on how to review progress
and expedite appropriate decisions in the best interests of children.
The Early Help and Neglect Strategy is inclusive. It is a strategy for all, for all partners and for all
of our children, young people and families, signifying our collective intention to identifying and
meeting need early.
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This document will:
1. Outline the vision and ambitions for County Durham’s Early Help and Neglect Strategy.
2. Define what we mean by early help in County Durham, how it relates to neglect and
hidden harm and why it is important within our services for children, young people and
families.
3. Outline the national and local policy directives and evidence driving the implementation
of the early help strategy, including the national focus on neglect and hidden harm.
4. Articulate the principles that underpin the future development and delivery of services.
5. Describe the role of ‘early help’ within our integrated delivery model, for supporting
children, young people and families and set out clearly what we plan to do and how we
intend to work.
6. Set out the implications of the Early Help and Neglect Strategy, how it compares to
current delivery and identifies the value and impact of partners and services across the
pathway of need, from universal to specialist services.
7. Describe the importance of effective commissioning across the County Durham
Partnership of services all partners will offer to children, young people and families.
8. Identify key priorities and actions for the implementation of the Early Help and Neglect
Strategy across all our services and our entire workforce.
9. Outline how we will measure the success of the strategy.
“Providing early help is more effective in promoting the welfare of
children than reacting later. Early help means providing support as
soon as a problem emerges, at any point in a child’s life, from the
foundation years through to the teenage years”.
Department for Education (2015) Working Together to Safeguard Children
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This document is supported by a suite of practitioner guidance, designed to provide succinct,
practical help to staff in all agencies across the partnership. These include:
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Screening Tool for Alcohol related risk
Neglect practice guidance (under review)
The Family Pack of Questionnaires and Scales
Cycle of Change
Home Conditions Checklist (under review)
Motivation to change questionnaire
Resilience/Vulnerability Matrix
Use of the risk and resilience matrix when planning for children
Using the child development checklist
Attachment
Attachment and Bonding Checklist
Wellbeing Tool
Three Houses
Adolescent Three Houses
Queen or King of the Island
Queen or King of the Island Exercise
Blank ecomap
County Durham Engaging Families Toolkit
Families First Team Support Menu
(Where the list above relates to an available document on the LSCB website a link has been
provide and underlined).
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Definition of Early Help
Children, young people and their families have different levels of need depending on their
individual circumstances and quite often these change over time with some families moving
between universal, targeted and specialist services.
Children can be helped in three broad ways:

