graded care profile · 2015-07-02 · the graded care profile is based on psychologist ab raham...
Post on 09-Aug-2020
1 Views
Preview:
TRANSCRIPT
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 1
Grad
ed C
are P
rofile
A
qualita
tive s
cale
for
measurin
g c
are
of c
hild
ren
V
ER
SIO
N 3
Ju
ne
20
15
Dr. L
eo
n P
oln
ay
Dr. O
. P. S
rivasta
va
E
meritu
s P
rofe
ssor in
Com
munity
C
onsulta
nt C
om
munity
Pae
dia
tricia
n, N
HS
P
ae
dia
trics, U
niv
ers
ity o
f Nottin
gh
am
C
am
brid
geshire
Com
munity
Serv
ices &
Desig
nate
d
D
octo
r for C
hild
Pro
tectio
n, N
HS
Luto
n.
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 2
IN
TR
OD
UC
TIO
N
Wh
en
we
are
un
de
rtak
ing
an
asse
ssme
nt in
a ch
ild w
elfa
re o
r child
pro
tectio
n co
nte
xt, it is vita
l tha
t we
sho
uld
be
ab
le to
ma
ke
a re
liab
le ju
dg
me
nt a
bo
ut th
e q
ua
lity o
f the
care
be
ing
rece
ived
by
the
child
ren
inv
olv
ed
. Ho
we
ver, th
e fin
din
gs o
f serio
us ca
se re
vie
ws a
t bo
th lo
cal a
nd
na
tion
al le
vels re
pe
ate
dly
sug
ge
st tha
t this is so
me
thin
g th
at w
e d
o n
ot d
o v
ery
we
ll. Th
e ju
dg
me
nts w
e m
ake
can
be
hig
hly
sub
jective
; pro
ne
to b
ias a
nd
va
ry a
ccord
ing
to w
hich
ag
en
cy is a
ssessin
g th
e q
ua
lity o
f care
.
Wh
en
we
are
face
d w
ith id
en
tifyin
g n
eg
lect o
f child
ren
, the
facto
rs tha
t we
are
tryin
g to
cap
ture
are
no
torio
usly
inta
ng
ible
an
d h
ard
to p
in d
ow
n. M
ost im
po
rtan
tly, d
esp
ite o
ur in
crea
sed
reco
gn
ition
of
ne
gle
ct as a
serio
us a
nd
wid
esp
rea
d co
mp
on
en
t of th
e h
arm
tha
t child
ren
suffe
r, we
still see
m to
be
ap
ply
ing
a
larm
ing
ly h
igh
th
resh
old
s fo
r re
cog
nitio
n
an
d
inte
rve
ntio
n.
To
ta
ckle
th
is ch
alle
ng
e
mo
re
effe
ctive
ly, N
orfo
lk LS
CB
ha
s de
cide
d to
ad
op
t the
Gra
de
d C
are
Pro
file, a
s a sin
gle
an
d m
ulti a
ge
ncy
asse
ssme
nt to
ol fo
r use
in situ
atio
ns w
he
re n
eg
lect o
f child
ren
is kn
ow
n o
r susp
ecte
d.
Th
e G
rad
ed
Ca
re P
rofile
(GC
P) sca
le w
as d
ev
elo
pe
d a
s a p
ractica
l too
l to g
ive
an
ob
jectiv
e m
ea
sure
of th
e
care
of ch
ildre
n a
cross a
ll are
as o
f ne
ed
. Th
is scale
wa
s con
ceiv
ed
to p
rov
ide
a p
rofile
of ca
re o
n a
dire
ct
cate
go
rical g
rad
e. It is im
po
rtan
t from
the
po
int o
f vie
w o
f ob
jectiv
ity b
eca
use
the
ill effe
ct of b
ad
care
in
on
e a
rea
ma
y be
offse
t by g
oo
d ca
re in
an
oth
er a
rea
.
It is a d
escrip
tive
scale
. Th
e g
rad
es in
dica
te q
ua
lity of ca
re a
nd
are
reco
rde
d u
sing
the
sam
e 1
to 5
scale
in
all a
rea
s. Inste
ad
of g
ivin
g a
dia
gn
osis o
f ne
gle
ct it de
fine
s the
care
sho
win
g b
oth
stren
gth
s an
d
we
ak
ne
sses a
s the
case
ma
y b
e. It p
rov
ide
s a u
niq
ue
refe
ren
ce p
oin
t. Ch
an
ge
s afte
r inte
rve
ntio
n ca
n
de
mo
nstra
bly b
e m
on
itore
d in
bo
th p
ositiv
e a
nd
ne
ga
tive
dire
ction
s.
It can
be
use
d to
imp
rov
e u
nd
ersta
nd
ing
ab
ou
t the
leve
l of co
nce
rn a
nd
to ta
rge
t spe
cific are
as o
f wo
rk as
it hig
hlig
hts a
rea
s of g
rea
ter risk
of p
oo
rer o
utco
me
s an
d sh
ou
ld b
e u
sed
in a
ll case
s wh
ere
ne
gle
ct is
susp
ecte
d o
r ide
ntifie
d. T
he
GC
P ca
n b
e u
sed
with
the
fam
ily b
y in
div
idu
al w
orke
rs, or g
rou
ps o
f wo
rkers,
to in
form
fam
ily a
ction
me
etin
gs a
nd
child
pro
tectio
n C
ore
Gro
up
me
etin
gs. It ca
n a
lso b
e u
sed
prio
r to
ad
op
ting
the
Sig
ns o
f Sa
fety
ap
pro
ach
.
Hie
rarch
y o
f ne
ed
s
Th
e G
rad
ed
Ca
re P
rofile
is ba
sed
on
psy
cho
log
ist Ab
rah
am
Ma
slow
’s hie
rarch
y o
f ne
ed
s. Th
e to
ol a
llow
s
pra
ctition
ers to
exp
lore
fou
r are
as, o
r “do
ma
ins” o
f care
– p
hy
sical ca
re, sa
fety
, love
an
d e
stee
m –
an
d to
jud
ge
th
e
pa
ren
ting
, w
hich
th
ey
o
bse
rve
a
ga
inst
simp
le
pre
de
term
ine
d
criteria
. T
he
re
sults
of
the
asse
ssme
nt a
re e
nte
red
on
to a
sum
ma
ry sh
ee
t, wh
ich p
inp
oin
ts tho
se a
rea
s of d
eficit, w
hich
req
uire
furth
er a
tten
tion
.
Fo
r ma
ny
use
rs, the
mo
st imp
orta
nt a
spe
ct of th
e to
ol’s su
ccess h
as b
ee
n th
e fa
ct tha
t it can
be
em
plo
ye
d
by
pra
ctition
ers fro
m a
ny a
ge
ncy in
volve
d in
child
we
lfare
. In th
at re
ga
rd, it p
re-d
ate
d th
e co
mm
on
asse
ssme
nt fra
me
wo
rk b
y ma
ny
ye
ars. T
he
pro
file g
ive
s the
ag
en
cies a
com
mo
n la
ng
ua
ge
, a co
mm
on
fram
e o
f refe
ren
ce.”
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 3
In
No
rfolk
, G
rad
ed
C
are
P
rofile
a
ssessm
en
ts co
mp
lete
d
by
a
ny
a
ge
ncy
sho
uld
b
e
acce
pte
d
by
child
ren
’s serv
ices a
s ev
ide
nce
of th
e n
ee
d fo
r inte
rven
tion
in ca
ses th
at m
ee
t certa
in crite
ria. T
his w
ill
red
uce
th
e
ne
ed
fo
r fu
rthe
r a
ssessm
en
t a
nd
m
inim
ize
the
p
ote
ntia
l fo
r in
ter-a
ge
ncy
misu
nd
ersta
nd
ing
. Wo
rk is o
ng
oin
g in
resp
ect o
f this a
spe
ct.
Ide
ntifie
s Stre
ng
ths a
nd
we
ll as a
rea
s of C
on
cern
Th
e stru
cture
of th
e a
ssessm
en
t pro
cess m
ea
ns th
at stre
ng
ths a
re h
igh
ligh
ted
alo
ng
side
we
ak
ne
sses, a
nd
are
as o
f con
cern
are
ide
ntifie
d su
fficien
tly p
recise
ly to
allo
w in
terv
en
tion
to b
e ta
rge
ted
spe
cifically
at
are
as o
f we
ak
ne
ss, wh
ich ca
n re
sult in
con
side
rab
le re
sou
rce sa
vin
gs. F
or e
xam
ple
, fam
ily ce
ntre
s can
stop
rece
ivin
g ra
the
r va
gu
e re
ferra
ls ask
ing
for g
en
era
lised
“pa
ren
ting
train
ing
”. Inste
ad
, the
Gra
de
d C
are
Pro
file p
rov
ide
s the
m w
ith a
con
cise a
na
lysis o
f the
care
be
ing
giv
en
wh
ich a
llow
s the
m to
de
vise
sho
rter
bu
t mo
re in
ten
sive p
rog
ram
me
s.
