CAF Form Common Assessment Framework for Children and Young People (CAF) PLEASE ENSURE THAT ALL SECTIONS ARE COMPLETED Assessment Start Date Have you made a CAF enquiry? Yes No Contact a CAF Coordinator on 0161 603 4239 Details of person(s) undertaking assessment If the CAF is co-authored please add both names in the boxes below and their places of work CAF co-author (optional) Author Role Organisation Address See http://www.salford.gov.uk/d/CAF_Co-author_definition.pdf Co-Author Role Organisation Telephone E-mail Postcode Telephone E-mail Lead Professional (if not CAF author) See http://www.salford.gov.uk/caf-lead-professional.htm for info Identifying details Record details of unborn baby, infant, child or young person being assessed. If unborn, state name as ‘unborn baby’ and mother’s name e.g. unborn baby of Ann Smith. Given name(s) Male Family name Female Unknown Address AKA /previous names Date of birth or EDD Child’s 1st language Postcode Parent’s 1st language Contact No Immigration Status E-mail Address Interpreter required? Ethnicity White Black or Black British Asian or Asian British Mixed/Dual Background White & Black Caribbean White & Black African Chinese & Other White British Caribbean Indian White Irish African Pakistani Traveller of Irish Heritage Any other White background Any other Black background Bangladeshi White & Asian Any other ethnic group Any other Asian background Any other mixed background Not given Chinese Gypsy / Roma If other, please specify Religion Christian Jewish Hindu Muslim Buddhist No religion Not given If other, please specify; Sikh Does the child or young person have a disability or any Special Educational Needs? Yes No If ‘yes’ give details What has led to this unborn baby, infant, child or young person being assessed? Details of parents/carers Name D.O.B. Relationship to unborn baby, infant, child or young person Address Parental responsibility? Yes No Postcode Email: Name Contact tel. no. D.O.B. Relationship to unborn baby, infant, child or young person Parental responsibility? Yes No Address Postcode Email: Contact tel. no. Current family and home situation (e.g. family structure including names and D.O.B. of siblings, other significant adults etc; who lives with the child and who does not live with the child). You may also wish to consider completing a genogram / family tree / risk and protective factors as part of your assessment. Please see link for further information; http://www.salford.gov.uk/supportingtools.htm Other services Universal Services working with this infant, child or young person GP Details Tel. Early years/education/FE training provision Details Tel. Service Details Tel. Service Details Tel. Service Details Tel. Service Details Tel. People present during the assessment CAF assessment summary: strengths and needs Consider each of the elements. Wherever possible, base comments on evidence, not just opinion, and indicate what your evidence is. However, if there are any major differences of view, these should be recorded too. You may also wish to consider completing a ‘Thought and Feelings’ questionnaire as part of your assessment. See the CAF website for supporting tools; http://www.salford.gov.uk/supportingtools.htm / http://www.salford.gov.uk/achildsvoice.htm The CAF author must complete the contents within each box. The baseline scores are only to be completed by staff within the Early Intervention and Prevention Service. 1. Development of unborn baby, infant, child or young person; Health General health Conditions and impairments; access to and use of dentist, GP, optician; immunisations, developmental checks, hospital admissions, accidents, health advice and information Baseline CAF Score Physical development Baseline CAF Score Nourishment; activity; relaxation; vision and hearing; fine motor skills (drawing etc.); gross motor skills (mobility, playing games and sport etc.) Speech, language and communication Baseline CAF Score Preferred communication, language, conversation, expression, questioning; games; stories and songs; listening; responding; understanding Emotional and social development Baseline CAF Score Feeling special; early attachments; risking/actual self-harm; phobias; psychological difficulties; coping with stress; motivation, positive attitudes; confidence; relationships with peers; feeling isolated and solitary; fears; often unhappy Behavioural development Baseline CAF Score Lifestyle, self-control, reckless or impulsive activity; behaviour with peers; substance misuse; anti-social behaviour; sexual behaviour; offending; violence and aggression; restless and overactive; easily distracted, attention span/concentration Identity, self-esteem, self-image and social presentation Baseline CAF Score Perceptions of self; knowledge of personal/family history; sense of belonging; experiences of discrimination due to race, religion, age, gender, sexuality and disability Family and social relationships Baseline CAF Score Building stable relationships with family, peers and wider community; helping others; friendships; levels of association for negative relationships Self-care skills and independence Becoming independent; boundaries, rules, asking for help, decision-making; changes to body; washing, dressing, feeding; positive separation from family Baseline CAF Score Learning Understanding, reasoning and problem solving Baseline CAF Score Organising, making connections; being creative, exploring, experimenting; imaginative play and interaction Participation in learning, education and employment Baseline CAF Score Access and engagement; attendance, participation; adult support; access to appropriate resources Progress and achievement in learning Baseline CAF Score Progress in basic and key skills; available opportunities; support with disruption to education; level of adult interest Aspirations Ambition; confidence and view of progress; motivation, perseverance; future goals. Baseline CAF Score 2. Parents and carers Basic care, ensuring safety and protection Baseline