Continuum of Need 2014
“Think Child, Think Adult, Think Family”
The St Helens Continuum of Need (CAF Thresholds)
This document outlines common risk triggers for beginning a common assessment and to
introduce the St Helens Continuum of Need model.
1. The Continuum of Need
Introduction
Working Together to Safeguard Children (2013) sets out a clear expectation that local
agencies will work together and collaborate to identify children with additional needs and
provide support as soon as a problem emerges. Providing early help is far more effective
in promoting the welfare of children – and keeping them safe – than reacting later, when
any problems, for example neglect, unmet health needs, and issues relating to education
may have become more entrenched. The importance of using a child-centred approach in
following the child’s journey as well as capturing the Voice of the Child is also emphasised.
All services which are provided must be based on a clear understanding of the needs and
views of the individual child in their family and community context.
This document provides a framework for professionals who are working with children,
young people and families; it aims to help you identify when a child may need additional
support to achieve their full potential. It introduces a continuum of help and support,
provides information on the levels of need and gives examples of some of the indicators
that a child or young person may need additional support. By undertaking assessments
and offering services on a continuum of help and support, professionals can be flexible
and respond to different levels of need in different children and families. Along this
continuum, services become increasingly targeted and specialised according to the level
of need. Children’s needs are not static, and they may experience different needs – at
different points on the continuum – throughout their childhood years.
This thresholds document provides the overarching framework for St Helens. The Local
Safeguarding Children Board (LSCB) should provide additional guidance locally to set out
the process for early help assessment and the type and level of early help services to be
provided. It should also clarify the threshold for making a referral to the Local Authority
Children’s Social Care for assessment and statutory services under S17, S47, S31 and
S20 of the Children Act 1989.
Remember where there is an immediate need to protect a child because they are being
harmed or are likely to suffer significant harm, contact the Police or Local Authority
Children’s and Young People’s Services without delay.
Core Principles when Working with Children, Young People and Families

Safeguarding children and young people is everyone’s responsibility everyone who
comes into contact with children and families has a role to play;

Services should intervene early to tackle any problems as soon as they emerge.
For children who need additional help, every day matters;

The child should be at the centre, their needs are paramount.
listened to by professionals and have their voices heard;
They must be

Any services provided to safeguard children and young people must be clearly
focused on the outcomes for the child.
Professionals should consider: The Welfare Checklist to which courts will have regard
when deciding whether to make an order in respect of a child (S31 Children Act 1989):
a. The ascertainable wishes and feelings of the child concerned (considered in the
light of his/her age and understanding); and ensure their voice is captured within
assessment plans and subsequent interventions;
b. His/her physical, emotional and educational needs;
c. The likely effect on him/her of any change in his/her circumstances
d. His/her age, sex, background and any characteristics which the court considers
relevant;
e. Any harm which he/her has suffered or is at risk of suffering;
f. How capable each of his/her parents, and any other person in relation to whom the
court considers the question to be relevant, is of meeting his/her needs.
Working Together to Safeguard Children (2013) requires each Local Authority to publish a
local assessment protocol which sets out clearly the arrangements for how cases will be
managed once a child is referred into local authority children’s social care. The
assessment protocol should ensure that assessments are timely, transparent and
proportionate to the needs of the individual children and their families.
Effective assessment requires all those working with children, young people and
families to:

Be alert to children and their needs;

Remember that the child’s needs are paramount. Where professionals provide
services to adults they must consider the adult service user in their role as a parent
or carer and assess the risks to any children in their care or with whom they have
contact;

Understand their individual role in keeping children safe, and the role of others; and