It is de
sign
ed
to b
e u
sed
by
wo
rkers to
ma
ke a
ba
selin
e a
ssessm
en
t at th
e b
eg
inn
ing
of in
terv
en
tion
an
d
the
n to
be
rea
pp
lied
reg
ula
rly to
ga
ug
e p
rog
ress. T
his is a
n a
spe
ct of th
e to
ol w
hich
fam
ilies h
av
e fo
un
d
pa
rticula
rly h
elp
ful, a
s it ha
s pro
vid
ed
the
m w
ith sp
ecific ta
rge
ts to a
im fo
r an
d a
clea
r ide
a o
f wh
at it is
the
y a
re try
ing
to a
chie
ve a
nd
ho
w th
ey
will b
e ju
dg
ed
.
It fits ne
atly
into
the
wid
er fra
me
wo
rk o
f inte
gra
ted
asse
ssme
nt, m
ak
ing
a u
sefu
l con
tribu
tion
at p
re-
refe
rral, a
nd
ea
rly he
lp, in
itial a
nd
core
asse
ssme
nt sta
ge
s.
It inv
olv
es g
rad
ing
care
In th
is scale
the
re a
re five
gra
de
s ba
sed
on
leve
ls of co
mm
itme
nt to
care
. Pa
ralle
l with
the
lev
el o
f
com
mitm
en
t is the
de
gre
e to
wh
ich a
child
’s ne
ed
s are
me
t an
d w
hich
also
can
be
ob
serv
ed
. Th
e b
asis o
f
sep
ara
tion
of d
iffere
nt g
rad
es is o
utlin
ed
in ta
ble
1 b
elo
w.
Ta
ble
1.
G
rad
e 1
. G
rad
e 2
. G
rad
e 3
. G
rad
e 4
. G
rad
e 5
.
1
All
child
’s n
ee
ds
me
t
Esse
ntia
l n
ee
ds
fully
me
t
So
me
e
ssen
tial
ne
ed
s un
me
t
Mo
st e
ssen
tial
ne
ed
s un
me
t
Esse
ntia
l n
ee
ds
en
tirely
un
me
t/ho
stile
2
Ch
ild first
Ch
ild p
riority
C
hild
/care
r at p
ar
Ch
ild se
con
d
Ch
ild
no
t
con
side
red
3
Be
st A
de
qu
ate
E
qu
ivoca
l P
oo
r W
orst
1. =
Leve
l of ca
re; 2
= C
om
mitm
en
t to ca
re; 3
= Q
ua
lity o
f care
Th
ese
gra
de
s are
the
n a
pp
lied
to e
ach
of th
e fo
ur a
rea
s of n
ee
d b
ase
d o
n M
aslo
w’s m
od
el o
f hu
ma
n
ne
ed
s – p
hy
sical, sa
fety
, lov
e a
nd
be
lon
gin
gn
ess a
nd
este
em
. Th
is mo
de
l wa
s ad
op
ted
no
t so m
uch
for its
hie
rarch
ical n
atu
re b
ut fo
r its com
pre
he
nsiv
en
ess. E
ach
are
a is b
rok
en
do
wn
into
sub
-are
as, a
nd
som
e
sub
-are
as to
item
s, for e
ase
of o
bse
rva
tion
. A re
cord
she
et sh
ow
s all th
e a
rea
s an
d su
b-a
rea
s with
the
five
gra
de
s alo
ng
side
.
Th
e fo
ur ‘a
rea
s’ – p
hy
sical, sa
fety
, lov
e a
nd
este
em
are
lab
elle
d a
s – A
, B, C
an
d D
resp
ectiv
ely
. Ea
ch a
rea
ha
s its ow
n ‘su
b-a
rea
s’, wh
ich a
re la
be
lled
nu
me
rically
– 1
, 2, 3
, 4 a
nd
5. S
om
e o
f the
‘sub
-are
as’ a
re
ma
de
up
of d
iffere
nt ‘ite
ms’, w
hich
are
lab
elle
d a
s – a
, b, c, a
nd
d. T
hu
s the
un
it for sco
ring
is an
‘item
’ or
a ‘su
b-a
rea
’ wh
ere
the
re a
re n
o ite
ms. T
o h
elp
ob
tain
a sco
re, a
cod
ing
ma
nu
al is p
rep
are
d w
hich
giv
es
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 4
brie
f exa
mp
les (co
nstru
cts) of ca
re in
all su
b-a
rea
s/item
s for a
ll the
five
gra
de
s. From
the
se, sco
re fo
r the
are
as a
re w
orke
d a
s pe
r instru
ction
s.
Ba
sed
on
wh
at w
e k
no
w a
bo
ut a
child
’s ne
ed
Item
s an
d su
b-a
rea
s are
ba
sed
on
facto
rs, wh
ich h
av
e b
ee
n sh
ow
n to
be
ar re
latio
n to
child
de
velo
pm
en
t.
Ca
re co
mp
on
en
t rela
ting
to th
e ite
ms/su
b-a
rea
s are
ba
sed
mo
re o
n in
tuitiv
e th
an
lea
rnt e
lem
en
ts (skills)
ke
ep
ing
th
e
inte
rest o
f ch
ild
up
pe
rmo
st, a
s so
me
skills
the
mse
lve
s co
uld
b
e
con
trov
ersia
l a
nd
e
ver
cha
ng
ing
(e.g
. pla
cing
ba
bie
s to sle
ep
on
the
ir ba
cks). Th
is sho
uld
min
imise
score
s be
ing
affe
cted
by
cultu
re, e
du
catio
n, a
nd
po
verty
, exce
pt in
extre
me
circum
stan
ces.
Wh
en
sho
uld
it be
use
d?
(Un
de
r Re
vie
w a
s of Ju
ne
20
15
)
In p
ractice
it can
be
use
d in
a v
arie
ty o
f situa
tion
s wh
ere
care
for ch
ildre
n is o
f con
cern
. In ch
ild
pro
tectio
n situ
atio
ns, it ca
n b
e u
sed
in co
nju
nctio
n w
ith co
nve
ntio
na
l me
tho
ds in
asse
ssme
nt o
f ne
gle
ct
an
d m
on
itorin
g; in
oth
er fo
rms o
f ab
use
it can
be
use
d a
s an
ad
jun
ct in risk
an
d n
ee
d a
ssessm
en
t. Wh
ere
risk a
pp
ea
rs low
bu
t care
pro
file is p
oo
r it will sa
feg
ua
rd th
e ch
ild b
y fla
gg
ing
up
the
issue
s, if the
care
pro
file is g
oo
d it w
ill relie
ve
an
y a
nxie
ty th
at th
ere
mig
ht b
e. W
he
re risk
is hig
h a
nd
care
pro
file is a
lso
po
or it w
ill stren
gth
en
the
case
an
d ca
re w
ill no
t be
a fo
rgo
tten
issue
, bu
t wh
ere
the
care
pro
file is g
oo
d,
it will th
en
be
mo
re d
ifficult to
do
wn
gra
de
the
risk o
n its o
wn
me
rit. In th
e co
nte
xt of ch
ildre
n in
ne
ed
, it
can
he
lp id
en
tify a
pp
rop
riate
reso
urce
s (de
pe
nd
ing
on
are
a o
f de
ficit) an
d ta
rge
t the
m. In
the
con
text o
f
child
he
alth
it can
be
use
d to
ide
ntify
care
de
ficit wh
ere
the
re is co
nce
rn a
bo
ut g
row
th, d
eve
lop
me
nt a
nd
care
, po
st-na
tal d
ep
ressio
n, re
pe
ate
d a
ccide
nts, o
r simp
ly w
he
re ca
re is th
e so
le co
nce
rn.
