CONFIDENTIAL

Agency Report for Child Protection Conference

This template is for guidance; please complete and as fully and legibly as possible.

When completing this form please refer to the:

The Leicester, Leicestershire, and Rutland Procedures Manual: ;

Child Protection Conference: Information for Professionals

Multi-Agency Report to Conference: Guidance Notes

Are you attending the conference?
Your agency:
FAMILY DETAILS
Name of child(ren)
NHS number(s)
Date(s) of birth
Do any of the children have a disability?
Address of the children
Name of parents
Name of main caregiver (if not a parent)
Any other household
members
(living in the same house as the children)
AGENCY DETAILS
Agency
Your name
Job title
Length of involvement with the family
Has your agency’s report been shared with the family? / Yes
Date: / No
Please state why not:

Brief Chronology

Overview of your agency involvement during last 12 months including dates of visits to the family by your service, if applicable (including any failed appointments), or details of attendance:

Date / Detail
Please describe the child(ren)’s developmental needs:
Including health, education, emotional and behavioural development, identity, family and social relationships, social presentation (e.g. are they usually happy, withdrawn or angry?) and self care skills.
What’s Working Well?
(Is there anything that can be identified within the family that might increase the safety of the child(ren)?)
What are you worried about?
(Is there anything that can be identified within the family that might increase the risk of harm to the child(ren)?)
Please describe the parenting capacity of the parents/main caregivers:
Please include their ability to provide (for their children) basic care, emotional warmth and stimulation, guidance and boundaries and to ensure the safety of the child(ren).
What’s Working Well?
What are you worried about?
Family and environmental factors:
Including family history and functioning, wider family and close friends, housing conditions and suitability for the family, employment and income, family’s social integration (their involvement in their immediate community) and community resources.
Are there any other adults involved in the children’s lives?
What’s Working Well?
What are you worried about?
What would reduce your concerns?
What do you believe will make this child or children safe?
What could your Agency do to reduce your concerns?

Name

Signed

Date

The content of this report should be shared fully with the parents/carers, unless you believe this will place any person at serious risk of harm.

Please submit this report at least 2 days before the Child Protection Conference to the Safeguarding office in the area where the conference is to be held.

Leicestershire: / Leicester: / Rutland:

Fax: 0116 305 7548
Tel: 0116 305 7570 /
Fax: 0116 454 0718
Tel: 0116 454 2440 / . uk
Fax: 01572 758 398
Tel: 01572 758 454
  • Secure electronic methods should always be used to exchange sensitive and personal information.
  • Secure E mail systems are available for use between most statutory agencies/organisations.
  • Your agencies I.C.T. and information security teams will be able to provide further advice on the best solution to transfer information securely.
  • Please note that a secure e-mail address must be used to send an e-mail to another secure email secure address as using an ordinary e-mail address will not be secure.

Multi-Agency Report to Conference 1