2.1 Children's Services Threshold Criteria for Children with Complex Needs (Children in Need)

The Children and Young Persons Act 2001 specifically targets services towards children ‘In Need’ and their families. The Act states that a child shall be taken to be In Need if:

• S/he is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining a reasonable standard of health or development without the provision for him/her of service by a local authority under this Part (S.23 5a);
• His/her health or development is likely to be significantly impaired, or further impaired, without the provision for him/her of such services (S.23 5b);
• S/he is disabled (S.23 5c);
• And ‘family’, in relation to such a child, includes any person who has Parental Responsibility for the child and any other person with whom s/he has been living.

Upon receipt of a Referral of a Child in Need the following steps will be taken:

• The Initial Response Team receive and assess the Referral to determine if it meets the criteria for a service from the Children and Families Service. This decision must be clearly communicated to the referrer where appropriate; The needs applicable to Children with Complex Needs is shown below:

A few children will have significant additional needs that are unmet and, there is a measurable deficit in their health, education and wellbeing. Features at this level will demonstrate a deficit in the resilience factors of the child’s development, compromised parenting and a vulnerable environment, resulting in a complex range of needs. This level will include circumstances where current or previous interventions have not achieved the outcomes required, and will include children stepping down from level 4 intervention (CP plan/re-unification from care). The child and young person’s needs are met through the voluntary provision of services co-ordinated through a key worker usually from within a specialist service such as a targeted health project, Youth Justice or social care.

Outcome: Families have access to specialist advice and support for the complex range of needs identified and assessed and children and young people have their needs met effectively at the most appropriate specialist level.

• Physical disability, complex health needs when access to support is frustrated or impaired by family functioning;
• Regular/escalating frequent use of alcohol or drugs combined with risk factors such as going missing, exploitation, offending;
• Mental health issues requiring specialist intervention in the community;
• Missed appointments routine and non-routine with evidence of impact on development of child;
• Under 16 pregnant or young parent, unsupported and with additional risk factors;
• Developmental delay and disengagement of parents from support;
• Offending behaviour placing at risk of caution, prosecution etc.;
• Young person is potentially homeless.

• Parental learning disability, mental health, substance misuse (including PND) with or without support, impacts on the parents ability to meet the needs of the child;
• Parental non-compliance with voluntary support at targeted level;
• Physical care or supervision is inconsistent and regularly inadequate;
• Parent unable to provide emotional guidance and boundaries leading to child being out of control.

• History of/ongoing domestic abuse;
• Child has previously been looked after or subject of a CP plan;
• Child is privately fostered;
• Child has indifferent attachments;
• Family are socially excluded and require support as a result of this;
• Family are homeless.

Most Complex Needs Plans will envisage that Children and Families intervention will end within twelve months. However, some children and families may require longer term support, for example children with disabilities.

• The Complex Needs Plan must:
  • Provide a summary of the outcome of the assessment with the needs of the child and family clearly identified;
  • Identify what needs to happen to support the child or family in response to the summary of needs;
  • Who needs to do it;
  • When it will be done.
• The outcomes to be achieved and the difference that the interventions will make to the child/family must be clearly stated;
• The roles and responsibilities of professionals and family members, needs to be clearly stated;
• A Network Group will be established;
• The date of the Review Challenge meeting must be identified.

Outcomes for children, young people and their families are likely to be much improved where there is open and honest communication, their views are taken into account and professionals and family members work in partnership. The following good practice must be employed in working with children and their families:

• Involve the child and their family in identifying strengths, risks and concerns as a basis for future actions;
• Actively seek the views wishes and feelings of children, young people and family members and take them into account at every stage;
• Achieve this by talking to the child or young person alone as appropriate for their age and stage and by observing interactions, play and behaviour especially with pre or non-verbal children. However, while it is important to gain and give weight to the views of children, they must never be given inappropriate responsibility for decisions and adults must not abdicate their own decision-making duties;
• Take a holistic approach and have one plan for the family rooted in the recognition that the needs of all family members are interrelated;
• Agree clearly with the family the intended outcomes and what needs to change - specify what is non-negotiable;
• Use plain language and appropriate communication e.g. via an interpreter if required or there is sensory loss or adapted communication for parents or a child with a learning or other disability.

Reviews will be conducted at intervals agreed within the Complex Needs Plan, which should be at least every three months, initially and 6 months thereafter, unless there are exceptional circumstances when timescales can be longer, for example in the case of children with disabilities.

