Professionals: Children's social care referrals
Assess a child’s levels of need
What are the levels of need?
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Level 1 - the child's needs are already met by existing universal services
You are satisfied that the child or young person’s needs are being met by existing universal services, such as health, care and education services.
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Level 2 - indicates a need for multi-agency early help support
You feel that the child or young person needs some extra support that requires a co-ordinated response from services – even if their current needs are unclear. An EHAT will identify a lead professional to co-ordinate this support.
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Level 3 - indicates a need for targeted support
You feel that the child or young person has unmet needs that are more significant or complex. An EHAT will ensure a co-ordinated multi-agency response that will help prevent these concerns escalating.
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Level 4 - indicates an acute, complex or specialist need, or a safeguarding concern
You believe that the child or young person has experienced significant harm or is at risk of significant harm (Section 47), or you have significant welfare concerns (Section 17). A single assessment coordinated by a social worker is required to determine what intervention is needed.
Levels of need online slider
This online tool will help professionals assess a child’s levels of need and decide which method of referral they should complete an EHAT or MARF referral.
Simply pick the appropriate level in response to each question. The answers will then offer guidance on what course of action to take.
Always contact Careline immediately if you think a child has suffered, or is likely to suffer significant harm.
Click on the headings and select the level in each category
If you select a Level 4 for any item in this list you must fill out a MARF.
Select which level you think applies.
- Physically Well
- Adequate diet/hygiene/clothing
- Developmental Checks/immunisations up to date
- Regular dental/optical care
- Health appointments kept
- Speech and language development met
- Defaulting on immunisation/checks
- Susceptible to minor health problems
- Slow in reaching developmental milestones
- Minor concerns re diet/hygiene
- Smokes/Alcohol concerns
- Starting to default on health appointments
- Teenage Pregnancy (consider age and social circumstances)
- Concerns re: diet, hygiene, clothing
- Some chronic health problems
- Missing routine and non-routine health appointment
- Substance misuse
- Developmental milestones are unlikely to be met
- Concerns around mental health
- Teenage pregnancy (multi-agency response consider age and social circumstances)
- Severe/chronic health problems
- Persistent substance misuse
- Developmental milestones unlikely to be met
- Teenage pregnancy (acute level of need)
- Serious mental health issues
- Skills/interest
- Success/achievement
- Cognitive development
- Access to books and toys, play
- Some identified learning or physical disability needs requiring support
- Poor punctuality
- Pattern of school absences
- Not always engaged in learning - poor concentration/low motivation/interest
- Not reaching educational potential
- Limited access to books/toys
- Significant learning needs and may have Statement or Educational needs (or Education Health Care Plan)
- Poor school attendance and Punctuality
- Some fixed term exclusions
- Not engaged in Education or reaching educational potential
- Out of school
- Permanently excluded from school or at risk permanent exclusion
- No access to leisure activities
- Feelings/actions demonstrate appropriate responses
- Good quality early attachments
- Able to adapt to change
- Able to demonstrate empathy
- Some difficulties with peer group relationships and adults
- Concern of self-harm (including substance misuse)
- Some evidence of inappropriate responses and actions
- Can find managing change difficult
- Starting to show difficulties Expressing empathy
- Low self esteem/self confidence
- Finds it difficult to cope with anger, frustration and upset
- Disruptive/challenging behaviour at school or in neighbourhood
- Cannot manage change
- Unable to demonstrate empathy
- Repeated episodes of self-harm and/or substance misuse
- Regularly involved in anti-social/criminal activities
- Puts self or others in danger eg missing from home or in care
- Suffers from period of depression
- Suicide attempts
- Children at risk of sexual Exploitation
- Positive sense of self and abilities
- Demonstrates feelings of belonging and acceptance
- Sense of self
- Ability to express needs
- Some Insecurities around identify expressed, low self-esteem for learning
- May experience bullying around �difference�
- Unsure or unable to disclose sexual orientation
- Is subject to discrimination, e.g. racial, sexual, or due to disabilities
- Demonstrates significantly low self-esteem in a range of situation
- Experiences persistent discrimination e.g. racial, sexual orientation or disability
- Stable,affections with care givers
- Good relationships with siblings
- Positive relationships wit peers
- Some support from family and friends
- Some difficulties sustaining relationships
- Gang associations through relatives, peers or relationships
- Has lack of positive role models
- Misses school or leisure activities
- Peers also involved in challenging Behaviour
- Involved in conflicts with peers/siblings
- Regularly needed to care for another amily member
- Periods of being accommodated by the Local Authority
- Family breakdown related in someway to child�s behavioural difficulties
- Subject to physical, emotional or sexual abuse or neglect
- Main carer for family member
- Unaccompanied asylum seeker
- Where parents have made private fostering arrangements
- Appropriate dress for different circumstances
- Good level of personal hygiene
- Can be over-friendly or withdrawn with strangers
- Can be provocative in appearance and behaviour
- Personal hygiene starting to be a problem
- Is provocative in behaviour/Appearance
- Clothing is regularly unwashed
- Hygiene problems
- Poor and inappropriate self-Presentation
- Growing level of competencies in practical and emotional skills such as feeding, dressing and independent living skills.
