ISLE OF WIGHT EARLY HELP SERVICE

Please sign and date toCAF confirm that youHELP have notified Hants EARLY ASSESSMENT Please sign and date to confirm that you have notified Hants Direct of your intention to undertake this assessment: IDENTIFYING DETAILS Record details of all unborn/ children/ young people in the family (add additional rows if required)

1. Details of children and/or young people in the family. Name

DOB or EDD

Gender

Address and postcode

Ethnicity

Day Care/ educational setting

Concerns

M/F

Y/N

M/F

Y/N

M/F

Y/N

M/F

Y/N

M/F

Y/N

M/F

Y/N

2. Details of parents/ carers Name

DOB

Gender

Address and postcode (If different)

Tel number

Ethnicity

M/F

In employment/ training Y/N

M/F

Y/N

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ISLE OF WIGHT EARLY HELP SERVICE

3. Any other significant people e.g. Extended Family/ friends Name

DOB or EDD

Gender

Address and postcode

Relationship to children

M/F

M/F

M/F

M/F

4. Family Tree – Try to include at least three generations (copy or delete images as required)

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ISLE OF WIGHT EARLY HELP SERVICE ASSESSMENT INFORMATION 5. Date of Assessment

6. Details of person(s) undertaking assessment Name Role Address

Contact No

Lead Professional?

7. Agencies currently working with the child and family Name Role Contact details Description of current involvement and phone/email which member of the family they are working with.

8. Why has this assessment been started? (Please tick all the reasons that apply) Relationship difficulties at home Relationship difficulties at school Behaviour: home/community Behaviour: school Attendance at educational setting please record current attendance % data and current unauthorised absence % data Exclusion from educational setting Not in education, employment or training Child's development/ learning Drug/alcohol issues (young person) Drug/alcohol issues (parent/carer) Offending behaviour (parent/ carer) Other: (please describe)

Domestic abuse Parenting Risk Taking Behaviour Teenage pregnancy Housing/ Economical issues

Mental health (parent/carer) Concerns regarding emotional wellbeing (child/YP) Child/YP disability Parental disability Low level/ emerging neglect Offending behaviour (child/ young person)

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ISLE OF WIGHT EARLY HELP SERVICE 9. Please outline your reasons for commencing an Early Help assessment. This should include: (1) conversations you have had with the child and family (2) how the information has been obtained (3) actions you have taken to date to offer support and interventions (4) what you are hoping to achieve from requesting a multi-agency response and how you propose to be involved in the resulting plan

EARLY HELP ASSESSMENT (Please remember to include strengths as well as needs) Consider each of the elements to the extent they are appropriate in the circumstances. You do not need to comment on every element. Wherever possible, base comments on evidence, not just opinion, and indicate what your evidence is. However, if there are any major differences of view, these should be recorded too. Complete for all children, young people in the family where there are additional needs/concerns. Please note, the boxes expand to accommodate additional children.

10. Development of unborn baby, infant, child or young person. Health General Health – Conditions and impairments; access to and use of dentist, GP, optician, immunisations, developmental checks, hospital admissions, accidents, health advice and information

Physical development – Nourishment;; activity; relaxation; vision and hearing; fine motor skills (mobility, playing games and sport etc)

Speech, language and communication – Preferred communication, language, conversation, expression, questioning, games, stories and songs, listening, responding, understanding

Emotional and social development - Feeling special; early attachments; risking/actual self-harm; phobias; psychological difficulties; coping with stress; motivation; positive attitudes; confidence; relationships with peers; feeling isolated and solitary; fears; often unhappy

Behavioural development-Lifestyle, self-control, reckless or impulsive activity; behaviour with peers; substance misuse; anti-social behaviour; sexual behaviour; offending; violence and aggression; restless and overactive; easily distracted, attention span/concentration

Identity, self-esteem, self-image & social presentation -Perceptions of self; knowledge of personal/family history; sense of belonging; experiences of discrimination due to race, religion, age, gender, sexuality & disability

Family & social relationships-Building stable relationships with family, peers and wider community; helping others; friendships; levels of association for negative relationships

Self-care skills and independence- Becoming independent; boundaries, rules, asking for help, decision-making; changes to body; washing, dressing, feeding , positive separation from family

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ISLE OF WIGHT EARLY HELP SERVICE

Learning Participation in learning, education and employment -Access and engagement; attendance % , participation; adult support; access to appropriate resources

