City of York Council

Specialist Teaching Team: Referral (Revised September 2017)

Making a Referral to the Specialist Teaching Team

Referrals must be made on the attached form and must be with the agreement of the child’s parents or carers who must sign the form. Referrals will not be accepted without parental consent.

Referrals from schools or other educational settings must be from the SENCo or the Head teacher / Head of setting. Referrals from other staff will not be accepted.

Referrals directly from parents can not be accepted.

Because of the nature of support provided for children with either Vision Support needs or those that are Deaf, referrals to these services will only be accepted from specialist practitioners:

Vision Support – referrals will only accepted from Health professionals – ophthalmologists, orthoptists, paediatricians. If parents or staff have concerns about a child or young person’s vision they should contact the child’s GP who will, if necessary, refer to the Ophthalmology Department at York Hospital who will then refer to the Vision Support team if the child meets the criteria for support.

Deaf and Hearing Support – referrals will only be accepted from the Audiology Department at York Hospital. If parents or staff have concerns about a child or young person’s hearing they should contact the child’s GP who will, if necessary, refer to the Audiology Department at York Hospital who will then refer to the Deaf and Hearing Support team if the child meets the criteria for support.

It is important that referrals to the Specialist Teaching Team include as much information as possible about other support that the child or young person is receiving.

For referrals to the Autism Team previous support shouldinclude recent attendance at Autism Awareness training and the use of autism friendly strategies in the CYPs classroom/setting in addition to copies of the CYP’s autism assessments where possible.

For referrals to the Home tuition team referrers must include a supporting letter from relevant health professionals.

All referrals should include details of any existing support provided by other professionals, e.g. Portage Worker, Physiotherapist, Occupational Therapist, CAMHS Worker. Contact details for others involved should be provided. Where specialist reports are available these should be provided with the referral.

For STT Office Use
(Date and Initials) / Referral Received / To New Referrals / Passed to Team

1. Please cross the box(es) to indicate the team(s)that you are making a referral to:

Autism Support / Communication Interaction / Deaf & Hearing Support / Physical &
Health Needs / Vision Support / Home
Tuition / Specific Learning Difficulty (Dyslexia)

Please refer to the Guidance Notes: ‘Working with Children and Young People –Referral Information for Schools and Settings before completing this referral.

Please note that referrals for support from the Deaf and Hearing Support Team and the Vision Support Team can only be made by a health professional.

2. Who is the referral for

Child / Young Person’s Name
Date of Birth / Male / Female / (dd/mm/yyyy) / M / F
Home Address
Post Code
Does the Child / Young Person have a / My Support Plan / Yes / No
Education, Health and Care Plan / Yes / No
Has a Family Early Help Assessment (FEHA) been completed? / Yes / No

3. The child’s family contact details

Parents / Carers First Name(s)
Parents / Carers Second Name(s)
Home Telephone Number
Mobile Number(s)
Email Address
Family Language
Family Communication Needs / e.g. text only

4. Where the child or young person is currently on role

Name of School or Setting

5. Who is making this referral

Name
Position / Role
School / Setting or Address
Contact Telephone Number
Contact Email Address

6. What is the reason for this referral?

Please provide as much information as possible. Please include a description of the desired outcomes from the involvement of the Specialist Teaching Team.

7. Who is already working with the child / young person

Please provide information about all those working with the child or young person and whether any reports are available.

Professional / Agency / Name / Contact Details / Report
Audiologist
CAMHS
School Wellbeing Worker
Keyworker / Childminder
Occupational Therapist
Orthoptist
Paediatrician
Physiotherapist
Portage Worker
Pre-School Teacher
Educational Psychologist
Social Worker
Family Support Worker
Specialist Nurse e.g.
Diabetes, Epilepsy, Enuresis
Speech and Language Therapist
Dietician
Other
8. Describe the strategies that have already been used to support the child / young person before making this referral.
It is very helpful to know what has already been done, or is currently in place, to help the child / young person before making this referral. Please provide as much information as possible.
Please provide copies of reports from other professionalsparticularly with regard to diagnosis details e.g.visual assessment results

9. How to submit the referral

Please return thisreferral form withany supporting reports and signed parental consentto:

Lynne Johns

Head of the Specialist Teaching Team

SEN Services

City of York Council

West Offices

Station Rise

York

YO1 6GA

or preferably by email to:

If returning by email please rename this file ‘STT Referral Child’s Name’

Please mark the subject line of the email ‘STT ReferralChild’s Name’

If emailing reports from Health professionals, please email the referral form and health reports to the secure email address:

Please mark the subject line of the email ‘STT Referral Child’s Name’

10. SEN Team – Privacy Notice

What information about you do we collect?