Prevention

Early Intervention

Protection/ Targeted intervention / treatment
needs or problems that are serious or will endure.
So that problems don’t arise in the first place
So that problems are cut off at an early stage
So that something is in place for
At any of the three stages, there will be a need for some level of help which requires services to
be equipped and able to respond to these changing needs and demands.
The need for early help can occur at any point in time and at any age. Central to this approach
is a focus on increasing independence for families and communities, supporting and building
resilience.
It is a way of thinking and working that views children, young people and their families as equal
partners with an emphasis on doing ‘with’ rather than
doing ‘to’.
“intervening early and as
soon as possible to tackle
For the purpose of this strategy we refer to early help
problems emerging for
both in the context of the early years of a child’s life
children, young people
(including ante-natal interventions) and early in the
and their families or with a
emergence of a problem at any stage in their lives.
population most at risk of
developing problems.
We incorporate the concepts of ‘protection / treatment’,
Early intervention may
‘early intervention’ and ‘prevention’ and the importance
occur at any point in a
child or young person’s
of anticipating problems and taking action to prevent
life”.
these.
It takes in to account the individual needs of the whole
family including social, educational, physical and mental
health and wider impacts such as social and health
inequalities and material disadvantage.
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Centre for Excellence and
Outcomes -C4EO (2010)
Vision
At the heart of this strategy are our children young people and their families. We share the
vision of the Children, Young People and Families Partnership Plan that in County Durham
‘All Children, Young People and Families believe, achieve
and succeed’.
We want children and families to have the help they need as early as possible to stop needs
worsening. However, where a child is in immediate danger, services will respond swiftly to
safeguard them.
Improving the outcomes and life chances for all, particularly our most vulnerable through a
collaborative and effective early help offer is the foundation of this strategy.
We have used the Early Intervention Foundation’s (EIF) maturity matrix for early help to provide
a framework for this work and to ensure that all areas are considered. The EIF suggest that
action is required in five main domains:
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PLAN – improve the identification of children in need of early help through partnership
DELIVER – embed effective interventions into the practice of all partners to support
families and prevent escalation of need
EVALUATE – demonstrate the impact of our assessments and intervention on families
and children
LEAD – demonstrate system leadership, shared priorities and clear governance across
the partnership
FAMILY FOCUS – the experience of our families informs and drives the development of
To deliver in all of these domains, we need to work together and share the responsibility. We
will learn from best practice and deliver high quality preventative help and intervention backed
by evidence of success. We will ensure we have seamless, clear and efficient pathways into
and through services and have integrated approaches to screening, assessment, planning and
service delivery and system leadership.
By identifying need early and offering help early with high quality coordinated services we will
increase the number of children, young people and families reaching positive outcomes and
reduce the number of families requiring higher cost interventions.
These domains have been used to develop an action plan, based on a self-assessment
exercise involving the Early Help Sub Group and the Early Help Forums. The action plan is
included at the end of this document.
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Why does County Durham need an Early Help and
Neglect Strategy?
There is a focus on early help in County Durham because we recognise the importance and
impact of intervening early to achieve positive outcomes for children and young people, the
disproportionately high demand for specialist support for children and young people, and
because of the continued pressure on public
sector budgets.
There is widespread recognition that it is better to
identify risks offer help early and prevent
problems from occurring, rather than responding
later when risks have heightened and require
action from intensive, high cost and statutory
services.
For children, young people and families who
need additional help, every day matters. The
actions taken by professionals to meet the needs
of these children as early as possible can be
critical to their future. Similarly, the sooner
support is identified and delivered to children
suffering neglect or hidden harm, the better the
outcomes for both the child and the family.
“The case for preventative and
Early Help Services is clear, both
in the sense of offering help to
children and families before any
problems are apparent and in
providing help when low level
problems emerge. From the
perspective of a child or young
person, it is clearly better if they
receive help before they have any,
or only minor, adverse
experiences.”
The Munro Review of Child Protection, 2011
There is sound evidence both nationally and locally that early help needs to be a priority when
working with children, young people and their families.
National Drivers
Over the last two decades successive governments have emphasised the importance of Early
Help. Policy direction has set the way for strategic thinking and funding streams nationwide
including the Early Intervention Grant (EIG), the Healthy Child Programme, the Health Visiting:
Call to Action programme, the Social Mobility Strategy, Supporting Families in the Foundation
Years and The Troubled Families Programme.
The central importance of early help in enabling children and adults to reach their full potential
has been a common theme in five recent key Government documents.
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Professor Sir Michael Marmot 2010: Fair Society, Healthy Lives
The Rt Hon Frank Field MP 2010: The Foundation Years: Preventing Poor Children
Becoming Poor Adults
Graham Allen, MP 2011: Early Intervention, the next steps
Dame Clare Tickell 2010: Review of the Early Years Foundation Stage
Professor Eileen Munro 2011: Review of Child Protection
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All five are united in their call for early intervention and all have independently reached the
same conclusions on the importance of providing help early in order to improve outcomes for
children and young people and helping parents achieve the aspirations they hold for their
children.
These principles relate directly to the early help, support and interventions to tackle neglect, and
hidden harm in particular alcohol and substance misuse, domestic abuse and mental illness.
The foundations for virtually
every aspect of human
development – physical,
intellectual and emotional are
laid in early childhood. What
happens during those early
years, starting in the womb, has
lifelong effects on many aspects
of health and wellbeing, from
obesity, heart disease and
mental health, to educational and
economic achievement… Later
interventions, although
important, are considerably less
effective if they have not had
good early foundations.”
Marmot 2010
