Introduction: Definition Step Up: Definition Step Down: Definition Step In Definition Step Out

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Supporting Documents

Stockport Levels of Need Document Common Assessment Framework

Social Work Assessment

Approved By Stockport Safeguarding

Children Board Policy and Procedure Sub Group on 6^th December 2013

Review Date: 25.11.2015

Quality Assurance

Reviewed every 2 years.

Policy Summary

This Policy describes the multi-agency protocol for use in the application of

‘step up’ and ‘step down’ mechanisms across Stockport to ensure a seamless journey for the child through services.

It should be read in conjunction with Stockport Levels of Need document which can be found in the appendices and on the link below

http://www.stockport.gov.uk/2013/2982/9322/55811/levelsofneeddocument

Title: Stockport Multi-Agency Step Up/Step Down Protocol

Version Date Authors Issue Reason Revision Date

1 DRAFT 25.11.2013 SC/DW 26.11.2015

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Introduction:

The process of Step Up and Step Down is an extremely important function in the journey of a child through services and in ensuring that children and families receive consistent, seamless support, at the right time and from the right range of professionals.

Definition Step Up: Step Up can occur at various points across the child concern continuum of need (see Appendix 1). Step Up describes the process of supporting children and families when additional, escalating need occurs. Below are examples of when Step Up would be required.

A child receiving universal provision can require Step Up to trigger the Common Assessment Framework (CAF) because additional unmet needs are identified.

Step Up can also occur when children’s needs are escalating and outcomes are not being met, despite intervention via the Common Assessment and Team around the Child/Family Process.

Definition Step Down: Step Down describes the process that occurs when problems experienced by a child and family have been addressed, the objectives within the plan for the family have been met and the identified level of need has moved down on the continuum of need (Appendix 1).

Step Down is a crucial facet of practice to prevent re-escalation and re- referral. It is important that professionals work together to sustain positive progress. Below are examples of when Step Down would be required.

Step Down can occur following a Common Assessment (CAF) and Team Around the Child/Family (TAC) process. If issues have been addressed satisfactorily and the additional needs have been met the case can step down to universal provision.

Step Down can also occur within statutory frameworks. An example of this is when a child and family have been subject to a Child Protection Plan and risk has diminished as the child and family have made positive progress. In this instance step down to TAC would occur when a Child Protection Plan is no longer required. However, step down would mean that the case remains within a statutory framework..

Definition Step In: Step In is when an additional service is required to meet an identified need in a Team around the Child plan and the service is asked to join the existing process. The Lead Professional will ensure that the service ‘stepping in’ provides the required support, however the overall identified need remains at the same level on the child concern continuum of need (see Appendix 1).

Definition Step Out: Step Out occurs when a service with an action in a Team Around the Child plan has completed that action satisfactorily and the family no longer require that particular support. The service will then

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step out of the process. The overall identified need remains at the same level on the child concern continuum of need (see Appendix 1).

Lack of engagement by a family or failure to keep appointments is not a reason for a service to step out of a Team Around the Child process. If this happens then a risk assessment will be required to identify if step up to the next level on the child concern continuum of need (see Appendix 1) is required.

Process/Practice Step Up

Step Up from universal provision:

When stepping a case up because there is evidence of additional need (not of a child protection nature) it is important to discuss this in the first instance with the parent/carer and if age appropriate, the child. This discussion should involve a description of the Common Assessment process and how it can help and support families that may be experiencing difficulties.

In instances of Step Up from universal provision a CAF should always be completed with the family and relevant professionals from universal and targeted provision should discuss how best to support the family, via the Team Around the Child process (TAC).

When the child is of school age it is always important to encourage discussion between lead professional, parents/carers and schools as it is vital that school is aware if there are issues that are impacting on the child, so that appropriate support can be offered in school.

Where other services/agencies are required to support the child and family it is important to discuss this with the parent/carer and then discuss this with the relevant service(s). This dialogue is crucial to broker the best possible support for children and families.

Other services/agencies should be invited to contribute to and support the Common Assessment and TAC process.

Step up from Common Assessment:

In instances of Step Up when a CAF/TAC intervention is already in progress, the updated Common Assessment and any additional, relevant evidence should be shared with Children’s Social Care who will make a decision on whether the issues highlighted warrant allocation to a Children’s Social Care social worker.

