Lead Practitioner: / Child(ren) / Young Person(s):
Job Title: / DOB:
Contact Details: / Date of original assessment:
If needs have not been met please use appropriate letter for reasons given below.
A Did not wish to engage with a service / BLong waiting list for service / CService not available
D Needs only partially met / E Other (please provide details of unmet need and reason)
Needs Analysis(please tick all that apply)
Child(ren)/Young Person(s)
Needs identified at original assessment / Met / Unmet / If unmet, why? / Needs identified at original assessment / Met / Unmet / If unmet, why?
Academic under-achievement / Mental healthFF
Anti-social behaviourFF / Offending (current)FF
Alcohol issuesFF / Offending (immediate risk of)
Attachment Issues / Peer relationship issues
Attends PRU/EOTAS FF / Personal safety issues
Behavioural ProblemsFF / Physical illness/disability
Behavioural Problems(inc. social, emotional, behavioural) / Post 16 NEET (current) FF
Bereavement / Post 16 NEET (at risk of) FF
Bullying (perpetrator) (inc. cyber bullying) / Previous Section 47 enquiry FF
Bullying (victim) (inc. cyber bullying) / Previously CP Plan or CiN involvement FF
Child not accessing Early Years entitlement (age 2) FF / Risky behaviour
Child of teenage parent / Risky behaviour (Going missing) FF
Development delay / School attendance issuesFF
Diet/eating issues / Self harm
Domestic abuse (perpetrator) FF / Sibling of child with disability
Domestic abuse (victim) FF / Social isolation
Drug issuesFF / Teenage parent – female (under 18)
Anti-social behaviourFF / Teenage parent – male (under 18)
Alcohol issuesFF / Teenage pregnancy
Low self esteem / Young Carer
Other (please explain)
Parent(s)/Carer(s)
Needs identified at original assessment / Met / Unmet / If unmet, why? / Needs identified at original assessment / Met / Unmet / If unmet, why?
Alcohol issuesFF / Parental crime/imprisonment(adult due for release from HMP within 12months who has parenting responsibilities)FF
Bereavement / Parental/family conflict
Carer / Parent in receipt of Out of Work Benefits FF
Domestic abuse (perpetrator) FF / Parent who has had an ASB intervention in last 12 months FF
Domestic abuse (victim) FF / Parenting – implementing boundaries, routines, age appropriate behaviour management
Drug issuesFF / Parenting – other (please explain)
Learning difficulties / Physical illness/disability
Low self esteem / Self harm
Mental healthFF / Social isolation
New Parent / Teenage parent – female (under 18)
Parental crime/imprisonmentFF / Teenage parent – male (under 18)
Other (please explain)
Environment
Needs identified at original assessment / Met / Unmet / If unmet, why? / Needs identified at original assessment / Met / Unmet / If unmet, why?
Discrimination / Housing problems
Financial difficulties / Neighbourhood conflict
Homelessness (Young person at risk of) / Single parent family – female
Homelessness (Family at risk of) / Single parent family – male
Other (please explain)
Views of Parent(s)/Carer(s) and Child(ren)/Young Person(s)
Did you find the FEHA useful?(please circle)
Parent(s)/Carer(s) / Yes / No / Not sure
Child(ren)/Young Person(s) / Yes / No / Not sure
If you didn’t find the FEHA useful, please can you give a reason why:
Parent(s)/Carer(s)
Child(ren)/Young Person(s)
Do you think things have got better for you?
Parent(s)/Carer(s) / No / In some ways / Yes, significantly
Child(ren)/Young Person(s) / No / In some ways / Yes, significantly
Would you have another FEHA in future if you felt you needed one?
Parent(s)/Carer(s) / Yes / No / Not sure
Child(ren)/Young Person(s) / Yes / No / Not sure
If you would not want another FEHA in future, please can you give a reason why:
Parent(s)/Carer(s)
Child(ren)/Young Person(s)
Thank you for taking the time to complete this form, it will help us to improve the services we offer to families in the future.
Please ensure you forward this document to the Local Area Teams to inform them that the work with the family has ended.
Tel: 01904 551900 Selecting option 2, option 2
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