The information you provide to the SEN Team helps us to support children, young people and families and meet our legal responsibilities, to help you get the help you need for example assessment of educational, health and social care for your child / young person (CYP)

The data collected will include personal characteristics such as your name, contact details, any special educational needs and medical information.

When we ask you for personal information, we will:

  • ensure you know why we need it
  • only ask for what is necessary for the work we are doing with you
  • protect it and make sure nobody has access to it who shouldn’t
  • make sure we don’t keep it for longer than is necessary and when we no longer have a need to keep it, we will delete or destroy it securely.

We ask that you:

  • give us accurate information
  • tells us as soon as possible of any changes
  • tell us as soon as possible if you notice mistakes in the information we hold about you

How do we use your personal information?

We will use your information to:

  • Ensure that services and practitioners understand how they can best help you.
  • Help inform which services and interventions require commissioning across the City of York to support families and communities.
  • Create statistics that are anonymous and cannot be linked back to you or your family for the purposes of local and national surveys.
  • Support our work with your child in his/her school or setting, or in your home or another setting for those children who are unable to attend school because of ill health.
  • Take photographs and / or video recordings of your child for record keeping and assessment arrangements. Photographs will not be used for any other purpose without the additional consent of parents / carers (see below).
  • Provide the child or young people with appropriate services
  • ‘Sign post’ the family to support appropriate
  • Measure whether our services are improving life for children, young people and families
  • Help us develop and improve our services
  • Administer and protect public funds.

Who we share data with

We may use the information to create statistics that are anonymous and cannot be linked back to your family or individuals. We could use these statistics to see how the Council and its partners are supporting families and individuals, to help design better services and to contribute to national surveys and government returns eg to the Department for Education (DfE),

We may be required or permitted under the Data Protection Act 1998 to disclose your personal information without your explicit consent e.g. if we have a legal obligation to do so, when we feel that you or others are at risk or in some circumstances crime prevention

You can find out more about how the City of York Council uses your information at

https://www.york.gov.uk/privacy

Your rights

You have the right to ask us if we hold personal information, what it is used for and to view the information we hold. You also have the right to know whether we disclose your personal information to other people and to ask us to correct anything that is wrong.

You have the right to see your personal information with some specific exceptions. For example, you will not be allowed to see personal information that contains details about someone else, even a member of your own family, until that person has given permission. There may be occasions when it would not be in your best interests to see it. If that is the case we will ensure that you are given a full explanation at the time so that you understand why this decision was made.

You can ask the council to stop processing your personal information in relation to any council service. This may delay or prevent us delivering a service to you. We will seek to comply with your request but may be required to hold or process information to comply with our legal duties.

To find out noreabout your rights under the Data Protection Act 1998, see the Information Commissioners Office (ICO) website..

If you have any questions about this Privacy Notice, your rights, or if you have a complaint about why your information has been collected, how it has been used or how long we have kept it for, please contact the Customer Feedback Team at ***

I give my consent for my personal information as described in the privacy notice above.
Name / Signature / Date

Lead Practitioner has confirmed that signed consent has been given and will be stored safely and securely in accordance with Data Protection legislation and their organisations own information sharing protocol (please tick)

Lead Practitioner Name / Signature / Date

Referrals will not be accepted without parental consent

Information for Parents and Carers:

The Specialist Teacher will always try to let you or the school/setting know when they are going to visit your child, and will always inform you following the visit on what they did and the advice that they gave your child’s school / setting.

By signing this referral form you are giving your consent for the Specialist Teaching Team to:

  1. Work with your child in his/her school or setting, or in your home or another setting for those children who are unable to attend school because of ill health.
  1. Take photographs and / or video recordings of your child for record keeping and assessment arrangements. Photographs will not be used for any other purpose without the additional consent of parents / carers (see below).

Please indicate whether you give your consent for your child’s photograph to be taken for the following purposes.

No child or young person will be named in the use of these photographs.

For record keeping and assessments / Yes / No
To illustrate the use of a specialist piece of equipment / Yes / No
To describe the work of the Specialist Teaching Team / Yes / No
To illustrate a special project or event organised by the Team / Yes / No
Name of Parent / Carer
Signature
Date

STT Referral Form (October 2017) Page 1STT Referral v.4