We have found overwhelming evidence that children’s life
chances are most heavily predicated on their development in the
first five years of life. It is family background, parental education,
good parenting and the opportunities for learning and
development in those crucial years that together matter more to
children than money, in determining whether their potential is
realised in adult life.
Field 2010
“The case for preventative and Early Help Services is clear, both
in the sense of offering help to children and families before any
problems are apparent and in providing help when low level
problems emerge. From the perspective of a child or young
person, it is clearly better if they receive help before they have
any, or only minor, adverse experiences.”
Munro 2011
Building their essential social and
emotional capabilities means children are
less likely to adopt antisocial or violent
behaviour throughout life. It means fewer
disruptive toddlers, fewer unmanageable
school children, fewer young people
engaging in crime and antisocial
behaviour. Early intervention can forestall
the physical and mental health problems
that commonly perpetuate a cycle of
dysfunction.
Allen 2011
The evidence is clear that children’s experiences in
their early years strongly influence their outcomes in
later life, across a range of areas from health and social
behaviour to their employment and educational
attainment. The most recent neuroscientific evidence
highlights the particular importance of the first three
years of a child’s life. A strong start in the early years
increases the probability of positive outcomes in later
life; a weak foundation significantly increases the risk
of later difficulties.
Tickell 2011
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Local Drivers
Neglect
The greatest single cause of children needing protection and care in County Durham is neglect.
63% of children were subject to a Child Protection plan in 2014 as a result of neglect, similar to
previous years. Neglect is a long term, chronic form of harm to children, and services offering
early help should be able to impact positively on outcomes for this group of children and young
people – either in reducing levels of neglect or in reducing delay that many children experience
before decisions are made about ‘good enough’ parenting.
It can be particularly difficult for practitioners
to recognise the signs of neglect because
there is unlikely to have been a significant
incident or event that highlights the concerns;
it is more likely that there will be a series of
concerns over a period of time that, taken
together, demonstrate that the child is in need
or at risk.
“Neglect is the persistent failure to
meet a child’s basic physical and/or
psychological needs, likely to result
in the serious impairment of the
child’s health or development.”
Department for Education (2015)
Working Together to Safeguard Children
Children (including those who are unborn)
need adequate food, water, shelter, warmth, protection and health care in order to thrive. They
also need their carers to be attentive, dependable and kind. Children are neglected if these
essential needs (the things they need to develop and grow) are persistently not met.
There are many signs that may indicate neglect as outlined below:
 Neglect may occur during or after pregnancy as a result of parental substance abuse
(drugs or alcohol)
 A chaotic family environment which can include an absence of boundaries or routines
 A parent / carer who has mental health difficulties or learning disabilities such that
impacts on their ability to meet the needs of any children
 Inadequate parenting and/or understanding of what it means to look after a child safely
including ensuring adequate supervision or using inadequate caregivers
 Ensuring access to appropriate medical care or treatment
 Ensuring that educational needs are met
 It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs
Signs of neglect can include poor physical appearance, bad hygiene, lack of appropriate
clothing, the child being withdrawn or exhibiting anti-social or sexualised behaviours, and the
child not meeting physical or emotional development milestones.
The above signs in isolation would not necessarily indicate for certain that a child is being
neglected, however, children who are severely and persistently neglected may be in danger and
neglect can also result in the serious impairment to their health or development.
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Some adults lack the resources and support to properly care for their children, but some have
more complex problems. In both cases help and support from professionals is essential.
Parental issues of domestic abuse, mental health and alcohol misuse continue to be key issues
which cause neglect in County Durham and are known collectively as Hidden Harm factors.
Unless parents’ issues are identified and supported through the provision of early help, the
outcomes for their children will remain poorer than their peers.
There is extensive evidence to show that this group of children often experience poorer
outcomes against a range of measures including education; higher prevalence within criminal
justice agencies, amongst others. The impact on children is both psychological and physical;
neglected children are smaller, fail to thrive and are less emotionally resilient.
Yet the circumstances causing neglect often take years to develop. If the early signs of neglect
and hidden harm had been recognised, and help offered, many families could have avoided
reaching the point where statutory intervention is required. For this reason, a single strategy for
early help and neglect is considered the best option for County Durham.
Serious case reviews are dominated by harm to babies and children under two. Although
young children are particularly vulnerable to neglect, as they are unable to care for themselves,
all partners need to remain vigilant to signs of neglect in children and young people of all ages.
Neglect of teenagers may be harder to identify but has the same impact.
Hidden Harm
Parental alcohol misuse has a considerable negative effect on children, young people and the
family. Children and young people experience poor outcomes due to parental alcohol misuse
including foetal alcohol syndrome, school attainment, inferior health and wellbeing, neglect,
greater likelihood of exposure to crime and alcohol-related domestic violence. In 2014/15
18.6% of initial child protection conferences in County Durham were as a result of parental
alcohol misuse. Balance (the North East Alcohol Office) estimate that 49,353 children living with
a parent(s) who drink at high risk levels in County Durham.
The main parental risk factor leading to a child being made subject to a child protection plan is
domestic abuse. In County Durham the levels of domestic abuse related incidents reported to
the police have seen a continuous but small increase since 2009/10. Domestic abuse continues
to be under-reported. Plans to build on the Central Referral Unit were developed as part of the
Early Help Strategy and resulted in the implementation of a Multi-Agency Safeguarding Hub
(MASH) launched in March 2015.
In September 2013 Durham County Council commissioned Harbour to deliver a countywide
domestic abuse service and a domestic abuse referral pathway was agreed and launched in
December 2014 as part of the multi-agency ‘Sorry’s Not Enough’ campaign. From April 2015
the countywide domestic abuse service was widened to provide a holistic service focussed on
early intervention. The LSCB has links to the County Durham Domestic Abuse and Sexual
