Current Child Indicators Carer Indicators Context Indicators Results Plan Declaration Complete Child Indicators Missed Appointments / Engagement with services 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description All health needs met Fully compliant with all treatment plans and use of specialist equipment Compassion for the child’s needs Missed and cancelled appointments but parent/ carer rearranges and attends rearranged appointments Any lack of compliance is due to legitimate reasons Compassion for the child’s needs Consistent missed/cancelled appointments but did not phone to cancel/rearrange or did not attend the rearranged appointment Compliance frequently lacking Shows limited compassion for unborn / child’s needs and the reasons for needing to attend appointments and services Parents not returning completed core screening consent to school health service Chronic missed appointments that are significantly detrimental to the unborn /child’s health Health needs unmet Shows no compassion for the child’s needs and the reasons for needing to attend appointments and services Difficulty in recognising and prioritising needs of the child Serious compliance failure (medication not given for no reason, specialist equipment not used, treatment plan not followed) Inexplicable deterioration in the child’s normal functioning behaviour Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 The child is of optimum health All health needs met Good relationship with parents/carers The child is reaching full potential for their medical condition Detection of treatable conditions in the Unborn child/child at increased risk of becoming delayed The child has health needs met within an appropriate timeframe The child likely to reach full potential Good relationship with parent/carer The child is not meeting their full health potential which will impact on health/wellbeing Increasing need for support due to not accessing relevant health services and appointments May not have the necessary equipment/services involved to meet their health needs and therefore impact on their growth, intellectual development and mental health Detection of treatable conditions in the Unborn child/child delayed A child suffering from preventable chronic ill health Risk of child’s health and developmental needs not being met Risk of child/ young person not reaching their full potential and intellectual development, and therefore impact on emotional health which may lead to depression, anxiety, self-harm Missed appointments in children may be critical due to the potential acute nature of their condition – could lead to hospitalisation or death Unborn child’s / child’s health needs undetected and therefore increased the likeliness of the child being born with health implications/child having health implications Invisibility of the child due to increased isolation Risk of severe or life-threatening harm Hygiene 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description Child is clean The child is treated for usual minor ailments The child has necessary self-care skills Child on occasion looks unwashed, hair uncombed, occasional body odour An occasional episode of head lice / nappy rash treated appropriately There have been low-level concerns raised from others, the parent is aware and agrees with the concerns and is engaging or willing to engage to address the issues Occasionally needs reminding of self-care needs The child is dirty, food spilt on clothes, dirty feet, dirty nails, nappy sodden, has body odour Head lice / nappy rash treatment only used if prompted Head often shaved or cut very short in severe style as head lice treatment There have been concerns raised by others that are significant on one or more occasion School often providing facilities for child / young person to wash Poor self- care skills for level of ability due to the impact of parenting The child is very dirty, has an offensive odour Hair matted and unwashed Repeated head lice infestation, untreated and may be showing signs of infection, head shaved or cut short due to infestation Severe nappy rash, untreated and may be showing signs of infection Ingrained dirt under finger and toenails Dirty clothes, clothes have an odour Invasive treatment unclean i.e. ng tubes, peg feeds, dialysis equipment There are on-going significant concerns raised by others and/or referrals to agencies in the past Inadequate self – care skills for level of ability due to the impact of parenting Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 All hygiene needs met The child can thrive, remain safe and enjoy and achieve May be at risk of gastrointestinal infections, threadworm Chid at increased risk of pain, soreness, itching and discomfort Irritability in babies The child at increased risk of being bullied and isolated - impact on emotional health therefore possible emergence of depression, anxiety and low self-esteem, poor friendships and reduced education attainment Increased risk of infections, fungal infection, threadworm – causing illness, pain and suffering for the child and increased stress levels The child at risk of severe infection/septicaemia – illness, pain and suffering for the child The child is isolated, lonely and at increased risk of bullying – increased risk of mental health issues, difficulty with forming and maintaining relationships, reduced educational attainment and at increasing risk of self-harm, severe anxiety, suicide Children may be uncomfortable, itchy, sore - which may impact on their sleep