The number of children referred to the English child protection system and the numbers receiving home-based intervention or placed in out of home care have been rising in recent years. It is difficult to judge whether these changes indicate that thresholds for intervention are low or high, as we know little about the severity of the maltreatment that draws children into the child protection system in England. This study compared the histories, circumstances and pathways of children receiving quasi-compulsory home-based support (under a child protection plan) to those for children ever placed in out of home care. It collected detailed data from the social workers of 390 children and is the first UK study to include a standardised measure of the severity of maltreatment, the Modified Maltreatment Classification System (MMCS). It found that the vast majority of children had experienced multiple types of maltreatment, including at least one type of high severity, suggesting that thresholds for the use of child protection plans and placement were high. The strongest predictors of placement (as opposed to home-based support) were severity of maltreatment, being unborn or under one year old at referral, being disabled and experiencing physical abuse. Findings are discussed in the context of developments in policy and services under the English government’s austerity programme.