Violence Executive Group (DASVEG) and we will continue to promote the need for domestic
abuse services to support children, young people and their families.
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Other challenges
Compared to national rates, our young people have a higher teenage pregnancy and childhood
obesity rate and County Durham is ranked amongst the worst of all Local Authorities for alcohol
related admissions for people under 18 years old.
Whilst their educational attainment has improved generally, the gap between those children in
the bottom 20% and their peers remains wider than in other Local Authority areas.
County Durham experiences higher levels of deprivation than the national average. Almost 50%
of the population live in relatively deprived areas. The
impact of welfare reforms add further anxiety and
stress to these vulnerable families. In turn, the
The health of the people of
Council’s approach to financial inclusion has evolved
County Durham has improved
with the main aims of the work to assist residents in
significantly over recent
maximizing their income – through sustainable
years but remains worse than
employment, as well as reducing household outgoings.
the England average. Health
Other key elements of this approach include the
inequalities remain persistent
principles of education, access to advice along with
and pervasive. Levels of
deprivation are higher, and
access to financial products.
life expectancy is lower, than
Homelessness can happen to anyone at any time, so it
the England average.
is important that services are available to all in housing
Annual Report- Director of public
need, in addition to those at greatest risk due to social
Health, County Durham 2012/13
or economic influences. Almost 8,000 people seek
homeless and housing advice in County Durham every
year. Homelessness has a detrimental effect on
individuals, families and communities and can undermine social cohesion. Tackling the effects
of homelessness can be costly to the public purse when compared to the costs associated with
proactively seeking to prevent homelessness in the first place.
Life expectancy for men in County Durham is 1.2 years less than the England average. For
women it is 1.1 years less than the England average (at birth 2008-10), but there are great
variations across the County liked to deprivation.
With welfare reform taking an estimated £150 million out from our economy in 2013/14, and with
further reductions planned, vulnerable families are likely to further struggle and the inequality
gap is likely to grow.
There are significant inequalities amongst our children, young people and families with almost
half of our population living in relatively deprived areas and almost a third living in the most
deprived areas of England.
The link between deprivation and poor health outcomes is well documented and the 2012
Marmot indicators (appendix 2/3) show County Durham to have significantly worse:
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Male and female life expectancy than England.
Inequality in disability-free life expectancy for males and females than England
Levels of children achieving a good level of development at age 5 than England
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Levels of young people not in education, employment or training compared to England
Households in receipt of means-tested benefits than England
It is clear that agencies need to work together to help families meet the challenges they face
and to prevent these stresses causing their children to be neglected or to suffer other forms of
harm.
The Cost Implications
Early Help to tackle neglect and Hidden Harm matters. Not only is it the right thing to do to
improve outcomes for children and their families as outcomes are improved and opportunities
for change are maximised, but it is also cost effective.
The social cost of failing to act for children and young people who experience multiple
disadvantage is significant. They run the risk of living with lower aspirations and failing to reach
their potential. This can become inter-generational as these children and young people go on
to become parents themselves.
There is good evidence, both nationally and locally, that investment in early help not only
improves outcomes for children and families but provides value for money. Incorporating the
concept of early help into Durham’s invest to save strategies has been a commitment for some
time, and we need to continue to implement an offer of early help effectively.
The financial case for delivering early help through coordinated, whole family services in a
targeted way is evidenced through extensive evaluation of both Family Intervention and Family
Pathfinder Projects. Cost benefit evaluation for the Troubled Families Programme has already
shown that for every £1 invested in early help services, £2 of value is achieved in cost
avoidance.
Reductions in public spending continue and public services are under financial pressure.
Providing effective early help is even more crucial in a time of austerity. With a squeeze on
budgets, it is increasingly necessary to ensure that resources are targeted where they will make
the greatest difference.
An effective offer of early help has the potential to reduce the need for more costly specialist
and statutory interventions. However it is important to note that although helping early may be
more cost effective in the long term, in the short and perhaps even medium term, it will require
the re-focus of already stretched resources.
There will always be some children, young people and families that will need the help and
support of specialist and statutory services. This strategy acknowledges that, and seeks to
ensure that decisions are made in a timely manner to protect children.
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Early Help across Durham’s Continuum of Need
System-wide prevention
Effective early help recognises that all agencies operate as part of an inter-dependent system
and that a cohesive approach to system-wide
prevention is required if we are to shift patterns of
need.
For children who need additional
help, every day matters.
Health Services, Schools and Police provide a
Academic research is consistent
universal service to all children and families and
in underlining the damage to
are often best placed to identify early signs of
children from delaying
need. To have the greatest impact, we need to
intervention. The actions taken
ensure that all of our universal, voluntary and
by professionals to meet the
needs of these children as early
targeted support services work together
as possible can be critical to
effectively to improve the lives of children, young
their future.
people and their families, and reduce the need
Department for Education Working
for statutory protection and looked after services.
Together to safeguard children (2013)
Early help is a concept relevant to all services
from universal to specialist services.
Most families will access our universal services at some point. These universal services are
well placed to provide the support and interventions for most families and are vital in preventing
many children, young people and families from escalating in to more targeted services.
In Durham our universal services include schools, health visiting and universal health services
and some aspects of our One Point Service such as Children’s Centres. Families may also use
leisure and play facilities, neighbourhood, community or voluntary sector services.
These universal services support an effective early help approach; prevention services such as