A u
nifo
rm ca
re p
rofile
(sam
e g
rad
e o
f care
in a
ll are
as) p
ose
s less o
f a p
rob
lem
in d
ecisio
n m
ak
ing
tha
n
un
ev
en
care
pro
files. F
rom
an
inte
rven
tion
po
int o
f vie
w th
e G
CP
will g
ive
a p
oin
t of fo
cus.
Fin
ally
it sho
uld
be
rem
em
be
red
tha
t the
GC
P p
rov
ide
s a m
ea
sure
of ca
re a
s it is actu
ally
de
livere
d
irresp
ectiv
e o
f oth
er in
tera
cting
facto
rs. In so
me
situa
tion
s wh
ere
con
du
ct an
d p
erso
na
lity o
f on
e o
f the
pa
ren
ts is of g
rav
e co
nce
rn, a
go
od
care
pro
file o
n its o
wn
sho
uld
no
t be
use
d to
dism
iss tha
t fact. A
t
pre
sen
t it brin
gs th
e issu
e o
f care
to th
e fo
re fo
r con
side
ratio
n in
the
con
text o
f ov
era
ll asse
ssme
nt.
Wh
ere
a sin
gle
ag
en
cy h
as co
nce
rns a
bo
ut a
child
an
d n
eg
lect is th
ou
gh
t to b
e a
facto
r, the
GC
P w
ill be
use
d in
pa
rtne
rship
with
the
pa
ren
ts. Wh
ere
the
pa
ren
ts do
no
t ag
ree
with
its use
or re
fuse
to e
ng
ag
e,
the
n
the
to
ol
ma
y
still b
e
use
ful
to
assist
ind
ivid
ua
l p
ractitio
ne
rs d
ecid
e
wh
ere
b
est
to
focu
s th
eir
inte
rve
ntio
n.
Wh
ere
con
cern
s ab
ou
t a ch
ild re
qu
ire m
ulti a
ge
ncy
inte
rven
tion
, a d
ecisio
n m
ay
be
ma
de
to co
mp
lete
a
GC
P. D
ecisio
ns a
bo
ut w
ho
will e
ng
ag
e th
e fa
mily
an
d w
hich
pro
fessio
na
ls will g
ath
er w
hich
info
rma
tion
will h
ave
to b
e m
ad
e.
Fin
ally
, the
GC
P is a
too
l to co
mp
lem
en
t pro
fessio
na
l jud
gm
en
t. Use
d a
s a m
ulti-a
ge
ncy
too
l, it will
con
tribu
te to
we
ll info
rme
d d
ecisio
n-m
ak
ing
ba
sed
on
clea
rly u
nd
ersto
od
an
d w
ell a
rticula
ted
con
cern
s
acro
ss diffe
ren
t discip
line
s.
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 5
Ho
w to
Use
1.
Fill in
the
rele
va
nt d
eta
ils at th
e to
p o
f the
reco
rd sh
ee
t.
2.
Th
e M
ain
Ca
rer: is w
ho
m th
ese
ob
serv
atio
ns m
ain
ly re
late
to –
on
e o
r bo
th p
are
nts a
s the
case
ma
y be
, sub
stitute
care
r or e
ach
pa
ren
t sep
ara
tely if n
ee
d b
e. M
ak
e n
ote
of it in
the
ap
pro
pria
te
pla
ce a
t the
top
righ
t corn
er o
f the
reco
rd sh
ee
t.
3.
Me
tho
ds: F
or p
rescrip
tive sco
ring
it is ne
cessa
ry to
do
a h
om
e v
isit to m
ak
e o
bse
rva
tion
s. In th
at
case
carry
a ch
eck
list of su
b-a
rea
s an
d ite
ms to
en
sure
tha
t the
y a
re co
vere
d d
urin
g th
e v
isit.
Alte
rna
tively
, carry
the
cod
ing
ma
nu
al itse
lf an
d if fe
asib
le, sh
are
it with
the
pa
ren
t/care
r. It can
also
be
use
d re
trosp
ective
ly w
he
re a
lrea
dy th
ere
is en
ou
gh
info
rma
tion
on
item
s or su
b-a
rea
s to
en
ab
le sco
ring
. Ca
rers u
sing
it for th
em
can
simp
ly g
o th
rou
gh
the
ma
nu
al.
4.
Situ
atio
ns:
a)
So
far a
s pra
cticab
le u
se th
e u
sua
l state
of a
n e
nv
iron
me
nt a
nd
disco
un
t an
y te
mp
ora
ry
insig
nifica
nt u
pse
ts e.g
. no
slee
p th
e n
igh
t be
fore
,
b)
Disco
un
t effe
ct of e
xtra
ne
ou
s facto
rs on
the
en
viro
nm
en
t (e.g
. ho
use
refu
rbish
ed
by
we
lfare
ag
en
cy) u
nle
ss care
rs ha
ve
po
sitively
con
tribu
ted
in so
me
wa
y –
kee
pin
g it cle
an
,
ad
din
g th
eir o
wn
bits in
the
inte
rest o
f the
child
like a
safe
ga
rde
n, o
utd
oo
r or in
do
or p
lay
eq
uip
me
nt o
r safe
ty fe
atu
res e
tc.
c) A
llow
an
ces
sho
uld
b
e
ma
de
fo
r b
ack
gro
un
d
facto
rs, w
hich
ca
n
affe
ct in
tera
ction
tem
po
rarily
with
ou
t ne
cessa
rily u
pse
tting
stea
dy
state
e.g
. be
rea
vem
en
t, rece
nt lo
ss of
job
, an
d illn
ess in
pa
ren
ts. It ma
y b
e n
ece
ssary to
rev
isit an
d sco
re a
t an
oth
er tim
e.
d)
If care
r is tryin
g to
misle
ad
(de
libe
rate
ly g
ivin
g w
ron
g im
pre
ssion
or in
form
atio
n in
ord
er
to
ma
ke
o
ne
b
elie
ve
o
the
rwise
) sco
re
as
ind
icate
d
in
the
m
an
ua
l (e
.g.
‘misle
ad
ing
exp
lan
atio
n’- g
rad
e fiv
e fo
r PH
YS
ICA
L He
alth
/follo
w u
p o
r ‘pu
t an
act sh
ow
ing
care
’ –
gra
de
five
for LO
VE
Ca
rer re
cipro
catio
n), o
the
rwise
score
as if it is n
ot tru
e.
5.
Ob
tain
ing
Info
rma
tion
on
diffe
ren
t item
s or su
b-a
rea
s:
A) P
HY
SIC
AL
1. N
utritio
na
l: (a) q
ua
lity (b
) qu
an
tity (c) p
rep
ara
tion
an
d (d
) org
an
isatio
n
Ta
ke
a g
oo
d a
nd
skilfu
l histo
ry a
bo
ut th
e m
ea
ls pro
vid
ed
inclu
din
g n
utritio
na
l con
ten
ts (milk,
fruits e
tc.), pre
pa
ratio
n, se
t me
al tim
es, ro
utin
e a
nd
org
an
isatio
n. A
lso n
ote
care
r’s kn
ow
led
ge
ab
ou
t nu
trition
, no
te ca
rer’s re
actio
n to
sug
ge
stion
s ma
de
reg
ard
ing
nu
trition
(wh
eth
er ke
en
an
d
acce
ptin
g
or
dism
issive
). O
bse
rve
for
ev
ide
nce
o
f p
rov
ision
, k
itche
n
ap
plia
nce
s a
nd
u
ten
sils,
din
ing
furn
iture
an
d its u
se w
itho
ut b
ein
g in
trusive
. It is imp
orta
nt n
ot to
lea
d a
s far a
s po
ssible
bu
t to o
bse
rve
the
resp
on
ses ca
refu
lly fo
r ho
ne
sty. O
bse
rva
tion
at m
ea
ltime
in n
atu
ral se
tting
(with
ou
t spe
cial p
rep
ara
tion
) is pa
rticula
rly u
sefu
l. Sco
re o
n a
mo
un
t offe
red
an
d th
e ca
rer’s
inte
ntio
n to
fee
d yo
un
ge
r child
ren
rath
er th
an
actu
al a
mo
un
t con
sum
ed
as so
me
child
ren
ma
y
ha
ve
ea
ting
/fee
din
g p
rob
lem
s.
2. H
ou
sing
(a) M
ain
ten
an
ce (b
) Dé
cor (c) F
acilitie
s
Ob
serve
. If de
ficien
t ask
to se
e if e
ffort h
as b
ee
n m
ad
e to
rem
ed
y, a
sk yo
urse
lf if care
r is cap
ab
le
of d
oin
g th
em
him
/he
rself. D
iscou
nt if w
elfa
re a
ge
ncie
s or la
nd
lord
do
es re
pa
ir or d
eco
ratio
n.