- Not always adequate selfcare e.g. poor hygiene
- Slow to develop ageappropriate self-care skills
- Poor self-care for age, including hygiene
- Inappropriately able to care for self
- Neglects to use self-care skills due to alternative priorities, eg substance misuse
Select which level you think applies.
- Provides for child�s physical needs e.g. food, drink and appropriate clothing, medical and dental care
- Engagement with services is Poor
- Requires advice on parenting issues
- Professionals are beginning to have some concerns around child�s physical needs being met
- Difficulty engaging parents with services
- Struggling to provide adequate care
- Previously Looked after LA
- Professionals have serious concerns e.g. parental drug/alcohol misuse, learning difficulties/mental health etc
- Unable to provide �good enough� parenting that is adequate and safe, including unborn child
- Mental health problems/Substance misuse significantly affect care of child
- Parents unable to care for previous children
- Protects from danger or significant harm, in the home and elsewhere
- Some exposure to dangerous situations in the home or community
- Parental stresses starting to affect ability to ensure child�s safety
- Perceived to be a problem by parents
- May be subject to neglect
- Experiencing unsafe situations
- Instability/violence in the home continually
- Parents involved in crime
- Parents unable to keep child safe
- Victim of crime
- Shows warm regard,praise and encouragement
- Inconsistent responses to child by parent(s)
- Able to develop other positive Relationships
- Receives erratic or inconsistent care
- Has episodes of poor quality of care
- Instability affects capacity to nurture
- Has no other positive relationships
- Parents inconsistent, highly critical or apathetic towards child
- Facilitates cognitive development through interaction and play
- Enables child to experience success
- Spends considerable time alone, e.g. watching television/computer games
- Child is not often exposed to new experiences
- Not receiving positive stimulation, with lack of new experiences or activities
- No constructive leisure time or guided play
- provides guidance so that child can develop an appropriate internal model of values and conscience
- Can behave in an antisocial way in the Neighbourhood e.g. petty crime
- Parent/carer offers inconsistent Boundaries
- Erratic/inadequate guidance provided
- Parent not offering good role model eg behaving in an anti-social way
- No effective boundaries set
- Regularly behaves in an anti-social way in the neighbourhood
- Ensures that secure attachments are not disrupted
- Consistency of emotional warmth over time
- Ensures child accesses education available to them
- Key relationships with family members not always maintained
- Starting to demonstrate difficulties with attachments
- Has multiple carers
- Has been Looked After by LA
- Beyond parental control
- Has no-one to care for child
Select which level you think applies.
- Good relationships within family, even when parents are separated
- Few significant changes in family composition
- Parents have some conflicts or difficulties that can involve the children
- Has experienced loss of significant adult eg through bereavement or separation
- Looked after by younger sibling
- Parent has physical or mental health issues
- Multiple changes of address
- History of Abuse
- Parents ability to cope with needs of disabled child
- Incidents of domestic violence between parents
- Acrimonious divorce/separation
- Family have serious physical and mental health difficulties
- Significant parental discord and persistent domestic violence
- Poor Relationships between siblings
- Sense of larger familial network/good friendships outside of family unit
- Some support from friends and family
- Caring responsibilities
- Family has poor relationship with extended family/little communication
- Caring responsibilities with no agency support
- No effective support from extended Family
- Destructive/unhelpful involvement from extended family
- Has basic amenities and appropriate Facilities
- Adequate/poor housing
- Living in Gang neighbourhood
- Poor state of repair, temporary or Overcrowded
- Homeless, Living in Hostel
- Physical accommodates places child in danger
- Parents able to manage working/Unemployment and do not perceive them as unduly stressful
- Periods of unemployment of the wage earning parent(s)
- Parents have limited formal education
- Parents starting to feel stressed around unemployment or work situation
- Parents experience stress due to unemployment or �overworking�
- Parents find it difficult to obtain employment due to poor/ basic skills
- Chronic unemployment, severely affecting parent�s own identity
- Unable to gain employment due to lack of basic skills or long term difficulties eg substance misuse
- Reasonable income over time, resources used appropriately to meet needs
- Low income
- Serious debts/poverty impact on ability to meet basic needs
- Extreme poverty/debt impacting on ability to care for child
- Family Integrated into community
- Good social and friendships networks
- Family may be new to the area
- Some social exclusion experiences
- Parents socially excluded
- Lack of support networks
- Associating with young people who are sexually exploited
- Family chronically socially excluded
- No supportive Network
- Good universal services in neighbourhood
- Adequate universal resources but family may have access issues
- Poor quality universal resources and access problems to these and targeted service
- Poor quality services with long-term difficulties with accessing target populations