Brighton & Hove Family Help Right Support at the Right Time – Interactive Online Framework Guide

  • Level 1. Universal

    Child has needs met within universal provision. May need limited intervention within the setting to avoid needs arising.

  • Level 2. Family Help

    Child has additional needs where more structured and focused help, sometimes through one professional or agency in order to prevent needs from escalating. May also require a more structured plan of support in order to co-ordinate help needed, in order that agreed outcomes can be reached.

  • Level 3. Specialist Services to address Acute & Chronic need

    Child will need specialist support that is led by children’s social work or another specialist service, or those who are most vulnerable where Family Help Plans have been tried but not able to make tangible difference, or where a child is at risk of significant harm or has suffered significant harm.

  • Child Developmental Needs
    • Good attendance (above 90%) 
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      Good attendance (above 90%) 


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    • Meeting developmental & learning milestones 
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      Meeting developmental & learning milestones 


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    • Has emotional well-being 
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      Has emotional well-being 


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    • Ability to protect self and be protected 
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      Ability to protect self and be protected 


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    • Resilient and able to adapt to change 
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      Resilient and able to adapt to change 


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    • Physically healthy 
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      Physically healthy 


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    • Age-appropriate self-care & independence skills 
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      Age-appropriate self-care & independence skills 


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    • Positive sense of self and abilities 
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      Positive sense of self and abilities 


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    • Ability to express needs 
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      Ability to express needs 


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  • Child Developmental Needs
    • Absence/truancy from school that may become persistent  
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      Absence/truancy from school that may become persistent

      Persistent Absence is attendance less than 90%.

       

      Good attendance is important because: 

      • Statistics show a direct link between under-achievement and absence below 95% 
      • Regular attenders make better progress, both socially and academically 
      • Regular attenders find school routines, schoolwork and friendships easier to cope with 
      • Regular attenders find learning more satisfying 
      • Regular attenders are more successful in transferring between primary school, secondary school, and higher education, employment or training 
      • Persistent absenteeism is linked with increased risk in relation to child sexual exploitation, criminal exploitation and a decrease in life opportunities that can have long term impacts into adulthood. 

        

      Parents & carers have a responsibility to plan for the education of their children either at school or in a different way.  Education in a different way includes being taught at home by a parent or private tutor. They must provide an education that is efficient, full-time and suitable for their child’s age, skills and capability, considering any special needs that the child may have. 

        

      If the child or young person has an ongoing health problem they can be referred to the 5-19 Healthy Child Programme following discussion with parent/ carer/ young person. Each school has a named School Nurse and schools have the referral form. 

        

      Children Missing Education are children who are not on a school roll or being provided with education in a different way.  

       

      PA (persistent absentees) are children who have low attendance. They are identified by schools and initial interventions come through schools and the local authority attendance team. Schools will be the first agency to identify and consider the risks, including risks of exploitation and of being missing from home, for a PA.  

       

      In Brighton and Hove, the local authority run a CME Panel, which schools refer children with below 30% attendance to for monitoring, consideration of support and further interventions.  

      Schools should consider possible further links for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence. 


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    • Incidence of absence/missing from home that may become regular or with no explanation.  
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      Incidence of absence/missing from home that may become regular or with no explanation.

      Children who are missing invariably place themselves at risk. The reasons for their absence are varied and complex and cannot be viewed in isolation from their home circumstances. 

      Sometimes children go missing with their families to evade contact with professionals. Every ‘missing’ episode should attract proper attention from the professionals involved with the child and those professionals must collaborate to ensure a consistent and coherent response is given to the child on their return and that parents and carers are supported appropriately. 

       Children Missing Education may help identify children who are not only missing from school but are also missing from home.  

       If staff are concerned that trafficking or sexual exploitation may be the reason for underlying prolonged or repeated periods of absence, then contact should be made with the Front Door For Families.  


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    • Persistent poor behaviour in school that may lead to fixed term exclusions or no school place.  
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      Persistent poor behaviour in school that may lead to fixed term exclusions or no school place.

      The expectations on schools regarding behaviour are outlined here: Behaviour in Schools – Advice for headteachers and school staff Feb 2024 (publishing.service.gov.uk) 

       

      Suspension (previously known as fixed term exclusions) and permanent exclusion should only be used once all other avenues of support and sanction have been utilised by the school. This should be outlined in the school’s behaviour policy 

       

      This guidance is here: Suspension and permanent exclusion guidance September 2023 (publishing.service.gov.uk) 

       

      ‘Under the Education and Inspections Act 2006, headteachers of maintained schools and pupil referral units must determine measures to be taken with a view to:  

      • promoting self-discipline and proper regard for authority among pupils, 
      • encouraging good behaviour and respect for others on the part of pupils and, in particular, preventing all forms of bullying among pupils, 
      • securing that the standard of behaviour of pupils is acceptable, 

       

      • securing that pupils complete any tasks reasonably assigned to them in connection with their education, and
      • otherwise regulating the conduct of pupils’

       

      Schools should take a staged approach to regulating behaviour; in line with the BHCC Graduated Response guidance, which should include setting up a support plan and undertaking a review of child’s learning needs and consideration of whether the child needs to be recognised as having any Special Educational Needs or Disability (SEND)  

      Suspension and exclusion A pupil may be suspended for one or more fixed periods (up to a maximum of 45 school days in a single academic year), or permanently excluded.  

      If the exclusion is longer than 5 school days, the school must arrange suitable full-time education from the sixth school day, e.g. at a pupil referral unit. 

      The school or local council must tell parents and carers about any alternative provision (education) they arrange. It is a parent or carers responsibility to make sure their child attends. 

      Permanent exclusion: Permanent exclusion means the child is unable to return to that school. The local council must arrange full-time education from the sixth school day. 

      The local agreement in Brighton and Hove is that all children at risk of permanent exclusion are discussed at the Primary or Secondary Behaviour & Attendance Partnership (BAP) meetings so alternatives to exclusion can be sought.  


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    • Risk of social exclusion  
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      Risk of social exclusion

      Social exclusion is “a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of a society as a whole” (Pierson, 2002).

      People who are socially excluded do not have access to the same institutions, services and social support networks that most people in a society take for granted. Although poverty is usually the main cause of social exclusion, there may be other contributing factors, such as racial discrimination or low educational achievement.

      The extent of a family or child’s social exclusion is being evidenced through the child or family’s behaviour that is beginning to show a negative impact on the development of the child and upon their life chances.


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    • Poor relationships  
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      Poor relationships

      The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond.  

       

      If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Healthy Child Programme for further support / advice.  

       

      Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator). 

      The impact of early experiences of poor relationships and often the resultant levels of low or high self-esteem can result in high levels of anxiety and potential conflict in the context of friendships and intimate relationships as a person grows and develops. 


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    • Language and communication difficulties  
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      Language and communication difficulties

      Pre-school 

      Children’s speech and language will be routinely reviewed at the 27-month health review. Those identified with difficulties will be offered interventions through the Healthy Child Programme (HCP) 0 – 19 team, Family Hub’s and specialist Speech and Language Therapy or Seaside View Child Development Centre as appropriate 

       

      School-age 

      If a child has language or communication difficulties all referrals to SLT are made through school. Schools can refer directly to Seaside View.  The HCP team 5-19 can make direct referrals to Seaside View. 


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    • Disability or additional special educational needs  
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      Disability or additional special educational needs

      Many children will need extra help with their learning at some point, but this does not necessarily mean that they have a Special Educational Need or Disability (SEND). 

        

      Children and young people have SEND if they: 

      • Have a significantly greater difficulty in learning than the majority of others of the same age 
      • Have a disability which prevents or hinders them from using the facilities generally provided in mainstream schools or colleges. 

        

      Special provision must be made for children and young people with SEND. Sometimes this may only be for a short time and can occur within mainstream provision. Sometimes support will be needed for the whole of someone’s life. 

        

      Identifying and assessing special educational needs and disabilities (SEND):
      If you are concerned about your child’s health or development, you should speak to a professional who works with you or them in the first instance. Depending on your child’s age or circumstances, this might be a health visitor, nursery worker, teacher, social worker or your GP. 

        

      You can also contact Amaze, the local SEND Information, Advice and Support Service, for advice around diagnosis and assessment. 

        

      If your child is at school or nursery, there are certain set processes for assessing their needs and the support that may help them.  

        

      Where there are shared concerns about a child or young person’s developmental progress, they may be referred for assessment through the following services: 

      • Social care support   – Integrated services for children and young people with SEND including health, education and social care 

        

      The assessment process might involve seeing different specialist services or being seen in more than one place, for example at the Seaside View Assessment Centre or school or nursery. 


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    • Potential for becoming NEET / NEET  
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      Potential for becoming NEET / NEET

      Young people up to the age of 16 are required by law to be in full time education.

      Since the Raising of Participation Age statutory guidance young people aged 16-18 are required to be participating in some form of education, training, or employment with training.

      Young people experiencing multiple types of marginalisation increases the risk of young people not being in employment, education, or training.

      It is important to identify these young people early, before they disengage from education, so that help can be put in place to support them. Young people who are NEET may be at greater risk of being victims of harm, abuse or exploitation.

      Some indicators that a young person is at risk of becoming NEET may include, but is not limited to:

      • low school attendance
      • highest level of qualification below Level 2
      • special educational needs
      • supported by Youth Justice
      • care experienced
      • young parent
      • young carer

       

      Every school and college must ensure that pupils are provided with independent careers guidance.

       

      Brighton & Hove City Council has a duty to promote the active participation in education and training of all young people in Brighton & Hove, including ensuring all 16–18-year-olds have an offer of an appropriate place in post -16 education or training, tracking process from pre- to post-16 learning and identifying those who are not participating.

       

      Many young people who are NEET will be so for a short period of time. However, there are some NEET young people who will have significant and complex barriers and may need intensive support from a range of specialist agencies before they are ready to re-engage in learning or employment. Brighton & Hove City Council has a responsibility for young people’s participation and NEET reduction and co-ordinates support for young people who have disengaged from learning.


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    • Difficulty in achieving in education  
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      Difficulty in achieving in education

      Schools should review a child’s learning needs, in accordance with the SEND Code of Practice. A pupil has special educational needs and disabilities (SEND) where their learning difficulty or disability calls for special educational provision, namely provision different from or additional to that normally available to pupils of the same age.

       

      Schools should make regular assessments of progress for all pupils. These should seek to identify pupils making less than expected progress given their age and individual circumstances. This can be characterised by progress which:

      • is significantly slower than that of their peers starting from the same baseline
      • fails to match or better the child’s previous rate of progress
      • fails to close the attainment gap between the child and their peers
      • widens the attainment gap

       

      Where progress continues to be less than expected the school, should assess whether the child has SEND.