and daily functioning The child develops poor self-care skills Dental Health 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description Good parental awareness of oral health The child is registered with a dentist Cleans teeth twice daily with toothpaste Age appropriate cup used for drinks Child given vitamin supplements to aid the absorption of calcium The child over 6 months not registered with a dentist Giving inappropriate drinks Using a baby bottle for a child over 1 year No evidence of decay Parents not engaged in prevention but open to advice Cleans teeth twice daily with children’s toothpaste Inappropriate use of dummy over the age of 1 year, parent/carer open to supporting to cease use The child not registered with a dentist Cleans teeth usually once per day with toothpaste Given inappropriate drinks in a baby bottle over 2 years Evidence of discolouration of teeth and decay – may be lacking in vitamin D Parents not accepting advice or engage in prevention The young person does not own a toothbrush or toothpaste Inappropriate use of dummy over the age of 2 years and/or parents reluctant to advise to cease use The child not registered with a dentist Does not clean teeth Has frequent sugary snacks/drinks Has obvious decay / or recurrent abscesses Using a baby bottle for drinks over 3 years Parents not taken on any previous advice The child frequently complaining of toothache and absent from school as a consequence Child given dummy over the age of 3 years and parents not open to advice The child is attending for dental extractions of baby teeth and or adult teeth due to decay Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 The child has good oral health, free from pain and discomfort The child has good dental health but is at risk of developing decay Increased risk of developing speech and language delay Some evidence of damage to teeth At risk of pain, discomfort, decay and associated infections Increased risk of reduced nutritional intake and communication – impacting on relationships Increased risk of being bullied – impacting on emotional health needs which may lead on to the emergence of depression, anxiety and self-harm Increasing risk of speech and language delay Increased risk of disturbed sleep patterns, crying and irritability The child has significant decay and dental caries Increased risk of reduced nutritional intake and effective communication At risk from sepsis, unclear speech, extreme pain and discomfort, disturbed sleep, low self-esteem due to appearance, frequent abscesses, halitosis, impact on diet and nutritional needs Increasing risk of isolation from peers, bullying and therefore increasing impact emotional health and well-being which can lead to depression, anxiety and self-harm At high risk of speech and language delay Nutritional Needs and Weight Abnormalities 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description Child is thriving BMI within normal limits and/or no concerns regarding centile chart information Special food supplement always available and parents fully accomplished in use and care of alternative feeding methods Parents always following the advice given by professionals Weight is proportional to height and within normal BMI, however, may appear large or small in stature and/or centile charts proportional to the stature (Consider parents build) Not having vitamin supplements Age appropriate diet and exercise is being considered but not always achieved Diet and exercise is appropriately monitored Special food supplements usually available and manage to provide adequate care in using specialised equipment The child is outside of normal BMI and/or data on centile charts, not in proportion Child’s weight increasing significantly The child is not putting on weight, looks thin and pale The child not engaging in healthy lifestyle activity, exercise, P.E A poor diet of poor nutritional value Not having vitamin supplements Attending appointments with paediatricians/weight management/dieticians Often does not have child’s food supplement and poor skills demonstrated in the use and care of specialised equipment Inconsistently following advice from professionals Parents not consenting to core/obesity screening in school, therefore, weight unable to be reviewed Parents not promoting the development of varied diet The child not encouraged in independency in eating Parents not engaging with some or all advice is given The child has BMI above or below the normal range and/or weight and height above or below centile charts normal range Has not attended Paediatric/Weight Management/ dietician appointment. Very unhealthy diet No vitamin supplements Breathless on exertion Engaging in unhealthy lifestyle choices such as playing video games/watch TV for long periods No priority is given to the provision of food supplement and feeding equipment not maintained or used Not following advice from professionals Parents not appropriately responsive to behavioural difficulties around meal time Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 The child can remain healthy, enjoy and achieve Nutritional needs fully met The child is at emerging risk of being deficient of vitamins and nutritional elements – impacting upon energy levels and lethargy The child may not be as active as is optimum and therefore impacting upon the child’s physical health and development The child is at risk of becoming obese or anorexic Less active and able to join in physical activities with peers The child at risk of failure to