ANNUAL REVIEW REPORT FOR SEN

(Revised April 2017)

Please ensure that ALL boxes are completed, even if just to note N/A. If the child/young person has a statement of SEN you do not use this form and you need to hold a conversion review. If they have an EHCP you need to use the Annual review form for EHCP. You may use this form to review where you are applying for Top Up (send in with TU application sheet) or a statutory assessment. All forms available on findability/ resources for professionals/ schools/toolkit.

FULLLEGALNAME : / Known as:
UPN: / DoB: / dd / mm / yyyy
SCHOOL(S)
Incl split placements
Date of review: / Date of last Review:
Home address / Current Yr group
Chronological Yr (if different)
Year of next Phase transfer / Sept 20_ _
Is this pupil at Phase transfer for any of the following (delete as appropriate): / Early Years to school entry / Y6 to Y7 / Transition(Y9)/ Year 11 to Post16
Pupil is eligible for Pupil Premium / Yes / No / If yes, what does it fund?
Pupil has existing funding: / Yes / No / Band level
Please complete if this is first submission to SEN, or any changes since last submission
Mother’s name incl Title
Mother’s address, incl Postcode & tel
Does Mother have PR? / Yes / No
Father’s name
Father’s address
(if different), incl Postcode & tel
Does Father have PR? / Yes / No
Home language / Ethnicity
Is Pupil CIC? / Yes / No / If yes, please see below
Care Status: / FCO / Vol. Section 20 / Other
Home LA
Name & Tel No of Social Worker
Name of foster carer/s
Address of foster carer/s
Participants in the Annual Review
Name / Responsibility / Report requested / Report received / Present at Review
Pupil
Parent/carer
School staff
SENCo
School staff (if transfer to new setting, involve staff from preferred settings eg EY):
LA staff - SEN
LA Staff - EP
LA Staff - BIT
LA Staff – The Hope School for Children in Care
LA Staff – Social Care
LA staff -
Health representative - Dr
Health representative – S&LT
Health representative - OT
Health representative - Other

SECTION A:

SCHOOL’S CONTRIBUTION

(To be circulated prior to the Review Meeting)

Progress review Yr ______to ______

Name
Year Group
Class Size
Currently identified Needs:
Primary Need / ASD SEMH HI MLD MSI OTHER PD PMLD SLD SpLD SLCN VI
circle/delete as appropriate
Secondary Need / ASD SEMH HI MLD MSI OTHER PD PMLD SLD SpLD SLCN VI
circle/delete as appropriate
Other
Pen picture of the pupil:
National Curriculum Assessment
Please complete fully (include last years levels)
FS / Y1 / Y2 / Y3 / Y4 / Y5 / Y6 / Evaluate progress
English
Speaking / Listening
Reading
Writing
Overall Subject level
Mathematics
Science
Standardised test results and/or Entry Assessment
Date of Test / Name of Test/Assessment / Results / Administered by (name and role)
National Curriculum Assessment
Please complete fully (include last years levels)
Y7 / Y8 / Y9 / Y10 / Y11 / Y12 / Y13 / Evaluate progress
English
Speaking / Listening
Reading
Writing
Overall Subject level
Mathematics
Science
Standardised test results and/or Entry Assessment
Date of Test / Name of Test/Assessment / Results / Administered by (name and role)
This section should clearly demonstrate that advice received from relevant outside agency/s has been acted upon.
Please evaluate effectiveness of interventions
Academic / Social/Emotional / non-lesson time
Outcomes for 1 Year
(must be SMART, in particular, how will you measure success?)
Provision to Meet Outcomes
Strategies and/or techniques used to meet Outcomes (e.g. by LSA or teacher)
Who is it Monitored By?
Progress made
Any changes of provision since last review
Evaluate progress in other curriculum areas:
Review of non-school provisions (OT, S&LT, Physio, CAMHS etc)
Involvement from support services, and date of last involvement
(eg BIP, BAT, EP, CAMHS, OT, SLT)
e.g. whole school advice on provision; staff training; consultation regarding individual pupils; direct assessment of pupil; direct work with pupil
Service / Type of Involvement / Date of last involvement
If Applicable, record time spent out of group/class/school and alternative arrangements provided for the pupil during this time. (Attach Personalised timetable if applicable)
Record all views including any future actions/provisions for the next year
Summary of final recommendations and actions from Annual Review
Outcomes of the Annual Review - to be completed AT END of the review meeting
PLEASE ENSURE THIS TABLE IS COMPLETED FULLY AND CLEARLY
Continue at SEN Support level / YES/NO
An Education Health and Care Needs Assessmentis requested: / YES / NO
Please indicate reason:
a)Specialist provision may be requested to meet pupil’s needs / YES / NO
b)Parent/Carer request / YES / NO
c)Please state any other reason:

Headteacher’s Signature…………………………………………….….Date….……...…

Parent/Carer signature…………………………………………...……..Date…..………..

The following checklist MUST be completed and relevant documents attached as appropriate:
Attendance print out* / Any other reports, as appropriate:
Pupil contribution* / EP report
Parent/Carer contribution* / BAT
Costed Individual Provision Map/Plan / BIT
Costed School Provision Map/Plan / LIT
IEP / Early Years report
Medical Report
Y9 Transition report or equivalent / S&LT
LPW 139’A’ / Physio
OT
CAMHS
Other incl Independent reports
Social Care report
Is Pupil a CHILD IN CARE ? / Yes / No
For CIC – latest Hope School/PEP report, if not previously submitted toSEN

*mandatory if requesting statutory assessment

Parent/Carer signature
Date