       

      For some children, SEND can be identified at an early age. However, for other children and young people difficulties become evident only as they develop.

       

      Persistent disruptive or withdrawn behaviours do not necessarily mean that a child or young person has SEND. Where there are concerns, there should be an assessment to determine whether there are any causal factors such as undiagnosed learning difficulties, difficulties with communication or mental health issues. If it is thought housing, family or other domestic circumstances may be contributing to the presenting behaviour a multi-agency approach, supported by the use of approaches such as the Early Help Assessment, may be appropriate. In all cases, early identification and intervention can significantly reduce the use of more costly intervention at a later stage.


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      Better Outcomes, Better Lives: Brighton & Hove’s Strategy for Tackling Educational Disadvantage 

    • Developmental milestones delayed or not being met which could be attributable to the care received by the child.  
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      Developmental milestones delayed or not being met which could be attributable to the care received by the child.

      Pre-school
      Children will routinely have their developmental milestones assessed by way of ASQ-3 assessment at their 9-12 month and 27-month health reviews. If a child is attending an Early Years setting they will be offered an ‘Integrated Review’ incorporating findings from the ASQ-3 domains with the Early Years Foundation Stage development assessment categories. If a child requires support that is additional to, or different from their peers a SEND Support Plan should be put in place. Children identified as slow to meet their milestones may be referred to the appropriate specialist services, for example, Seaside View Child development Centre, including BHISS Early Years Team. 

        

      If there are concerns regarding speech, language and communication then a referral should be made for Speech and Language Therapy for Children.  

       

      Children can be reviewed using ASQ -3 assessments at any time from the age of 1 month. This can be accessed by contacting the Healthy Child Programme Team (Health Visiting Service) for their geographical location. 

        

      School-age:
      School-age children who are not meeting their developmental milestones and not progressing in school should be discussed with the Special Educational Needs Coordinator to see if additional assessments or support is required. 

      All Children in their reception year are offered a vision and hearing screening test by the 5-19 Healthy Child Programme team. If the child is identified as having a possible concern, they will be referred to an orthoptist or audiologist with parent/carer consent. 

        

      If there are subsequent concerns about a child’s vision or hearing this should be discussed with the child’s parent/carer to check whether they are already seeing a specialist. If they are not already being seen by audiology or an optician the parent/carer should be advised to seek a free eye assessment. Special Educational Needs Coordinators can make a referral to audiology directly from Year one onwards. 

        

      If there are concerns about a child’s fine or gross motor skills schools should refer to and liaise with their link therapist. Parents can get further support and advice from their School Nurse or ask their GP for a referral to audiology. 

      If there is a concern about a child or young person’s speech, development or motor skills that is felt to be attributable to the care the child has been receiving then call the Front Door For Families on 01273 290400 who will be able to advise how best to support them and access an assessment if necessary. 

      If you are concerned that a child is not thriving because they have a Special Educational Need or Disability (SEND) – then please see further information here 

        

      Schools and parent/carers can access supportive health and wellbeing information through NHS Choices, or contacting the appropriate HCP 5-19 team. 


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    • Missing health checks/immunisations which could lead affect developmental progress.  
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      Missing health checks/immunisations which could lead affect developmental progress.

      Babies are offered regular health and development reviews until they are two years old to make sure their development is on track and support parents & carers. The reviews are usually done by a Health Visitor or Community Nursery Nurse and can take place in the home, a GP surgery, baby clinic or Family Hub.  

       

      If a baby/child (up to 5 years old old) has missed a check or there are any concerns about their development, please feel free to contact the service: 

       

      Health visitor single point of contact – 01273266000 

      Email sc-tr.bh-healthvisitors@nhs.net 

      Parent line – 07507331296 

       

      For school aged children please use: 

      School nurse single point of contact – 01273 696011 (ext 1692) 

      Chat health- 07480635423 

       

      Children are offered a range of vaccines from the age of eight weeks to 14 years. Deciding not to vaccinate a child puts them at risk of catching a range of potentially serious, even fatal, diseases. For more information on the NHS Vaccination programme see Vaccinations – NHS (www.nhs.uk).  


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    • Minor health problems / Chronic or recurring health problems  
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      Minor health problems / Chronic or recurring health problems

      School-age Children and young people can be referred to the Healthy Child Programme School Nursing service where there are concerns about a child or young person’s health following discussion with parent/ carer/ young person. If they have a complex need or a long-term health condition School Nurses can work together with the child/young person, parent/carers, schools and the health professionals who are involved in their care, to help them get the support that they need. 

        

      There is also a group of children that present with perplexing/medically unexplained symptoms (perplexing presentations). Perplexing presentations may include cases of functional disorders (conditions with a psychological cause of the symptoms) and those cases that medical professionals are unable to explain based on their clinical assessment and medical investigations. Rarely in some of these cases, symptoms are being reported to gain support that may not be required or recommended by health and education professionals. This group can include cases where a parent is exaggerating symptoms, misreporting or misunderstanding conditions. If worried about an urgent medical concern, call 111 and speak to a fully trained advisor. 


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    • Early signs of offending/anti-social behaviour which could lead to child entering the Youth Justice System  
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      Early signs of offending/anti-social behaviour which could lead to child entering the Youth Justice System

      Referrals to the Adolescent Service Youth Justice Team via the Police or Courts. 

        

      Young people (age 10-17) who are arrested for a first offence can be referred by Police to the Youth Justice Service via the Diversion pathway. If the Police decide to charge (e.g. not guilty plea or serious / persistent offending), the young person will be summonsed to Court and may receive a Court Order. Young people referred to the Diversion scheme will be assessed and offered a programme to meet their needs. Each young person’s case is reviewed at the joint decision-making panel with Police and Youth Justice, with potential outcomes being Youth Conditional Caution, Caution, Community Resolution of Outcome 22.  

        

      The allocated Youth Justice Worker will work closely with the young person and family to address the underlaying factors related to offending behaviour, build strengths and resilience though positive activities and address safeguarding issues.  The Youth Justice worker will collaborate with partners, such as CAMHS, social worker, psychologist, family therapist, ru-ok? or others to deliver an individually tailored programme to meet need. The lead professionals will also liaise with the school or educational provision in planning for the young person. 

        

      The diversion programme may consist of a single intervention, such as restorative justice or drugs/ alcohol awareness, or the programme may involve up to three months or more with weekly contact, depending on the level of risk and need.  


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    • Underage sexual activity which may lead to teenage pregnancy.  
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      Underage sexual activity which may lead to teenage pregnancy.

      It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust. 

        

      The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity. 

        

      Schools and other agencies will / may have a confidentiality policy which clearly dictates what information they will pass to interested parties in relation to underage sexual activity if the young person is aged 13 years and above. 

      Young people can access their Sexual Health clinic or a Sexual Health Outreach Nurse for contraception, STI testing, treatment and information through sexual health and contraception clinic (SHAC). Trained youth support practitioners are available at a range of community venues and can provide confidential information, advice and signposting. Young people can access free condoms, chlamydia testing and pregnancy testing from a range of community settings. 

       

      Free Emergency Hormonal Contraception (EHC) is available from Pharmacies across Brighton & Hove. Please phone the pharmacy before attending to ensure the trained pharmacist is available to dispense the EHC. Young people can also access free EHC from their GP or local sexual health clinic.  

       

      Pregnant teenagers are entitled to the same support and information as all pregnant women and will be under the care of their GP and Midwife. Schools should make a referral to EOTAS (Education Other Than At School) so that girls can get home tuition for 18 weeks.  To contact the EOTAS team email eotas@brighton-hove.gov.uk  or phone 01273 295 180 for information and advice. 

        

      In Brighton and Hove all pregnant teenagers are offered the Healthy Child Programme with additional support for the most vulnerable teenagers and those teenagers requiring additional support via the Healthy Futures Team, a city-wide team based at Tarner Family Hub (Tel: 01273 266000).


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    • Risky sexual behaviour (e.g. unprotected sex)  
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      Risky sexual behaviour (e.g. unprotected sex)

      The age of consent to any form of sexual activity is 16 for both men and women. The age of consent is the same regardless of the gender or sexual orientation of a person and whether the sexual activity is between people of the same or different gender. 

        

      It is an offence for anyone to have any sexual activity with a person under the age of 16. However, Home Office guidance is clear that there is no intention to prosecute teenagers under the age of 16 where both mutually agree and where they are of a similar age and there is no evidence of coercion or exploitation. 

        

      It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust. 

        

      The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity. 

        

      Schools and other agencies will / may have a confidentiality policy which clearly dictates what information they will pass to interested parties in relation to underage sexual activity if the young person is aged 13 years and above. Alternatively they can access their Sexual Health clinic or a Sexual Health Outreach Nurse for contraception, STI testing, treatment and information through sexual health and contraception clinic (SHAC). Trained youth support practitioners are available at a range of community venues and can provide confidential information, advice and signposting. 

        

      Young people can access free condoms, chlamydia testing and pregnancy testing from a range of community settings. 

        

      Some secondary schools offer support and advice about sexual health to young people at a weekly drop in run jointly by a School Nurse and Youth Worker. 

        

      Free Emergency Hormonal Contraception (EHC) is available from Pharmacies across Brighton & Hove. Please phone the pharmacy before attending to ensure the trained pharmacist is available to dispense the EHC. Young people can also access free EHC from their GP or local sexual health clinic.  


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    • Drug/alcohol misuse  
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      Drug/alcohol misuse

      The Adolescent Health Service (Ru-ok?) is a service for young people up to the age of 18 who require support around drugs, alcohol or sexual health. Parents/ carers or the young person can self- refer, or professionals or schools can refer but the consent of the young person is required. 

        

      It offers structured treatment for young people whose substance misuse is problematic to the degree that it is impacting on their daily life. For example, physically, emotionally, or impacting their education, family relationships, or leading to offending, safeguarding or other significant issues. 

        

      Young people would have a comprehensive assessment leading to a bespoke care plan, which could include a range of interventions, for example, harm reduction, motivational interviewing, advice and guidance. The service works alongside partner agencies to support young people and their families/ carers.  

       

      They also work to prevent and divert young people away from substance use before it has become a problematic. Referrals to the DASH workers (prevention) can come from schools, professionals and young people and their families/carers.   

       

      The Family Drug and Alcohol worker delivers brief intervention alongside harm reduction and health promotion. This is for parents and carers of young people affected by substance use and siblings of the young people, also extended to young people whose parent’s alcohol or substance use is having a negative effect on them. The Family and Drug Alcohol Worker also delivers alcohol and drug awareness drop-in sessions to families and carers to build a wider peer supportive network. 

       

      To contact them please call 01273 293966 or email ruokdb@brighton-hove.gov.uk. 

      Young people should be referred when a substance related incident occurs and where there are concerns that they are becoming involved in regular absence or are displaying changes in behaviour, due to substance misuse. Young people’s consent must be gained for the referral and confidentiality and need for safeguarding should be addressed. 