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 6
3. C
loth
ing
(a) In
sula
tion
(b) F
itting
(c) Loo
k
Ob
serve
. Se
e if e
ffort h
as b
ee
n m
ad
e to
wa
rds re
stora
tion
, clea
nin
g, iro
nin
g. R
efe
r to th
e a
ge
ba
nd
in th
e m
an
ua
l.
4. H
yg
ien
e
Ch
ild’s a
pp
ea
ran
ce (h
air, sk
in, b
eh
ind
ea
rs an
d fa
ce, n
ails, ra
she
s du
e to
lon
g te
rm n
eg
lect o
f
clea
nlin
ess, te
eth
). Ask a
bo
ut p
ractice
. Re
fer to
ag
e b
an
d in
ma
nu
al.
5. H
ea
lth (a
) Op
inio
n so
ug
ht (b
) follo
w-u
p (c) S
urv
eilla
nce
(d) D
isab
ility
Se
e if p
rofe
ssion
als o
r som
e k
no
wle
dg
ea
ble
ad
ults a
re co
nsu
lted
on
ma
tters o
f he
alth
, che
ck
ab
ou
t imm
un
isatio
n a
nd
surv
eilla
nce
up
tak
e, re
aso
ns fo
r no
n-a
tten
da
nce
if an
y, se
e if re
aso
ns
can
be
ap
pre
ciate
d p
articu
larly
if ap
po
intm
en
t do
es n
ot o
ffer a
clea
r be
ne
fit. Co
rrob
ora
te w
ith
rele
va
nt p
rofe
ssion
als. D
isting
uish
ge
nu
ine
diffe
ren
ce o
f op
inio
n b
etw
ee
n ca
rer a
nd
pro
fessio
na
l
from
no
n-g
en
uin
e m
islea
din
g re
aso
ns. B
ew
are
of b
ein
g o
ve
r symp
ath
etic w
ith ca
rer if th
e ch
ild
ha
s a d
isab
ility or ch
ron
ic illne
ss. Re
ma
in o
bje
ctive.
B) S
AF
ET
Y
1. In
Pre
sen
ce (a
) Aw
are
ne
ss (b) P
ractice
(c) Tra
ffic (d) S
afe
ty F
ea
ture
s
Th
is Su
b-A
rea
cov
ers h
ow
safe
ly e
nv
iron
me
nt is o
rga
nise
d. It in
clud
es sa
fety
fea
ture
s an
d ca
ree
r’s
be
ha
vio
ur re
ga
rdin
g sa
fety (e
.g. lit cig
are
ttes le
ft lyin
g in
the
vicin
ity o
f child
) in e
ve
ry d
ay
activ
ity.
Th
e a
wa
ren
ess m
ay
be
infe
rred
from
the
pre
sen
ce a
nd
ap
pro
pria
te u
se o
f safe
ty fixtu
res a
nd
eq
uip
me
nt in
an
d a
rou
nd
the
ho
use
or in
the
car (ch
ild sa
fety
sea
t etc.) b
y o
bse
rvin
g h
an
dlin
g o
f
yo
un
g b
ab
ies a
nd
sup
erv
ision
of to
dd
lers. A
lso o
bse
rve h
ow
care
r instin
ctive
ly re
acts to
the
child
be
ing
exp
ose
d to
da
ng
er. If o
bse
rvatio
n n
ot p
ossib
le, th
en
ask
ab
ou
t the
aw
are
ne
ss. Ob
serve
or
ask
ab
ou
t child
be
ing
allo
we
d to
cross th
e ro
ad
, pla
y o
utd
oo
rs etc. a
lon
g th
e lin
es in
the
ma
nu
al.
If po
ssible
ve
rify fro
m o
the
r sou
rces. R
efe
r to th
e a
ge
ba
nd
wh
ere
ind
icate
d.
2. In
Ab
sen
ce: T
his co
ve
rs child
care
arra
ng
em
en
ts wh
ere
the
care
r is aw
ay
, tak
ing
acco
un
t of
rea
son
s a
nd
p
erio
d
of
ab
sen
ce
an
d
ag
e
of
the
m
ind
er.
Th
is itse
lf co
uld
b
e
a
ma
tter
for
inv
estig
atio
n in
som
e ca
ses. C
he
ck fro
m o
the
r sou
rces.
C) LO
VE
:
1.
Ca
rer (a
) Se
nsitiv
ity (b
) Re
spo
nse
Syn
chro
nisa
tion
(c) Re
cipro
catio
n
Th
is ma
inly
rela
tes to
the
care
r. Se
nsitiv
ity d
en
ote
s wh
ere
care
r sho
ws a
wa
ren
ess o
f an
y sig
na
l
from
the
child
. Ca
rer m
ay
be
com
e a
wa
re ye
t resp
on
d a
little la
ter in
certa
in circu
msta
nce
s.
Re
spo
nse
syn
chro
nisa
tion
de
no
tes th
e tim
ing
of ca
rer’s re
spo
nse
in th
e fo
rm o
f ap
pro
pria
te
actio
n in
rela
tion
to th
e sig
na
l from
the
child
. Re
cipro
catio
n re
pre
sen
ts the
em
otio
na
l qu
ality
of
the
resp
on
se.
2.
Mu
tua
l En
ga
ge
me
nt (a
) Ove
rture
s (b) Q
ua
lity
It is a d
ya
dic tra
it infe
rred
from
ob
serv
ing
mu
tua
l inte
ractio
n d
urin
g fe
ed
ing
, pla
yin
g, a
nd
oth
er
activ
ities. O
bse
rve w
ha
t ha
pp
en
s wh
en
the
care
r an
d th
e ch
ild ta
lk, to
uch
, see
k o
ut fo
r com
fort,
see
k o
ut fo
r pla
y, b
ab
ies re
ach
ing
ou
t to to
uch
wh
ile fe
ed
ing
or sto
p fe
ed
ing
to lo
ok
an
d sm
ile a
t
the
ca
rer.
Sk
ip
this
pa
rt if
child
is
kn
ow
n
to
ha
ve
b
eh
av
iou
ral
pro
ble
ms
as
it m
ay
be
com
e
un
relia
ble
.
Sp
on
tan
eo
us
inte
ractio
n
is th
e
be
st o
pp
ortu
nity
to
o
bse
rve
th
ese
ite
ms.
Se
e
if ca
rer
spo
nta
ne
ou
sly ta
lks an
d v
erb
alise
s with
the
child
or re
spo
nd
s wh
en
the
child
ma
kes o
ve
rture
s.
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 7
No
te if th
e p
lea
sure
is de
rive
d b
y b
oth
the
care
r an
d th
e ch
ild, e
ithe
r or n
eith
er. N
ote
if it is
leisu
re e
ng
ag
em
en
t or fu
nctio
na
l (e.g
. fee
din
g e
tc.)
D) E
ST
EE
M
1. S
timu
latio
n:
Ob
serve
o
r e
nq
uire
h
ow
th
e
child
is
en
cou
rag
ed
to
le
arn
. S
timu
latin
g
ve
rba
l in
tera
ction
,
inte
ractiv
e
pla
y,
nu
rsery
rhy
me
s o
r jo
int
story
rea
din
g,
lea
rnin
g
socia
l ru
les,
pro
vid
ing
de
ve
lop
me
nta
lly stim
ula
ting
eq
uip
me
nt a
re su
ch e
xam
ple
s with
infa
nts (0
– 2
ye
ars). If la
ckin
g,
try to
no
te if it w
as d
ue
to ca
rer b
ein
g o
ccup
ied
by
oth
er e
ssen
tial ch
ore
s. Follo
w th
e co
nstra
ints
in th
e m
an
ua
l for a
pp
rop
riate
ag
e b
an
d. T
he
fou
r ele
me
nts (i, ii, iii a
nd
iv) in
ag
e b
an
d 2
-5 y
ea
rs
an
d 5
- ye
ars a
re co
mp
lem
en
tary
. Sco
re in
on
e o
f the
item
s cou
ld su
ffice. If m
ore
item
s are
score
d,
score
for w
hich
eve
r colu
mn
de
scribe
s the
case
be
st. In th
e e
ven
t of a
tie ch
oo
se th
e h
igh
er sco
re
(also
de
scribe
d in
the
ma
nu
al).