immunisation programmes, early years advice, health visiting and school nursing and universal
and accessible public health information that supports better life style choices all serve to
ensure that the huge numbers of children, young people and families they reach get what they
need and preventing them from needing further support.
In respect of neglect and hidden harm universal services are in a key position to identify
situations where a more targeted and assertive approach is required. Targeted services and
intervention delivered early will reduce the need for specialist services. Pro-actively challenging
non-engagement, such as missed health appointments, also facilitates early help.
Schools, like other universal services have a key role in identifying emerging concerns early on,
and close working with the school community is critical to the successful delivery of early help to
children, young people and their families. Often a child missing school will be the first indication
that the family is experiencing problems.
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Schools play a key role in helping build resilience and stronger networks of support for families
in their local community. Funding is increasingly devolved to schools to meet the needs of their
pupils around careers advice, sex and relationship education, and other areas.
Durham County Council will continue to work with schools to ensure that appropriate access to
services is maintained, considering the needs of both individual school communities and the
wider needs of children and young people across Durham, particularly through initiatives such
as the Team Around the School.
Levels of Need
In County Durham, a staircase model has been used to illustrate levels of need since 2012. The
lowest need is shown as the bottom step and the highest level of need as the top step.
Regardless of which ‘step’ children, young people and families needs are on, they will be
supported at the earliest opportunity and continue to be supported by the relevant services as
they move up and down the staircase.
The Durham staircase illustrates our integrated services pathway model and is designed to
reflect the fact that the needs of children, young people and families exist along a continuum.
The staircase sets out need across 5 levels- 5 steps and is shown on the following page.
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The Durham Staircase & Continuum of Need
GOVERNANCE
NEED
SERVICES TIERS INVOLVED
ISSUES
OUTCOMES
Step 5 / Level 4 Need
Children and Young People who
have needs that cannot be met
safely at home
(Specialist practitioner/agency)
Looked After
Children
All
Permanence
Step 4 / Level 4 Need
Children and Young People who
need support to live safely at
home
(Specialist Practitioner/Agency)
Specialist
Targeted
and Universal
Child Protection
& Child in Need
Improve outcomes
and keep child
safely at home
Eligibility Criteria
Step 3 / Level 3 Need
SAF
Full Assessment
Children and Young People with
additional and complex needs
(Multi Practitioner/Multi Agency
Response)
Universal
and Targeted
Whole Family,
coordinated
multi agency
response
required
Improve outcomes
and prevent
escalation to
Safeguarding
Step 2 / Level 2 Need
SAF
Early Help Assessment
Children and Young People with
additional needs
(single or multi agency/practitioner
response)
Universal
and Targeted
Universal
support unable
to meet need
Prevent escalating
need and improve
outcomes
Step 1 / Level 1 Need
Universal Providers
Children and Young People with
no additional needs
Universal
Voluntary and
Community Sector
Not making
expected
progress
19
Universal support
and monitoring
Early Support and Intervention
Continuous Assessment
ICPC
Pre proceedings / Resource
Panels
Statutory
Resource Panels
Eligibility Criteria
Court
Children and young people who are achieving expected outcomes and have their
needs met through universal service provision. Typically, these children/young people
are likely to live in a resilient and protective environment. Families will make use of
community resources. Universal services remain in place regardless of which level of
need a child is experiencing.
Level 2 - Early Help – Targeted Provision Children with Additional Needs which
can be met by a single practitioner/single agency or where a coordinated multiagency response is needed.
These are children and young people identified as having an additional need which
may affect their health, educational or social development and they would be at risk of
not reaching their full potential. The single assessment process Early Help
Assessment is the tool to use to identify need and plan help for the family.
Level 3 - Early Help – Targeted Provision for Children with multiple issues or
complex needs where a co-ordinated multi-agency response is required.
These are children and families whose needs are not being met due to the range,
depth and significance of their needs which makes them very vulnerable and at risk of
poor outcomes. A multi-agency response is required using either the single
assessment framework whole family assessment tools as in most instances there will
be issues for parents which are impacting on the children achieving positive outcomes.
These families need a holistic and coordinated approach and more intensive
intervention and help. Lead Professionals could come from a range of agencies as the
key issue will be the quality of the relationship that exists between practitioner and
family to assist them to make change and reduce the likelihood of moving into Level 4
services.
Level 4 - Services to keep the child safely at home – where a statutory response
is required.
These are children whose needs and care is significantly compromised and they may
be at risk of harm or at risk of becoming accommodated by the Local Authority. These
families require intensive support on a statutory basis. This will include support
provided by Children’s Services under a Child Protection Plan and may require the use
of legal orders. The assessment and multi-agency response will be coordinated by a
social worker, will be holistic and consider the needs of all family members.
Level 4 (step 5) - Need that cannot be managed safely at home.
Children and young people who require intensive help and support from a range of
specialist services. These children will often need to be accommodated outside of their
immediate family or may require admission into hospital or other institutional settings.
In most cases the multi-agency involvement would be led by a social work Lead
Professional.
Cross cutting themes
20
In general, children and young people with disabilities will have their needs met through early help and targeted services at levels
1, 2 and 3.
However, some children with a high level of need related to severe disabilities may require specialist services at levels 4.
Level 1 - Universal Provision Children with no additional needs.
Cross Cutting Themes
The LCSB is a statutory partnership made up of local agencies. In County Durham there is a
longstanding and high commitment amongst partner agencies to develop and improve
arrangements to protect and safeguard children from harm and to share responsibility and
accountability for those services.
This strategy is not a stand-alone document, it cross cuts across much of the strategic thinking
in County Durham.
We will all achieve our strategic vision through sharing and delivering our key priorities both
through Durham County Council and our Partners. The County Durham Partnership (CDP) is
the overarching partnership for County Durham and is supported by five thematic Partnerships,
each of which has a specific focus:





Economic Partnership – ‘altogether wealthier’ – creating a vibrant economy and putting
regeneration and economic development at the heart of all our plans
Children and Families Partnership –‘altogether better for children and young people’ –
enabling children and young people to develop, achieve their aspirations and maximise
their potential
Health and Wellbeing Board – ‘altogether healthier’ – improving health and wellbeing
Safe Durham Partnership – ‘altogether safer’ – creating a safer and more cohesive
county
Environment Partnership – ‘altogether greener’ – ensuring an attractive and ‘liveable’
local environment and contributing to tackling global environmental challenges
It is acknowledged that the foundations for positive outcomes for our children, young people
and families relies on wider needs and social inequalities being addressed; for example,
employment, health and wellbeing, education, transport, crime and disorder. These are best
addressed through the Sustainable Community Strategy (SCS) which is the over-arching
strategic document of the County Durham Partnership.
Early help will be the golden thread that runs through all of our services, strategies and thematic
partnerships for children young people and their families. The Early Help and Neglect Strategy
is linked with existing strategies across the County Durham Partnership which have a broader
application to population risk factors such as Durham’s Joint Strategic Needs Assessment, the
Joint Health and Wellbeing Strategy, The Safe Durham Partnership Plan, Durham’s Homeless
Strategy and Durham’s Financial Inclusion Plan.
The Early Help and Neglect Strategy is underpinned by Durham’s Children & Young People and
Families Plan.
Early help will thread through the work of the County Durham Partnership and the Children and
Families Partnership. It will act as the over-arching principle and guide the vision for much of the
development work within Children and Adults Services and act as a “coat hanger” for its
strategies.
21
Early help: Progress to date
There has been significant investment in early help services such as Children’s Centres, the
Family Intervention Project and Family Pathfinder service, the One Point service, the Pre-Birth
Assessment service and the Health Visitor expansion programme.
If all work with children and families is shown fairly distributed across the levels of need
staircase, a pattern should be expected as seen in chart 1. In this, numbers decrease as need
increases in a predictable pattern.
CHART 1: A projected proportionate service delivery in Durham
Please note level 1 is not represented on this chart
Following a mapping exercise in March 2013 a graph was produced to show how activity was
actually distributed across the continuum of need in Durham (see below Chart 2). This showed
that a disproportionate amount of work was being directed into statutory levels of service, with
insufficient help being provided at levels 2 and particularly level 3. This showed that families in
need of complex multi-agency support were more likely to be receiving this through statutory
children in need or child protection services. If we successfully supported families better at the
earliest opportunity, we would expect to see a significant reduction in the numbers of children
needing to access high need high cost services and an expansion in those assisted at levels 2
and 3.
CHART 2: Services Delivered to Children, Young People and their Families at 31 March 2013
Level 5
626
Level 4
Level 3
2959
211
Level 2
1616
0
500
1000
1500
2000
22
2500
3000
3500
There was evidence that numbers of referrals into early help services from key adult agencies
was very low, despite hidden harm issues of parental alcohol and drug misuse, domestic abuse
and mental ill health being the predominant causes driving neglect.
Professionals working with adults who are parents are well placed to identify at an early stage
the emerging needs of the children within the families and play a critical role in the early
identification and support for families, in line with the Think Family approach.
Year on year, the pattern of service delivery has been moving in the right direction, towards the
expected pattern of delivery.
Chart 3 illustrates activity in Durham in March 2015 and shows how much progress has been
made. It also shows how much more there is to do.
CHART 3: Services Delivered to Children, Young People and their Families at 31 March 2015
CHART 4: Families Receiving Early Help
23
This shows the progress we have made in providing early help to families over recent years,
and is consistent with the equivalent reduction in families supported at statutory levels.
These graphs illustrate the progress we have made in County Durham. Further evidence
exists. The numbers of children with a Child Protection Plan and Children In Need per 10,000
are lower in County Durham than elsewhere in the region and compared to statistical
neighbours, and rates of Looked After Children are low, although these have risen steadily in
recent months.
Alongside this, we can evidence that a much higher proportion of families receive early help
than other authorities, (chart 4) which indicates that the early help we already provide is being
effective in reducing demand for statutory services.
CHART 5: Number of children receiving early help.
Number of children subject to Early Help/Common Assessment (Level 2/3)
(2012/13 to September 2015)
6000
5000
4000
3000
5329
4583
2000
3133
1000
2104
0
2012/13
2013/14
2014/15
24
At 30 Sept 2015
Measuring the Impact of the Early Help Strategy
How will we know that the Early Help and Neglect Strategy has been effective?
A number of indicators can be used to track progress against this strategy.

