What is Early Help?

Early help is providing the right children, young people and families with the right support, in the right place at the right time. We all believe that by supporting children and families earlier we can stop any problems they are facing from getting worse and help them to find the solutions that will make their lives better in the future. We can do this by working together, building on children’s and families’ strengths, and developing their capacity to make positive changes for themselves.

Our ambition

We believe that delivering Early Help well has the potential to transform the lives of children, young people and their families across Cambridgeshire and Peterborough. We are committed to reducing inequalities and providing high quality early help to families makes an important contribution to achieving that aim. We make no apologies for setting out a vision that is very ambitious. Our goals, which flow on from the three Best Start in Life headline goals, are that:

In order to achieve these high-level goals, we have identified five intermediate outcomes. We believe that if we focus on these things then we will have the biggest and most lasting impact on our overall goals. Our intermediate outcomes are:

Strong families

The care and love provided by strong, supportive families is the essential foundation for enabling children and young people to lead safe, healthy and successful lives.

Trusted relationships

Forming positive, trusting relationships with adults (both inside and outside the family) and with their peers gives children and young people emotional stability and opportunities to flourish in life and learning.

Safe places and positive activities

Safe places to socialise and a wide range of activities that build self-esteem, excite young people and create a sense of belonging are all important contributors to children and young people growing up healthy and happy.

Capacity to manage challenges

An important component of secure mental health and good emotional wellbeing is the capacity of a child or young person to cope with setbacks and manage the inevitable ups and downs of life.

Enjoyment of life and learning

Ultimately children and young people who are thriving find enjoyment in their everyday lives and find their learning rewarding. This is what we hope for, for all our children and young people.

Our principles

We have a strong set of guiding principles that inform our approach to Early Help across our partnership. These are:

Children and young people are at the heart of what we do.

We will listen to children and young people’s views and feelings and understand the impact on them and their family.

We build capacity, not create dependency.

We will work with children, young people and families to recognise and build on their strengths. We will help them develop the skills to solve problems and overcome challenges.

We work as a partnership to effect change.

Early Help is everyone’s business. We will draw on the skills and knowledge of all the partners who work with children and families.

We intervene early to prevent problems from getting worse.

We will not wait before problems become unmanageable before we offer help, and we recognise that support might come from a range of different places.

We work with the whole family.

We know that children and young people live in families, so we will work with the family as a whole, and the individuals within the family, to understand their needs and develop holistic support.

We join up our systems and processes.

Families will tell their story once and will work with a trusted professional throughout their journey.

We use evidence to inform what we do.

Our offer of support will be guided by the latest research and evidence of what works. We will be bold and innovate, but always test the impact of new approaches.

We work in places and communities.

We will build the capacity of communities to support their members, create local networks of professionals who work together, and target our support to meet the different needs of individual places.

How we work together to deliver Early Help

Early Help is not a service in a conventional sense. It is a philosophy of how we can utilise all the resources available in families, communities, the voluntary sector and public bodies to provide timely and effective support when it is needed. In Cambridgeshire and Peterborough our Early Help offer comprises three key dimensions:

Our expectation, as a partnership, is that children, young people and families will receive support at the lowest level of intervention that can meet their needs. That means that we can use our collective capacity in the most efficient way to support as many children and young people as possible. We know that the needs of children, young people and their families change over time and therefore may be supported at different levels in the system depending on what is happening in their lives.

Community support

Our ambition is that most children, young people or families who encounter difficulties can be supported to overcome these with the resources available in their communities. In Cambridgeshire and Peterborough, we have a thriving voluntary and community sector offering a wide range of positive activities, supportive networks, drop-in sessions and advice. Our aim, over the next three years, is to develop and grow this capacity further, make it easier for parents, young people and professionals to find the support that they need and create better opportunities for bringing all those who work with children and young people together to share information and knowledge about what works.

More support

Some children, young people and their families, will need individual help to successfully overcome the challenges they are facing. For these families, or young people, we aim to offer earlier and more bespoke support, organised through a trusted professional. The trusted professional can be anybody who has a strong relationship with the family and the capacity to work with them on what they want to achieve. This might be, for example, someone who works in the child’s school, a health professional such as a GP or practice nurse or youth club worker.

