Children / Young Peoples Details

Early Help Assessment & Support Plan

for Children & Families

Ref Number
Date Assessment Started

Children / Young Peoples Details

Child / Name / Date of Birth
/EDD
dd/mm/yy / Gender
(M/F) / Disabilities / Ethnicity / School/Nursery/College
1
2
3
4
5

Primary Home Address

Address / Telephone Number
Postcode / Mobile Number

Secondary Home Address

Address / Telephone Number
Postcode / Mobile Number

Main Parent / Carer

Name / Gender (M/F) / Ethnicity
Relationship to child(ren) / Date of Birth
Address
(if different from above) / Telephone Number
Postcode / Mobile Number

Other adult family/household member or significant other

Name / Gender (M/F) / Ethnicity
Relationship to child(ren) / Date of Birth
Address
(if different from above) / Telephone Number
Postcode / Mobile Number

Other adult family/household member or significant other

Name / Gender (M/F) / Ethnicity
Relationship to child(ren) / Date of Birth
Address
(if different from above) / Telephone Number
Postcode / Mobile Number

Name of Lead Professional Completing the Assessment

Name / Date
Position / Organisation
Email / Telephone Number
Manager’s Name / Manager’s contact details

Information Sharing and Consent

Rotherham Council is committed to offering Early Help to children and families as problems begin to emerge.
This assessment is important so that we can gather your thoughts, wishes and concerns and work together to put in place a plan that will help you and your family. In order to support you and your family, it may be necessary for your information to be shared between Council departments and other relevant organisations. Rotherham Council will ensure that any information sharing that takes place is proportionate, lawful and managed securely. Furthermore, your information will only be shared for the purpose of ensuring that relevant support is offered to you and your family, and to ensure that services are better coordinated and focused on your family’s needs.
For further information, visit http://www.rotherham.gov.uk/info/200031/data_protection_and_freedom_of_information
By completing this section you confirm your consent to this assessment, support plan and relevant information sharing.
Signed / Dated
Print Name
By completing this section and checking the ‘Yes’ box below (which inserts a cross) you, the practitioner, confirm that you have received signed, written consent on the original copy of the Early Help Assessment and Support Plan document and that the family, child or young person understand and agree that we will share the information with other agencies to maximise the support available to them. Yes

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Family Tree / Genogram

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List other agencies currently or previously (at least 12 months)involved.e.g. GP, Health Visitor

Family Member involved / Service/Agency / Name and role of Key Worker/Professional / Contact details / Approx. Start and End dates / Reason for involvement

Reasons for Seeking Support & Overview

(Please tickand identify which family member the issue is related to)

Health / Mental health of parents
Emotional health / Physical Health
Alcohol or other substance misuse by child or adult (please specify) / Behavioural difficulties
Speech, language or communication issues / Sexually harmful behaviour (e.g. sexting)
Domestic violence / Parenting issues
Adult offending / Child offending
Anti-social behaviour (adult) / Anti-social behaviour (child)
Experiencing bullying / Child missing from home
Teen pregnancy/sexual health / Risk of or involved in CSE
School attendance / At risk of or NEET
Employment support / Housing / environment
Financial pressures / Neglect
Family breakdown / Homeless
Bereavement / Other (please specify)

Reasons for Assessment

Please provide an outline of the reasons for completing this assessment. Include a brief summary of the concerns; including who is worried about what and why.

In each of the domains below, you will find prompts to help you provide analysis and evidence of strengths and needs. Please complete the information you have and leave blank the things that don’t seem relevant or that you don’t know.

