Caption: Level Four - Children at Risk of Significant Harm or Being Removed from Home
1. Development Needs of Baby (including unborn Child), Child or Young Person

Health, e.g.

  • Has severe/chronic health problems;
  • Persistent substance misuse;
  • Developmental milestones unlikely to be met;
  • Teenage pregnancy (acute level of need);
  • Serious mental health issues.

Education and Learning, e.g.

  • Is out of school;
  • Permanently excluded from school or at risk of permanent exclusion;
  • Has no access to leisure activities.

Emotional and Behavioural Development, e.g.

  • Regularly involved in anti-social/criminal activities;
  • Puts self or others in danger, e.g. missing from home or care;
  • Suffers from periods of depression;
  • Suicide attempts;
  • Children at risk of sexual exploitation.

Identity, e.g.

  • Experiences persistent discrimination, e.g. on the basis of ethnicity, sexual orientation or disability;
  • Is socially isolated and lacks appropriate role models.

Family and Social Relationships, e.g.

  • Periods of being accommodated by the Local Authority;
  • Family breakdown related in some way to child's behavioural difficulties;
  • Subject to physical, emotional or sexual abuse or Neglect, incl children subject to Child Protection Plans;
  • Is main carer for family member;
  • Unaccompanied asylum seekers;
  • Where parents have made Private Fostering Arrangements.

Social Presentation, e.g.

  • Poor and inappropriate self-presentation.

Self-care Skills, e.g.

  • Neglects to use self-care skills due to alternative priorities, e.g. substance misuse.
2. Parents and Carers 3. Family and Environmental Factors

Basic Care

  • Parents unable to provide "good enough" parenting that is adequate and safe, including unborn children;
  • Parents' mental health problems or substance misuse significantly affect care of child;
  • Parents unable to care for previous children.

Ensuring Safety

  • There is instability and violence in the home continually;
  • Parents involved in crime;
  • Parents unable to keep child safe;
  • Victim of crime.

Emotional Warmth

  • Parents inconsistent, highly critical or apathetic towards child.


  • No constructive leisure time or guided play.

Guidance and Boundaries

  • No effective boundaries set by parents;
  • Regularly behaves in an anti-social way in the neighbourhood.


  • Beyond parental control;
  • Has no-one to care for him/her.

Family History and Functioning

  • Significant parental discord and persistent domestic violence;
  • Poor relationships between siblings.

Wider Family

  • No effective support from extended family;
  • Destructive/unhelpful involvement from extended family.


  • Physical accommodation places child in danger.


  • Chronic unemployment that has severely affected parents' own identities;
  • Family unable to gain employment due to significant lack of basic skills or long-term difficulties, e.g. substance misuse.


  • Extreme poverty/debt impacting on ability to care for child.

Family's Social Integration

  • Family chronically socially excluded;
  • No supportive network.

Community Resources

  • Poor quality services with long-term difficulties with accessing target populations.