        

      Drinkaware have a definition of the early signs of alcohol misuse and the ‘Talk to Frank’ website offers a definition of the early signs of drug misuse. 


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    • Poor self-esteem  
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      Poor self-esteem

      Self-esteem should be viewed as a continuum, and can be high, medium or low (often quantified as a number in empirical research but not by practitioners). It is important to note that there is no expectation for certain numbers to be proven at each level.  

      When considering self-esteem, it is important to note that both high and low levels can be emotionally and socially harmful for the individual. It is thought that an optimum level of self-esteem lies somewhere in the middle of the continuum. 

      Socially children with low self-esteem can be withdrawn or shy and may find it difficult to have fun. Although they may have a wide circle of friends, they are more likely to yield to group pressure and more vulnerable to being bullied. 

      Living with low self-esteem can harm your mental health, leading to problems like depression and  anxiety and as they get older children may rely on health harming behaviours, such as  smoking and  drinking too much, as a way of coping. 

      Research has also shown that low self-esteem has been linked to an increased risk of teenage pregnancy.   


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    • Mental health  
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      Mental health

      Certain individuals and groups are more likely to develop emotional and behavioural problems than others. One in ten children and young people aged 5-10 has a clinically diagnosed mental health disorder and 20.3% of 8 to 16-year-olds had a probable mental health disorder in 2023 (NHS England report 2023). Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems. 

       

      An important key to promoting children’s mental health is to understand the protective factors that enable children to be resilient when they encounter problems and challenges. Resilience is linked to self-esteem and confidence, a belief in self-efficacy, an ability to deal with change and adapt alongside having a range of problem-solving approaches. 

        

      Research suggests that there is a complex interplay between risk factors in children’s lives and promoting their resilience. As social disadvantage and the number of stressful life events accumulate for children and young people, more factors that are protective are required to counterbalance. Risk factors can be located in the child, the family, the environment, educational establishment or across all the factors. 

        

      Schools can promote pupils’ mental health and well-being by setting a culture that values all pupils, allows them to feel a sense of belonging and makes it possible to talk about problems in a non-stigmatising way, alongside setting a strong ethos for high expectation of attainment. 

       

      The Schools Mental Health Service (previously known as Schools Wellbeing Service and Mental Health Support Team) works to promote mental well-being in schools and reduce stigma around mental health. The team helps set up systems and services in schools that will enable schools to be more proactive in meeting the mental health needs of their pupils. They also work to build staff confidence in understanding and supporting students’ mental health needs.  

       

      The service aims to make it easier for children, young people and families to access appropriate support when it’s needed and works with schools and other education settings, offering a range of support to schools, including: 

       

      • assisting settings in determining the appropriate pathway for support by signposting to local services as needed. 
      • mental health consultations to professionals involved with children and young people 
      • training and reflective practice for professionals 

       

      The Schools Mental Health Service works with children and young people and their families, offering a range of support to children and young people and their families including: 

       

      • therapeutic interventions to support children and young people’s mental health 
      • group work with children and young people 
      • workshops and groups for parent carers 
      • mental health consultations with parents concerned about their child or young person 

       

      To contact the Schools Mental Health Service send an email to SchoolsMentalHealthService@brighton-hove.gov.uk . 

       

      The Brighton & Hove Wellbeing Service is a free NHS service offering support with mild to moderate mental health difficulties, for adults and children aged 4+.  

        

      Specialist CAMHS referrals should go through the Brighton & Hove Wellbeing Hub apart from crisis / urgent referrals. If an urgent response is necessary (if the young person is at immediate risk of taking their own life or is showing severe psychotic symptoms) then please telephone the Specialist CAMHS service directly. The Duty Clinician on call for CAMHS is available from 9am to 5pm, Monday to Friday on 0300 304 0061.  


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    • Emotional & behavioural issues that may be linked to attachment and/or emotional development delay  
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      Emotional & behavioural issues that may be linked to attachment and/or emotional development delay

      Brighton & Hove Educational Psychology Service works in a range of different ways to achieve positive outcomes for young people. The majority of our time is delivering through support to schools.  We can offer support with an educational setting’s understanding of attachment through our Attachment Aware Behaviour Policy Guidance. This emphasises the importance of whole school approaches on children’s attachment needs. 

       

      For families, we also have a small number of targeted evidence-based interventions to offer. These include, Video Interaction Guidance, play therapy, EMDR, and emotion coaching for parents. We work in collaboration with families in a respectful and strengths-based way to help them achieve the change they would like to see in their relationships and the emotional development of their child.   


      Useful links
      • About AVIGuk (for more information about Video Interaction Guidance).  
    • Children who were previously in care, and children who do not live with their birth parents. i.e adopted children, Special Guardianship Orders, Kinship Care  
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      Children who were previously in care, and children who do not live with their birth parents. i.e adopted children, Special Guardianship Orders, Kinship Care

      Children who were previously in care and are now living in adoptive families or with family and friends under Special Guardianship or Child Arrangement Orders will be living with the impact of the circumstances and experiences which led to the need for them to leave the care of their birth parents. 

        

      Many of these children can struggle to respond to usual parenting approaches and strategies because of their past experiences of neglect, abuse and trauma.  They have learned their own strategies to feel safe; these don’t always work in their new families, and this can present significant challenges to their new parents and carers.  This can also mean that some interventions will be less successful for these children than they are for children who are growing up with the parents they were born to and haven’t experienced repeated changes of primary carer. 

       

      All children placed with Special Guardians from care, and all children adopted from care are entitled to: 

      • Priority School Admission – please contact School Admissions 
      • Pupil Premium Plus payments made to support their school in meeting their additional needs (as long as the parents or carers have informed the school of their status) – discuss with your class teacher at school 
      • Assessment for Special Guardianship or Adoption Support needs: This entitlement extends to Children and their carers if subject to an SGO or child arrangement order / Residence Order.  For Adopted children, the child, the parents, and any siblings of the child in the adoptive family are entitled to assessment of their adoption support needs.  These assessments are additional to any other assessments of the child’s needs and development. 
      • Therapeutic Support – The Adoption Support Fund is a fund provided by the Department of Education which exists to fund specialist therapeutic assessments and therapy for children who are adopted from care, or who were in care and are now subject to a Special Guardianship Order. The fund offers up to £2500 per year for specialist assessments of therapeutic needs and up to £5000 per year for therapy.  Unfortunately, those children subject to child arrangement orders or residence orders are not eligible for this funding.  Those children who are subject to SGO but were not previously in care are also not eligible for this fund. 

      Useful links
  • Child Developmental Needs
    Persistent/continued/severe:
    • Chronic persistent absence, permanent exclusions or no school place that risks entry to the care system  
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      Chronic persistent absence, permanent exclusions or no school place that risks entry to the care system

      Persistent Absence is attendance less than 90% or Attendance less than 90%.

       

      Good attendance is important because:

      • Statistics show a direct link between under-achievement and absence below 95%
      • Regular attenders make better progress, both socially and academically
      • Regular attenders find school routines, schoolwork, and friendships easier to cope with
      • Regular attenders find learning more satisfying
      • Regular attenders are more successful in transferring between primary school, secondary school, and higher education, employment, or training
      • Persistent absenteeism is linked with increased risk in relation to child sexual exploitation, criminal exploitation and a decrease in life opportunities that can have long term impacts into adulthood.

       

      Chronic and persistent absence from school or no school place, alongside other identified risk factors that place a child at risk of coming into care, increases the risk of further negative outcomes.

       

      Children Missing Education are children who are not on a school roll or being provided with education in a different way. PA (persistent absentees) are children who have low attendance. They are identified by schools and initial interventions come through schools and the local authority attendance team. Schools will be the first agency to identify and consider the risks, including risks of exploitation and of being missing from home, for a PA.

       

      In Brighton and Hove, the local authority run a CME Panel, which schools refer children with below 30% attendance to for monitoring, consideration of support and further interventions.

      Schools should consider possible further links for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence.

       

      If the child or young person has an ongoing health problem, they can be referred to the 5-19 Healthy Child Programme following discussion with parent/ carer/ young person. Each school has a named School Nurse and schools have the referral form.

       

      Good systemic approaches to persistent absence from school is important (versus within-child) to avoid behaviours becoming pathologized. When the reasons for persistent absence are examined within the system the child is in, the behaviours can often then be seen as anormal response to cumulative ACEs/trauma, which require different support systems for the child to move on from.


      Useful links
    • Persistent social exclusion  
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      Persistent social exclusion

      Social exclusion is “a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of a society as a whole” (Pierson, 2002). 

      People who are socially excluded do not have access to the same institutions, services and social support networks that most people in a society take for granted. Although poverty is usually the main cause of social exclusion, there may be other contributing factors, such as racial discrimination or low educational achievement. 

      At Famil Help level the extent of a family or child’s social exclusion is being evidenced through the child or family’s behaviour that is beginning to show a negative impact on the development of the child and upon their life chances.    

       


      Useful links
    • Poor relationships  
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      Poor relationships

      The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond. 

        

      If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Health Visiting Service for further support / advice. 

       

      Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator).  


      Useful links
    • Complex / multiple disabilities  
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      Complex / multiple disabilities

      Young people who have more complex needs and disabilities and who may need ongoing support from social care will be given support from the 0 to 24 Specialist Community Disability Service (SCDS). This service provides support and guidance to young disabled people between the ages of 0 – 24 years.

       

      SCDS 0 – 24 service is divided into 2 pods. Pod 1 is for children / young people aged 0 – 13. Pod 2 is for young people and young adults aged 14 – 24. Pod 2 supports the transition of young people into adult services.

      This service is in addition to the support available for all young people with an Education Health and Care Plan.

       

      What is the criteria for SCDS?

      For children and young people 0- 17

      • A diagnosis of a moderate to severe learning disability and/or a sever physical disability.

       

      For young adults aged 18 – 24

      • A diagnosis of moderate to severe learning disability.

      Useful links
    • Complex mental health issues affecting development needs, including self-harm  
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      Complex mental health issues affecting development needs, including self-harm

      Certain individuals and groups are more likely to develop emotional and behavioural problems than others. One in ten children and young people aged 5-10 has a clinically diagnosed mental health disorder. Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems. 20.3% of 8 to 16-year-olds had a probable mental disorder in 2023 (NHS England report 2023).  

        

      An important key to promoting children’s mental health is to understand the protective factors that enable children to be resilient when they encounter problems and challenges. Resilience is linked to self-esteem and confidence and a belief in own self-efficacy and ability to deal with change and ability to adapt and being able to have a range of problem-solving approaches. 

        

      Research suggests that there is a complex interplay between risk factors in children’s lives and promoting their resilience. As social disadvantage and the number of stressful life events accumulate for children and young people, more factors that are protective are required to counterbalance. 