1a. /

Health and development of unborn baby, infant, child or young person

1a(i) /

HEALTH

Conditions and impairments: eg registered with and use of dentist, GP, optician, immunisations, developmental checks, hospital admissions, accidents, health advice and information.
Evidence of Strengths
Evidence of Needs
Physical Development: Nourishment; activity; relaxation; vision and hearing; fine motor skills (drawing etc.); gross motor skills (mobility, playing games and sport etc.)
Evidence of Strengths
Evidence of Needs
Speech, Language & Communication: Preferred communication/learning style, language, conversation, expression, questioning; games; participation in stories and songs; listening; responding; understanding appropriate to age.
Evidence of Strengths
Evidence of Needs
1a(ii) /

EMOTIONAL AND BEHAVIOURAL

Early attachment/strong attachment observations; risk taking/actual self-harm; phobias; psychological difficulties; coping with stress; motivation, positive attitudes; confidence; relationships with peers; age appropriate peers; feeling isolated and solitary; fears; often unhappy; bereavement; family breakdown (i.e. mother and father separate). Lifestyle, self-control, reckless or impulsive activity (lack of impulse control); behaviour with peers; substance misuse; sexually harmful behaviour, anti-social behaviour; offending behaviour; associates who are involved in crime and anti-social behaviour; violence and aggression; restless and overactive; easily distracted; attention span/concentration.
Evidence of Strengths
Evidence of Needs
1a(iii) /

IDENTITY

Perception of self; knowledge of personal/family history; sense of identity and belonging; experiences of discrimination due to race, religion, age, gender, sexuality and disability.
Evidence of Strengths
Evidence of Needs
1a(iv) /

SOCIAL PRESENTATION

Has positive social relationships/friendships; has a wide range of interests and feels positive about self; is empathetic and shows consideration of others appropriate to age.
Evidence of Strengths
Evidence of Needs
1a(v) /

SELF-CARE SKILLS

Becoming independent; boundaries, rules, asking for help, decision-making; changes to body; washing, dressing, feeding; positive separation from family; ability to travel independently (appropriate to age)
Evidence of Strengths
Evidence of Needs
1b /

Health of Adults

1b(i) / CONDITIONS AND IMPAIRMENTS; registered with and use of dentist, GP, optician; immunisations, developmental checks, hospital admissions, accidents, health advice and information.
Evidence of Strengths
Evidence of Needs
1b(ii) / EMOTIONAL/SOCIAL- Attachments, forming relationships and social networks including wider family support, coping with stress and general resilience, motivation, positive attitudes, confidence, relationships and stability; self-esteem low, feeling isolated, fear, domestic abuse, family relationships, caring responsibilities, require help with self-care.
Evidence of Strengths
Evidence of Needs
2. /

Learning & Education

2a. /

CHILD

Include pre-school and at home; school/college experience; school attendance, access to resources, understanding, reasoning, problem solving, creative lay, organisation, employment, training, aspirations and achievement. Provide information from Statements/ EHC plans, individual learning plans, individual behaviour plans (where applicable).
Evidence of Strengths
Evidence of Needs
2b /

Adult - Employment & Training

2b(i) / EMPLOYMENT, TRAINING, WORK PROGRAMMES; work history, apprenticeships and work related benefits. If unemployed explore motivation to week work and approaches to becoming work.
Evidence of Strengths
Evidence of Needs
2b(ii) / INCOME/BENEFITS; effects of hardship; long term out of work benefits.
Evidence of Strengths
Evidence of Needs
3. /

Behavioural

3a / CHILD BEHAVIOUR; behavioural difficulties; home/school, anti-social behaviour, school exclusions, risk of exclusion, attendance, positive role models, engaging in positive activities. Please describe how these issues manifest.
Evidence of Strengths
Evidence of Needs
3b / ADULT BEHAVIOUR; Anti-social behaviour, offending behaviour, police attendance at address, positive friendship. Provide detail of any contributory factors to offending/ ASB.
Evidence of Strengths
Evidence of Needs
4. /

Family Relationships

4a / FAMILY RELATIONSHIPS - CHILD; Building stable relationships with family, peers and wider community; age appropriate peers; helping others; friendships; levels of association for negative relationships; consistent, positive role models.
Evidence of Strengths
Evidence of Needs
4b / FAMILY RELATIONSHIPS - ADULT; Formal and informal support networks from extended family and others; wider caring and employment responsibilities e.g. childcare arrangements. Anti-social behaviour in area; peer groups, social networks and relationships.
Evidence of Strengths
Evidence of Needs
Is there evidence of domestic abuse? / Yes No Unsure
If ‘Yes’ give details
Is there evidence of parental alcohol or substance misuse? / Yes No Unsure
If ‘Yes’ give details
Has the young person ever gone missing/absent from home? / Yes No Unsure
If ‘Yes’ give details
(No. of incidents/action taken)
Is there evidence of CSE involvement? / Yes No

The Child / Young Person’s Story

Note: If there is more than one child in the family, please add an additional section for each child to ensure that each child is prominent in the assessment.