Dialogue with Children’s Social Care is always welcomed and Lead Professionals can telephone the Contact Centre to broker this discussion. The current updated CAF should be shared with Children’s Social Care with an invitation to the next TAC. This invite to ‘step in’ to assess thresholds is a useful mechanism as it enables full discussion between Children’s Social Care and professionals/parents/carers and children to ascertain the most appropriate next steps.

Cases can also Step Up to more intensive statutory intervention if needs and risk continue to escalate and subsequently require a Child Protection Plan to support the child and family and keep the

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child safe from harm. Concerns of a child protection nature should always be telephoned through immediately to the Contact Centre and followed by written confirmation.

Process/Practice Step Down

When children and families have received a statutory intervention, and the family have progressed positively, it is important that the progress made is sustained and that children and families do not feel that they are being passed from ‘service to service’. The Step Down process enables relevant professionals from Children’s Social Care and a range of other services to support the intervention plan appropriately. CAF and TAC are crucial to the step down process as it enables the effective planning and monitoring of cases once statutory services step out of the team around the child.

Step Down from child protection-case remaining in Children’s Social Care

The Child Protection Conference makes the decision to end the child protection plan as the case no longer meets requirements for child protection.

The Conference Chair should always make a recommendation that the child/family continue to be supported via a TAC plan, unless there are specific circumstances agreed by the conference.

The Child Protection conference may make recommendations for the TAC plan which may include the continuation of social care involvement.

The case will remain with the allocated social worker who will then review the care plan under TAC processes and identify a Lead Professional to step down to at the appropriate time; at this point responsibility to complete/update the CAF lies with the Social Worker stepping down.

Step Down from Social Work Assessment to the Common Assessment

When issues affecting the child and family no longer require statutory involvement it is important that good progress is sustained. Effective dialogue between the Social Worker and the future Lead Professional is crucial to pave the way for a seamless transition for children and families.

When Children’s Social Care step out of a case, communication is important to gain agreement on who the Lead Professional will be and this should be recorded clearly.

Step Down from Social Work Assessment 1^st Analysis: When Children’s Social Care makes the decision to step out of a case following a Social Work Assessment that concludes at or shortly after 15 days and where the Social Worker hasn’t held a TAC or developed a TAC plan; the Social Worker should summarise analysis of the assessment and outline what activity/intervention is required to support the child and family.

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The responsibility to complete or update the CAF then reverts back to the original referrer and this process is managed through the Supporting Families Pathway.

Case is screened through the Supporting Families Pathway (SFP) using summary information from Social Worker.

Where a Lead Professional hasn’t been negotiated, the original referrer will be identified as the lead practitioner

Lead Professional will be contacted and a request made to complete/update the CAF within 20 working days

Lead Professional advised of screening tool outcome and additional services indicated that could offer support to CAF TAC process

Important- Where original referral was Police or A&E, a CAF Recommendation will be made and LP identified via SFP screening tool

Step Down at point of Social Work Assessment completion and TAC meetings have been convened by Children’s Social Care:

Children’s Social Care make the decision to step out of a case following full Social Work Assessment

Social Worker should discuss Step Down of case with key stakeholders and negotiate a Lead Professional to take over coordination of the case at Step Down

Responsibility for CAF completion lies with Social Worker and the CAF to be completed/updated within 7 days

This should include key roles and responsibilities clearly outlined within the TAC plan so that the child, family and services ‘stepping in’ are clear on the plan and required outcomes moving forward CAF completion/ update monitored by SFP Senior Practitioner

following 7 day time span

Social Worker contacted to liaise/ offer challenge/support if CAF not submitted

New Lead Professional coordinates intervention using agreed TAC plan

CAF and TAC plan should be regularly updated to reflect activity and intervention/ outcomes for child/family

Step Down from Common Assessment to Universal provision:

When all issues have been addressed satisfactorily and the child/family no longer require support, the CAF should always be closed. This is crucial to ensure that the CAF episode does not remain open on central records. This can be done through the CAF form and a reason for CAF closure should be selected.

Key Principles

Decisions around step up and step down should be underpinned by the needs of the child and family. This ensures a ‘needs led’ not ‘service led’

approach.