2. A
pp
rov
al:
Fin
d o
ut h
ow
an
d h
ow
mu
ch ch
ild’s a
chie
ve
me
nt is re
wa
rde
d o
r ne
gle
cted
. It can
be
asse
ssed
by
ask
ing
ho
w th
e ch
ild is d
oin
g o
r simp
ly b
y p
raisin
g th
e ch
ild a
nd
no
ting
the
care
r’s resp
on
se
(ag
ree
s with
de
ligh
t or n
eg
lects)
3. D
isap
pro
va
l:
If o
pp
ortu
nity
pre
sen
ts, o
bse
rve
h
ow
th
e
child
is
rep
rima
nd
ed
fo
r u
nd
esira
ble
b
eh
av
iou
r,
oth
erw
ise e
nq
uire
tactfu
lly (do
es th
e sh
e th
row
tan
trum
s? H
ow
do
you
de
al if it h
ap
pe
ns w
he
n
yo
u a
re tire
d y
ou
rself?
) Be
wa
re o
f discre
pa
ncy
be
twe
en
wh
at is sa
id a
nd
wh
at is d
on
e. A
ny
ob
serv
atio
n is b
ette
r in su
ch situ
atio
ns e
.g. ch
ild b
ein
g rid
icule
d o
r sho
ute
d a
t. Try
an
d p
rob
e if
care
r is con
sisten
t.
4. A
ccep
tan
ce:
Ob
serve
or p
rob
e h
ow
care
r ge
ne
rally
fee
ls afte
r she
ha
s rep
rima
nd
ed
the
child
or w
he
n th
e ch
ild
ha
s be
en
rep
rima
nd
ed
by
oth
ers (e
.g. te
ach
er), w
he
n ch
ild is u
nd
era
chie
vin
g o
r fee
ling
sad
for
va
riou
s rea
son
s. Se
e if th
e ch
ild is re
jecte
d (d
en
igra
ted
) or a
ccep
ted
in su
ch circu
msta
nce
s as
sho
wn
by
wa
rm a
nd
sup
po
rtive
be
ha
vio
ur.
6.
Sco
ring o
n th
e m
an
ua
l: Ma
ke
sure
you
r info
rma
tion
is factu
al a
s far a
s po
ssible
. Go
thro
ug
h th
e
con
structs in
the
ord
er –
(Su
b-A
rea
s an
d Ite
ms) a
s in th
e m
an
ua
l. Fin
d th
e co
nstru
ct wh
ich
ma
tche
s be
st, rea
d o
ne
gra
de
on
eith
er sid
e to
ma
ke
sure
, the
n p
lace
a tick o
n th
at co
nstru
ct (use
pe
ncil w
hich
can
be
era
sed
an
d m
an
ua
l reu
sed
). Th
e n
um
be
r at th
e to
p o
f the
colu
mn
will b
e th
e
score
for th
at ite
m o
r sub
-are
a. W
he
re m
ore
tha
n o
ne
item
rep
rese
nts a
sub
-are
a, u
se th
e
me
tho
d d
escrib
ed
be
low
to o
bta
in th
e sco
re fo
r the
sub
-are
a.
7.
No
tes: U
se th
e co
lum
n se
ction
an
d th
e n
ote
s sectio
n in
ea
ch o
f the
are
as to
ad
d a
ny
com
me
nts
in re
latio
n to
the
scorin
g. T
he
se ‘sp
ace
s’ can
be
use
d fo
r flag
gin
g u
p issu
es, w
hich
are
no
t
de
tecte
d b
y the
scale
bu
t ma
y b
e re
lev
an
t in a
pa
rticula
r case
. Fo
r exa
mp
le, a
child
wh
o is
tem
pe
ram
en
tally
difficu
lt to e
ng
ag
e w
ith (in
the
‘ma
nu
al e
ng
ag
em
en
t’ a su
b-a
rea
of ‘lo
ve’) o
r a
pa
ren
t(s) wh
ose
ov
er p
rote
ctiven
ess g
ave
rise to
con
cern
(ma
y score
be
tter in
the
sub
-are
a o
f
‘disa
pp
rov
al’ in
‘are
a’ o
f este
em
). Th
ese
ma
y n
ee
d se
pa
rate
exp
ert e
valu
atio
n.
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 8
8.
Ob
tain
ing
a sco
re fo
r a su
b-a
rea
from
score
in its ite
ms:
a) R
ea
d th
e sco
re fo
r all tick
s for d
iffere
nt ite
ms o
f a p
articu
lar su
b-a
rea
: if the
re is a
clea
r mo
de
bu
t no
ne
of th
e tick
s are
be
yon
d th
ree
(3) sco
re th
e m
od
e fo
r tha
t pa
rticula
r sub
-are
a.
Exa
mp
le: N
utritio
n
Qu
ality
�
Qu
an
tity
�
Pre
pa
ratio
n
�
Org
an
isatio
n
�
Sco
re fo
r Su
b-A
rea
Nu
trition
he
re w
ou
ld b
e 2
b) If th
ere
is no
clea
r mo
de
(score
s ev
en
ly o
r un
eve
nly sp
ilt) bu
t no
tick is a
bo
ve
po
int th
ree
, use
the
hig
he
r score
.
Qu
ality
�
Qu
an
tity
�
Pre
pa
ratio
n
�
Org
an
isatio
n
�
Sco
re fo
r Su
b A
rea
Nu
trition
he
re w
ou
ld b
e 3
c) If the
re is a
sing
le sco
re a
bo
ve
po
int 3
, score
tha
t po
int re
ga
rdle
ss of m
od
e.
Qu
ality
�
Qu
an
tity
�
Pre
pa
ratio
n
�
Org
an
isatio
n
�
Sco
re fo
r Su
b A
rea
Nu
trition
he
re w
ou
ld b
e 4
9.
Ob
tain
ing
a sco
re fo
r an
‘are
a’ fro
m sco
re in
its con
stitue
nt su
b-a
rea
s: - Sa
me
as a
bo
ve
(6)
No
rfolk
LSC
B G
rad
ed
Ca
re P
rofile
Ve
rsion
3 Ju
ne
20
15
Pag
e 9
10
. Th
is me
tho
d h
elp
s ide
ntify th
e p
rob
lem
ev
en
if it is on
e su
b-a
rea
or ite
m. Its p
rima
ry a
im is to
safe
gu
ard
ch
ild’s
we
lfare
w
hile
b
ein
g
ob
jectiv
e.
Be
side
s, if
ma
the
ma
tical
com
pu
tatio
n
like
calcu
latin
g th
e m
ea
n a
re d
on
e to
ob
tain
a co
mm
on
score
it will n
ot b
e p
ossib
le to
refe
r to a
n ite
m
or su
b-a
rea
s wh
ich g
ave
a p
oo
r score
in o
rde
r to ta
rge
t it wh
ich is a
n a
dv
an
tag
e w
ith th
is scale
.
Th
is is wh
y it h
as b
ee
n le
ft as a
cate
go
rical sca
le.
11
. Tra
nsfe
rring
the
score
from
the
Re
cord
she
et to
the
‘Su
mm
ary sh
ee
t’. Tra
nsfe
r all sco
res to
the
sum
ma
ry sh
ee
t an
d th
en
ide
ntify
the
are
as fla
gg
ed
for a
tten
tion
tog
eth
er w
ith th
e a
ction
req
uire
d w
ithin
a g
ive
n tim
esca
le.
12
. Use
‘Asse
ssing
Pro
gre
ss’ she
et to
reco
rd th
e in
itial a
ssessm
en
t follo
we
d b
y a
diffe
rtnly co
lou
red
line
with
ide
ntifie
s targ
et sco
res a
nd
/or w
hich
ma
ps p
rog
ress. A
be
tter sco
re ca
n b
e a
ime
d a
t
afte
r a p
erio
d o
f inte
rve
ntio
n. B
y a
imin
g fo
r on
e g
rad
e b
ette
r will p
lace
less d
em
an
d o
n th
e ca
rer
tha
n b
y a
imin
g fo
r ide
al in
on
e le
ap
.
13
. Use
th
e
Su
mm
ary
sh
ee
t a
nd
A
ssessin
g
pro
gre
ss sh
ee
t to
d
iscuss
con
cern
s w
ith
pa
ren
ts, in
sup
erv
ision
an
d in
mu
lti ag
en
cy m
ee
ting
s.