        

      Risk factors can be located in the child, the family, the environment and educational establishment or across all the factors. 

        

      Schools can promote pupils’ mental health and well-being by setting a culture that values all pupils, allows them to feel a sense of belonging and makes it possible to talk about problems in a non-stigmatising way, alongside setting a strong ethos for high expectation of attainment.  


      Useful links
    • High level emotional health issues and very low self-esteem  
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      High level emotional health issues and very low self-esteem

      Self-esteem should be viewed as a continuum, and can be high, medium or low (often quantified as a number in empirical research but not by practitioners). It is important to note that there is no expectation for certain numbers to be proven at each level.  

      When considering self-esteem, it is important to note that both high and low levels can be emotionally and socially harmful for the individual. It is thought that an optimum level of self-esteem lies somewhere in the middle of the continuum. 

      Socially children with low self-esteem can be withdrawn or shy and may find it difficult to have fun. Although they may have a wide circle of friends, they are more likely to yield to group pressure and more vulnerable to being bullied. 

      Living with low self-esteem can harm your mental health, leading to problems like depression and  anxiety and as they get older children may rely on health harming behaviours, such as  smoking and  drinking too much, as a way of coping. 

      Research has also shown that low self-esteem has been linked to an increased risk of teenage pregnancy.   


      Useful links
    • Non-organic Faltering Growth /Faltering Growth (previously known as failure to thrive)  
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      Non-organic Faltering Growth /Faltering Growth (previously known as failure to thrive)

      Faltering growth is used to describe a pattern of slower weight gain than expected for age and sex in infants and preschool children, and it is often due to inadequate nutritional intake. Faltering growth is complex and multifactorial. Parents may feel ‘blamed for their child’s slow weight gain. Professionals should remain alert to the possibility of a safeguarding concern but should be sensitive to the emotional impact of caring for a child with faltering growth.  


      Useful links
    • Inappropriate sexual knowledge / sexualised behaviour for a child’s age  
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      Inappropriate sexual knowledge / sexualised behaviour for a child’s age

      As children get older, the way they express their feelings about learning about sex changes. Through social media children can be exposed to sexual images at a far younger age. And in more places than ever before, including music videos, websites and social media. So, it’s not surprising that sometimes children’s sexual development can seem out of step with their age. 

      It’s important that we have a good idea of what’s normal sexual behaviour and can also spot the warning signs if something might not be quite right. 


      Useful links
    • Harmful Sexual Behaviour  
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      Harmful Sexual Behaviour

      Harmful sexual behaviour (HSB) is the umbrella term for those actions that are either:

      • Sexually abusive, where there is an element of manipulation, force or coercion or where the subject of the behaviour is unable to give informed consent, or
      • Sexually problematic, where there may not be an element of victimisation but where the behaviours may interfere with the development of the child demonstrating the behaviour or which might provoke rejection, cause distress or increase the risk of victimisation of the child.

       

      Children’s sexual behaviour should be thought about as being on a continuum, ranging from healthy, through problematic, to abusive.

       

      Defining what behaviours fit where on the continuum can be a difficult task and should be thought about within the context of the behaviour itself and the developmental situation of the child. A particular behaviour in one circumstance could be harmful whilst in another it may not.


      Useful links
    • Teenage parent/pregnancy under the age of 13  
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      Teenage parent/pregnancy under the age of 13

      Pregnant teenagers are entitled to the same support and information as all pregnant women and will be under the care of their GP and Midwife. Schools should make a referral to EOTAS so that girls can get home tuition for 18 weeks.  

       

      In Brighton and Hove all pregnant teenagers are offered the Healthy Child Programme with additional support for the most vulnerable teenagers and those teenagers requiring additional support via the Healthy Futures Team, a city-wide team based at Tarner Family Hub (Tel: 01273 266000).  

       

      The Age of Consent 

      The age of consent to any form of sexual activity is 16 for both men and women. The age of consent is the same regardless of the gender or sexual orientation of a person and whether the sexual activity is between people of the same or different gender. 

      It is an offence for anyone to have any sexual activity with a person under the age of 16. However, Home Office guidance is clear that there is no intention to prosecute teenagers under the age of 16 where both mutually agree and where they are of a similar age. 

      It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust. 

      The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity. 


      Useful links
    • Concerns about exploitation (including sexual exploitation/ abuse, radicalisation; criminal exploitation; gang affiliation)  
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      Concerns about exploitation (including sexual exploitation/ abuse, radicalisation; criminal exploitation; gang affiliation)

      Exploitation can affect any child or young person under the age of 18 years. It is typified by some form of power imbalance in favour of those perpetrating the exploitation and may involve force and/or enticement-based methods of compliance and is often accompanied by violence or threats of violence. Situations may still be exploitation even if the activity appears consensual, and this abuse may be perpetrated by individuals or groups, males or females, adults or other young people. 

        

      One of the key factors found in most cases of criminal exploitation is the presence of some form of exchange (e.g. carrying drugs in return for something). Where it is the victim who is offered, promised or given something they need or want, the exchange can include both tangible (such as money, drugs or clothes) and intangible rewards (such as status, protection or perceived friendship or affection). The fact that the victim is in receipt of something does not make them any less of a victim. 

        

      Additional vulnerabilities such as learning disabilities, mental health issues, substance misuse and adverse childhood experiences may increase the chance that a person will be exploited by others. Whilst these factors do not mean that a person will be exploited it is important to recognise the increased vulnerability that some people face. 

        

      Sexual Exploitation / abuse:  

      Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities. 

        

      Child sexual exploitation can occur through the use of technology without the child’s immediate recognition; for example being persuaded to post sexual images on the Internet/mobile phones without immediate payment or gain. In all cases, those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economic and/or emotional vulnerability. 

        

      Both girls and boys are at risk of sexual exploitation, and it is seriously harmful to children both emotionally and physically. Children and young people often find it very hard to understand or accept that they are being abused through sexual exploitation, and this increases their risk of being exposed to violent assault and life-threatening events by those who abuse them. 

       

      Useful links:  

       

      Radicalisation: 

      The current threat from terrorism in the United Kingdom can involve the exploitation of vulnerable people, including children, young people and adults with care and support needs to involve them in terrorism or activity in support of terrorism. This can put the individual at risk of being drawn into criminal activity and has the potential to cause significant harm. This is safeguarding issue. Preventing someone from being radicalised is no different from safeguarding vulnerable individuals from other forms of harm or exploitation. 

       

      Useful links:  

       

      If you want advice from the Prevent team regarding concerns about an individual, please email Channel.Prevent@brighton-hove.gov.uk. 

       

      Criminal Exploitation: 

      Vulnerable young people may be exploited into criminal activity or violence by other young people or adults who are able to coerce them to do so. 

        

      County lines is the term given to tactics used by drug dealing gangs. Originating from urban gangs supplying drugs to suburban areas and market and coastal towns, this business model is now been emulated by local crime groups. These tactics revolve around communication, using dedicated mobile phone lines or “deal lines”, movement, violence and exploiting the vulnerable. It involves child criminal exploitation (CCE) as gangs use children and vulnerable people to deal and transport drugs, weapons and money. 

        

      Another tactic is establishing a base by taking over the homes of local vulnerable adults by force or coercion in a practice referred to as ‘cuckooing’. These properties are commonly used to cook, store or deal drugs from, but individuals can be cuckooed to facilitate any type of criminal activity. 

       

      Useful links:  

       

       

       Gang affiliation: 

      Groups of children often gather together in public places to socialise, and peer association is an essential feature of most children’s transition to adulthood. Groups of children can be disorderly and/or anti-social without engaging in criminal activity. 

        

      The statutory definition of a gang is: “A relatively durable, predominantly street-based group of young people who: 

      • See themselves (and are seen by others) as a discernible group, and 
      • Engage in a range of criminal activity and violence 

        

      They may also have any or all of the following factors: 

      • Identify with or lay claim over territory (not necessarily geographical but can include an illegal economy territory) 
      • Have some form of identifying structural feature 
      • Are in conflict with other similar gangs 

        

      Professionals are advised to avoid applying definitions of a gang too rigorously; if a child or others think s/he is involved with or affected by ‘a gang’, then professionals should act accordingly. Children rarely use the term ‘gang’, instead they used terms such as ‘family’, ‘breddrin’, ‘crews’, ‘cuz’ (cousins), ‘my boys’ or ‘the people I grew up with’.  

       

      Useful links: 


      Useful links
    • Child victims of modern slavery or human trafficking  
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      Child victims of modern slavery or human trafficking

      Modern Slavery can take many forms including human trafficking, forced labour, criminal and sexual exploitation and domestic servitude. 

        

      Children are considered victims of trafficking, whether or not they have been coerced, deceived or paid to secure their compliance. They need only have been recruited, transported, received or harboured for the purpose of exploitation. 

        

      Trafficking doesn’t only happen across international borders. A child can be trafficked between counties, cities or even across a city from one address to another. 

       

      The National Referral Mechanism 

      Under Section 52 of the Modern Slavery Act (2015) some public bodies are designated ‘first responder’ agencies. This means they have a duty to notify the Home Office if they believe someone may be a victim of slavery or human trafficking. For those under 18 this duty does not require consent. A list of the organisations that can fulfil this duty can be found here 

       

      For further advice, contact the Modern Slavery Helpline on 08000 121700.  

       

      Professionals and practitioners can also seek advice from BHCC’s Community Safety Team by emailing modernslavery@brighton-hove.gov.uk  


      Useful links
    • Unaccompanied minors  
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      Unaccompanied minors

      At least half of the estimated 57.4 million people displaced by war around the world are children, and millions of those children have been separated from their families (UNICEF). 

        

      Many children have endured unimaginable horrors in an effort to escape from war and conflict. 

        

      War can lead to temporary or permanent separation of children from their parents or other adult caregivers. Separation can have a devastating social and psychological impact, as well as making children vulnerable to continued exploitation. 


      Useful links
    • Drug/alcohol use severely impairing development  
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      Drug/alcohol use severely impairing development

      Exposure to drugs and alcohol can have an impact across children’s childhoods to the extent that development is severely impaired. The exposure could be either through their parent/carers own use or though their own. 

        

      Foetal alcohol spectrum disorders are a group of birth defects that can happen when a pregnant woman drinks alcohol. There is no safe level of alcohol consumption in pregnancy. FASD results when prenatal alcohol exposure affects the developing brain and body.; most children with FASD do not have any physical (facial) abnormalities. FASD is a spectrum and each person with FASD is affected differently. FASD is a lifelong neurodevelopmental condition. Foetal Alcohol Syndrome (FAS) is the most severe type of the disorder.  