Be able to identify symptoms and triggers of abuse and neglect and share
information with other professionals in a timely way.
The Four Levels of Needs
1. Children with no additional needs – these are children with no additional needs;
all of their health and developmental needs will be met by universal services. The
majority of children living in each local authority area require support from universal
services alone;
2. Children with additional needs showing early signs of vulnerability - these are
children with additional needs or health/educational needs, who may be vulnerable
and showing early signs of abuse and/or neglect; their needs are not clear, not
known or not being met. This is the threshold for a multi-agency early help
assessment to begin (this is also sometimes known as a common assessment,
CAF or a Family CAF); note the requirement for consent in such cases.
3. Children in need who require statutory or specialist services – these are
children who are unlikely to achieve or maintain a satisfactory level of health or
development, or their health and development will be significantly impaired, without
the provision of services; or children who are disabled. They may require longer
term intervention from statutory and specialist services. This is the threshold for an
assessment led by Children’s social care services\practitioners under S17 Children
Act 1989.
4. Children who are suffering or likely to suffer significant harm – these children
are suffering or are likely to suffer significant harm. They will require intensive
support under S47 Children Act 1989. This is the threshold for child protection.
The Continuum of Need establishes a consistent approach for:
• four levels of need and corresponding service intervention; and
• beginning the CAF process.
This approach aims to facilitate swift and easy access to appropriate services and help
remove barriers to cross-authority integrated service delivery. It is acknowledged that
children may move from one level of need to another and that agencies (including
universal services) may offer support at more than one level.
The Continuum of Need does not guarantee service
provision by particular agencies at each level.
There may be restricting factors such as:
• specific service criteria related to the agency's
specialist area of work;
• previous interventions;
• geographical location;
• age limits; and
• time limited provision, e.g. only available during
school term.
2. The Four Levels of Need
The Continuum builds from the four levels of need
Level 1
Level 2 - Low risk to vulnerable
No identified additional needs. Response
services are universal services.
Child's needs are not clear, not known or
not being met. This is the threshold for
beginning a common assessment.
Response services are universal support
services and consideration of
implementation of “Think Family process”.
Level 3 - Complex
Level 4 - Acute
Complex needs likely to require longer
term intervention from statutory and/or
specialist services. High level of additional
unmet needs - this will usually require a
targeted integrated response, which will
usually include a specialist or statutory
service. This is also the threshold for
a child in need which will require the
Council’s Early Help Service and\or
Children's Social Care intervention.
Acute needs, requiring statutory
intensive support. This in particular
includes the threshold for child
protection which will require
Children's Social Care
intervention; children in care are at
Level 4 of the continuum.
3. The Continuum of Need descriptors – important notes
The Continuum of Need within this annex represents the four main level descriptors.
Detailed risk and resilience factors relating to specific policy areas are provided in
Annex 2(b).
• The Continuum identifies a set of risk and resilience triggers and levels of need
• When there is an immediate need to protect a child because they are being harmed
or at risk of harm the practitioner must contact the local authority Children's Social
Care and/or police directly and make a telephone referral (Council Contact Centre
01744 676789). All practitioners must follow the prescribed referral process
Continuum Charts
Level 1
No additional needs, only requiring universal service support
Features
Children with
no additional
needs
Children
whose
developmental
needs are met by
universal
services
Action Needed
Universal Services
to liaise to ensure
children’s needs
are met
Universal Example
indicators
Developmental Needs
Learning / Education
• Achieving key stages
• Good attendance at school/college/training
• No barriers to learning
• Planned progression beyond statutory school age
Health
Assessment
Process
No common
assessment is
required
Children should
access universal
services in a
normal way
• Good physical health with age appropriate developmental
milestones including speech and language
Social, Emotional, Behavioural, Identity
• Good mental health and psychological well-being
• Good quality early attachments, confident in social situations
• Knowledgeable about the effects of crime and antisocial
behaviour
• Knowledgeable about sex and relationships and consistent
use of contraception if sexually active
Key universal
services
that may provide
support at this
level:
Schools
Children's Centres
Family and Social Relationships
• Stable families where parents\carers are able to meet the
child's needs
Early Years
Providers
Self-Care and Independence
Health Visitors
• Age appropriate independent living skills
