Section 1 - Family details

Child/young person’s name / DOB/EDD / Sex M/F / Ethnic origin / Religion
SEND / Registered disabled Y/N / First language / Immigration status / Contact number
Current home address / Is this a confidential address? Has a risk assessment been completed at this address? Is this a safe address for lone working?

Those living in the family home

Full name / DOB/EDD / Sex M/F / Family member? E.g. mother, father child / PR / Ethnic origin / Religion / First language / SEND / Immigration Status

Does anyone else have PR? (who are not listed above)

Full name / DOB/EDD / Sex M/F / Address / Family member? E.g. mother, father / PR

PR: Parental Responsibility EDD: Estimated Due Date SEND: Special Educational Needs Disability

Details of the Lead Professional undertaking the assessment

Name / Role
Team / Contact number
Email
Postal Address

Who was present at the assessment?

Who else is working with the child/young person? (Please add additional boxes for number of people working with child/young person)

Name / Role
Team / Contact number
Email
Postal Address

Summarise the reason for undertaking this assessment

Parents/carers view
Children/young people’s view
Practitioners view

Section 2 –Holistic Assessment

(Please see guidance notes for support and appendix 1 for PROGRESS score)

Part a) Family & Environment Factors

Family History, functioning and well-being / PROGRESS Score*
Wider family, social relationship and community resources / *
Housing / *
Finance / *
Significant events / *
Strengths
Needs

Part b) Child’s Development Needs (copy and paste for each child/young person within the family as necessary)

Family and Social Relationships / *
Health / *
Behaviour, emotional and identity / *
Self care skills / *
Learning, participation and aspirations / *
Caring responsibilities / *
Strengths
Needs

Part c) Parent/carer/adult

Health / *
Parenting / *
Social relationships, Community elements and resources / *
Employment, training and education / *
Strengths
Needs

Section 3- Conclusions

What do you think could support and help make change happen?

Children/young people’s view
Parent/carers view
Assessors view
Are there any differences of opinion?

Section 4 – Family Action Plan

This summarises the outcomes identified in the assessment to enable a solution focused plan. This plan will be monitored and ongoing throughout the TAF approach.

Need
Identified in assessment conclusions / Desired Outcome
What child/young person, family, practitioner want to achieve / Action
What will be done to achieve this outcome / Who will do this
(child, young person, parents, family member, professional) / When will this be done?
Specify date

Section 5 – Consent and information sharing

Consent statement for information storage and information sharing

As and when we consider involving other professionals to support your family, we will keep you informed.

I understand that the information gathered regarding my family is recorded and will be securely stored on an electronic system and used for the purpose of providing services to my family and may also be used for monitoring and auditing.We are obliged to share information if there are safeguarding concerns or for the purposes of reducing or preventing anti-social behaviour, crime and disorder.

I do not wish information to be shared with the following agencies unless we are required by law to do so:

Can someone contact you regarding feedback? Yes/No

I/we agree this assessment is an accurate summary of my/our family’s situation and agree with the family plan. I/we understand the information that is recorded on this form and that it will be stored and used for the purpose of providing services.

Parent/Carers/Young Person Signature: / Name: / Date:
Lead Professionals Signature: / Name: / Date:

Please send a signed copy of the completed Assessment to: Or via secure email:

The Early Help Partnership Service (Egress)

Quadrant Court (GCSX)

35 Guildford Road

Woking

GU22 7QQ

Appendix 1: Progress Score – Distance Travelled Tool

Our Early Help Approach has a scaling tool incorporated – PROGRESS to benchmark and measure the outcomes through the Early Help Assessment , Team Around the Family, Review and Closure. This is a measure of impact and is a joint process between the Lead Professional and the parent/young person.When completing a domain area on the Early Help Assessment, e.g. Family and Social Relationships, you will ask an additional question relating to the statements provides below. The score will be added to the Early Help Assessment. This score will identify what actions are needed on the Family Action Plan. The same questions will be asked at the TAF, Review and Closure. This will provide a measure of distance travelled and related outcomes.This tool takes into account the age range of 0 – 25 years old. It can be completed with the views of young people and parents. It is important to complete for each child/young person within the Early Help Assessment. These are the PROGRESS tool statements:

Family and environmental factors 5. Our family is achieving well with no additional support 4. Our family is achieving well with appropriate support networks in place 3. Our family needs occasional support to consistently achieve well 2. Our family needs regular support to achieve well 1. Our family needs a high level of support to improve the impact on our child/young person’s well being 0. Our family needs intensive support to improve the impact on our child/young person’s well being

Child’s Development Needs 5.Child/young person is achieving well with no additional support 4. Child/young person is achieving well with appropriate support networks in place 3. Child/young person needs occasional support to consistently achieve well 2. Child/young person needs regular support to achieve well 1. Child young/person needs a high level of support to improve the impact on their well being 0.Child/young person needs intensive support to improve the impact on our child/young person’s well being

Parents and Carers 5. Our parenting is achieving well with no additional support 4. Our parenting is achieving well with appropriate support networks in place 3. Our parenting needs occasional support to consistently achieve well 2. Our parenting needs regular support to achieve well 1. Our parenting needs a high level of support to improve the impact on our child/young person’s well being 0. Our parenting needs intensive support to improve the impact on our child/young person’s well being

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