Promoting a culture that is underpinned by a true partnership ethos will support quality provision for our children and families in Stockport.

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The Common Assessment Framework and subsequent TAC Plan are crucial elements of the Step Up and Step Down processes, to ensure that effective plans follow the child and family through services and families experience consistency at all times.

Services delivering at contrasting levels of need should work together to ensure a seamless journey through provision for children and families with the ultimate aim of a child being stepped down to universal provision.

At points of step down/ step out, resistance by professionals within the Team Around the Child plan to take on the Lead Professional responsibility should be discussed by the withdrawing service with their line manager in supervision. The line manager should negotiate with the line managers of the other agencies involved in the TAC to try and resolve the situation. If a solution cannot be agreed then this should be referred to the agency representative on the CAF TAC Multi Agency Strategic Steering Group and raised if required as an agenda item. for

Information sharing after Step Up/Down

Following step up/down any further information shared with professionals that have previously led on the case should be submitted centrally to the Contact Centre to ensure current professionals involved with children and families are informed. An example of this would be a family member ringing the social worker, who was previously leading the case prior to step down, with new concerns. Professionals should do this as a matter of course and, although it may assist the process to discuss with the ‘new’

lead professional directly, the concerns should always be shared centrally with the Contact Centre.

Monitoring effective application of Step Up/ Step Down

Data on the application of Step Up and Step down processes will be captured through the Supporting Families Pathway quarterly monitoring reports. This will provide quantitative evidence of the effectiveness of the process.

Audit reports to the CAF TAC Strategic Steering Group will provide further qualitative analysis of impact and effectiveness of Step up and Step Down processes.

The CAF TAC Strategic Steering Group will regularly monitor and oversee effectiveness and report progress to relevant boards.

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PROMOTING CHILDREN AND YOUNG PEOPLE'S WELL-BEING:

UNDERSTANDING LEVELS OF NEED

LEVEL 1: These are children and young people who make good overall progress in all areas of development.

Broadly, these children receive appropriate universal services, such as health, care and education. They may also use leisure and play facilities, housing or voluntary sector services. These children may have a single identified need that can be met adequately by a universal service, however if further additional needs are identified a CAF will be required and step up to level 2.

1. Development Needs of Infant, Child or Young Person

Health, eg Physically well

Adequate diet/hygiene/clothing

Developmental checks/immunisations up-to-date Regular dental and optical care

Health appointments are kept Developmental milestones met Speech and language development met

Education and Learning, eg Skills/interests

Success/achievement Cognitive development Access to books/toys, play

Emotional and Behavioural Development, eg Feelings and actions demonstrate appropriate responses Good quality early attachments

Able to adapt to change Able to demonstrate empathy

Identity, eg

Positive sense of self and own abilities

Demonstrates feelings of belonging and acceptance An ability to express needs age appropriately

Family and Social Relationships, eg

Stable and affectionate relationships with care givers Good relationships with siblings

Positive relationships with peers Positive role models

Social Presentation, eg

Appropriate dress for different settings Good level of personal hygiene

Self-care Skills, eg

Growing level of competencies in practical and emotional skills, such as feeding, dressing and independent living skills

2. Parents and Carers 3. Family and Environmental Factors

Basic Care

Provides for child's physical needs, eg food, drink, appropriate clothing, warmth, medical and dental care

Ensuring Safety

Protect from danger or significant harm, in the home and elsewhere

Emotional Warmth

Shows warm regard, praise and encouragement

Stimulation

Facilitates cognitive development through interaction and play

Empowers child to experience success

Guidance and Boundaries

Provides guidance so that child can develop an appropriate internal model of values and conscience

Stability

Ensures that secure attachments are not disrupted Provides consistency of emotional warmth over time

Family History and Functioning

Good relationships within family, including when parents are separated

Few significant changes in family composition

Wider Family

Sense of larger familial network and positive friendships outside of the family unit

Housing

Accommodation has basic amenities and appropriate facilities

Employment

Parents able to manage the working or

unemployment arrangements and do not perceive them as unduly stressful

Income

Reasonable income over time, with resources used appropriately to meet individual needs

Family's Social Integration

Family feels integrated within the community Good social and friendship networks exist

Community Resources

Good universal services in neighbourhood

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LEVEL 2: These are children and young people whose needs require some extra support from a targeted intervention/service. This may be short term but requires a co-ordinated response from additional services, these children and young people will benefit from a CAF/TAC episode to ensure that needs are met and risk of escalation of need is minimised. A CAF will also ensure that information is held centrally and visible to other professionals who may also have concerns.

