In Kingston and Richmond we refer to the London Threshold Document: Continuum of Help and Support  which proves a framework for professionals working with children, young people and families and to be used in conjunction with the London Safeguarding Children Procedures.

It introduces a continuum of help and support, provides information on the levels of need and gives examples of some of the factors that may indicate a child or young person needs additional support. By undertaking assessments and offering services on a continuum of help and support, professionals can be flexible and respond to different levels of need.

The framework recognises that however complex a child’s needs are, universal services, such as education and health, will always be provided alongside any specialist additional service.

Tiers of support

Children’s needs are not static, and they may experience different needs – at different points on the continuum – throughout their childhood years.

The threshold of continuum of need matrix refreshed (February 2023) provides practitioners with an overarching view of what tier/level of support and/or intervention a family might need.

It is not intended to be a 'tick box' exercise, but to give a quick-reference guide to support professionals in their decision making, including conducting further assessments, referring to other services and understanding the likely thresholds for higher levels of intervention.

Any safeguarding indicators of concern should always be considered alongside any related needs. It should be remembered that some children will have additional vulnerability because of their disability or complex needs and the parental response to the vulnerability of the child must be considered when assessing needs and risks.

Tier 1/Level 1 - No additional needs

All of the health and developmental needs of these children will be met by universal services. These are children who consistently receive child-focused care giving from their parents or carers.

The majority of children living in each local authority area require support from universal services alone.

Tier 2/Level 2 - Early help

These are children with multiple needs and require a coordinated approach.

In Kingston and Richmond 'Early help is everyone's business' and the approach is:

  • Early Help Resilience Networks to support the child, their family, and the universal services they access, in order to address the vulnerability and stop their needs escalating. Networks are held monthly. Bookings are via the AfC's Learning portal
  • Early Help Assessment completed with the most relevant agency who has the relationship with the child/family

These are children with additional needs, who may be vulnerable and showing early signs of abuse and/or neglect; their needs are not clear, not known or not being met. These children may be subject to adult focused care giving. 

This is the threshold for a multi-agency early help assessment to begin. These are children who require a lead professional for a coordinated approach to the provision of additional services, such as family support services, parenting programmes and Children and Family Centres. These will be provided within universal or targeted services provision and do not include services from children’s social care.

Tier 3/Level 3 - Children with complex multiple needs

These children require specialist services in order to achieve or maintain a satisfactory level of health or development, or to prevent significant impairment of their health and development. They may also be disabled. They may require longer term intervention from specialist services. In some cases these children’s needs may be secondary to the adults' needs.

This is the threshold for an assessment led by children’s social care under Section 17, Children Act 1989 although the assessments and services required may come from a range of provision outside of children’s social care.

Tier 4/Level 4 - Children in acute need

These children are suffering or are likely to suffer significant harm. This is the threshold for child protection. They are likely to have already experienced adverse effects and to be suffering from poor outcomes.

Their needs may not be considered by their parents.

This tier also includes Tier 4 health services which are very specialised services in residential, day patient or outpatient settings for children and adolescents with severe and/or complex health problems. This is likely to mean that they may be referred to children’s social care under section 20, 47 or 31 of the Children Act 1989. This would also include those children remanded into custody and statutory youth offending services.