If there are significant changes in the family circumstances, an early review must take place.

Any child protection or safeguarding issues which arise during the course of a Complex Needs Plan must be responded to in line with the Isle of Man Safeguarding Board Procedures.

The Review will usually be carried out by the Lead Professional, who must invite or seek the views of the child, parents and any service providers. The responsible team will administer all Complex Needs Reviews.

The Review will generally take place within a meeting, unless the manager agrees otherwise. The team manager will usually chair the meeting.

7.2 Chairing

• Reviews may be chaired by the Lead professional unless the Review is the first one following a de-escalation from CwSP to CwCN; under these circumstances the chair will be the relevant IRO;
• Chairs will need the following skills and knowledge to carry out the process/intent of the Review Challenge meeting:
  • To determine whether the actions agreed, as part of the Plan, have been implemented and whether a positive difference has been made to the child or family. Any differences need to be clearly documented. If positive changes have not been made, the review meeting needs to decide what else needs to done to make it positive;
  • To consider whether the needs of the child have changed and which category they now fit into: universal, additional needs, complex needs (i.e. no change) of safety and protection needs;
  • To reach consensus on the needs of the child;
  • To reach agreement on the what needs to happen to support and meet the child’s needs;
  • To determine whether any concerns should be escalated;
  • To decide whether the original Plan should be amended; step-up to safety/protection needs; or step-down to additional needs;
  • To decide and agree whether closure can be considered;
  • To document what has been learnt about what has worked and hasn’t worked from the child’s perspective.

7.3 Attendance

• Attendance to be proportionate and be people with a direct and significant contribution regarding the child or parent;
• Both parents and other significant adults to attend as appropriate. Where parents cannot or choose not to attend the meeting can go ahead and the outcomes and decisions notified to them;
• Young people enabled to attend as appropriate or be given opportunity to put views forward without attending;
• There is no ‘quorum’ but there is an expectation that practitioners will prioritise attendance;
• An interpreter or supporter to attend where needed and agreed;
• If a participant could pose a risk a clear decision must be taken and recorded that they have been excluded and the reasons.
  
  

7.4 Venue

• A variety of venues are possible, including the family home but size/space considerations etc. may make a neutral or office venue more likely especially if any participants may pose a risk.

7.5 Records

• The allocated worker must produce their Report to the Review meeting using the pro forma available on Protocol, this must be with the Chair at least 2 working days prior to the Review;
• The Chair must record the Outcomes (which includes a record of attendance) using the pro forma on Protocol within 2 working days and the Minutes by either the Chair (or minute taker with Chair’s authorisation where applicable) within 10 working days of the Review;
• Other professionals must produce a report of their activity.

7.6 Visiting

• There are no statutory visiting periods for Children with Complex Needs. Visiting requirements must be discussed and agreed and recorded in the Plan between the allocated worker and their manager and based upon the need, services provided in the Plan and any risk factors present. Visits and contact with other relevant professionals must be at a level to ensure appropriate monitoring and review of progress to inform further decision-making.

All professionals must:

• Focus on needs and outcomes to be achieved for children and young people;
• Within this, take a holistic view of the family’s needs;
• Participate and comply with all processes to promote children’s welfare including the appropriate and timely sharing of information.

Allocated Case Workers must:

• Lead on carrying out NARRATES CwCN within 45 working days, including building on the information supplied by the referrer, working in partnership with families and relevant agencies, analysing the information and developing a CwCN Plan;
• Be the key worker for planning and reviewing;
• Carry out their own part of the CwCN Plan;
• Share information appropriately.

Children and Families Team Managers must:

• Manage Referrals which appear to meet the threshold for intervention by Children and Families;
• Authorise and decide the outcome of completed NARRATES CwCN;
• Chair Reviews of complex cases where required;
• Monitor compliance and outcomes for Children in Need in supervision, ensuring that visiting arrangements are clear and being carried out;
• Ensure that risk is assessed appropriately.

Partner professionals must:

• Identify Children with Complex Needs and refer them to Children and Families appropriately, in line with the advice in the Isle of Man Safeguarding Board (IoM SB) website, Information Sharing and the Isle of Man Safeguarding Board Procedures, Referral to Social Services Procedure and in consultation with their own managers and Children and Families Initial Response Team, if necessary;
• Gain the consent of the parents/young people, wherever possible, to refer and share information;
• Contribute to the NARRATES CwCN;
• Carry out their own parts of CwCN Plan and participate fully in planning and review meetings;
• Continue to share information appropriately.