Tameside Safeguarding Framework

Section 5 - Assessments

• Introduction
• The Common Assessment Framework
• The Framework for the Assessment of Need
  - Outcomes of Assessment
• Initial assessment
  - Inter-agency Checks
  - Notifying the Police
  - Information from Previous areas/Countries of residence
  - Strategy Discussion/Meeting
• Core assessment
• Paediatric Assessment
  - Consent for Paediatric Assessments or Medical Treatment
  - Arranging the Paediatric Assessments
  - Recording of Paediatric Assessment
• Pre-birth Referral & Assessment
  - Referrals
  - Pre-birth Initial Assessment
  - Pre-birth Strategy Meeting
  - Pre-birth s47 enquiry and core assessment

Introduction

5.1 This section provides a brief overview of assessment processes. Section 6 describes how these assessments are used in child protection enquiries.

5.2 Everybody is constantly making assessments about human relationships in every day life and big decisions are often based on such assessments. For example, many people decide whether to buy a service such as plumbing based on what they know about the person who will deliver the service. This will include making some judgement about whether the plumber will be reliable and do a good job rather than cause damage to the property.

5.3 Assessment is the central task in deciding whether a child is thriving or is at risk of harm. Early assessment and intervention is important. This is because a child's welfare will often depend on parents/carers being able to access services to meet the child's needs and because situations where abuse is developing can, at times, be resolved by preventative services outside the child protection procedures.

5.4 All assessments must: 

• Be holistic in approach
• Involve parents and carers (see section 4)
• Involve children and young people, subject to level of understanding (see section 4)
• collate verbal and written contributions from relevant agencies
• Have a solution focus, building on strengths as well as identifying difficulties 

5.5 Types of assessment include: 

• Common Assessment undertaken by practitioners in any of the agencies or organisations providing services for children and their families (Common Assessment Framework or CAF)
• Initial assessment undertaken by Tameside Council Children's Social Care with the involvement of other practitioners, the child and family, using the Framework for the Assessment of Children in Need and their Families (the ‘Assessment Framework')
• Core assessment undertaken by Tameside Council Children's Social Care with the involvement of other practitioners, the child and family using the Assessment Framework (see sub-section on Core Assessment below)
• Other specialist assessments undertaken by health, education or other specialist practitioners (e.g. paediatric assessment, special educational needs assessments or medical/psychiatric diagnoses) 

5.6 Assessments should, as far as possible, build on, rather than repeat, previous assessments where these exist. 

5.7 At all stages of referral and assessment, consideration must be given to issues of diversity to take into account: 

• The impact of cultural expectations and obligations on the family
• The family's knowledge and understanding of English and UK law in relation to parenting and child welfare
• The impact if the family has recently arrived in the UK and their immigrant status
• The need to use interpreters for discussions about parenting and child welfare, even though the family's day-to-day English may appear/be adequate

The Common Assessment Framework

5.8 The Common Assessment Framework (CAF) is a key component of the Tameside Children's Needs Framework which should be consulted for more detailed information about the CAF

5.9 The Common Assessment Framework provides a common method of assessment across all children's services in Tameside and throughout England. It facilitates early identification of needs, leading to coordinated provision of services, involving a Lead Professional where appropriate, and sharing information to avoid the duplication of assessments. 

5.10 A Common Assessment should be completed when a practitioner in any agency (all health, childcare, early years settings, schools, education, Connexions, social care, crime reduction and the voluntary sector) has concerns that a child will not progress, without additional services, towards one or more of the five Every Child Matters priority outcomes (being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being). It is designed for when: 

• There are concerns about how well a child is progressing in terms of their health, welfare, behaviour, progress in learning or any other aspect of their well-being
• The child's needs are unclear or broader than a single service can address 

5.11 Completing a Common Assessment should: 

• Enable the practitioner to identify the child's needs
• Provide a structure for systematic gathering and recording of information
• Record evidence of concerns and a base-line for measuring progress in addressing them
• Provide a framework for a referral to/consultation with Tameside Council Children's Social Care for an initial or care assessment or to another agency/service for a specialist assessment
• Provide a standardised written referral proforma to support a telephone referral 

5.12 A Common assessment cannot be carried out unless the child (subject to age and understanding) and/or their parent agree. The Common assessment is entirely voluntary. If a common assessment is refused and a practitioner is concerned about the welfare of a child, they should talk to Children's Social Care and record this on the child's file.