       

      Exposure to drugs such as cannabis, opiates, cocaine and even nicotine can also affect a developing brain and have an impact on their cognition, behaviour, language development and academic achievement. throughout a child’s life  

        

      The Adolescent Health Service (Ru-ok?) is a service for young people up to the age of 18 who require support around drugs, alcohol or sexual health. Parents/ carers or the young person can self- refer, or professionals or schools can refer but the consent of the young person is required. 


      Useful links
    • Frequently missing from home resulting in self-neglect  
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      Frequently missing from home resulting in self-neglect

      Children who are missing invariably place themselves at risk. The reasons for their absence are varied and complex and cannot be viewed in isolation from their home circumstances. 

      Sometimes children go missing with their families to evade contact with professionals. If a child is missing in this context professionals should consult the Pan Sussex Children and Families who Go Missing Procedure. 

      Thought should be given to Contextual Safeguarding concerns and risks of Child Criminal or Sexual Exploitation. 

       Every ‘missing’ episode should attract proper attention from the professionals involved with the child and those professionals must collaborate to ensure a consistent and coherent response is given to the child on their return and that parents and carers are supported appropriately. 

       Children Missing Education may help identify children who are not only missing from school but are also missing from home. There may also be a further link for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence.  

       If staff are concerned that trafficking or sexual exploitation may be the reason for underlying prolonged or repeated periods of absence, then contact should be made with the Front Door For Families.  Additional information and guidance is available from the Pan Sussex Trafficked Children Procedure . 


      Useful links

      Pan Sussex Child Protection and Safeguarding Procedures Manual 

    •  
      • ×

      Demographic and social changes over the last three decades have resulted in families that are more diverse and complex in their structure. Children now have a higher probability of experiencing parental separation, having a lone parent, being part of a stepfamily than was once the case.

       

      The impact of family separation and breakdown is a key issue to consider when taking a Whole Family approach to supporting a child. It is important to say that whilst children can be adversely impacted upon by relationship breakdown, they can equally be adversely affected through living with parents who are in abusive and unhappy relationships.

       

      Relationships may break down between parents and carers and the children they are responsible for. It is rare that Social Work will need to intervene however may need to in the following circumstances:

      • Child has been abandoned and there are no family/ friends options
      • Parents are deceased and there are no family/friends options
      • Parents are in prison and there are no family/friends options
      • Parents in hospital and no family and friend options
      • Child whose welfare and development can only be safeguarded through provision of accommodation outside of the family/friend network
      • Child is assessed as being beyond parental control and there are no family/friends options
      • Meets criteria for secure accommodation
      • Child remanded to Local Authority care/custody
      • Unaccompanied asylum-seeking children who require accommodation
      • Eligible & Relevant Care Leavers
      • Children and young people whose adoption placement has broken down and there is no family or friend options.

      Useful links
    • Offending and in the criminal justice system  
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      Offending and in the criminal justice system

      A child can be convicted of a criminal offence and sentenced in the Youth Court from the age of 10. Children or young people who plead not guilty at Police interview will be charged to court if there is adequate evidence. Although there is a diversion pathway for PACE non-admissions (‘no comment’ interviews). Prior to conviction, the Youth Justice workers attend Court and provide advice and guidance to young people and families. The service work with young people on bail programmes (prior to conviction) or throughout remand periods but otherwise complete assessments of young people and make recommendations to the Court following conviction. 

       

      The young person would be allocated a YJ worker at the point of sentence and this person will complete the assessment, plan and work with the young person and parents/ carers until the Order is completed. The YJ worker will assess the risk of harm, risk of offending and highlight any safeguarding concerns and advise the Court on sentencing as appropriate. The YJ worker will collaborate with involved professionals (e.g. social worker, ru-ok?, CAMHS), working as a part of a multi-agency service to meet the needs of the young person and family.  

       

      The Adolescent Service holds responsibility for young people subject to all Court Orders, including custody, under criminal justice and child welfare legislation and therefore has dual responsibility for public protection and safeguarding in YJS cases. 

       

      Contact the Youth Justice Service at brighton-hove.yos@brighton-hove.gov.uk  


      Useful links

       

    • Unexplained / suspicious injury  
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      Unexplained / suspicious injury

      Unexplained or serious injury should be suspected when a physical injury correlates to:

      Findings – bruises, burns, bites that have:

      • Inconsistent history
      • History that does not match the physical finding or inconsistent reports of pain (or lack of)
      • Injuries that do not match the developmental (motor) stage of the child
      • bruises –>
      • away from bony prominences
      • Back
      • Buttocks
      • Forearm, upper arm & hands
      • Face, ears, neck
      • Abdomen
      • Posterior leg & foot
      • Bruises with petechiae, clusters of bruises, bruises with a uniform shape, bruises with unusual pattern
      • UNEXPLAINED sub-conjunctival haemorrhages in infants over 3 weeks of age

      High-Risk Presentations

      • Unexplained or poorly explained death of an infant
      • Unexplained apnoea
      • bruises/fractures/burns in non-mobile infant
      • Ingestion or toxin exposure with suspicious history
      • Repeated drug or toxin exposure

      Head injury

      • Unexplained CNS insults resulting in coma, seizures or obtundation
      • Skull fracture with suspicious or no history of significant trauma, especially:
      • Depressed skull fracture
      • Diastatic fracture
      • Fracture >3 mm wide
      • Complex or multiple skull fractures
      • Bilateral skull fractures
      • Fracture with associated intracranial injuries
      • Evidence of Abusive Head Trauma (previously known as Shaken Infant Syndrome); altered level of consciousness, closed head injury, CNS or retinal haemorrhages.
      • Subdural hematoma without history of significant trauma

       

      There is also a group of children that present with perplexing/medically unexplained symptoms (perplexing presentations). Perplexing presentations may include cases of functional disorders (conditions with a psychological cause of the symptoms) and those cases that medical professionals are unable to explain based on their clinical assessment and medical investigations. Rarely in some of these cases, symptoms are being reported to gain support that may not be required or recommended by health and education professionals. This group can include cases where a parent is exaggerating symptoms, misreporting or misunderstanding conditions (see FII below).


      Useful links
      • Sussex Child Protection and Safeguarding Procedures Manual 
    • Fabricated or Induced Illness  
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      Fabricated or Induced Illness

      Fabricated or induced illness (FII) is a rare form of child abuse. It happens when a parent or carer exaggerates or deliberately causes symptoms of illness in the child.

      The parent or carer tries to convince doctors that the child is ill, or that their condition is worse than it really is.

      The parent or carer does not necessarily intend to deceive doctors, but their behaviour is likely to harm the child. For example, the child may have unnecessary treatment or tests, be made to believe they’re ill, or have their education disrupted.

      FII used to be known as “Munchausen’s syndrome by proxy” (not to be confused with Munchausen’s syndrome, where a person pretends to be ill or causes illness or injury to themselves).


      Useful links
  • Family & Environment
    • Stable & affectionate relationships with caregivers  
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      Stable & affectionate relationships with caregivers  


      Useful links
    • Housed, good diet and kept healthy 
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      Housed, good diet and kept healthy 


      Useful links
    • Supportive networks 
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      Supportive networks 


      Useful links
    • Access to positive activities
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      Access to positive activities


      Useful links
    • Positive relationships with peers 
      • ×

      Positive relationships with peers 


      Useful links
    • Positive relationships with parents 
      • ×

      Positive relationships with parents 


      Useful links
  • Family & Environment
    • No access to universal services / Hidden Children  
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      No access to universal services / Hidden Children

      In 2001 the National Family and Parenting Institute (NFPI) conducted a national mapping of family services in England and Wales (Henricson et al., 2001). One of the key findings was that availability was patchy across the country, but take-up of services by parents tended to be low across the board (with the exception of targeted services). 

        

      Some specific groups of parents were less likely to access services than others, in particular: 

      • Fathers 
      • Disabled parents 
      • Parents of teenagers 
      • Black and Global Majority families 
      • Asylum-seeking parents 
      • Homeless or peripatetic families 
      • Rural families. 

         

      A parallel survey by NFPI of parents (NFPI, 2001) found the majority had concerns that could be helped by services, and that just over half wanted more information about child development and sources of help. The findings indicate the need for a wide range of parenting and family support services.  


      Useful links
    • Young carers  
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      Young carers

      A Young Carer is a young person under 18 who has a responsibility for caring for a relative (or very occasionally a friend) who has an illness or disability, including some-one with mental health or substance misuse problems. For many young carers, caring can lead to feelings of pride and help develop additional skills. However, caring can also lead to a variety of losses for the child and have a negative impact on their mental or emotional health, and/or educational attainment and attendance. It can also have an impact on friendships and social activities.  

         

      All agencies in contact with young carers should consider if they need support services in their own right, and / or whether the family might benefit from additional support.  A key way to ensure the young carer’s responsibilities are minimised is to ensure that the ‘cared for’ is accessing relevant services.  This might include Adult Social Care, GP’s, Amaze, Family Hubs  and wellbeing support.  

         

      See The Carers Hub Website for further information and to make a referral.    

         

      An Early Help Strengthening Families Assessment and Plan can be completed if the Young Carers Coordinator/Family Hub Keyworker identifies the following:  

      • the family have little or no support network around their health or caring roles, including through friends, family and professionals  
      • the young carer is doing multiple inappropriate tasks, such as personal care, budgeting or precociously mature, emotional support  
      • there is a significant impact on the young carers school attendance and attainment  
      • there is a significant impact on the young carers mental or physical health  

        

      A Team Around the Family Meeting may be set up and/or a keyworker allocated, where the threshold is met.  

         

      The local authority should consider whether any provisions of the Children Act 1989 or The Children and Families Act 2014 and The Care Act 2014, should be applied.  Depending on the extent and effect of caring responsibilities, the young carer may come within the definition of a Child In Need under Section 17 of the Children Act 1989.  


      Useful links
    • Poor parent/child relationships  
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      Poor parent/child relationships

      The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond.  

       

      If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Health Visiting Service for further support / advice. Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator). 


      Useful links
    • Children of prisoners / parents subject to community orders  
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      Children of prisoners / parents subject to community orders

      Children affected by parental imprisonment may experience a severe disturbance to family life, including prolonged separation from a parent, and possibly intermittent and traumatic contact through prison visits. The sudden loss of a parent will upset the attachment between the child and both their parents, increasing levels of stress, anxiety and depression, and may manifest in behavioural problems. 

        

      Many families feel ashamed by the stigma associated with imprisonment, and so will not ask for support, and may encourage their children to keep the situation a secret. The remaining parent may find themselves facing added financial pressures due to the loss of a wage, a change to benefit entitlements and additional costs including childcare and travelling to visit the prisoner.  Children may also face additional challenges such as supporting their parent, coping with bullying and reconciling conflicting emotions such as grief and anger. 