This section should present information on health, education, emotional and behavioural development, identity, family and social relationships, the child/ young person’s social presentation and their self-care skills, where applicable.

Also record here any views expressed during interviews that took place and in response to the needs you have identified, and what they think life is like for them.

Child/Young Person’s Thoughts, Wishes and Feelings

This section should record the child(ren’s)/young person’s voice and evidence what their views are on the issues affecting the family. In addition their thoughts on what they feel is needed to help things improve.

Tools and observations can be used to assist you as professionals in capturing evidence for this section, particularly when the child is unable to articulate their thoughts. If you have captured this using a specialist tool please indicate this in the box below and send the document(s) electronically with this assessment.

Please indicate if you intend to send additional documents for voice of the child/young person Yes

The Parents / Carer’s Story

This section should present information on strengths and any issues such as substance abuse, mental health issues. Also, please record here information on the child’s basic care, safety, emotional warmth displayed, stimulation, parental guidance and boundaries and stability. Consideration should be given to the family background, history, housing or accommodation issue, employment and income, the family’s community and social integration and any resources and resilience support in the community.

The Parents/Carer’s View of the Assessment

Please usethis section to evidence the parents/carer’s voice and capture their views on the issues identified as part of the assessment process.

Early Help Assessment Strengths and Needs

Consider each of the elements to the extent they are appropriate in the circumstances. (Note: You do not need to comment on every element if you do not have relevant information.)

• Use the information gathered in the earlier part of the assessment to support your analysis in this section. Think about all the domains completed.
• Base comments on evidence, not opinion, and indicate clearly what that evidence is and the source of the evidence (e.g. how you know, what you know).
• Analysis of conversations and observations with the child and family, gathered during the assessment is important to include rather than a transcript of conversations; it is the analysis that helps to support the family in addressing need.
• If there are any major differences of opinion, these should be acknowledged and recorded clearly.

Are there any grey areas?
These might be areas where we don’t have enough information or where there is lack of clarity or dispute on issues. It is important to include grey areas and revisit them when further information is obtained or comes to light.

Next Steps

This section should be a summary of what the Lead Professionalsuggests is required next and should include analysis of whether the information gathered in the assessment warrants progression to a plan or whether the case can be stepped down to universal as a result of no additional need being identified.

Manager/Supervisor Oversight and Analysis

This section should evidence management/supervisory oversight of the case. Managers should record whether they agree with the Lead Professionals comments in the ‘Next Steps’ section(above) and add time limited actions accordingly. This section should make it clear on how the case should progress.

Manager/Supervisor signature: / Date:

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Early Help Support Plan & Team Around the Family Planning

Pleaseuse the strengths and needs you have identified to agree the support plan that will have the greatest impact on the family members and their circumstances. These will be used in your first team around the family (TAF) meeting to set desired outcomes and action and agree who will do what and when.

Domain of the early help assessment being addressed e.g. health; education; emotional wellbeing / What do we want to achieve? / How are we going to do it? / What is Plan B if this action does not progress? / Who is responsible? (family member, extended family, friend, practitioner, other) / When by?
(dd/mm/yyyy) / Review Comments
Date completed
(dd/mm/yyyy)

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Team Around the Family

Please record a list of the people you would like to invite to the first Team Around the Family meeting where appropriate.

Name / Role / Organisation / Contact Number

Agreement

I understand the information that is recorded on this form and agree to the plan to support my family and I.

I understand that the information will be stored and used for the purpose of providing services to my children for whom I am parent or carer to and my family members.

Parents Name / Parents Signature
Carers Name / Carers Signature
Young Person’s Name / Young Person’s Signature
Date

Please return this form securely to:

,

from an external secure email account

Date Assessment Completed

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