For families or young people who need this level of support, the Lead Professional will work with the family or young person to complete an early help assessment. This is an honest assessment of the family or young person’s strengths and weaknesses. They will then use this to work with the family to create an Early Help plan which sets out the goals that the family or young person want to achieve, and the support that they will need to get there. The Lead Professional will not provide all the support that a family might need at this level, but they will be a consistent point of contact, brokering in the extra help and advice that might be needed. Examples of the types of help that families might receive include access to parenting courses either online or in groups, counselling or lower-level mental health support, or the range of support offered through children and family centres.

Targeted support

For a minority of families, the support that a trusted professional can offer, even bringing in a range of additional specialist services, will not be enough. For families or young people who need more help, Cambridgeshire and Peterborough offer bespoke targeted support delivered both online and in the home, that is designed to address immediate barriers and rapidly build the capacity and resilience that a family or young person need to get their lives back on track.

The nature of the intensive support on offer will depend on the needs of the family or young person and will be set out clearly in the Early Help plan. However, it might typically involve one or more homes visits a week for a period of time, prompt access to a range of specialist services or interventions and regular online conversations to build confidence and embed learning.

The targeted support offer will be delivered by a dedicated early help or specialist practitioner, who may be a member of a local authority team or work for an organisation that has been commissioned by the local authority to deliver this support offer. Whoever delivers the support will work in the same way with the family, and to the same exacting standards.

To enable us to help children, young people and their families more effectively we are creating a consistent approach to organising our local authority teams across Cambridgeshire and Peterborough.

There will be one worker or team per family, where this is possible and in the best interests of the children concerned. Across both Cambridgeshire and Peterborough, services will be a mixture of direct delivery and commissioned provision.

The service will be place based, and work across four geographical quadrants. In each quadrant the following teams will be brought together and operate as an integrated service:

• A Child and Family Centre with the attached Children and Family Centre staff
• 0-11 Targeted Children’s Support Team(s)
• 11-19 Targeted Youth Support Team(s)
• 10-19 Specialist Support Team(s) – these are combined YOS and social care teams
• Transition (education) service – this focuses on school transition issues and NEET/ NIAP, and liaison with Education colleagues where education is a complex issue for the young people with whom we are working
• Leaving Care Team

Specialist partners or smaller teams will also be linked to each area including:

• Police
• Probation
• Mental Health
• Drug and Alcohol
• Sexually Harmful Behaviours/ ISS High Risk
• SAFE team
• Other commissioned provision, for example parenting programmes.

Each area will also run a volunteer provision, and support the local community through parenting programme delivery, befrienders, Princes Trust, and mentors.

The four quadrants will each be managed by a dedicated head of service. Each head of service will also be the lead for one specialist area across the entirety of Cambridgeshire and Peterborough. The specialist areas of focus will be strong families; learning and participation; exploitation of vulnerable and at-risk adolescents; and physical and mental health.

The purpose of these changes will be to enable greater alignment across Cambridgeshire and Peterborough, to deliver a more joined up service for children and families and to enable closer working with partners on a place-based approach.

Joining the dots

Working together effectively as a partnership to deliver Early Help relies on clear systems and processes that are easy to use and enable excellent practice. Our popular Back to Basics online training session is available to colleagues from across the partnership, supporting professionals to develop the skills and knowledge required to guide families through the Early Help assessment process. For further details and booking please click here.

Early help assessments

The early help journey for families in Cambridgeshire and Peterborough starts with an Early Help assessment. It is an impartial and honest assessment of strengths, opportunities and challenges that is undertaken with the family, and only ever with their permission. It should be completed when more than one unmet need would benefit from a multi-agency support approach. More guidance on the early help assessment tools and process can be found here in the Effective Support for Children and Families in Peterborough and Cambridgeshire document.

Early Help assessments (EHAs) are also used as a gateway to access several other forms of support. From 2021, an Early Help assessment will need to be completed by a professional looking to access a neurodevelopmental assessment in both Peterborough and Cambridgeshire and the Early Support Pathway in both local authorities. In Peterborough, an EHA is also needed to access a place on a commissioned evidence-based parenting programme, a Behaviour Panel referral, and specialist sleep support.

Early help plan

The Early Help plan is where families and professionals record their goals for the future and the steps that they are going to take to reach those goals. All Early Help plans in Peterborough and Cambridgeshire will follow the same structure whether they are developed by a Lead Professional or an Early Help practitioner. A critical attribute of the plan is that it is developed with the family and owned by them. It is also the benchmark against which progress for the family or young person is measured.