      Useful links
      • Children with a parent in prison  
    • Bullying  
      • ×

      Bullying

      Bullying is a common form of deliberately hurtful behaviour, usually repeated over a period of time, where it is difficult for the victims to defend themselves. It can take many forms, but the three main types are physical (e.g. hitting, kicking, theft), verbal (e.g. racist or homophobic / religious remarks, threats, name calling) and emotional (e.g. isolating an individual from social activities, cyberbullying). 

        

      The damage inflicted by bullying is often underestimated and can cause considerable distress to children to the extent that it affects their health and development. In the extreme it can cause Significant Harm, including self-harm. 

        

      There are many reasons why children bully others, and they might not even realise that what they’re doing is bullying. Peer pressure plays an important part in bullying, and children may bully because they want the approval of others. On the other hand, they might bully others because they feel powerless – perhaps because they’ve been a victim of bullying, or they have suffered inconsistent parenting, or lacked warmth and care. 

        

      In Brighton & Hove Impact Initiative Safety Net’s services are designed to support the mental, physical and emotional well-being of children and young people aged 8 –13 (and sometimes 7-year-olds) across the city. The service works with children, families, schools and neighbourhoods, building communities where children know they have the right to feel safe and adults are actively involved in protecting them from harm. 

        

      The council’s Community Safety Casework Team can provide support in some cases of bullying or prejudice-based incidents (hate incidents).  


      Useful links
    • Poor housing & home environment impacting on child health  
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      Poor housing & home environment impacting on child health

      Poor housing during childhood has financial and social costs across many areas including health, education and the economy. Children in temporary accommodation and poor housing suffer far higher rates of ill health, both physical and mental, and declining life chances and educational attainment. “Poor housing” is defined by the government as homes that are hazardous (i.e. in need of repair), overcrowded, damp, have mould issues, or are cold.  

      A 2021/22 NatCen report found there are 3.5 million households in England living in a home that fails to meet the Decent Homes Standard. 2.3 million households are living in a home with at least one Category 1 hazard and 935,000 households are living in a home with damp problems. Overall, 815,000 households with dependent children (12% of all households with dependent children) lived in a non-decent home. Households with no dependent children (15%, 2.6 million) were more likely to be living in a home that failed the Decent Homes Standard. 

      Children living in overcrowded and unfit conditions are more likely to experience respiratory problems such as coughing and asthmatic wheezing. For many children this means losing sleep, restricted physical activity, and missing school. 


      Useful links
    • Community harassment/ discrimination  
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      Community harassment/ discrimination

      Brighton & Hove’s Community Safety Partnership’s overarching duty is to: 

      • reduce crime and disorder 
      • improve community safety 
      • reduce re-offending in Brighton & Hove 

      This will serve to improve the quality of life for everyone who lives in, works in or visits the city and they work with many agencies to tackle hate incidents, anti-social behaviour, violence against women and girls, and other priority work areas to reduce crimes and increase safety.  They also work in partnership with communities to protect people from the threat of terrorism and support vulnerable individuals from being drawn into terrorism. 

      They work with statutory bodies including: 

      • Brighton & Hove City Council  
      • the local probation service 
      • fire and rescue 
      • police and the office of the Sussex Police Crime Commissioner  
      • health services 
      • local housing providers 

      Partners in the community and voluntary sector also play an important role, as do local residents through community forums. 

      The Community Safety Casework Team (CSCT) addresses anti-social behaviour (ASB) and hate incidents and reduces the harm that they cause in private rented sector housing & with owner occupiers in Brighton and Hove. 

      The CSCT duty service is available between Monday to Friday 09:00am to 17:00pm. The service allows any person to report ASB & hate incidents and get advice, guidance and ongoing support if desired. The service also provides ASB and hate incident advice and guidance to other Brighton and Hove City Council departments and partner agencies.  

      The CSCT duty service can be contacted on 01273 292735 or communitysafety.casework@brighton-hove.gov.uk  

      ASB and hate incidents can also be reported to us online https://new.brighton-hove.gov.uk/report-anti-social-behaviour-your-neighbourhood. All CSCT duty reports and enquiries are responded to within five working days. 

      The CSCT has agreed victim and witness service standards and offers a Hate and ASB Risk Assessment (HARA), an ongoing support plan and will address the behaviour of the perpetrator if this is desired by the harmed person. 

      The CSCT has been awarded the Restorative Standards Quality Mark by the Restorative Justice Council. 

       

      Remember, in an emergency always call 999.


      Useful links
    • Low-income households which could impact the child’s ability to thrive  
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      Low-income households which could impact the child’s ability to thrive

      Research studies advise that children in lower-income households tend to fare less well in school and to have worse health than their better-off peers. However, it is not clear how far this is due to differences in financial resources and how far it is due to other household factors (e.g. levels of parental education or parenting approaches). This uncertainty leaves room for considerable difference of opinion about solutions. A review of available research demonstrated that household income directly correlates with the level of children’s achievements. 


      Useful links
    • Parenting advice needed to prevent needs escalating  
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      Parenting advice needed to prevent needs escalating

      Working Together 2023 is clear that providing early help is more effective in promoting the welfare of children than reacting later on. 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. Early help can also prevent further problems arising for a family and is the responsibility of all Universal Services. (See S10 Children Act 2004). 

         

      Family Hubs deliver a range of evidence – based interventions to support all families during times of difficulties. Most families have times that are more challenging and we positively encourage families and professionals to ask for help as early as possible. 

       

      Interventions are delivered as one-one interventions in the home, face – face, on line or in the Family Hubs buildings.  

      Interventions are also delivered in small groups, including one off workshops and courses that run over several weeks. 

      There are lots of different interventions that span the 0-19 age range (25 years with SEND)  


      Useful links
    • Parental conflict and risk of relationship breakdown  
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      Parental conflict and risk of relationship breakdown

      Conflict between parents is a normal part of relationships. However, when the conflict is frequent, intense and poorly resolved, it puts children’s mental health, education attainment and long-term outcomes at risk.  

      This can result in poorer academic outcomes, negative peer relationships and psychological difficulties shown as aggression, anxiety, depression, withdrawal, fearfulness and even suicidality.  It can also affect risk-taking behaviours such as smoking, drug use and early sexual activity (EIF).  

         

      Brighton & Hove City Council define Harmful Parental Conflict as: “Relationship distress and/or destructive behaviours between parental figures; involving aggression, non-verbal conflict or the ‘silent treatment’, lack of respect and emotional control and lack of resolution.  Power is balanced and there is no consistent pattern of victim and abuser.”  

      Parental conflict can harm children’s outcomes regardless of whether parents are together, separated, or biologically related to the child such (i.e. blended or foster families).  

       

      Family breakdown is not a single event but a process that involves a number of risk and protective factors that interact in complex ways both prior to and following family relationship breakdown.  The interrelated factors to consider include parental conflict, the quality of parenting and of parent-child relationships, parents mental health, financial hardship, repeated changes in living arrangements, including family structure.  

         

      Separation can be a time of high emotions and increased conflict between parents, including accusation and counter accusations, particularly when involved in the legal process.  Speaking to both parents is crucial when working within the Whole Family approach.  

         

      It is almost always in a child’s best interest to maintain contact with both parents, if safe to do so.  

         

      Even if children feel relieved when their parents separate, most children will still feel some loss and grief (NSPCC).   

        


      Useful links
    • Domestic abuse & coercive control  
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      Domestic abuse & coercive control

      It is often difficult to tell if domestic abuse and/or coercive control is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children who witness domestic abuse may: 

      • become aggressive 
      • display anti-social behaviour 
      • suffer from depression or anxiety 
      • not do as well at school – due to difficulties at home or disruption of moving to and from refuges. 

        

      The presentation of the following characteristics might be a sign that a child is being abused. The list is not exhaustive and may include a combination of the following, or none. However if you are worried that a child may be exposed to domestic abuse it is good to be alert to the signs of a child being; withdrawn, suddenly behaving differently, anxious, clingy, depressed, aggressive, having problem sleeping, eating disorders, wetting the bed, soils clothes, takes risks, misses school. changes in eating habits, obsessive behaviour, nightmares, using drugs and alcohol, self-harm, thoughts about suicide. 

        

      Coercive control is a pattern of behaviour which seeks to take away the victim’s liberty or freedom, to strip away their sense of self. It is not just a person’s bodily integrity which is violated but also their human rights. 

        

      Coercive control is not domestic purely in the sense that it occurs at home, technology allows for surveillance wherever a victim is, and often the victim effectively becomes controlled, internalising the rules, adapting behaviour to survive. 

        

      Living in a home where there’s domestic abuse is harmful. It can have a serious impact on a child’s behaviour and well-being. 

        

      Parents or carers may underestimate the effects of the abuse on their children because they don’t see what’s happening. Children witnessing domestic abuse is recognised as ‘significant harm’ in law.   

        

      The effects of exposure to domestic abuse can continue into adulthood. Often, once children are in a safer and more stable environment, most children are able to move on from the effects of witnessing domestic abuse. 


      Useful links
    • Housing tenancy at risk  
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      Housing tenancy at risk

      Being at risk of homelessness or being homeless can be very stressful. If you are at risk of homelessness, it is important to get help and advice at an early stage.  

        

      The Street Outreach Service is responsible for identifying new rough sleepers and supporting existing ones.  They engage with and rapidly assess the needs of those living on the streets and provide appropriate support to enable individuals to access accommodation, support or to relocate where an individual has a support network or a local connection elsewhere, offering a quick route away from the streets to avoid entrenchment. 

      The service operates street shifts at least 6 days a week to find, identify and support people sleeping on the streets of the city.  

      The Street Outreach Service organises and runs bi-monthly street counts of rough sleepers and jointly facilitates the Autumn rough sleeper count or estimate with the local authority in line with Homeless Link Guidance. 

      The service also supports severe weather provision (SWEP) in Brighton & Hove, providing 1 x worker to carry out client assessments 6pm – 10pm when SWEP is active. 


      Useful links
    • Transient families  
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      Transient families

      Children and families who move more frequently between local authorities include homeless families, asylum seekers and refugees, gypsy, traveller and Roma families and families experiencing domestic abuse. 

      In Brighton & Hove these families are offered the Healthy Child Programme and additional support via the Healthy Futures Team, a city-wide team.  

        

      Contact sc-tr.healthyfuturesteam@nhs.net Tel 01273 266000.  

        

      A parent’s homelessness or placement in temporary accommodation, often at a distance from previous support networks, can result in or be associated with transient living arrangements. There is a risk that the family may become disengaged from health, education and other support systems. There may also be a reduction in previously available family / community support.. 

        

      Families that move frequently can find it difficult to access the services they need. For those already socially excluded, moving frequently can worsen the effects of this exclusion and increase isolation. Some families in which children are harmed move home frequently to avoid contact with concerned agencies, so that no single agency has a complete picture of the family. 