Health, eg

Defaulting on immunisations/checks Is susceptible to minor health problems Slow in reaching developmental milestones Minor concerns re diet/hygiene/clothing Starting to default on health appointments Teenage pregnancy

Education and Learning, eg

Has some identified learning needs that place him/her on “School Action”

or “School Action Plus” in the Code of Practice Poor punctuality

Pattern of regular school absences

Not always engaged in learning, eg poor concentration, low motivation and interest observed

Emotional and Behavioural Development, eg

Some difficulties with peer group relationships and with adults Some evidence of inappropriate responses and actions Can find managing change difficult

Starting to show difficulties expressing empathy

Identity

Some insecurities around identity expressed, eg low self-esteem May experience bullying around “difference”

Family and Social Relationships, eg Some support from family and friends Has some difficulties sustaining relationships Attachment issues observed

Can be over-friendly or withdrawn with strangers Can be provocative in appearance and behaviour Personal hygiene starting to be a problem

Not always adequate self-care, eg poor hygiene Slow to develop age-appropriate self-care skills

Basic Care

Parental motivation to engage with services low Parent requires support on parenting issues

Professionals are beginning to have some concerns around child‟s physical needs being met

Signs of substance misuse issues developing

Ensuring Safety

Some exposure to potentially risky situations in the home or community Parental stresses starting to affect ability to ensure child‟s safety Emotional Warmth

Inconsistent responses to child by parent(s) Able to develop other positive relationships

Stimulation

Spends considerable time alone, eg watching television/playing electronic gaming

• Child is not often exposed to new experiences Guidance and Boundaries

Can behave in an anti-social way in the neighbourhood, eg subject to enforcement action

Parent/carer offers inconsistent boundaries or colludes with negative behaviour

Stability

Key relationships with family members inconsistent or negative May have different carers

Starting to demonstrate difficulties with attachments

Parents have some conflicts or difficulties that can involve the child Has experienced loss of significant adult, eg through bereavement or

separation

May be required to look after younger siblings Parent has physical/mental health difficulties

Wider Family

Some support from friends and family

Housing

Adequate/poor housing

Family seeking asylum or refugee status

Employment

Periods of unemployment of the wage-earning parent(s) Parents have limited formal education

Parents starting to feel stressed around unemployment or work situation

Income Low income

Family's Social Integration Family may be new to the area Some social exclusion experiences

Adequate universal resources but family may have access issues

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LEVEL 3: These are children and young people with increasing levels of unmet needs that are more complex.

The depth of need with level 3 children is more significant than those experienced in level 2. Children and families may require both specialist and statutory intervention to support these needs. The CAF and subsequent TAC should be coordinated to address the needs of the child and reduce further escalation of need. The CAF will inform specialist assessments that may be required and can be used to „step down‟ to level 2 (when issues have diminished) or step up to level 4 (when issues have escalated). The CAF can be led by a Lead Professional from a range of services or by a Social Worker.

Health, eg

Concerns re diet, hygiene, clothing Has some chronic health problems

Missing routine and non-routine health appointments Attending health appointments however concerns emerging regarding fabricated illness

Overweight/underweight/enuresis Smokes, substance misuse

Developmental milestones are unlikely to be met Some concerns around mental health

Inappropriate sexual relationships/risk of CSE

Education and Learning, eg

Identified learning needs and may have a Statement of Special Educational Needs

Not achieving key stage benchmarks Poor school attendance and punctuality Some fixed term exclusions

No interests/skills displayed

Emotional and Behavioural Development, eg

Finds it difficult to cope with anger, frustration and upset

Disruptive/challenging behaviour at school or in neighbourhood and at home

Cannot manage change Self harm

Unable to demonstrate empathy

Identity, eg

Is subject to discrimination, eg racial, sexual or due to disabilities Demonstrates significantly low self-esteem in a range of situations