Jun
e 2
01
5
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 10
GRADED CARE PROFILE
Child’s Name Date of Birth Age
Agency Date completed Client Number
Using the Graded Care Profile
The Graded Care Profile is an assessment tool, which can be used to assist in the assessment of neglect. The tools will identify strengths
and difficulties across a number of child development areas. It is likely to be triggered by concerns about the care the child is receiving.
Whilst it may be focussed on assessing difficulties, the Graded Care Profile also identifies strengths. Focussing on strengths assists the
assessor to appreciate the potential that exists within the family for change and improvement. This potential will inform decisions about
possible support or interventions to meet areas of need.
The Graded Care Profile has been adopted by the LSCB in Norfolk where neglect is an area of concern for a child's welfare. The 'tools' can
be used across the Children's Continuum of Need and Response model and by practitioners from various agencies.
How to use the Graded Care Profile:
• Work through the four areas, ticking the description that best describes the care that the child receives
• Use the Scoring Grid at the end of each area section to record a baseline score for each item
• Use the Scoring Grid to record an ‘overall score’ for each sub-area (see Summary Guidance)
• Use the Scoring Grid to record any areas that you consider should be flagged for attention/intervention.
• Use the Scoring Grid to record relevant comments/ evidence in relation to strengths and difficulties.
• Transfer the sub-area scores to the Summary Score sheets
• Use the ‘Areas flagged for intervention’ sheet to identify the needs assessed and action/ interventions indicated.
• Record your decisions and further actions on the final sheet.
• Needs and interventions can then be incorporated into the care planning processes of the relevant agency or inserted into the
Early Help form Form.
• Guidance notes are available to support the use of this tool.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 11
A Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) Nutrition
A. Quality Provides good
quality and healthy
food and drink
Provides reasonable
quality and healthy
food and drink.
Provides reasonable
quality healthy food
but inconsistently.
Provides poor quality
food or an unhealthy
diet through lack of
awareness or effort.
Improves when
prompted.
Does not consider
the health or quality
of diet. When
prompted, very little
improvement.
B. Quantity Enough food all of
the time.
Enough food nearly
all the time.
Enough food most of
the time.
Sometimes not enough
food or inappropriate
feeding
Not enough/too
much food most of
the time.
D. Organisation Meals organised and
well timed. Family
sitting together to
eat food.
Well organised, often
seating together and
regular timing of
meals.
.
Organised sometimes ,
irregular timing
Not well organised,
no clear meal times.
Chaotic, eat when
and whatever food is
there.
C. Preparation Always carefully
prepared or cooked
for the child.
Well prepared and
usually taking
account of the
child’s needs.
Prepared mainly to
meet the parent’s
needs. The child’s
needs sometimes
accommodated.
Often little
preparation. The
child’s needs and
tastes are not
accommodated or the
child inappropriately
prepares their own
meal.
Hardly ever any
preparation. Child
lives on
snacks/cereals/junk
food and is expected
to prepare their own
food.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 12
A. Maintenance Well maintained
Additional features
that benefit the
child. e.g. insulation,
double glazing,
draught proofing and
house safe for
children.
Reasonably well
maintained and some
additional features.
Efforts made to
benefit the child
only lacking if
issues such as
money interfere
No additional
features but well
maintained.
In disrepair. Some
repairs could be
carried out by the
parents
Dangerous disrepair
(exposed nails, live
wires) and some
repairs could be
carried out by the
parent/carer
A Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
2) Housing
B. Décor
(relates to house
generally and child’s
bedroom)
Good, clean showing
evidence of care.
Child’s bedroom has
age appropriate
decor
Showing evidence of
being kept clean and
with some evidence
of child’s
development age and
choice.
In need of some
decoration and kept
reasonably clean.
In urgent need of
decoration. Grubby
very untidy and
cluttered.
In very urgent need
of decoration. Very
chaotic and dirty
and/or an unpleasant
smell.
NOTE: Discount any direct external influences like repair done by other agency but count if the carer has spent a loan or a grant on the house or had
made any other personal effort towards house improvement.
C. Facilities All essential
facilities in good
working order and
there is play and
learning space.
Essential facilities.
Effort to maximise
benefit for the
child. Lacking only
due to practical
constraints e.g.
finance.
Essential to bare
Little effort to
maximise benefit to
the child.
Very bare. Adult
needs are met first
and child needs met
if anything is left.
Bathing facilities
very poor
Child dangerously
exposed or not
provided for e.g.
lack of heating,
electricity. Lack of
working facilities
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 13
A Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
3) Clothing
B. Fitting Clothing fits very
well and bought
especially for child
Fits well, may not
necessarily be new.
Sometimes
inadequate fit.
Often inadequate
fit.
Completely
inadequate fit.
A. Insulation e.g.
harm, warm
clothing
Well protected with
appropriate
garments.
Mostly well
protected
Adequate to variable
weather protection. Inadequate weather
protection.
Dangerously
inadequate. Child is
exposed to bad
weather.
C. Appearance Clothes always very
clean and well cared
for.
Clean and cared for. Not always clean or
cared for.
Appears worn,
sometimes dirty and
crumpled.
Appears to be dirty,
badly worn and
crumpled/and or
unpleasant odour.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 14
A Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
4) Hygiene
Child Aged 5 - 7
Some independence
with keeping clean and
bathing but always
helped and
supervised.
Usually reminded to
keep clean and
bathe. Supervised
and helped if needed.
Sometimes but not
always reminded to
keep clean and bathe
Not always routinely
monitored.
Reminded only now
and then with
minimum supervision.
No concerns or
interest shown about
keeping personal
hygiene.
Child aged 0 - 4 Always appears clean
and bathed and hair
is clean and clearly
cared for daily.
Usually appears
clean, bathed and
hair usually clean and
brushed .
Presentation is varied.
and/or babies are
usually clean. Older
toddlers less so.
Often but not
always appears dirty
and hair and nails
seem uncared for.
Always appears with
dirty skin, hair and
nails seen Rarely
bathed, clean or hair
cared for.
Child Aged 7 + Reminded, helped and
monitored. Reminded regularly
and followed up if
not done.
Sometimes reminded. Usually left to their
own initiative.
No concerns shown
about personal
hygiene.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 15
Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
5) Health
A. Opinion sought
and professional
advice given
Appropriate opinion
sought not only on
illnesses but also
other genuine health
matters. All advice
followed.
Opinion sought on
issues of genuine
and immediate
concern about child
health. Advice
followed.
Opinion sought on
illness of any
severity. Advice
followed.
Help initially sought
but delayed even
when illness
becomes quite
serious.
Help sought but
delayed or ignored
even when illness
becomes critical or an
emergency. Advice
may be not followed.
B. Follow Up
All appointments
kept. Re-arranged
if there is a
problem.
Fails one in two
appointments
because they doubt
their importance or
have other pressing
practical priorities.
Fails one in two
appointments even if
they are important
because it’s
inconvenient for the
parent.
Attends third time
after reminder.
Contests the
importance even if
it’ is of benefit to the
child.
Fails a needed follow
up a third time
despite reminders.
Misleading or
doubtful
explanations.
C. Surveillance
and oversight of
health matters
Visits in addition to
the standard
checks. Up
to date with
immunisations unless
valid
reservations.
Up to date with
standard checks and
immunisation unless
parent refuses for
no obvious reason.
Omissions for
reasons of adult’s
personal
convenience but
takes up if
persuaded.
Omissions because
of carelessness,
accepts service if it
is provided at home.
Clear disregard of
child’s welfare.
Frustrates home
visits.
A
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 16
Area of Physical Care
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
5) Health
D. Disability /
chronic illness (3
months after
diagnosis)
Compliance with
treatment and
advice is excellent.
Any issues due to
differences of
opinion. Very good
affection shown.
Compliance is good.
Any issues relate to
practicality or
finance. Good
affection shown.
Compliance is
sometimes lacking
for no apparent
reasons.
Inconsistent
affection shown.
Compliance is
frequently lacking
and trivial reasons
offered as excuses.
Little affection
shown.
Serious compliance
failure. Medication
not given.
Inexplicable
deterioration. Any
affection appears
contrived.