The Framework for the Assessment of Need

5.13 The Framework for the Assessment of Children in Need and their Families (the Assessment Framework) provides a systematic approach to analyse and record what is happening to a child within their family and the wider context of the community in which they live (see Appendix 3 for a summary of the Framework for the Assessment of Children in Need and their Families). 

5.14 Tameside Council's Children's Social Care are responsible for carrying out the Assessment of need in two stages as either an Initial Assessment or a Core Assessment. They do this with the input and co-operation of other agencies and practitioners. Initial and Core Assessments form the basis of s47 child protection enquiries (see section 6). 

5.15 Child in Need eligibility criteria are used to: 

• Ensure statutory duties are fulfilled by all agencies;
• Provide a range of services to reduce family breakdown or the need for child protection services;
• Target resources for children with higher levels of need;
• Make decisions fairly and consistently; and
• Get the right service to the right people at the right time. 

5.16 Further information about children in need is contained in appendix 2 including how the definition relates to the levels of need set out in the Tameside Children's Needs Framework.

Outcomes of Assessment

5.17 The purpose of Assessment is to ensure that the needs of the child are met sufficiently to promote their welfare and protect them from significant harm. The outcome of these assessments may be: 

• No further action
• The immediate provision of services to the child and their family. This can be done by referral to an appropriate service or by convening a Child and Family Meeting (see appendix 2 for more information)
• Actions to protect the child from significant harm. (see sections 3 and section 6) 

5.18 If you suspect that a child has suffered significant harm or is at risk of significant harm then go immediately to section 3.

Initial assessment

5.19 The initial assessment should be carried out by Tameside Council Children's Social Care in accordance with the Assessment Framework. Where a Common Assessment has been completed this information should be used to inform the initial assessment. 

5.20 The initial assessment should be completed within a maximum of 7 working days of the date of the referral.

5.21 The initial assessment must be led by a qualified social worker. The social worker should, in consultation with their Manager and the other agencies involved with the child and family, carefully plan action with clarity about who is doing what: 

• Whether the child should be seen and spoken to with or without their parents or carers
• When to interview the child (within an appropriate timescale)
• When to interview parents/ carers and any other relevant family members
• What the child and parents should be told of any concerns
• What contributions (historical and contemporary information) to the assessment from other agencies should be and who will provide them
• Whether information from abroad is required. If it is, then Practitioners from each agency will need to request information from their equivalent agencies in the country in which the child has lived 

5.22 The outcome of the initial assessment should be discussed with the child and family and provided to them in written form. Exceptions to this are where this might place a child at risk or jeopardise an enquiry 

5.23 A Children's Social Care Manager must approve the outcomes of an initial assessment consistent with the Initial Assessment Record. The Manager must also record and sign the reasons for decisions, future actions to be taken and also that:

• The child has been seen or there has been a recorded management decision that this is not appropriate e.g. a s47 enquiry and Police investigation initiated which will plan method of contact with child
• The needs of all children in the household have been considered
• A chronology on the front of the file has been completed and/or updated
• Written feedback has been provided to the family, other agencies and referrers about the outcome of this stage of the referral in a manner consistent with respecting the confidentiality and welfare of the child.

Inter-agency Checks

5.24 When referrals are made to Children's Social Care it is sometimes not only the referrer that has knowledge of the child. The social worker and their manager should make a reasoned decision about which agencies to contact for further information. 

5.25 Personal information about non-practitioner referrers should not be disclosed to third parties (including subject families and other agencies) without consent. 

5.26 The parents' permission should be sought before discussing a referral about them with other agencies. If the Manager decides to proceed with checks without parental knowledge or permission, they must record the reasons, e.g. that doing so would: 

• Prejudice the child's welfare
• Aggravate seriously concerning behaviours of the adult
• Increase the risk of further significant harm to the child
• Prejudice a criminal investigation 

5.27 The checks should be undertaken directly with involved professionals and not through messages with intermediaries. 

5.28 The relevant agency should be informed of the reason for the enquiry, whether or not parental consent has been obtained and asked for their assessment of the child in the light of information presented. 

5.29 Children's Social Care should make it clear to families (where appropriate) and other agencies that the information provided for this assessment may be shared with other agencies and contribute to the written form completed at the end of the assessment. 

5.30 If the child and their parents or carers have moved into the Children's Social Care' local authority area, all practitioners should seek information from their respective agencies covering previous addresses in the UK and abroad. 