Family and Social Relationships, eg Has lack of positive role models Misses school or leisure activities

Peers also involved in challenging behaviour Involved in conflicts with peers/siblings

Regularly needed to care for another family member

Is provocative in behaviour/appearance Clothing is regularly unwashed Hygiene problems

Poor self-care for age, including hygiene Precociously able to care for self

Basic Care

Difficult to engage parents with services Parent is struggling to provide adequate care Previously looked after by Local Authority Professionals have concerns

Substance misuse affecting parenting capacity Ensuring Safety

Perceived to be a problem by parents May be subject to neglect

Experiencing unsafe situations

Receives erratic or inconsistent care Has episodes of poor quality of care Parental instability affects capacity to nurture Has no other positive relationships

Stimulation

Not receiving positive stimulation, with lack of new experiences or activities

Lack of interaction with child e.g. distracted by social media

Erratic or inadequate guidance provided

Parent does not offer a good role model, eg by behaving in an anti-social way

Stability

Has multiple carers

Has been “looked after” by the Local Authority

Incidents of domestic abuse between parents/significant others Acrimonious divorce/separation

Family have serious physical and mental health difficulties

Wider Family

Family has poor relationship with extended family or little communication Family is easily isolated

Housing

Poor state of repair, temporary or overcrowded

Employment

Parents experience stress due to unemployment or “overworking”

Parents find it difficult to obtain employment due to poor basic skills

Income

Serious debts/poverty impact on ability to have basic needs met

Family's Social Integration Parents socially excluded Lack of a support network

Reduced access to/engagement with quality universal resources and targeted services

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LEVEL 4: These are children and young people whose needs have reached the threshold of significant harm or risk of significant harm. Needs is level 4 are complex and cross many domains. These are cases of a Child Protection nature (Sec 47 of the Children Act) or are within Care Proceedings (Sec 20 and Sec 31 of the Children Act). They will be coordinated and led by a Social worker. The CAF/TAC process will be used to „step down‟ to level 3 when levels of risk and need diminish.

Health, eg

Has severe/chronic health problems that are not being treated/addressed Persistent substance misuse/smoking

Developmental milestones unlikely to be met Early teenage pregnancy

At risk or exposed to sexual exploitation Serious mental health issues

Education and Learning, eg Is out of school (unofficially)

Permanently excluded from school or at risk of permanent exclusion Has no access to leisure activities

Emotional and Behavioural Development, eg Regularly involved in anti-social/criminal activities Puts self or others in danger, eg missing

Suffers from periods of depression Self-harming or suicide attempts

Identity, eg

Experiences persistent discrimination, eg on the basis of ethnicity, sexual orientation or disability

Is socially isolated and lacks appropriate role models

Family and Social Relationships, eg

Periods of being accommodated by the Local Authority

Family breakdown related in some way to child‟s behavioural difficulties Subject to physical, emotional or sexual abuse or neglect

Is main carer for family member

Poor and inappropriate self-presentation

Neglects to use self-care skills due to alternative priorities, eg substance misuse

Basic Care

Parents unable to provide “good enough” parenting that is adequate and safe Parents‟ mental health problems or substance misuse significantly affect care

of child

Parents unable to care for previous children

Ensuring Safety

There is frequent instability and violence in the home Parents involved in crime

Parents involving child in crime Parents unable to keep child safe Victim of crime

Parents inconsistent, highly critical or apathetic towards child

Stimulation

No constructive leisure time or guided play

No interaction with child e.g. constantly distracted by social media

No effective boundaries set by parents

Regularly behaves in an anti-social way in the neighbourhood

Stability

Beyond parental control Has no-one to care for him/her

Significant parental discord and persistent domestic violence Poor relationships between siblings

Wider Family

No effective support from extended family

Destructive/unhelpful involvement from extended family

Housing

Physical accommodation places child in danger

Employment

Chronic unemployment that has severely affected parents‟ own identities Family unable to gain employment due to significant intergenerational

unemployment, lack of basic skills or long-term barriers, eg substance misuse

Income

Extreme poverty/debt impacting on ability to care for child

Family's Social Integration Family chronically socially excluded No supportive network

No/little access to/engagement with quality universal resources and targeted services

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