      Useful links
    • No recourse to public funds  
      • ×

      No recourse to public funds

      Families with No Recourse to Public Funds include asylum seekers and other families whose immigration status may exclude them from mainstream services. This can also include EU nationals who are not entitled to benefits. 

        

      Families may have been forced from their country of origin under life-threatening situations and lived through very difficult experiences, including separation from close relatives. Their needs can strongly relate to these circumstances and also to the ongoing situation in their country of origin. 

       

      If you are working with a family who are NRPF and they are destitute then make a referral to the Front Door for Families for them to screen and assess if there is a duty to support. The link to refer is below: 


      Useful links
  • Family & Environment
    • Significantly harmful parental conflict and or/relationship breakdown  
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      Significantly harmful parental conflict and or/relationship breakdown

      Significantly harmful parental conflict puts children’s mental health and long-term outcomes at risk when it is frequent, intense and poorly resolved. This can result in poorer academic outcomes, negative peer relationships and psychological difficulties shown as aggression, anxiety, depression, withdrawal, fearfulness and even suicidality.  It can also affect risk-taking behaviours such as smoking, drug use and early sexual activity (EIF).

       

      Brighton & Hove City Council define Harmful Parental Conflict as: “Relationship distress and/or destructive behaviours between parental figures; involving aggression, non-verbal conflict or the ‘silent treatment’, lack of respect and emotional control and lack of resolution.  Power is balanced and there is no consistent pattern of victim and abuser.”

       

      Family breakdown is not a single event but a process that involves a number of risk and protective factors that interact in complex ways both prior to and following family relationship breakdown.  The interrelated factors to consider include parental conflict, the quality of parenting and of parent-child relationships, parents mental health, financial hardship, repeated changes in living arrangements, including family structure.

       

      Separation can be a time of high emotions and increased conflict between parents, including accusation and counter accusations, particularly when involved in the legal process.  Speaking to both parents is crucial when working within the Whole Family approach to supporting a child.


      Useful links
    • Suspicion of physical, emotional or sexual abuse or neglect  
      • ×

      Suspicion of physical, emotional or sexual abuse or neglect

      Abuse and neglect are forms of maltreatment of a child. Somebody may cause or neglect a child by inflicting harm or failing to act to prevent harm. Children may be abused in a family, or in an institutional or community setting; by those known to them or, more rarely by a stranger. They may be abused by an adult or adults or another child or children.

       

      Working Together to Safeguard Children 2023 includes definitions of the four broad categories of abuse which are used for the purposes of recognition:

      • Physical Abuse
      • Emotional Abuse
      • Sexual Abuse
      • Neglect.

       

      These categories overlap and an abused child does frequently suffer more than one type of abuse.


      Useful links
    • Domestic abuse resulting in child being at risk of significant harm  
      • ×

      Domestic abuse resulting in child being at risk of significant harm

      It is often difficult to tell if domestic abuse and/or coercive control is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children who witness domestic abuse may:

      • become aggressive
      • display anti-social behaviour
      • suffer from depression or anxiety
      • not do as well at school – due to difficulties at home or disruption of moving to and from refuges.

       

      The presentation of the following characteristics might be a sign that a child is being abused.  The list is not exhaustive and may include a combination of the following, or none.  However, if you are worried that a child may be exposed to domestic abuse it is good to be alert to the signs of a child being; withdrawn, suddenly behaving differently, anxious, clingy, depressed, aggressive, having problem sleeping, eating disorders, wetting the bed, soils clothes, takes risks, misses school. changes in eating habits, obsessive behaviour, nightmares, using drugs and alcohol, self-harm, thoughts about suicide.

       

      Coercive control is a pattern of behaviour which seeks to take away the victim’s liberty or freedom, to strip away their sense of self.  It is not just a person’s bodily integrity which is violated but also their human rights.  Coercive control is not domestic purely in the sense that it occurs at home, technology allows for surveillance wherever a victim is, and often the victim effectively becomes controlled, internalising the rules, adapting behaviour to survive.


      Useful links
    • Homeless child/young person  
      • ×

      Homeless child/young person

      In May 2009, the House of Lords made a landmark judgement in the case of R (G) v London Borough of Southwark which affects how local authorities provide accommodation and support for homeless 16- and 17-year-olds.

      Where the young person requires emergency accommodation (level 4) the statutory agency receiving the approach shall accommodate pending any statutory determination of duties owed.

      Where a district housing authority accommodate under (4) above or the young person requests an Assessment of Need under Section 17 Children’s Act 1989, the district housing authority shall continue to accommodate pending that statutory determination

       

      Where Children’s Services accommodate under (4) above but the young person chooses to progress under homelessness provisions rather than be accommodated under Section 20 The Children Act 1989:

      Children’s Services shall refer the young person to the district housing authority.


      Useful links
    • Family intentionally homeless  
      • ×

      Family intentionally homeless

      A family may be deemed intentionally homeless if one or more of the following is applies

      • they have given up accommodation that they could have continued to occupy
      • they’ve lost accommodation through their actions which they knew, or should reasonably be expected to have known, would cause their homelessness
      • they have made an arrangement with someone in order to take advantage of the homeless legislation.

      Useful links
    • Community harassment/discrimination  
      • ×

      Community harassment/discrimination

      Brighton & Hove’s Community Safety Partnership’s overarching duty is to:

      • reduce crime and disorder
      • improve community safety
      • reduce re-offending in Brighton & Hove

      This will serve to improve the quality of life for everyone who lives in, works in or visits the city and they work with many agencies to tackle hate incidents, anti-social behaviour, violence against women and girls, and other priority work areas to reduce crimes and increase safety. They also work in partnership with communities to protect people from the threat of terrorism and support vulnerable individuals from being drawn into terrorism.

      They work with statutory bodies including:

      • Brighton & Hove City Council
      • the local probation service
      • fire and rescue
      • police and the office of the Sussex Police Crime Commissioner
      • health services
      • local housing providers

      Partners in the community and voluntary sector also play an important role, as do local residents through community forums.

      The Community Safety Casework Team (CSCT) addresses anti-social behaviour (ASB) and hate incidents and reduces the harm that they cause in private rented sector housing & with owner occupiers in Brighton and Hove.

      The CSCT duty service is available between Monday to Friday 09:00am to 17:00pm. The service allows any person to report ASB & hate incidents and get advice, guidance and ongoing support if desired. The service also provides ASB and hate incident advice and guidance to other Brighton and Hove City Council departments and partner agencies.

      The CSCT duty service can be contacted on 01273 292735 or communitysafety.casework@brighton-hove.gov.uk

      ASB and hate incidents can also be reported to us online https://new.brighton-hove.gov.uk/report-anti-social-behaviour-your-neighbourhood. All CSCT duty reports and enquiries are responded to within five working days.

      The CSCT has agreed victim and witness servimailto:communitysafety.casework@brighton-hove.gov.ukce standards and offers a Hate and ASB Risk Assessment (HARA), an ongoing support plan and will address the behaviour of the perpetrator if this is desired by the harmed person.

      The CSCT has been awarded the Restorative Standards Quality Mark by the Restorative Justice Council.

       

      Remember, in an emergency always call 999.


      Useful links
    • Extreme poverty affecting child well-being  
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      Extreme poverty affecting child well-being

      “Individuals, families and groups in the population can be said to be in poverty when they lack resources to obtain the type of diet, participate in the activities and have the living conditions and amenities which are customary, or at least widely encouraged and approved, in the societies in which they belong.” (Prof Peter Townsend) 

        

      Higher levels of child poverty are associated with worse child health outcomes, read more about this in the BMJ Journal here. This report identifies and discusses evidence about the relationship between poverty and child abuse and neglect. 


      Useful links
    • Forced marriage, Honour Based Violence, Female Genital Mutilation (Cutting)  
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      Forced marriage, Honour Based Violence, Female Genital Mutilation (Cutting)

      Harmful Practices are forms of violence and abuse which have been committed primarily against women and girls in certain communities and societies for so long that they are considered, or presented by perpetrators, as part of accepted cultural practice. This includes:

       

      FGM/FGC – All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reason.

       

      Forced Marriage – “Where one or both people do not (or in cases of people with learning disabilities, cannot) consent to the marriage and pressure or abuse is used.” The pressure put on people to marry against their will can be:

      Physical (including threats, actual physical violence and sexual violence)

      Emotional and psychological (for example, when someone is made to feel like they’re bringing shame on their family).

      Financial abuse (taking wages or not giving someone any money) can also be a factor.

       

      So-called Honour Based Violence.  A violent crime or incident which may have been committed to protect or defend the honour of the family or community. It is often linked to family members or acquaintances who mistakenly believe someone has brought shame to their family or community by doing something that is not in keeping with the traditional beliefs of their culture.

       

      Risk indicators to be considered include:

       

      Education:

      • Truancy
      • Low motivation/withdrawn
      • Poor exam results/driven to perform well
      • Withdrawn from education for extended periods of time / long holiday to ‘country of origin’
      • Not involved in extra-curricular activities, trips, parties, etc.
      • Withdrawn from PSHE education

       

      Agency Involvement:

      • Other family members reported missing
      • History of domestic violence
      • Young person reported for other offences
      • Threats to kill
      • Child protection issues raised previously/on child protection register

       

      Health

      • Self-harm/attempted suicide
      • Physical or learning disability
      • Eating disorders
      • Depression/isolation
      • Problematic use of substances (prescription and non-prescription drugs, alcohol)

       

      Family

      • Other siblings forced to marry
      • Family history of undergoing or practicing FGM
      • Family disputes
      • Has run away from home before
      • Excessive restrictions, ‘house arrest’, escorted to school, doctors, etc.
      • Older family members have a heavy influence on upbringing
      • FGM is believed to be integral to identity
      • Not engaging with professionals (e.g. health, education, other)

      Useful links

       

  • Parents & Carers
    • Protected by carers 
      • ×

      Protected by carers 


      Useful links
    • Secure and caring home 
      • ×

      Secure and caring home 


      Useful links
    • Receive and act on information, advice and guidance 
      • ×

      Receive and act on information, advice and guidance 


      Useful links
    • Appropriate boundaries maintained 
      • ×

      Appropriate boundaries maintained 


      Useful links
  • Parents & Carers
    • Inconsistent care arrangements  
      • ×

      Inconsistent care arrangements

      Consistency teaches children predictability, and it eliminates the stress, confusion and anxiety that comes from not knowing what might happen or being able to contain inevitable uncertainties. 

        

      Children need to feel trust in their parents and care givers. This trust provides important security that shapes the child’s behaviour and emotions. When a child doesn’t feel trust because parents are inconsistent, the child may feel confusion, anxiety and distrust. Inconsistent parenting may even contribute to negative behaviour in children because children may be seeking to illicit predicted responses. 