The Early Help hub

The Early Help Hub is the first point of contact for families and professionals doing an Early Help Assessment. It coordinates access to targeted early help services in Cambridgeshire and Peterborough and provides advice and guidance on cases managed by the professionals already involved. The Early Help Hub receives contacts for children and families who require multi agency support through Early Help Services to support their needs.

Team around the family

The Team Around the Family describes the group of professionals or wider family members who are involved in providing support or advice to a family. It provides an opportunity for the family and professionals to work together on achieving a family’s goals. The Lead Professional will normally coordinate the different contributions of the individuals within the Team around the Family. This will generally be managed through regular meetings of the Team around the Family and monitoring progress against the Early Help plan.

Every contact counts

The Team Around the Family provides a focal point for decision-making and planning for the professionals and practitioners who are most directly involved in providing early help for a family. However, we know that there will be a wider range of trusted adults who engage regularly with children, young people and families and who can ensure that their daily interactions support the early help goals and principles and can make ‘every contact count’ in a positive way. The wider range of trusted adults might include anyone from GPs to neighbourhood policing teams, housing officers to faith and community leaders. As part of this strategy, we are committed to rolling out a wider programme of communication and training to ensure that everyone who interacts with children, young people and their families regularly has the skills and understanding they need to support the early help goals by making every contact count. This might entail skills in active listening and asking open questions; understanding of how to identify signs of risk; awareness of the goals of the early help strategy and how these can be supported through day-to-day activities; or knowing how to share information safely or connect a family to other forms of support and guidance.

Collective decision-making

Early help is a partnership endeavour. Creating the opportunity for partners to come together to contribute to shared decisions about how a family can best be supported is therefore an important underpinning of how we work. In each of the four quadrants there will be a regular forum for partners to discuss families or young people where additional professional input might be needed. In Peterborough, the MASG panel will continue to perform this function. In Cambridgeshire, a new multi-agency forum will be convened on a regular basis in each quadrant. It will provide an opportunity for Lead Professionals to refer a family or young person with whom they have been working and for whom progress has slowed or risks have escalated for a multi-agency discussion and decision-making about future support options. The Early Help Hub will also recommend cases for an initial partnership-based discussion where the way forward is not clear cut. These regular fora will generally be held virtually to encourage strong attendance.

Common practice model

We will be more effective in supporting families if all those delivering Early Help, from ‘community support’ to ‘targeted support’, are able to use a common language and a common approach. The way that professionals or other adults work with families and young people is the ‘practice model’ and defines the way in which that interaction takes place. From 2021 we will be adopting Motivational Interviewing as our shared practice model across all Early Help. This is the same practice model as is currently used by Children’s Social Care teams across Cambridgeshire and Peterborough.

Motivational Interviewing is based on the belief that every person has the potential for change. It is a strengths-based approach to supporting children and families which encompasses four key principles – empathy, congruence, positive regard and supporting self-efficacy. Practitioners use skills such as open-ended questions, reflection, active listening, affirmations and summarising to support a child, young person or parent / carer to recognise their own qualities and strengths and to draw on these to modify any behaviours which may not be positive and those which are having a detrimental impact on their wellbeing and the wellbeing of others. Because the model relies on the individual effecting his or her own change, any immediate change is more likely to be sustained in the long term.

Moving towards a shared practice model of Motivational Interviewing will be supported through a multi-agency training programme for staff and partners and regular opportunities for reflective practice to embed and refine new ways of working.

In addition to Motivational Interviewing as the core practice model there are several tools and approaches that early help practitioners and lead professionals may use with families. A guide to these, and how and when they might be most usefully deployed has been developed by the Cambridgeshire and Peterborough partnership board and is available here.

Sharing information

The ability to share information quickly and securely about a family with trusted professionals is critical to effective partnership working for early help. To that end we have invested in the development of an early help module as part of our integrated case management system for Children’s Services. The Liquid Logic early help module is now being extensively used by early help practitioners in children’s services, as well as partners in schools and health. Early feedback suggests that professionals find the system easy to use and navigate. Over the coming months we will be consolidating the effective use of the system by those who have received access and training. We will also look for opportunities to expand the network of people working with families who are able to share essential information through the system, for example by broadening access to VCS providers and groups where appropriate and useful. This will help secure our commitment that families need only tell their story once, while placing the concept of consent and data protection at the heart of what we do.