5.31 Tameside Council's Education Welfare service should be contacted to establish that a school age child is attending an educational establishment. If it is found that the child is not attending school then Tameside Education Welfare must take responsibility for ensuring that the child receives education as soon as possible.

Notifying the Police

5.32 It will not necessarily be clear whether a criminal offence has been committed, which means that even initial discussions with the child should be undertaken in a way that minimises distress to them and maximises the likelihood that s/he will provide accurate and complete information, avoiding leading or suggestive questions. 

5.33 The Police must be informed at the earliest opportunity when it is identified that a crime may have been committed. The Police will decide whether to commence a criminal investigation.

Information from Previous areas/Countries of residence

5.34 If the child and/or family have been resident in another local authority area in England for a significant period, the Tameside Council social worker who carries out the assessment will make contact with Children's Social Care in that area to check whether there has been previous involvement by agencies in that area and will obtain copies of assessments from those agencies. 

5.35 It is never acceptable to delay immediate action required whilst information from foreign countries is accessed. 

5.36 Information from other UK countries can be obtained in a similar way to the equivalent local authority bodies (or in Northern Ireland from the Health and Social Care Trusts - www.hscni.net/ ) 

5.37 Information from foreign countries can be accessed via many embassies in the UK, details of which can be found at the website of the Foreign and Commonwealth Office on www.fco.gov.uk . In some cases, specialist assessments and information can be undertaken or obtained through independent consultants or through specialist agencies such as International Social Services. 

5.38 International Social Services is an organisation based in London which can be contacted via its website address on www.issuk.org.uk . Its work is also described at the website.

Strategy Discussion/Meeting

5.39 Whenever there is reasonable cause to suspect that a child is suffering, or is likely to suffer significant harm, there should be a Strategy Discussion/Meeting involving Tameside Council Children's Social Care and the Police, and other agencies as appropriate (for example, children's centre/school and PCT), in particular any referring agency. 

5.40 See Section 6 for more information about Strategy Discussions/Meetings.

Core assessment

5.41 If the criteria for initiating a child protection (s47) enquiry are met at any stage during an initial assessment, the assessment should be regarded as concluded and a Strategy Discussion held immediately to decide if a s47 enquiry and core assessment is required. 

5.42 A core assessment should be undertaken when a more in-depth assessment is necessary to understand the child's developmental or welfare needs and circumstances and the parents' capacity to respond to those needs, including the parents' capacity to ensure that the child is safe from harm now and in the future. 

5.43 The decision to undertake a core assessment may be taken: 

• At the conclusion of an initial assessment which recommends further assessment , and/or
• When new information is obtained on an open case 

5.44 A core assessment should be based on the Assessment Framework. It must be led by a qualified social worker. 

5.45 The core assessment must be completed within a maximum of 42 working days, including the maximum 7 working days taken to complete an initial assessment. It may be necessary to commission specialist assessments (e.g. from child and adolescent mental health services) which it may not be possible to complete within this time period. This should not delay the drawing together of the core assessment findings at this point. 

5.46 There are no circumstances in which national guidance permits extension to the above timescales. 

5.47 Any request to Children's Social Care from another agency for a core assessment must be given serious consideration and if there is a decision not to undertake the core assessment the decision and the reasons for it must be recorded in the child's file and conveyed in writing to the referring agency. 

5.48 A Children's Social Care Manager must sign and approve the outcomes of a core assessment and ensure that: 

• There has been direct communication with the child alone and her/his views and wishes have been recorded and taken into account
• All the children in the household have been seen and their needs considered
• The parent has been seen and her/his views and wishes have been recorded and taken into account
• The analysis has been completed
• The assessment provides clear evidence for decisions on what types of services are needed to provide good outcomes for the child and family
• The chronology at the front of the child's file is up-to-date. 

5.49 If the assessment is that further support is required, a child in need plan should be agreed with family and other agencies. The child in need plan may be activated through Child & Family meetings (see appendix 2). The child in need plan should be monitored and reviewed regularly at maximum intervals of 6 months. 

5.50 See Section 6 for more information about Strategy Discussions and how child protection enquiries proceed under s47 Children Act, using the Core Assessment. 

5.51 If the child is a hospital patient (in- or out-patient) or receiving services from a child development team, the medical consultant responsible for the child's health care should be involved, as should the senior ward nurse if the child is an in-patient. Where a medical examination may be necessary or has taken place a senior doctor from those providing services should also be involved.