Increased members of families supported with needs identified ante or postnatally
through a TAF

Increase in number of children who are school ready as measured by Early Years
Foundation Stage Providers (EYFSP)

Gap between achievement of a Good Level of Development of children eligible for free
school meals and the rest at EYFS

Gap narrowed between children in the 20% most deprived areas and the rest

Increase in number of pupils gaining 5 or more A-C grade GCSEs or equivalent at key
stage 4

Reduction in the number of children in need and children subject to a child protection
plan

Reduction in the number of children in need and children subject to a child protection
plan as a result of neglect

Reduction in the number of children Looked After by the Local Authority

Reduction in re referral rates to Children’s Care

Reduction in the percentage of children becoming the subject of a Child protection Plan
for a second or subsequent time

Increase in the number of assessments completed by a range of partners at levels 2 & 3

Increase in numbers of assessments in place at the point of referral to statutory services

Reduction in First Time Entrants (FTEs) in to the Youth justice system aged 10-17

Reduction in percentage of 16-18 year olds not in education employment or training
(NEETS)

Improved health outcomes
Outcome Framework
All of these are important indicators of positive change across the children’s services system.
However, few of these are outcomes. Success should also be directly measured against the
outcomes experienced by children, young people and their families.
County Durham has developed an outcomes framework to monitor progress in areas that are
meaningful to families, such as health and mental health, educational attainment, employment
and training, housing, emotional resilience. This will be used alongside the process measures
to track impact.
25
Commissioning
For the Early Help and Neglect Strategy to achieve its intentions, all commissioners involved in
Children’s Services will need to consider early help provision when reviewing or commissioning
service delivery. They must work together to develop coherent plans and strategies to transform
activity on a much wider scale. This also applies to Adult Commissioning Services covering the
hidden harm issues of alcohol and substance misuse, domestic abuse and mental illness. This
may require new commissioning partnerships and effective joint commissioning.
At a time when there are significant financial pressures on local authorities to make continued
savings and efficiencies, commissioning provides an opportunity to review service delivery,
deliver better outcomes for families and to achieve financial efficiencies which do not
compromise the quality of our services. Commissioning early help will be cost effective and will
lead to better outcomes in the longer term as well as breaking the cycle of intergenerational
disadvantage.
The following principles / standards will be promoted when commissioning services for Early
Help, Neglect and Hidden Harm:
 Basing all decision on evidence of a favourable impact on outcomes for children and best
value for money;
 Ensuring that changing policy and legal and regulatory guidance is taken into account;
 Providing early help services at the earliest appropriate opportunity to support young
people and their carers;
 Using open and transparent processes that build confident partnerships between
commissioners and providers;
 To decommission services which are inefficient, ineffective, inequitable, unsustainable or
no longer required;
 Aiming for continuous improvement and best outcomes.
Children’s Services is in the process of transforming its services in line with the aims of this
strategy through the restructuring of existing services, creation of new job roles, as well as
workforce development.
To date, new service activity has been promoted through government grant and local pilot
programmes. This has led to effective service forms such as the Family Intervention Project, the
Family Pathfinder Service and the Family Nurse Partnership. More recently, Troubled Families
funding has been used to support workforce development activity through Think Family Mentors
and new specialist Stronger Families roles in the One Point Service.
The Department for Education’s Innovation fund is supporting this development, and in so doing
recognises that County Durham is one of the areas at the forefront of social care reform.
The Stronger Families programme is also being used to drive new ways of working in line with
this strategy.
Public Heath has recently developed a specification for a 0-19 service for health visiting and
school nursing with a significant focus on early help.
26
Governance and Accountability
An effective early help offer is not the responsibility of a single agency. It requires a Think
Family approach owned by all partners working with children, young people and families.
These include Health, Police, Probation, Schools / Education, Children and Adult Services,
Public Health, Housing, Voluntary and Community Organisations
Working Together (2015) requires local agencies to have in place effective ways of identifying
emerging problems and potential unmet needs for individual children and their families. It also
requires local agencies to work together to put processes in place for the effective assessment
of needs of individual children who may benefit from early help services.
Governance for this strategy is provided by the Durham Local Safeguarding Children’s Board.
Early Help and Neglect continue to be two of Durham LSCB’s priorities. The LSCB provides
scrutiny and challenge by holding partners to account for delivering the changes necessary to
implement this strategy.
An Early Help and Neglect subgroup has been established by the LSCB. At local level, Early
Help Forums provide the link between the strategy and practice by considering local
implementation issues. There are three Early Help Forums meeting bi-monthly, with a broad
multi-agency membership.
County Durham
Partnership
Children & Families
Partnership
Durham LSCB
Think Family
Partnership
Early Help and
Negelct SubGroup
Local Early Help
Forums
27
Early Help and Neglect Action and Commissioning Plan (Covering 2015 to 2017)
This plan sets out actions we need to take to continue implementation of our aspirations for early help. It follows the format of the Early
Intervention Foundation’s Early Help Maturity Matrix. The Early Help Sub group and the Early Help Forums have completed a self-assessment
and used this to identify next steps.
This plan sets out the actions we will take through the LSCB to achieve our ambitions.
PLAN
1. Overall Aim: Improve identification of children in need of early help through Partnership Working
1
Understand the cohort in
need of early help by
agreeing definitions, offer
early help and neglect and
a common language
2
Agree a menu of evidence
based, effective
interventions for families
How
 Research definitions and glossary of
terms, agree via LSCB
 Analyse data to quantify numbers and
groups of families needing help
Who
CP
When
Sept 15
 Research of best practice
 Select the most appropriate
interventions
 Ensure individual service procedures
articulate evidence-based multiagency interventions
MG / KD
Dec 15 Draft
28
Jen / Feb 16
sign off
Outcomes
All partners have a
shared understanding
of terms. There is a
consistent “golden
thread” theme through
all plans and strategies
across the County
Durham Partnership.
All partners deliver
services known to be
effective as part of a
shared pathway of
service
3
4
Commission effective
interventions
Commissioner and services managers to
ensure the Neglect Practice Guidance is
incorporated in to all service
specifications, for services such as
 Health Visiting Specification
 School Nurse Specification
 Family First team
 Children’s Centres
 One Point Service
 Child Protection
 Housing Solutions / Housing Providers
 Mental Health Services
 DA Service Specifications
 GP Services
 Midwifery services
 Police
 Substance Misuse
 Self Harm
 Teenage Pregnancy
Align CAS and Public Health
Commissioning Strategies
Endorse a clear joint action  Include common pathway and process
plan for the Team around
into all agency procedures
the Family (TAF) involving  Audit agency use of new interventions
all relevant partners
 Audit TAF membership and
engagement with Family Plans
 Focus on ante and postnatal services
involvement in single assessments
processes
 Focus on schools’ involvement in
single assessment processes
29
Ongoing /
March 2017
GO’N
GO’N
HF
RHD
RHD
MG
LWa
CA
March 16
All partners deliver
services known to be
effective as part of a
shared pathway of
service, so that
resources can be
shown to be used
effectively.
CA
CA
PG
LWi
LWi
LW1
JR / GO’N
GO’N / KD
JD / LSCB
RHD/KD
CA
CO’N
March 2017
All partners work
together to achieve
best outcomes for
children and families
5
Review the effectiveness
of the Team Around the
School model in supporting
Early Help




6
Standardise parenting
programmes across the
County and ensure joint
delivery with partners
 Review current programmes
 Agree pathway of interventions
 Ensure all partners follow
Audit use of TAS
Audit agency involvement in TAS
Audit outcomes of TAS
Engage with schools in the
identification of children requiring Early
help through Early Help Forums
30
RHD / LR
March 2016
RHD/KD
Sept 2016
DELIVER
2. Overall Aim: Embed effective interventions into practice of all partners to support families and prevent escalation
of need
1
2
3
How
Review Single
 Revise procedure so that early help
Assessment Procedure
assessment operates as a referral,
to ensure neglect is
and single assessment is used earlier
identified and
 Include neglect practitioner guidance
responded to effectively
as one of the SAP practice tools
Agree screening tool for  Review levels of need document
identification of early
around use of the tool
risk of neglect
 Use levels of need audit
 Pilot Home Environment Risk
Assessment
 Introduce Home Environment Risk
Assessment for universal use
 Develop suite of tools for all ages
including Graded Care Profile
Ensure the LSCB
 Partners workforce development
partners workforce is
programme to be review in light of
able to identify early
updated guidance.
signs of neglect and to
 Common pathway of intervention
respond appropriately
(Single Assessment and level of need)
to be agreed and implemented by all
partners
 Rollout ‘Practice Toolkit’ across all of
Children’s Services
 Promote the LSCB Neglect training
31
Who
JS
When
Sept 15
Outcome
There is a common
effective approach to
assessment of need.
LW/MB/ PC
Dec 15
SL/JS/FF
Dec / Jan
2016
April 2016
There is a common
approach to the
identification of need in
use across the
partnership.
CDDFT/
DCC
Dec / Jan 16
KD
March 2016
Partner
workforce
leads
Training,
Development
and
communications
Group
Needs are met at the
earliest point and do
not escalate.
4
5
6
7
Research best practice
in risk assessment to
identify suitable model

Endorse Home
Environment Risk
Assessment and adopt
across the partnership
Adopt Home
Environment Risk
Assessment across the
workforce
Train workforce to
deliver agreed
interventions