Measuring progress

Our commitment to continuing to improve our partnership-wide early help offer depends on our ability to accurately and consistently measure the progress made by the children and families whom we support. In Peterborough, our tool for measuring the progress made by an individual family is the Outcomes Star. In Cambridgeshire we use a bespoke tool for measuring progress called the Measuring and Assessing Progress tool (MAP). In the short term, as we establish a more joined up approach to early help across Cambridgeshire and Peterborough, we will carry out a comparative audit of how outcomes and progress are assessed across the two local authorities and synthesise, as far as possible, the two approaches. In the medium term we will await the announcements on the future of the Supporting Families programme, and the accountability framework that may accompany this, before co-designing a future approach to measuring progress and tracking outcomes, building on the best of what is currently in place in both local authorities and across partners.

Specialist Support

Some children, young people and families will need to access specialist assessments and support as a result of risks that have been identified. Specialist assessments for our most complex and at-risk young people will be available through Asset Plus Assessments and/or Child and Family Assessment. This support can only be accessed through Youth Offending Service Police and Court referral processes and Effective Support for Children and Families processes if young people meet the required threshold (see the Effective Support for Children and Families in Peterborough and Cambridgeshire document). For young people and families with more complex needs we will work within a partnership contextual safeguarding framework and will utilise approaches such as motivational interviewing and trauma informed practice ensuring every contact counts and building on relationships with trusted adults.

The voice of children, young people and their families

Listening to children, young people and families, and then acting on what they tell us, is central to making sure that this strategy, and the actions that flow from it, remain relevant and purposeful. We will therefore put in place a structured programme of engagement with children, young people and families that uses some existing and some new communication routes. The information gathered through this ongoing programme will help us first to test the principles and goals of this strategy and subsequently to monitor how well we are putting them into practice. The feedback routes that we will employ are summarised below:

• Regular surveys of children and young people conducted by the safeguarding board.
• Annual digital health questionnaires provided to families with children in reception year and year 6, and for young people in year 9.
• The work of youth and community coordinators and the Youth Voice and Youth Engagement Partnership.
• Regular structured feedback on YOS and mental health and emotional wellbeing services.
• Capturing the voice of children and young people in measuring progress against early help plans.
• Recommissioning an annual survey, across Cambridgeshire and Peterborough, of children and young people in schools.

Our priorities

Based on an analysis of our data and extensive consultation with staff, partners and children and young people we have identified the following strategic priorities to guide our work to deliver early help over the next three years. These are priorities to which all those engaged in the early help partnership can contribute and are arranged against the four thematic areas of focus.

Strong families

In both Cambridgeshire and Peterborough, the rate of referrals to children’s social care reduced in 2019-20 at a much greater rate than nationally. This means that in Cambridgeshire considerably fewer children and young people were referred to children’s social care per 10,000 population than nationally or in similar authorities. In Peterborough, the rate remains above the national average and slightly above the rate in similar authorities but is falling more quickly. It is also encouraging that the rate of children with new child protection plans in 2019-20 reduced in both local authorities and is now below the national average and below the average in similar local authorities in both Peterborough and Cambridgeshire. These data are very positive and suggest that the partnership wide provision of early help may be helping to reduce the need for more specialist and more costly interventions.

However, the impact of the Covid pandemic over the last 12 months has been profound and we are only just beginning to understand the potential implications for families. In recent months we have begun to see increasing incidence of domestic violence and many more families experiencing financial hardship than previously. This is bringing children and families to the attention of early help who may never before have needed support. We are also aware that the pandemic has been a particularly challenging and isolating period for many of our young carers. Data shows that in both Cambridgeshire and Peterborough challenging behaviour in the home, poor behaviour in school, parenting concerns and poor parental mental health all feature in the ten most common reasons for an early help assessment. Extended lockdowns and time away from school are likely to impact negatively on all these factors which suggest they should be a real focus for the partnership going forward.

At the same time, some of the changes to the way we have worked during the pandemic offer real opportunities for rethinking and improving the way in which early help is delivered through the partnership. Locality hubs have become more vibrant and there is a structure in place to take these forward. Working with a range of partners, both statutory and community, has accelerated. Professionals believe that joint work and planning around the most vulnerable children has improved and there is an opportunity to reimagine services on a new ‘hybrid’ model which combines the best of virtual and face to face interactions.

What we can do as a partnership

Learning and participation

The disruption that all children and young people have experienced to their education as a result of the pandemic has been profound, and all the evidence suggests that children from more disadvantaged backgrounds are likely to suffer the greatest negative impacts. This context will set the agenda for early help for years to come.