Paediatric Assessment

5.52 Paediatric Assessments may be necessary in the course of s47 child protection enquiries. 

5.53 Where the child appears in urgent need of medical attention e.g. suspected fractures, bleeding, loss of consciousness, they should be taken to the nearest A & E Department. 

5.54 In other circumstances the Strategy Discussion/meeting will determine, in consultation with the paediatrician, the need and timing for a paediatric assessment. Where a child is also to be interviewed by Police and/or Children's Social Care, this interview should take place prior to a medical examination unless there are exceptional circumstances agreed with the Police and Children's Social Care.

5.55 A paediatric assessment should always be sought when there is a suspicion or disclosure of child abuse and/or neglect involving a suspicious or serious injury, suspected sexual abuse and serious neglect. 

5.56 A paediatric assessment should demonstrate an holistic approach to the child and assess the child's well being, including development if under five years old, and their cognitive ability if older (educational psychologists can offer further expertise).

5.57 A paediatric assessment is necessary to: 

• Inform treatment, investigations, clinical care and follow up arrangements for the child (any injury, infection, new symptoms including psychological)
• Obtain documented medical opinion
• Provide re-assurance for the child, parent or carer and Children's Social Care
• Secure forensic evidence 

5.58 Only doctors may physically examine the whole child, but all other staff should note any visible marks or injuries on a body map and record, date and sign details in the child's file.

Consent for Paediatric Assessments or Medical Treatment

5.59 The following may give consent to a paediatric assessment: 

• A child of sufficient age and understanding
• Any person with parental responsibility
• The local authority when the child is the subject of a Care Order (though the parent/carer should be informed and consulted)
• The local authority when the child is accommodated under s.20 of the Children Act 1989, and the parent/carers have abandoned the child or are physically or mentally unable to give such authority (in these circumstances legal advice should be sought)
• The High Court when the child is a ward of court
• A Family Proceedings Court as part of a direction attached to an Emergency Protection Order, an interim Care Order or a Child Assessment Order 

5.60 When a child is looked after under s20 and a parent/carer has given general consent authorising medical treatment for the child, legal advice must be taken about whether this provides consent for paediatric assessment for child protection purposes (the parent/carer still has full parental responsibility for the child) 

5.61 A child of any age who has sufficient understanding (generally to be assessed by the doctor with advice from others as required) to make a fully informed decision can provide lawful consent to all or part of a paediatric assessment or emergency treatment. 

5.62 A young person aged sixteen or seventeen has an explicit right [s8 Family Law Reform Act 1969] to provide consent to surgical, medical or dental treatment and unless grounds exist for doubting her/his mental health, no further consent is required.

5.63 A child who is of sufficient age and understanding may refuse some or all of the paediatric assessment, though refusal can potentially be overridden by a court. Legal advice must be sought if this is considered necessary.

5.64 Wherever possible the permission of a parent should be sought for children under sixteen prior to any paediatric assessment and/or other medical treatment.

5.65 Where circumstances do not allow permission to be obtained and the child needs emergency medical treatment then: 

• The medical practitioner may regard the child to be of an age and level of understanding to give her/his own consent
• The medical practitioner may decide to proceed without consent 

5.66 In these circumstances, parents must be informed by the medical practitioner as soon as possible and a full record must be made at the time. 

5.67 In non-emergency situations, when parental permission is not obtained, the social worker and manager must consider whether it is in the child's best interests to seek a court order.

Arranging the Paediatric Assessments

5.68 In the course of s47 enquiries, appropriately trained and experienced practitioners must undertake all paediatric assessments. 

5.69 Referrals for child protection paediatric assessments from a social worker or a member of the Police are made to the local service, usually the community paediatric department. 

5.70 The paediatrician may arrange to examine the child her/himself, or arrange for the child to be seen by a member of the paediatric team in the hospital or community. 

5.71 In cases of suspected sexual abuse a detailed examination will take place at the St Mary's Sexual Assault Referral Centre (SARC). The referral to SARC is made by the Police via the GMP Duty Officer. 

5.72 In cases of severe neglect, physical injury or penetrative sexual abuse, the assessment should be undertaken on the day of referral, where compatible with the welfare of the child. 

5.73 The need for a specialist assessment by a child psychiatrist or psychologist should be considered. 

5.74 In planning the examination, the Police officer and relevant doctor must consider whether it might be necessary to take photographic evidence for use in care or criminal proceedings. 

5.75 Where such arrangements are necessary, the child and parents must be informed and prepared and careful consideration given to the impact on the child.