Progress and achievement in learning Progress in basic and key skills; available opportunities; support with disruption to education; level of adult interest

Aspirations Ambition; pupil's confidence and view of progress; motivation, perseverance

11. Parents and carers Basic care, ensuring safety and protection - Provision of food, drink, warmth, shelter, appropriate clothing; personal, dental hygiene; engagement with services; safe and healthy environment

Emotional warmth and stability Stable, affectionate, stimulating family environment; praise and encouragement; secure attachments; frequency of house, school, employment moves

Guidance, boundaries and stimulation - Encouraging self-control; modelling positive behaviour, effective and appropriate discipline; avoiding over-protection; support for positive activities

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ISLE OF WIGHT EARLY HELP SERVICE

12. Family and environmental Family history, functioning and well-being Illness, bereavement, violence, parental substance misuse, offending behaviour, anti-social behaviour; culture, size and composition of household; absent parents, relationship breakdown; physical disability and mental health; abusive behaviour

Wider family Formal and informal support networks from extended family and others; wider caring and employment roles and responsibilities

Housing, employment and financial considerations Water/heating/sanitation facilities, sleeping arrangements; reason for homelessness; work and shifts; employment; income/benefits; effects of hardship

Social and community elements and resources, including education Day care; places of worship; transport; shops; leisure facilities; crime, unemployment, anti-social behaviour in area; peer groups, social networks and relationships; religion

Identified Needs 13. What are the outcomes the family would like from this assessment? (Transfer these headings to the Early Help Family Plan) 1.

2.

3.

4.

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ISLE OF WIGHT EARLY HELP SERVICE

14. Which new agencies will need to be consulted or involved (consider whether they need to be invited to the first team Around the Family Meeting)

15. Child’s or young person’s views on the assessment and identified actions to be addressed. Please summarise EACH child’s views and detail how these views were sought.

16. Parents’ Views on the assessment and identified actions to be addressed please summarise each parent’s views and detail how these views were sought and recorded.

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ISLE OF WIGHT EARLY HELP SERVICE

17. Distance Travelled (Please complete this form for each child/ young person you have concerns about. It should be then be reviewed every 3 months and on closure and a copy sent to the locality co-ordinator on each occasion. Guidance is available in a separate document.) Child’s/Young person’s name: Date of birth: None 0

Minor 1

Moderate 2

Significant 3

Critical/ Complex 4

1. Development of the infant, child or young person Health a. General health b. Physical development c. Speech, language and communication d. Emotional and social development e. Behavioural development f. Identity, self-esteem, self-image and social presentation g. Family and social relationships h. Self-care skills and independence Learning i. Understanding, reasoning and problem solving j. Participation in learning, education and employment k. Progress and achievement in learning l. Aspirations Totals: Total for Development section: 2. Parents and carers a. Basic care, ensuring safety and protection b. Emotional warmth and stability c. Guidance, boundaries and stimulation Totals: Total for Parents and Carers section: 3. Family and environmental a. Family history, functioning and wellbeing b. Wider family c. Housing, employment and financial considerations d. Social and community elements and resources, including education Totals: Total for Family and Environment section: Total ratings score

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ISLE OF WIGHT EARLY HELP SERVICE

18. Using your personal information: I understand that information gathered regarding myself and my family will be held by the Isle of Wight Council and used only for the purpose of providing, coordinating and evaluating Early Help services to my family. . I agree that information about me can be shared with other professionals and organisations where this is necessary to provide; coordinate and evaluate Early Help services to support the family. I understand that this may include health organisations, education, housing and social care services, police, youth offending team, criminal justice, registered social landlords, the Department for Work and Pensions, and also services that have been commissioned to coordinate, evaluate and provide early help support to families. I understand that information about me will only be shared without my consent if the information suggests a person is at serious risk of harm or where necessary for the prevention or detection of a crime. Where the information suggests significant harm to an infant, child or young person local safeguarding children board procedures (4LSCB) will be followed and this has been explained to me.

Signed: Parent / Carer signature: Name

Date:

Young person signature: Name

Date:

Signed by completer: Name

Date:

19. The first Team Around the Family Meeting Date : Time : Venue:

Please ensure a copy of this form is sent to your locality CAF Coordinator either to [email protected],uk (ensuring it is encrypted) or by post to CAF, Early Help services, Floor 3, County Hall, Newport, Isle of Wight. PO30 1UD.

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