A
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 17
A4 Hygiene
1 2 3 4
5 Flagged for Attention Overall Score Record Sheet
D Nutrition Organisation
C Nutrition Preparation
A Nutrition Quality
B Nutrition Quantity
A1 Nutrition
C Housing Facilities
A Housing Maintenance
B Housing Décor
A2 Housing
C Clothing Appearance
A Clothing Insulation
B Clothing Fitting
A3 Clothing
A Child Hygiene
A Health opinion sought A5 Health
B Health Follow Up
C Health Surveillance and oversight of health
matters
D Disability / chronic illness (3 months after
diagnosis)
A4 Hygiene
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 18
Comments / Evidence (e.g. what you have observed). Recording strengths as well as the difficulties ensure that the
potential of the family to change is recognised and their achievements built upon.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 19
B Area of Safety
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) In Presence of Parent
B. Practice at
Pre-mobility age
Always cautious with
handling and laying
down child. Baby
seldom left
unattended.
Cautious whilst
handling and laying
down child. Frequent
checks if
unattended.
Handling of child is
uncertain.
Frequently
unattended when in
the house.
Handling of child is
uncertain.
Unattended during
care chores e.g.
feeding bottle
left in mouth.
Dangerous handling.
e.g. left dangerously
unattended whilst
feeding or bathing.
B. Practice at
Infant School
Close supervision
indoors and
outdoors.
Supervision indoors.
No direct
supervision outdoors
if known to be at a
safe place.
Little supervision in
or out of doors.
Intervenes only if in
considerable danger.
No supervision.
Intervenes after
mishaps which soon
lapses.
Minor mishaps ignored
or the child is blamed.
Intervenes casually
even after major
mishaps and lapses.
A. Awareness of
Safety
Very aware of
appropriate safety
and risk issues.
Aware of important
safety and risk
issues.
Poor awareness of
safety and risk
except for immediate
danger.
Rarely notices
safety or risk issues
Unconcerned about
safety or risks.
B. Practice at
Acquisition of
mobility
Constant alertness
and effective
measures against any
dangers.
Alert and effective
measures against any
danger.
Action taken to
prevent danger are
of limited use.
If action is taken it
is ineffective. Short
term improvement
after mishaps soon
lapses.
Inadvertently
exposes to serious
dangers. E.g. hot
iron/drinks left
nearby.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 20
5 to 10 year old
escorted by adult
when crossing a
busy road. Walk
closely together.
Well secured in the
pushchair or pram
or walks at child’s
pace with hand
firmly held.
Infants not secured
in pram. 3 to
4 year old expected
to keep up with
adult when walking.
Occasional glance
back if left behind.
Not always aware of
whereabouts
outdoors. Believing
it is safe as long as
the child returns on
time.
B Area of Safety
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) In Presence of Parent
C. Traffic
Age 5 and above
5-8 year old allowed
to cross road with a
13+ child. 8-9 year
old allowed to cross
alone if they are
safe to do so.
5-7 year old allowed
to cross with a child
who is under 13. 8-9
year old allowed to
cross alone.
5-7 year old
allowed to cross a
busy road alone
because they are
believed to be safe.
At age 7 child
crosses a busy road
alone without any
concerns regarding
safety.
B. Practice
Junior and Senior
School
Allows out in known
safe surroundings
with agreed time
limits and checks.
Allows out in
unfamiliar
surroundings if felt
to be safe. Sets
reasonable time
limits and checks.
Unconcerned about
daytime outings but
concerned about
late nights in case
of child younger
than 13.
Unconcerned
despite knowledge
of dangers
outdoors. E.g.
railways,ponds,
unsafe building, or
staying away until
late evening.
C. Traffic
Age 0-4
3 to 4 year old
allowed to walk, but
close by parent.
Always in sight,
hand held firmly if
necessary e.g.
crowds or by roads.
Babies not secured
in pushchair. 3 to 4
year old child left
far behind when
walking.
Babies, toddlers
unsecured, careless
with pram or
pushchair. 3 to 4
year old child left
to wander
unsupervised.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 21
B Area of Safety
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) In Presence of Parent
D. Safety
Features This item along with
other safety
provisions which are
not fixtures, such as
bike helmets or
safety car seats can
be used to help to
score Item 1
(Awareness of safety)
All relevant safety
features. Gates,
guards, secure
windows, locked
medicine cabinets,
smoke alarms,
household chemicals
secured, electrical
and gas safety
devices, intercom,
safety within
garden e.g. pond.
Most essential
features.
Improvisation and
DIY safety features
when they cannot be
afforded.
No safety features
and some hazards
through lack of
repair or concerns.
No safety features
and dangerous
hazards or
disrepair. E.g.
exposed electric
wires and sockets,
unsafe or broken
windows, dangerous
household chemicals
or no smoke alarms.
Lacking in essential
features, very little
improvisation or
DIY is ineffective.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 22
2) Safety in Absence of Parent
B Area of Safety
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
Child is left in care
of a competent and
safe adult. Never in
the sole care of a
young person under
16.
Child aged is left
for a short time
with a young person
over 13 who is
familiar, competent
with no significant
problems. The
above applies to
babies only in
urgent situations.
When out playing a
0-7 year old is left
with an 8-10 year
old or person not
known to be
competent.
When out playing a
0-7 year old is left
alone or with a
slightly older child
i.e. 8 or less, or with
an unsuitable young
person or adult.
When out playing
leaves a young
child/baby with
child aged 10-13 or
a person not known
to be competent.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 23
1 2 3 4
5 Flagged for Attention Overall Score Scoring Grid
D Safety Features
C Traffic
A Awareness
B Practice
B1 In
Presence of
Parents
B2 Safety in
Absence of
Parents
Comments / Evidence (e.g. what you have observed). Recording strengths as well as the difficulties ensure that the
potential of the family to change is recognised and their achievements built upon.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 24
Not sensitive
enough. Signals have
to be intense to be
noticed e.g. child
crying.
C Area of Responsiveness
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) Carer
C. Appropriate
responsiveness to
the child
Warm emotional and
practical responses
appropriate to the
signal.
Practical responses
e.g. treats are
lacking but
emotional responses
are warm and
reassuring.
Emotional and
practical responses
warm if in good
mood. Otherwise
flat.
Emotional response
is brisk, flat and
functional.
Annoyance if child
in moderate
distress but
attentive if in
severe distress.
Unpleasant/punitive
even if child in
distress. Acts
after a serious
mishap mainly to
avoid criticism.
Any warmth or
remorse is
deceptive.
A. Sensitivity
Anticipates or picks
up very subtle signals
both verbal or
nonverbal expressions
including emotions or
mood.
Understands distinct
verbal or clear
nonverbal expressions
including emotions or
mood.
Insensitive. Needs
repeated or
prolonged and
intense signals to be
noticed e.g.
screaming.
Insensitive to even
repeated and
prolonged intense
signals or is even
averse to signals.
B. Timing of
response
Responses well timed
with signals or even
anticipates those
signals.
Responses mostly
timely except when
occupied by
essential chores.
Not timely if
distracted. Timely if
they are not
otherwise occupied or
if the child is
distressed.
Responses delayed
even when child is in
distress.
No responses unless
there is a clear
mishap.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 25
Approaches mainly
by child and,
sometimes by the
carer. Negative
response if the
child’s behaviour is
defiant.
C Area of Responsiveness
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
2) Mutual Engagement
A. Overtures –
two way
communication
Two way with parent
usually going first
and engaging child.
Equally positive by
both. Parent
responds even if
the child is defiant.
Mainly by the child.
Seldom by the
carer.
Child appears
resigned or
apprehensive and
does not make
approaches.
B. Quality Both engage and
enjoy it.
Frequent pleasure
shown.
Both engage and
enjoy it.
Pleasure is usually
shown.
Sometimes engaged
and pleasure shown.
The child gets most
enjoyment and the
carer passively joins
in and occasionally
gets enjoyment.
Engagement mainly
practical.
Indifferent when
child attempts to
engage. Child can
derive some
pleasure e.g.
attempts to sits on
knees, tries to show
toys.
Dislikes approaches
by the child. Child
is resigned or plays
on its own. Carer
engages only if told
to do so.
CAUTION: If child has temperamental/behavioural problems, scoring in this sub-area (mainly quality item) can be affected unjustifiably. Scoring should
be done on the basis of score in area C/1 (Carer) and problem noted as comments.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 26
1 2 3 4
5 Flagged for Attention Overall Score Scoring Grid
C2 Mutual
Engagement
Comments / Evidence (e.g. what you have observed). Recording strengths as well as the difficulties ensure that the
potential of the family to change is recognised and their achievements built upon.
C Appropriate responsiveness to the child
A Sensitivity
Awareness B Timing of response
C1 Carer
A Overtures two way communication
Awareness B Quality
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 27
Inadequate and/or
inappropriate. Baby
left alone while
carer does what
they want.