Data and information collected before the pandemic points to some of the key areas of focus going forward. We know that children presenting with challenging behaviour either in the home or at school has historically been one of the most common reasons for a referral to early help. Despite the significant progress made on reducing both permanent and fixed term exclusions in secondary schools in Cambridgeshire, primary fixed term exclusions still remain a cause for concern. In Peterborough fixed term and permanent exclusions in both phases of education are above national averages.

The age group that might be a particular focus for our efforts over the next period are the ‘transition years’ of 9- to 12-year-olds. Evidence collected from a wide range of partners and professionals, which underpins the development of this strategy, suggests that the offer of support for this age group, in terms of preventative work and early intervention, is not currently sufficient. Children aged 9 to 12 currently represent between 20% and 25% of the overall early help cohort in Cambridgeshire and Peterborough. Interestingly, on average in Cambridgeshire and Peterborough schools progress and attainment made by primary aged pupils is below national averages.

At the other end of the age spectrum our young people aged 16 to 18, embarking on their adult lives, have experienced a very turbulent period with uncertainty over examination results and challenges around planning their next steps in learning. Before the pandemic, the percentage of 16- to 17-year-olds not in education, employment or training was high in Peterborough and above that of similar authorities in Cambridgeshire. Going forward identifying and supporting those young people at most risk of disengagement as a result of the pandemic will be a key priority.

What we can do as a partnership

Vulnerable and at-risk adolescents

In both Cambridgeshire and Peterborough, the percentage of young people entering the youth justice system is below national average, and the average in similar authorities, having fallen dramatically in recent years. This is really encouraging and suggests that a focus on prevention is leading to better outcomes. However, we also see the complexity of cases is increasing. Furthermore, the capacity to support intervention before young people engage in risky or criminal behaviour is limited and there is a need to join up resources across the partnership to have the greatest possible impact on prevention. It remains a challenge that for many of those young people who enter care as a teenager, there may have been opportunities to intervene earlier had the right support and capacity been in place.

For many of those young people who might previously have been at risk of exploitation or criminalisation, the pandemic will have reduced the range of positive activities and supports in their lives. Without the safety net offered by school, clubs, sports or youth activities many of these young people will be even more vulnerable than they were previously. Indeed, there are early indications that young people’s engagement in anti-social behaviour, gang-related activity, or serious crime, violence or exploitation may now be higher than it was a year ago. It is therefore a priority for this strategy to find ways to instill protective behaviours and support young people earlier to prevent the escalation of risk and need.

What we can do as a partnership

Promoting good mental and physical health

Providing timely support for children and young people’s mental health, when their needs are moderate rather than severe, in order to prevent problems from escalating, has long been a challenge in Cambridgeshire and Peterborough. This challenge is faced by many areas of the country and has been identified by the Children’s Commissioner as a priority for the future wellbeing of children and young people in England. The pandemic is likely to exacerbate many of the underlying causes of anxiety and poor mental health including deprivation, bereavement, isolation, and pressure associated with exams or education. There are already reports, nationally, of increased incidents of issues such as self-harm and eating disorders. Working to support both young people and parents who are suffering from poor mental health, early enough and with sufficient expertise, to prevent some of these challenges escalating and becoming acute should be a priority for the whole partnership. The new integrated approach to commissioning mental health support, coupled with distributing expertise and skills for enabling emotional wellbeing, is a key element of this strategy.

In terms of physical health, we know that many of the referrals to community health teams are related to the consequences of adopting unhealthy nutritional habits and poor health routines. These include issues related to weight-gain, incontinence, digestive problems and poor oral health. Many of these health complications can be addressed successfully by earlier adoption of healthy eating habits, including good hydration, active lifestyles and maintaining health routines.

At the same time, the pandemic has taken a toll on the physical health of children and young people in terms of reduced opportunities for exercise, sport and play; routine appointments with healthcare providers that may not have taken place; and fewer opportunities for therapeutic interventions. We need to take the time to understand the impact of this changed landscape and put in place the support that will enable an improvement in children’s physical health over time. Moreover, in the context of the pandemic, vaccine hesitancy is seldom out of the news. Poor take-up of childhood and adolescent immunisations has been a challenge in more disadvantaged communities within Cambridgeshire and Peterborough for many years. We need a targeted approach to building communities’ trust in healthcare providers and developing their understanding of the essential contribution vaccines make to children’s ongoing health.

What we can do as a partnership

Outcomes framework

To measure whether we are having the impact that we hope, we have constructed the attached outcomes framework that is organised against our headline goals.