thrive, anaemia, poor brain growth, malnutrition, electrolyte imbalance, poor vitamin absorption Impact on self- esteem – can lead to eating disorders, depression, anxiety and self-harm Increased risk of being bullied and associated impact on emotional health The child is at increased risk of diabetes, asthma, heart disease The child is undernourished and therefore at increased risk of health issues, growth problems, retardation and socio-emotional deficits, severe malnutrition The child is tired and having unnecessary investigations At high risk of developing an eating disorder and being bullied, impacting on emotional health and increased risk of depression, anxiety and self-harm Clothing 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description The child is always dressed in clean and appropriate clothes The child is wearing clothes appropriate to their age, level of maturity and occasion whilst promoting independence Parents and/or child are following advice from professionals The child is dressed appropriately but clothes appear unwashed Does not have many clothes Child occasionally seen wearing few or too many clothes for temperature, but plausible reasons are given by a carer Parents happy to accept charity referral The child is often dressed in unsuitable clothes for the environment/weather Clothes are too small/too large Shoes are too small/too big Holes in clothes/shoes The child frequently presents in school without school uniform even though school have previously provided one School frequently washing child’s clothing in school Clothing frequently unwashed, looks dirty, has an odour The child is always dressed in clothes not appropriate to the environment/weather Clothes are too big/small Clothes have an offensive odour Shoes too big/small and may have an offensive odour Parents do not see an issue The child is not wearing clothes appropriate to their age, level of maturity and occasion whilst promoting independence Parent and/or child is not following advice from professionals Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Confident and good self-esteem Appropriate body temperature Maybe self-conscious due to clothing and therefore impact on self-esteem May be too warm or too cold impacting on the ability to enjoy and achieve in activities Impact on emotional health due to poor self-esteem and increased risk of being bullied and isolation which can lead on to depression, anxiety, self- harm Increased risk of infections Issues with forming and maintaining relationships Impact on educational attainment The child is affected socially and emotionally, therefore, increased risks of depression, anxiety, self–harm and suicide Issues with forming and maintaining relationships Feet may be damaged which could lead on to issues with gross motor development, carrying out exercise and activities and play Increasing risk of infection - leading on to poor health Poor self-esteem and confidence – may negatively impact on educational attainment, peer relationships and emotional health Multiple Injuries / A + E attendance supervision and safety 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description Child accesses health services promptly and appropriately Optimal age appropriate supervision of children Appropriate safety equipment in place and used Appropriate road safety Medication and alcohol stored safely The child attends A & E for minor illnesses instead of GP Occasional minor accident Attends A&E in a timely manner Lack of safety equipment in the home Parents are willing to accept advice and have knowledge of child developmental needs Occasionally child not supervised age appropriately The child not registered with a G.P There have been low level concerns raised by others, the parent is aware and agrees with the concerns and is engaging or willing to engage to address the issues Storage of medication/alcohol inadequate The child has had 2 or more accidents which could be due to lack of supervision within age appropriate time frame Frequent A&E attendances for minor illnesses due to a poor home environment/ poor diet /anxious parents Inappropriate use of A&E Medical attention is not sought in a timely manner Safety equipment is not in place Parents reluctant to accept advice Poor supervision of children Poor road safety measures are taken and/or child has limited road safety awareness There have been concerns raised by others that are significant on one or more occasion The child attends A& E frequently for illness and accidents due to poor supervision The child is not taken promptly to GP/ A&E when injured and/or ill The home environment presents danger/risk of accidents to the child Child is unsupervised Parents do not accept advice Reduced school attendance due to injuries, attendance at A + E No road safety measures and/or have no awareness of road safety There are on-going significant concerns raised by others and/or referrals to agencies in the past Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 The child has all health needs met Is safe and supervised At risk of injuries At risk of delay of seeking appropriate medical advice and neglecting basic health needs The child is at increased risk of injuries The child unable to enjoy and achieve for periods of time May be out of education, therefore, impact on attainment – child becoming more invisible to professionals At risk of more severe health issues and consequences of illness and injuries At risk of serious illness, severe injuries and death The child unable