CAF Score Provision of food, drink, warmth, shelter, appropriate clothing; personal, dental hygiene; engagement with services; safe and healthy environment Emotional warmth and stability Baseline CAF Score Stable, affectionate, stimulating family environment; praise and encouragement; secure attachments; frequency of house, school, employment moves Guidance, boundaries and stimulation Baseline CAF Score Encouraging self-control; modelling positive behaviour; effective and appropriate discipline; avoiding over-protection; support for positive activities 3. Family and environmental Family history, functioning and wellbeing Baseline CAF Score Illness, bereavement, culture, size and composition of household; absent parents, relationship breakdown Wider family Baseline CAF Score Formal and informal support networks from extended family and others; wider caring and employment roles and responsibilities Housing Water/heating/sanitation facilities, sleeping Arrangements; reason for homelessness. Baseline CAF Score Employment and financial considerations Baseline CAF Score Work and shifts; employment; income/benefits; debt accrued, effects of hardship Social and community elements and resources, including education Day care; places of worship; transport; shops; leisure facilities; crime, unemployment, antisocial behaviour in area; peer groups, social networks and relationships; religion Baseline CAF Score Stress factors within Families Please tick the appropriate boxes if you, or any other parent/carer of your child, are experiencing any of the issues below Your worker can help make sure that you get the support that you need. Current Issue? Yes Does this impact on your child? No Yes No **Would you like some support? Yes No Drug use Alcohol use Mental health issues Domestic abuse Criminal conviction Learning difficulty Physical disability Terminal illness Debt issues Poor/overcrowded housing **If either parent/carer has indicated they would like support then the worker should make the appropriate referral If further information is needed then please see http://www.salford.gov.uk/contact-socialservices.htm Please provide details of any stress factors identified; Children’s Centres Is the child registered with a Children’s Centre? Yes No For more information about Sure Start Children’s Centres and registering see: http://www.salford.gov.uk/surestart.htm Young Carers Is there a possible caring role for the child or young person? Yes No “A young carer is a child or young person under the age of 18 who carries out significant caring tasks and assumes a level of responsibility for another person which would normally be taken by an adult.” (Princess Royal Trust for Carers) For more information email: [email protected] Private Fostering Is the child living in a private fostering arrangement or likely to live in one in the future? Yes No “Private fostering happens when a child (up to 16, 18 with a disability) is being looked after by someone other than parents, siblings, blood-related aunt/uncle, or grandparents for the majority of a 28 day period or more. By law, anyone involved in private fostering must inform the Private Fostering Officer in Salford City Council so they can get the support they are entitled to. This includes the child’s parents, carers or any third party/practitioner.” If yes or in doubt, contact the private fostering officer on 779 7800 or email: [email protected] What are your conclusions? Strengths and resources: Needs and worries: Actions Agreed Actions (in order of priority list the actions agreed for the people present at the assessment) Please ensure that all actions are SMART i.e. Specific, Measurable, Achievable, Realistic and Timed Desired Outcomes Action Who will do this? By when? As agreed with the child / young person / family Agreed review date A CAF needs to be reviewed every 412 weeks at level 2a/2b (TAC) on the CAF review and closure form. Parent or Carer’s comments on the assessment and actions identified; Child or young person’s comments/wishes and feelings on the assessment and actions identified; PLEASE ENSURE THAT THIS SECTION IS ALWAYS COMPLETED Supporting tools for children/young people of all ages can be found at ; http://www.salford.gov.uk/achildsvoice.htm Additional supporting information can be uploaded with the CAF form e.g. thoughts and feelings / pictures etc. Full name of child/young person Date of birth Consent for information storage and information sharing Information sharing guidance can be found at; http://www.salford.gov.uk/supportingtools.htm We need to collect the information in this CAF form so that we can understand what help you may need. I understand the information that is recorded on this form and that it will be stored, read for quality assurance and used for the purpose of providing services to: Me This infant, child or young person for whom I am a parent or carer I have had the reasons for information sharing and information storage explained to me and I understand those reasons Yes No I agree to the sharing of information except to the services listed below Signed Name Date Name Date Assessor’s signature Signed Send all CAFs to Children’s Services via the secure upload: http://www.salford.gov.uk/secureupload.htm You should send a ‘Referral Form to Children’s Services’ if you are requesting any service from the Early Intervention and Prevention Service. Remember to send a copy of the CAF to the parent and to any other professionals that are working with the family. Exceptional circumstances: concerns about significant harm to infant, child or young person If at any time during the course of this assessment you are concerned that an infant, child or young person has been harmed or abused or is at risk of being harmed or abused, you must follow your Local Safeguarding Children Board (LSCB) safeguarding children procedures If you think the child may be a child in need (under section 17 of the Children Act 1989) then you should also consider referring the child to children's social care.