Recording of Paediatric Assessment

5.76 The paediatrician should supply a report to the social worker with a copy to the GP and, where appropriate, the Police. The timing of any letters to parents should be determined in consultation with Children's Social Care and Police. 

5.77 The report should include: 

• A verbatim record of the carer's and child's accounts of injuries and concerns noting any discrepancies or changes of story
• Documentary findings in both words and diagrams
• Site, size, shape and where possible age of any marks or injuries
• Date, time and place of examination
• Those present
• Who gave consent and how (child / parent, written / verbal)
• Other significant medical findings e.g. squint, learning or speech problems etc.
• Opinion on the child's developmental progress (especially important in cases of neglect)
• Time examination ended 

5.78 All reports and diagrams should be signed and dated by the doctor undertaking the examination.

Pre-birth Referral & Assessment

Referrals

5.79 Where agencies or individuals anticipate that prospective parents may need support services to care for their baby or that the baby may be at risk of significant harm, a referral to Tameside Council's Children's Social Care must be made as soon as the concerns are identified. 

5.80 The referrer should clarify as far as possible their concerns in terms of how the parent's circumstances and/or behaviours may impact on the baby and what risks are predicted. 

5.81 A referral should be made at the earliest opportunity in order to: 

• Provide sufficient time to make adequate plans for the baby's protection
• Provide sufficient time for a full and informed assessment
• Avoid initial approaches to parents in the last stages of pregnancy, at what is already an emotionally charged time
• Enable parents to have more time to contribute their own ideas and solutions to concerns and increase the likelihood of a positive outcome to assessments
• Enable the early provision of support services so as to facilitate optimum home circumstances prior to the birth 

5.82 Concerns should be shared with prospective parent/s and consent obtained to refer to Tameside Council's Children's Social Care unless obtaining consent in itself may place the welfare of the unborn child at risk e.g. if there are concerns that the parent/s may move to avoid contact with investigative agencies.

Pre-birth Initial Assessment

5.83 A pre-birth initial assessment should be undertaken on all pre-birth referrals and a Strategy meeting held where: 

• A parent or other adult in the household, or regular visitor, has been identified as posing a risk to children
• A sibling in the household is subject to a Child Protection Plan
• A sibling has previously been removed from the household either temporarily or by court order
• Domestic violence is known to have occurred
• The degree of parental substance misuse is likely to impact significantly on the baby's safety or development
• The degree of parental mental illness / impairment is likely to impact significantly on the baby's safety or development
• There are concerns about parental ability to self care and/or to care for the child e.g. unsupported young or learning disabled mother
• Any other concern exists that the baby may be at risk of significant harm including a parent previously suspected of fabricating or inducing illness in a child or harming a childPre-birth Strategy Meeting

Pre-birth strategy meeting

5.84 The need for a s47 enquiry should be considered and, if appropriate, initiated by a Strategy Meeting as soon as possible following receipt of the referral. The expected date of delivery will determine the urgency for the discussion/meeting. 

5.85 Consideration of the need to initiate a s47 enquiry should follow the procedures described in section 6 (Child Protection Enquiries). 

5.86 The Strategy Meeting should follow the procedures described in section 6 (Strategy Discussion/Meeting). 

5.87 The meeting must decide: 

• Whether a s47 enquiry and pre-birth core assessment is required (unless previously agreed at any earlier ante-natal meeting)
• What areas are to be considered for assessment
• Who needs to be involved in the process
• How and when the parent/s are to be informed of the concerns
• The actions required by ward staff and midwifery service when the baby is born 

5.88 The assessment plan must be consistent with standards required for possible court proceedings, including clear letters of instruction. 

5.89 The parents should be informed as soon as possible of the concerns and the need for assessment, except on the rare occasions when medical advice suggests this may be harmful to the health of the unborn baby and/or mother.

Pre-birth s47 enquiry and core assessment

5.90 In undertaking a pre-birth s47 enquiry and core assessment, Children's Social Care, the Police and relevant other agencies must follow the procedures described in this section above and in section 6 Child Protection Enquiries. 

5.91 In summary, the investigation should identify: 

• Risk factors
• Strengths in the family environment
• Factors likely to change and why
• Factors that might change, how and why
• Factors that will not change and why
   

5.92 The enquiry must make recommendations regarding the need, or not, for a pre-birth Child Protection Conference which should wherever possible be held 10 weeks prior to the expected delivery date or earlier if a premature birth is anticipated.