School nurses
GPs
Family and Environmental Factors
Play Services
Family History and Well-Being
• Supportive family relationships
Youth Services
Housing, Employment and Finance
• Child fully supported financially
• Good quality stable housing
Housing
Social and Community Resources
• Good social and friendship networks exist
• Safe and secure environment
• Access to consistent and positive activities
Parents and Carers
Police
Voluntary &Community
Sector
Basic Care, Safety and Protection
• Parents\carers able to provide care for child's needs
Emotional Warmth and Stability
• Parents\carers provide secure and caring parenting
Guidance Boundaries and Stimulation
• Parents\carers provide appropriate guidance and boundaries
to help child develop appropriate values
Level 2 – Low to Vulnerable
Targeted Support
Features
Children with
some additional
needs
Children whose
developmental
needs are met by
universal
services
Action Needed
Initiate a CAF
Low to Vulnerable - Example
Indicators
Developmental Needs
Learning / Education
 Occasional truanting or non attendance
 School action or school action plus
 Identifies language and communication difficulties
 Reduced access to books, toys or educational materials
 Few or no qualifications
 Not in Education, Employment or Training (NEET)
Health
 Slow in reaching developmental milestones
 Missing immunisations or checks
 Minor health problems which can be maintained in a
mainstream school
Social, Emotional, Behavioural, Identity
 Low level mental health or emotional issues requiring
intervention
 Pro offending behaviour and attitudes
 Early onset of offending behaviour or activity (10-14)
 Coming to notice of police through low level offending
 Expressing wish to become pregnant at young age
 Early onset of sexual activity (13-14)
 Sexual active (15+) with inconsistent use of contraception
 Low level substance misuse (current or historical)
 Poor self esteem
Self-Care and Independence
 Lack of age appropriate behaviour and independent living
skills that increase vulnerability to social exclusion
Family and Environmental Factors
Assessment
Process
A common
assessment
A common
assessment
should be
completed
with the child and
family to identify
their strengths &
needs and to gain
specialist support
Programmes aiming
to build self-esteem
and enhance social
/life skills Prevention
Programmes
Positive activities
Key agencies that
may provide
support at this
level:
Universal and
targeted
Youth Offending
Service
Alcohol and Drug
Treatment Services
Health, education
Family and Social Relationships and Family Well-Being
 Parents/carers have relationship difficulties which may affect
the child
 Parents request advice to manage their child's behaviour
 Children affected by difficult family relationships or bullying
Housing, Employment and Finance
 Overcrowding
 Families affected by low income or unemployment
Social and Community Resources
 Insufficient facilities to meet needs e.g. transport or access
issues
 Family require advice regarding social exclusion e.g. hate
crimes
 Associating with anti social or criminally active peers
 Limited access to contraceptive and sexual health advice,
information and services
Parents and Carers
Basic Care, Safety and Protection
 Inconsistent care e.g. inappropriate child care arrangements
or young inexperienced parent
Emotional Warmth and Stability
• Inconsistent parenting, but development not significantly
impaired
Guidance Boundaries and Stimulation
• Lack of response to concerns raised regarding child
Childrens Centres &
Early Years
Educational
psychology
Educational Welfare
Play Services
Youth Services
Voluntary &
community
services
Family support
services
Level 3 – High or Complex
Additional needs requiring integrated targeted support OR child in need (section 17)
Features
Children with
high
level additional
unmet needs
Complex needs
likely to require
longer term
intervention from
statutory and/or
specialist services
Action Needed
Engage and refer
to specialist
services eg.
Social care, SEN,
YOS, CAMHS
Child in need:
These children
may be eligible for
a child in need
service from
children's social
care and are at
risk of moving to a
high level of risk if
they do not
receive early
intervention.
These may
include children
who have been
assessed as "high
risk" in the recent
past, or children
who have been
adopted and now
require additional
support. If a social
worker is
allocated they will
act as the Lead
Professional
Medium Risk Example Indicators
Developmental Needs
Learning / Education
• Short term exclusions or at risk of permanent exclusion,
persistent truanting
• Statement of special educational needs
• No access to books, toys or educational materials
Health
• Disability requiring specialist support to be maintained in
mainstream setting
• Physical and emotional development raising significant concerns
• Chronic/recurring health problems
• Missed appointments - routine and non-routine
Social, Emotional, Behavioural, Identity
• Under 16 and has had (or caused) a previous pregnancy ending
in still birth, abortion or miscarriage
• 16+ and has had (or caused) 2 or more previous pregnancies or
is a teenage parent
• Under 18 and pregnant
• Coming to notice of police on a regular basis but not progressed
• Received fixed penalty notice, reprimand, final warning or triage
of diversionary intervention
• Evidence of regular/frequent drug use which may be combined
with other risk factors
• Evidence of escalation of substance use