Occasional
interactions with
the baby.
D Area of Esteem
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) Stimulation
Excellent provision.
Provides all that is
necessary and tries
for more. Adapts if
carer can’t afford.
Essentials only. No
effort to improvise
if unaffordable.
Lack of even
essential toys.
None unless
provided by others
e.g. gifts or grants.
Age 0 – 2 years
A great deal of
appropriate
stimulation. E.g.
talking, touching,
reading &looking.
Many positive
educational toys.
Adequate and
appropriate
stimulation.
Some positive
educational toys.
Baby left alone
while carer pursues
own interests
unless the baby
demands attention.
None. Even mobility
restricted e.g.
confined in
chair/pram for the
carer’s convenience.
Irritated if the
baby demands
attention.
Age 2 – 5 years
i Interactive
stimulation
talking to and playing
with the child. Reading
stories and discussion.
Plenty and good
quality.
Sufficient and of
satisfactory quality.
Variable.
Deficient even if
the carer is totally
unoccupied
No stimulation.
Age 2 – 5 years
ii Toys and gadgets
items of uniform,
sports equipment
books etc.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 28
Very good but may be
limited e.g. by
finances.
Child accompanies
carer going where
carer decides but
usually in child
friendly places.
D Area of Esteem
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) Stimulation
Active interest in
school which is
supported at home.
Active interest in
school. Support at
home when carer is
free of essential
tasks.
Some interest in
school. but little
support at home,
even if carer has
spare time.
Little interest and
poor support in
school. Interest for
other reasons e.g.
free meals.
Disinterested or
even discouraging.
Age 2 – 5 years
iii Outings
taking the child out
for recreational
purposes
Frequent visits to
child centred places
both locally and
further away.
Enough visits to
child centred places
locally (e.g. parks)
and occasionally
further away.
Child accompanies
carer e.g. local
shopping. Plays
outside and outings
to keep up with
others.
No outings for the
child. May play in the
street if carer goes
out locally
Age 2 – 5 years
iv Celebrations
seasonal and personal.
Notable, happy, fun
and appropriate.
Mainly seasonal and
low key personal e.g.
birthdays.
Only seasonal. Low
key to keep up with
other people.
Even seasonal
festivities absent or
dampened.
Age 5+ years
Education
Age 5+ years
ii Sports and leisure
Well organised
outside school hours
e.g. clubs and
swimming.
All support that is
affordable.
Not active in finding
activities, but will
use local facilities.
Child finds activities
for themselves
Parent/carer is
indifferent.
Disinterested even if
the child is involved
in other unsafe or
unhealthy activities.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 29
Poor provision.
Supports if a child is
from a family who
are friendly with
carer.
D Area of Esteem
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
1) Stimulation
Age 5+ years
iii Peer/friend
interaction
Assisted and new
friends checked.
Some assistance and
new friends checked.
Child finds own
friends. No help from
carer unless serious
problems e.g.
bullying.
Disinterested,
indifferent or even
discouraged.
Well provided and
tries to provide
more.
Age 5+ years
iv Provision equipment
Fully provided e.g.
sports gear or
computer.
Some limited
provision.
No provision made
and even
discouraged.
2) Approval
Talks fondly about
the child when
asked. Generous
praise and emotional
reward, less
practical reward e.g.
financial
constraints.
Talks about the
child with pleasure
and praises without
prompting.
Appropriate
emotional and
practical rewards
for achievement.
Agrees with other
people’s praise of
the child. Gives low
key praise and some
emotional rewards.
Uninterested if
the child is praised
by others.
Indifferent to the
child’s achievement
which is only briefly
acknowledged.
Undermines if the
child is praised.
Achievements are
not acknowledged.
Reprimanded or
mocking is the only
response.
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 30
Inconsistent
boundaries or
methods. Shouts or
ignores child. Low
level physical and
moderate other
sanctions.
D Area of Esteem
Sub-areas 1 All Needs Met
2 Essential Needs
Met
3 Some Essential
Needs Unmet
4 Many Essential
Needs Unmet
5 Most/ all Essential
Needs Unmet
3) Disapproval
Unconditional
acceptance, even if
temporarily upset
by child’s behaviour.
However, always
warm and
supportive.
Mild and consistent
verbal disapproval if
a set limit is
crossed.
Consistent verbal
and low level
physical and other
sanctions if any set
limits are crossed.
Inconsistent.
Shouts/harsh
verbal or moderate
physical, or severe
other sanctions.
Terrorised.
Ridiculed, severe
physical or cruel and
spiteful other
sanctions.
Unconditional
acceptance. Always
warm and supportive
even if child is
failing.
Annoyance at child’s
failure.
Unsupportive or
rejecting if the
child is failing.
Indifferent if child
is achieving and
rejects or belittles
if the child makes
mistakes or fails.
4) Acceptance
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 31
1 2 3 4
5 Flagged for Attention Overall Score Scoring Grid
D2 Approval
Comments / Evidence (e.g. what you have observed). Recording strengths as well as the difficulties ensure that the
potential of the family to change is recognised and their achievements built upon.
A Age 0 – 2 years
B Age 5 + years
D1 Stimulation
D2
D3 Disapproval D3
D4 Acceptance D4
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 32
Graded Care Profile (GCP) – Summary Sheet
Area Sub-Area Sub-Area Score
A Physical
1. Nutrition
2. Housing
3. Clothing
4. Hygiene
5. Health
1. In Carer’s Presence
2. In Carer’s Absence
1. Carer
2. Mutual Engagement
1. Stimulation
2. Approval
3. Disapproval
4. Acceptance
B Safety
C Responsivenes
s
D Esteem
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 33
Areas flagged for attention – Physical, Safety, Responsiveness, Esteem
Area, sub area
and score E.g. Physical: Housing: Maintenance:
Score
Description and child’s need E.g. Description: Dangerous disrepair (exposed live
wires).
Child’s Need: Child needs to be kept safe from electric
shocks
Action required E.g. 1. Parent to buy some electric masking tape and
wrap around exposed wire/broken socket until the
landlord repairs. 2. Parent and worker to notify the
landlord of the danger and request immediate repair
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 34
Decisions
Please record your decisions after completing the Graded Care Profile. Areas identified at level 4 and 5 may be indicative of neglect
Where this harm is considered ‘significant’, Child Protection Procedures must be followed.
This should be discussed with your manager.
Concerns about neglect in this case have not been substantiated. �
Some concerns about neglect in this case have been substantiated, but I do not consider that this child is suffering significant harm. �
Concerns about neglect in this case have been substantiated and I am concerned that this child is suffering significant harm. �
Further Action arising from this assessment
In the Graded Care Profile you may have recorded items ‘flagged for attention’. These flagged items may indicate the need for discussions with your
manager and/or further discussions within a multi-agency setting to confirm actions, decisions and interventions. Many agencies will have systems to
record plans and interventions to meet the needs of children.
⇒ This agency [or named agency] will undertake on-going work with this family. �
⇒ Agency to undertake on-going work with this family with the support, advice and guidance of other agencies.
� ⇒ This is not appropriate for this agency and a referral will be made to a more appropriate agency.
�
⇒ Referral to Children’s Social Care due to Child Protection concerns �
On-going work. Choose one or more of the following options:
⇒ No further action �
Consent
For sharing information or referral to another agency the consent of the child/parent is usually required. Please confirm whether the consent of the
child/parent has been obtained.
⇒ I have obtained consent to share information/refer to another agency. �
⇒ I do not have consent to share information/refer with another agency but have Child Protection concerns and obtaining consent
may harm the child.
�
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 35
Comments / Evidence
Name of Professional Date Completed
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 36
Child: Date
Physical Safety Love Esteem
Nutritio
n
Housing Clothing Hygiene Health Carer
Present
Carer
Absent
Carer Mutual Stimulatio
n
Approva
l
Disapprov
al
Acceptan
ce
1
2
3
4
5
Black Line = Assessment Red Line: Progress after weeks
Assessing Progress
Norfolk LSCB Graded Care Profile Version 3 June 2015
Page 37
EXAMPLE : Date
Physical Safety Love Esteem
Nutrition Housing Clothing Hygiene Health Carer
Present
Carer
Absent
Carer Mutual Stimulatio
n
Approva
l
Disapprov
al
Acceptan
ce
1
2
3
4
5
Black Line = Assessment Red Line: Progress after weeks
top related