The London Continuum of Need establishes a consistent approach for four levels of need and corresponding service intervention; and beginning the Common Assessment Framework (CAF) process.
However, some Local Authorities have more detailed local descriptors and the London Continuum does not provide an exhaustive list of all possible scenarios. Practitioners should always use their professional judgment.
The continuum process acknowledges that children may move from one level of need to another, and that agencies (including universal services) may offer support at more than one level. The various risk levels that are integrated within the Multi Agency Safeguarding Hubs and Public Protection Department process is based on this continuum of need.
The Four Levels of Need
Tier 1: No additional needs
These are children with no additional needs; all their health and developmental needs 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: Early help
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 co-ordinated approach to the provision of additional services such as family support services, parenting programmes and children's centres. These will be provided within universal or targeted services provision and do not include services from children's social care.
Tier 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 and/or who are 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: Children in acute need
These children are suffering or are likely to suffer significant harm. This is the threshold for child protection. These children 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 service