• Evidence of changing attitudes and more disregard to risk
• Mental health issues requiring specialist intervention in the
community
• Significant low self esteem
• Victim of crime including discrimination
Self-Care and Independence
• Lack of age appropriate behaviour and independent living skills,
likely to impair development
Assessment
Process
The common
assessment can be
used as supporting
evidence
to gain specialist /
targeted support
The common
assessment may
also be
completed to
support
child moving out of
complex needs
Statutory or
specialist
services
assessment
(NB a common
assessment must
NOT
replace a specialist
assessment)
Key agencies that
may provide
support
at this level:
LA children's social
care
Early Help Services
Family and Environmental Factors
Family and Social Relationships and Family Well-Being
• History of domestic violence
• Risk of relationship breakdown with parent or carer and the child
• Young carers , Privately fostered, children of parents detained in
custody, periods of LAC
• Child appears to have undifferentiated attachments
 Separation of a parent from a child as a result of them being on
remand or sentenced to custody
Housing, Employment and Finance
• Severe overcrowding, temporary accommodation, homeless,
unemployment
Other statutory
service
e.g. SEN services.
Specialist health or
disability services
Youth Offending
Team
Targeted drug and
alcohol
CAMHS
Family support
Social and Community Resources
• Family require support services as a result of social exclusion
• Parents socially excluded, no access to local facilities
services Voluntary &
community
services
Parents and Carers
Basic Care, Safety and Protection
• Physical care or supervision of child is inadequate
• Parental learning disability ,parental substance misuse or mental
health impacting on parent's ability to meet the needs of the
child
• Parental non compliance
Emotional Warmth and Stability
• Inconsistent parenting impairing emotional or behavioural
development
Guidance Boundaries and Stimulation
• Parent provides inconsistent boundaries or responses
Services at
universal
level
Level 4 – Complex or Acute
Additional needs requiring specialist or statutory integrated response OR child
protection (section 47)
Features
Complex
additional
unmet needs
These children
require specialist /
statutory
integrated support
Action Needed
Possible
completion of
single
assessment
S47/investigation
Child Protection
Children
experiencing
significant harm
that require
statutory
intervention such
as child protection
or legal
intervention.
These children
may also need
to be
accommodated
by the local
authority either on
a voluntary
basis or by way of
Court Order
Agencies should
make a verbal
referral to
children's social
care
accompanied by a
written referral
High Risk Example Indicators
Developmental Needs
Learning / Education
• Chronic non-attendance, truanting
• Permanently excluded, frequent exclusions or no education.
Provision
• No parental support for education
Health
• High level disability which cannot be maintained in a mainstream
setting
• Serious physical and emotional health problems
Social, Emotional, Behavioural, Identity
• Challenging behaviour resulting in serious risk to the child and
others
• Failure or rejection to address serious (re)offending behaviour.
Likely to be in Deter cohort of youth offending management
• Known to be part of gang or post code derived collective
• Complex mental health issues requiring specialist interventions
• In sexually exploitative relationship
• Teenage parent under 16 and compromised
• Under 13 engaged in sexual activity
• Frequently go missing from home for long periods
• Distorted self image
• Young people experiencing current harm through their use of
substances
 Young people with complicated substance problems requiring
specific interventions and/or child protection
• Young people with complex needs whose issues are
exacerbated by substance use
Self-Care and Independence
• Severe lack of age appropriate behaviour and independent living
skills likely to result in significant harm e.g. bullying, isolation
Family and Environmental Factors
Assessment
Process
Additional
services:
The common
assessment can be
used as supporting
evidence
to gain specialist /
targeted support
Statutory or
specialist services
assessment
(NB a common
assessment must
NOT replace a
specialist
assessment)
Key agencies that
may provide
support
at this level:
Specialist health or
disability services
Youth Offending
Service
CAMHS
Family support
services
Family and Social Relationships and Family Well-Being
• Suspicion of physical, emotional, sexual abuse or chronic
neglect • High levels of domestic violence that put the child at risk
• Parents are unable to care for the child
• Children who need to be looked after outside of their own family
Housing, Employment and Finance
• No fixed abode or homeless.
• Family unable to gain employment or extreme poverty
Social and Community Resources
• Child or family need immediate support and protection due to
harassment /discrimination and no access to community
resources
Voluntary &
community
services
Services at
universal
level
Statutory Children’s
Social Care
Services
Parents and Carers
Basic Care, Safety and Protection
• Parent is unable to meet child's needs without intensive support
Emotional Warmth and Stability
• Parents unable to manage and risk of family breakdown
Guidance Boundaries and Stimulation
• Parent does not offer good role model e.g. condones antisocial
behaviour