Internet / professional network
search
Attend Conference
Develop Practice Guidance
G O’N
HF
Oct 2015
All agencies to incorporate
common pathway into their
procedures
G O’N
LSCB
April 2016
 Train LSCB Partners workforce in use
of tool and the common pathway
 Audit use of new model
G O’N
LSCB
April 2016
 Review and promote the LSCB
Neglect training
KD
April 2016


 Develop, pilot and deliver reflective
practice (Learning Communities)
sessions for staff
8
9
Ensure the LSCB
partners workforce
Develop and deliver workshops on the
understands and
implementation of the Family Outcome
implements the Family
Framework
Outcome Framework to
ensure all family plans
Develop IT system to capture outcomes
are outcome focussed
Ensure all services are e.g
mindful of the family
 Family information in plain English and
level of accessibility,
languages etc ,
equality and diversity
 services comply with equality and
need.
diversity
32
Pilot April 16
KF
Children
March 2017
Families unable to
make changes are
identified early, so that
children do not suffer
neglect any longer than
is necessary.
All practitioners use
common tools and
work in common
purpose.
All practitioners use
common tools and
work in common
purpose.
Staff are confident and
competent in working
with families,
particularly where there
is neglect.
Staff and managers
are confident in the
implementation of
outcome focussed
multi agency family
plans
10
11
Implement effective
approached to engage
non-consenting families

Train workforce in
information sharing


Audit use of Family Engagement
Toolkit
Review and revise in light of findings
RHD
Embed LSCB Learning course across
partner agencies
JD
33
April 16
Dec 16
Dec 16
Improved engagement
of families at early help
level
All practitioners
practice in line with
expectations of 8
Golden Rules
EVALUATE
3.
1
Overall Aim: Demonstrate the impact of our assessments and intervention on families and children
Review progress of family
against assessed needs
How
Who
When
 Introduce an agreed Family Outcomes
Framework
RHD
October 2015 We can demonstrate
that the help we have
provided has improved
Oct 2015
the lives of children
and their families
HF
 Build in regular monitoring points to
single assessment process
2
Develop a performance
report to monitor impact
3
Involve service users in the
development and
monitoring of these
services
4
Evaluate the successes of
the Families First teams
and consider implementing
successful elements
 Implement effective ‘distance travelled’
tools to monitor the differences
services have made
 Review and agree performance
measures for early help and neglect
Outcome
April 2016
JD / GO’N
Feb 2016
 Service user feedback
 Focus groups
CP
April 2016
 Part of the Innovations external
evaluation
 Good practice to inform services
development
34
HF
There is evidence that
outcomes and other
performance measures
have improved as a
result of the help that
has been provided
Service users value the
services we provide
and are clear that they
meet their needs.
Service users
recommend our
services to others
We can demonstrate
that the help we have
provided has improved
the lives of children
across the broader
Children’s Services
5
Evaluate effectiveness of
TAF meetings
 Audit attendance and engagement
 Audit effectiveness of agreed actions
GO’N
Sept 16
6
Review the effectiveness
of perinatal support
 Audit services provided
 Seek mother’s feedback on
effectiveness of services
 Redesign the pathway for perinatal
support
CA
Sept 16
35
and their families and
we are committed to
expanding our success
TAF meetings are used
proportionately to
facilitate outcomes for
families
Vulnerable women are
supported
LEAD
4.
1
Overall Aim: Demonstrate system leadership, shared priorities and clear governance across the partnership
Early Help is a clear
priority for all partnerships
How
Who
When
 Updated Early Help Strategy in place
with explicit messages around early
signs of neglect
LSCB
CYPFP
October 2015 County Durham is able
to evidence
commitment to early
help through its
strategies, plans,
priorities and resource
allocations
October 2015 We are clear what is
working well and what
needs to improve, no
matter who is
responsible for it. We
are open to that
feedback from each
other.
March 2017
Leader at all levels
promote early help
through all plans and
strategies across a
wide strategic agenda
 Early help is visible in a range of plans
2
3
Constructive challenge on
delivery of early help
actions is embedded
 Multi-agency case file audits
Senior leaders and elected
members provide system
leadership on early help
 Leaders reference early help in
strategies and actions across
partnerships
 Briefings for chief officers, senior
leaders and elected members
 Performance update on the Early help
strategy
LSCB
 Monitoring of action plans
36
County
Durham
Partnership
Outcome
FAMILY FOCUS
5.
1
2
3
Overall Aim: The experience of our families informs and drives the development of our services
Engage children, young
people and families in the
design of early help
services and procedures
Embed service user
feedback across the early
help partnership
Embed Third Sector
Alliance in the delivery of
early help to families
How
 Agenda days held with children,
young people and parents who
have received services
 Ensure the voice of the child is
listened to and heard.
 Stakeholder forums
 Children Services Teams have
Investing in Children status
 Introduce a consistent service user
survey in all areas of service to
assess the experience of early
help services
 Jointly support the appointment of
3 voluntary sector alliance
coordinators
 Coordinators to support the
Families First teams and other
Children’s Services to develop
relationships with local VCS
organisation and harness effective
use of community resources.
37
Who
Children’s
Services /
Public
Health
When
September
2015
December
2016
Children’s
Services
December
2015
LSCB
partners
Children’s
Services,
DCC VCS
Partnership
February
2016
Outcome
Children, young people
and parents/carers are
fully engaged in the
design and
implementation of early
help services
All children, young
people and
parents/carers have
the opportunity to
provide feedback on
the services and
support they receive
Children, young people
and families have
access to the support
of the third sector
throughout and beyond
the support of statutory
services
38