      Useful links
    • Poor supervision by parent/carer  
      • ×

      Poor supervision by parent/carer

      Poor parental supervision often begins at early childhood; however, the consequences of this parenting style might not become obvious until the child becomes a teenager. 

        

      Indications of poor parental supervision in early childhood can be when children experience injuries for which they and parents appear to have no explanation. Teenagers who lack parental supervision are more likely to engage in early sexual behaviour and experiences with drugs and alcohol than children of authoritative parents. The influence of peers is significantly high during the teenage years, and a poor self-image may allow these individuals more susceptible to engage in criminal behaviour or becomes the subject of exploitation themselves. 

        

      In some cases, the problem is complicated by public and professional responses to young people. Sometimes children are considered a source of disorder, and their behaviour must be restricted, this may make young people feel angry and unwanted. They are out on the streets because they have nowhere else to turn, and because they are not appreciated at home. 

        

      There may be reasons why a parent or carers ability to provide care and supervision has been compromised and professionals need to remain mindful of this wider context when seeking to support a parent improving their ability to keep their child in mind. 


      Useful links
    • Poor response to child’s identified needs  
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      Poor response to child’s identified needs

      There is significant research as to how parents and carers responses shape children’s development. The quality of parent-child relationships is significantly associated with: Learning skills and educational achievement, Social competence, Children’s own views of themselves. Including their sense of self-worth, aggressive ‘externalising’ behaviour and delinquency, depression, anxiety and other ‘internalising’ problems, high-risk health behaviours. 

        

      Research has found that parenting programmes to support parents have increasingly become a matter of public health. 


      Useful links
    • Parents/carers own childhood experiences – i.e. Adverse Childhood Experiences  
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      Parents/carers own childhood experiences – i.e. Adverse Childhood Experiences

      There is a growing body of evidence that our experiences during childhood can affect health throughout our lives. Children who experience stressful and poor-quality childhoods are more likely to adopt health-harming behaviours during adolescence which can themselves lead to mental health illnesses and higher rates of diseases such as cancer, heart disease and diabetes later in life. 

        

      Adverse Childhood Experiences (ACEs) are not just a concern for health. Experiencing ACEs means individuals are more likely to perform poorly in school, more likely to be involved in crime and ultimately less likely to be a productive member of society. 

        

      People who experience ACEs as children often end up trying to raise their own children in households where ACEs are more common. Such a cycle of childhood adversity can lock successive generations of families into poor health and anti-social behaviour for generations. Equally however, preventing ACEs in a single generation or reducing their impacts can benefit not only those children but also future generations. 


      Useful links
    • Parental learning/physical disability, substance misuse or mental health impacts on parenting ability  
      • ×

      Parental learning/physical disability, substance misuse or mental health impacts on parenting ability

      Substance misuse, domestic violence, learning disability and mental illness, can have a significant impact on children’s welfare. 

        

      Research, and in particular the biennial overview reports of serious case reviews (Brandon et al 2008; 2009; 2010), have continued to emphasise the importance of understanding and acting on concerns about children’s safety and welfare when living in households where these types of parental problems are present. 

        

      In addition to meeting the general needs of parents from disadvantaged backgrounds, it is important to consider the more specialised forms of support required by families in specific circumstances, such as support for parents with mental health difficulties or disabilities, or with substance misuse problems. Good collaborative arrangements are required between services for adults, where the adult is a parent, and children’s services, in particular, where children may be especially vulnerable. 

        

      Prevention and supporting recovery is at the heart of this strategy. A ‘whole life’ approach is proposed in order to break the inter-generational paths to dependency by supporting vulnerable families, providing good quality education and advice, intervening early and supporting people to recover. Relevant agencies are expected to work together to address the needs of the whole person. To prevent substance misuse amongst children and young people (some of whom will have parents who misuse drugs and alcohol) 


      Useful links

       

  • Parents & Carers
    • Edge of care  
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      Edge of care

      Children may be on the edge of care for a number of reasons. The criteria for accessing care is detailed below:

      • Child has been abandoned and there are no family/ friend options
      • Parents are deceased and there are no family/friend options
      • Parents are in prison and there are no family/friend options
      • Parents in hospital and no family and friend options
      • Child whose welfare and development can only be safeguarded through provision of accommodation outside of the family/friend network
      • Child is beyond parental control and there are no family/friend options
      • Meets criteria for secure accommodation
      • Child remanded to Local Authority care/custody
      • Unaccompanied asylum-seeking children who require accommodation
      • Eligible & Relevant Care Leavers
      • Children and young people whose adoption placement has broken down and there is no family or friend options.

      Useful links
    • Parental encouragement of abusive/offending behaviour  
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      Parental encouragement of abusive/offending behaviour

      Adverse family circumstances and conditions have commonly been found to increase the likelihood of involvement in offending. More specifically, the following family factors have been identified in the literature as relevant to children coming into conflict with the law:

      • parenting styles
      • parental monitoring/supervision
      • presence of parental conflict
      • attitudes to involvement in offending
      • attitudes to police/criminal justice system/state authorities
      • attitudes to education
      • history of family involvement in criminal justice system
      • alcohol use/misuse amongst family members
      • substance use/misuse amongst family members
      • intra-family violence (domestic violence, child-to-parent violence)
      • significant loss/bereavement in family
      • level of attachment to parents
      • socio-economic background (including parental employment status)

      The evidence on the quality of family relationships and the impact on offending has been further summarised as follows:

      • poor parenting can lead to pro-criminal associations and learning pro-criminal attitudes
      • lack of parental oversight allows children to associate with antisocial associates without censure from parents and carers
      • poor attachment to parents and carers leads to later deficits in sociability and the forming of constructive adult friendships and intimate relationships that protect against criminality
      • divorce or separation of parents, if marked by emotional conflict, is a major risk factor
      • frequent disruptions to caregivers are associated with large increases in offending. Boys who experience two or more caregivers before the age of 10 are twice as likely to be convicted of a violent crime.

      Useful links
    • Continuing poor supervision in the home  
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      Continuing poor supervision in the home

      Poor parental supervision often begins at early childhood; however, the consequences of this parenting style might not become obvious until the child becomes a teenager. 

        

      Indications of poor parental supervision in early childhood can be when children experience injuries for which they and parents appear to have no explanation. Teenagers who lack parental supervision are more likely to be exploited criminally or sexually. The influence of peers is significantly high during the teenage years, and a poor self-image may allow these individuals more susceptible to engage in criminal behaviour or becomes the subject of exploitation themselves. Contextual Safeguarding is the model of considering extra familial harm. 

        

      In some cases, the problem is complicated by public and professional responses to young people. Sometimes children are considered a source of disorder, and their behaviour must be restricted, this may make young people feel angry and unwanted. They are out on the streets because they have nowhere else to turn, and because they are not appreciated at home. 

       There may be reasons why a parent or carers ability to provide care and supervision has been compromised and professionals need to remain mindful of this wider context when seeking to support a parent improving their ability to keep their child in mind. 


      Useful links
    • Parental non-compliance / superficial co-operation  
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      Parental non-compliance / superficial co-operation

      Was not Bought: Children rely on their parents to take them to meetings or appointments that relate to their welfare, care or health, and as a result they are sometimes not taken to them. This may mean that a practitioner may record them as having ‘not attended’, but it was because they were not brought. Practitioners should use “Was Not Brought (WNB)” rather than “Did Not Attend” for recording or noting the non-attendance of children who are reliant on someone else to take them to a meeting or appointment. The phrase “Did Not Attend” implies that the child is responsible for not attending. Recording “Was Not Brought (WNB)” is a more accurate representation of the situation and enables a practitioner to consider the reasons why a child was not brought to a meeting or appointment, the implications for them not having been brought, and assess the potential risks or safeguarding concerns for them, especially if there is a repeat pattern of non-attendance. Repeated cancelled and rescheduled appointments should also be treated with some curiosity and may occasionally indicate potential harm. This could be a sign of disguised compliance. Disguised Compliance involves a parent or carer giving the appearance of engagement, they may cancel appointments frequently at the last minute, or after a period of non-engagement may attend appointments to reduce professionals’ concerns.  

      Disguised compliance involves parents giving the appearance of co-operating with child welfare agencies to avoid raising suspicions and allay concerns. Published case reviews highlight that professionals sometimes delay or avoid interventions due to parental disguised compliance.  

      Non-compliant behaviour involves proactively sabotaging efforts to bring about change or alternatively passively disengaging. 


      Useful links
    • Inconsistent parenting affects child’s developmental progress  
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      Inconsistent parenting affects child’s developmental progress

      Consistency teaches children predictability, and it eliminates the stress, confusion and anxiety that comes from not knowing what might happen.  

         

      Children need to feel trust in their parents and care givers. This trust provides important security that shapes the child’s behaviour and emotions. When a child doesn’t feel trust because parents are inconsistent, the child may feel confusion, anxiety and distrust. Inconsistent parenting may even contribute to negative behaviour in children because children may be seeking to elicit predicted responses.  

         

      There is significant research as to how parents and carers responses shape children’s development. The quality of parent-child relationships is significantly associated with: Learning skills and educational achievement, social competence, children’s own views of themselves. Including their sense of self-worth, aggressive ‘externalising’ behaviour and delinquency, depression, anxiety and other ‘internalising’ problems, high-risk health behaviours.  


      Useful links
    • Private fostering  
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      Private fostering

      A private fostering arrangement is essentially one that is made without the involvement of a Local Authority for the care of a child under the age of 16 (under 18 if disabled) by someone other than a parent or close relative for 28 days or more. Privately fostered children are a diverse and sometimes vulnerable group which includes: 

      • Children sent from abroad to stay with another family, usually to improve their educational opportunities 
      • Asylum-seeking and refugee children 
      • Teenagers who, having broken ties with their parents, are staying in short-term arrangements with friends or other non-relatives 
      • Language students living with host families 

        

      Under the Children Act 2005, private foster carers and those with Parental Responsibility are required to notify the local authority of their intention to privately foster or to have a child privately fostered, or where a child is privately fostered in an emergency.  


      Useful links
  • Action & Assessment
    Go direct to Service, search the Family Services Directory
    Family Service Directory | Useful Information (familyinfobrighton.org.uk)
    No formal Assessment
  • Action & Assessment
    Consider Family Help Guidance and Assessment through Family Hubs. In more complex circumstances a Family Help Strengthening Families Assessment (FHSFA) should be undertaken to understand need and to co-ordinate work across agencies to best address this need.
    For advice or guidance in respect of the child’s needs contact Family Hubs.
  • Action & Assessment
    Contact Front Door For Families on 01273 290400 or if the child is at immediate risk call the Police on 999
    Family Help Strengthening Families Assessment ➔ Child in Need Plan or Child Protection Conference