CAF Form Common Assessment Framework for Children and Young People (CAF)

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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.
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