to enjoy and achieve for significant periods of time – impact on peer relationships Educational attainment impacted upon due to non-attendance at school Increased risk of depression, anxiety and self-harm Low birth weight / prematurity 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description The child is thriving and gaining weight Development within expected limits Having vitamin and folic acid supplements Attending all follow-up appointments and baby clinic Increased risk of sudden infant death being managed appropriately Attending for immunisations The child following adjusted growth centiles Occasionally not attending a baby clinic for weight review but with a plausible explanation Having vitamins and folic acid Missed/could not attend the occasional appointment Adhering to safe sleeping guidelines The child frequently not attending a baby clinic for weight review Has missed 2 or more follow-up appointments with no explanation Evidence of developmental delay occurring Not up-to-date with immunisations Safe sleeping guidelines only being adhered to when reminded The young person presents in school as failure to thrive Frequent absence from school due to frequent illnesses The child has been discharged from hospital follow-up due to non-attendance Not having vitamin supplements Not attending a baby clinic for weight review Not accessing services No evidence of toys/play and stimulation Childs development clearly below what is expected Outstanding immunisations Not adhering to safe sleeping guidelines Not attending school due to health needs Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 The child is having all health needs met Thriving and well stimulated No lasting effects of prematurity Potential issues with weight gain and development Emerging risk of effects of prematurity becoming prolonged The child not achieving full developmental and educational potential Increased risks of prolonged effects of prematurity At risk of failure to thrive At risk of rickets At risk of communicable disease Increased risk of sudden death The child at risk of death Significant risk of severe developmental delay Significant risk of failure to thrive, rickets and other health issues Significant risk of communicable disease Significant risk of sudden death Significantly at risk of prolonged effects of prematurity Physical Development 1 2a 2b 3 Threshold information Threshold Universal Services Threshold Early Help Threshold Specialist Support Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Description The child is meeting all developmental milestones Observed playing with age appropriate toys Parent adapts the stimulation/leisure activities that meet the child’s level of need; This includes the use of readily available outside agencies and this is overseen carefully Specialised equipment and advice is fully implemented. Child occasionally seen strapped in buggy/car seat in the home Child occasionally seen sat in a highchair in the home when not meal times Attends occasional Stay and Play Sessions Occasionally age appropriate stimulation and play needs of the child not achieved Parents open to advice There have been low level concerns raised by others, the parent is aware and agrees with the concerns and is engaging or willing to engage to address the issues Occasionally specialist equipment not used when needed The child often seen strapped in buggy/Highchair No toys in reach Frequent use of television as stimulation Only attending local groups if required to by professional Some developmental/speech delay evident Parent reluctant to accept advice The parent uses inappropriate stimulation/leisure activities for the child’s level of need Referrals needed to community paediatrician due to concerns of developmental delay The young person not allowed to engage in school activities, activities after school or access to peers as parental permission is not given There have been concerns raised by others that are significant on one or more occasion Limited use of specialist equipment The child is always seen in highchair/buggy No toys observed in the home Missed appointment with Community Paediatrician Not attending any groups Parents not engaging with services and not receptive to advice No overseeing of support or outside agency involvement to ensure if they are appropriate No stimulation or leisure activities for the child There are on-going significant concerns raised by others and/or referrals to agencies in the past No use of specialist equipment Impact on child Score 1 Score 2a - Single Agency Early Help Score 2b – Multi Agency Early Help Score 3 Child is thriving The child is reaching their full potential Able to enjoy and achieve The child is healthy and safe Child occasionally unable to enjoy and achieve for periods of time Emerging risk of delay of gross and fine motor development Delayed gross motor and fine motor skills Delayed Speech and Language Evidence of some behaviour issues Isolation from peers causing an impact on self – esteem and social development which may lead on to depression, anxiety, self-harm Marked developmental delay in all areas and significant behaviour problems The child is unable to communicate needs Socially isolated – leading on to depression, anxiety, self-harm and suicide Risk of developing asthma, heart disease, obesity Additional information: (Including areas of self-reporting) Analysis Child’s Voice / Views (if non-verbal use assessment of non-verbal communication): Parent / Carers Views: Assessors Views: 14688