CAF Form
Common Assessment Framework for Children and Young People (CAF)
PLEASE ENSURE THAT ALL SECTIONS ARE COMPLETED
Assessment Start Date
14/03/2014
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
Author
Role
Organisation
Address
Sam Smith
SENCO
Case Study High School
Swinton Road
Swinton
Postcode
M30 2PT
Telephone
E-mail
0161 231231
sam.smith@casestudyhigh.gov.uk
CAF co-author (optional)
See http://www.salford.gov.uk/d/CAF_Co-author_definition.pdf
Co-Author
Role
Organisation
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
Lisa May (Case Study)
Female
Family name
Unknown
Taylor
AKA /previous names
1 Case Study Lane
Swinton
Salford
Date of birth or EDD
01/03/2000 - Year 9
Child’s 1st language
English
Postcode
M27 9TY
Parent’s 1st language
English
Contact No
0161 231231
Immigration Status
British
E-mail Address
not given
Interpreter required?
Address
Ethnicity
White
Black or Black British
Asian or Asian British
White British
Caribbean
Indian
White Irish
African
Pakistani
Traveller of Irish
Heritage
Any other Black
background
Any other Asian
background
Gypsy / Roma
Mixed/Dual Background
White & Black
Caribbean
White & Black
African
Chinese & Other
Bangladeshi
White & Asian
Not given
Any other mixed
background
Any other White
background
Chinese
Any other
ethnic group
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?
Lisa's mother Julie, left the household with her younger brother Robin 2 months ago. Lisa's has become very quiet
and withdrawn, but then also has very emotional outbursts, often bursting into tears; she has also been verbally
aggressive to both her peers and school staff; she often appears very tired, is pale and has lost weight. Her
attendance has started to drop.
Details of parents/carers
Name
Michael Taylor
D.O.B.
Relationship to unborn baby, infant, child or young person
Address
1 Case Study Lane
Swinton
Salford
Postcode
M27 9TY
Email:
Name
Parental responsibility?
Yes
No
D.O.B.
Relationship to unborn baby, infant, child or young person
Address
Father
Contact tel. no.
Julie Taylor
12/07/1971
0161 954 7534
26.5.1969
Mother
Unknown
Parental responsibility?
Yes
No
Postcode
Email: unknown
Contact tel. no.
unknown
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
Lisa lives in a private property with her father. Lisa's mother and brother (5 years old) left the family home 2 months
ago. Lisa has had no contact apart from two phone calls when she first left. Mother's current address is unknown.
Lisa's mother told Lisa that she has a new boyfriend and that when Lisa finishes school, she wants Lisa to come and
live with her.
Universal
Services working with this infant, child or young person
GP
Details
Dr John Harvey
Swinton Medical Centre
Swinton Drive
Swinton M27 5XX
Tel.
0161 123 4567
Early
years/education/FE
training provision
Details
Case Study High School
Swinton Road
Swinton
M27 5ZZ
Tel.
0161 278 0987
Swinton Health Centre
139 Partington Lane
Swinton
M27 0NS
Tel.
0161 255 7689
Other services
Service
School Nurse
Gemma Piper
Details
Service
Details
Tel.
Service
Details
Tel.
Service
Details
Tel.
People present during the assessment
Lisa Taylor- young person
Michael Taylor-dad
Sam Smith-SENCO
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
Lisa states that she has a poor appetite, no energy, is having
trouble sleeping and appears to have lost weight. Lisa has recently
visited her G.P. who prescribed some mild sleeping tablets,
however Lisa states that these don’t seem to be helping. Lisa states
that when she goes to bed at night “her brain won’t shut up” and she
lies awake for hours.
Lisa has had all her immunisations; she has regular dental checks.
Physical development
Nourishment; activity; relaxation; vision and
hearing; fine motor skills (drawing etc.); gross
motor skills (mobility, playing games and sport
etc.)
Speech, language and communication
Preferred communication, language,
conversation, expression, questioning; games;
stories and songs; listening; responding;
understanding
Emotional and social development
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
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
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
Building stable relationships with family, peers
and wider community; helping others;
friendships; levels of association for negative
relationships
Baseline CAF Score
Lisa regularly went swimming with her father and younger brother.
However, she no longer goes swimming and often truants from P.E.
because she is too tired to take part.
Lisa also says that she has no appetite and sometimes ‘forgets’ to
eat, she may not eat anything other than an apple and a piece of
toast during the day. Michael Taylor (father) states that he has
noticed that Lisa has lost weight. Michael and Lisa do not eat meals
together as Michael will often go to the chip shop on his way home.
Baseline CAF Score
Lisa presents as an articulate young person, she has a wide
expressive vocabulary and communicates effectively.
Recently Lisa has become increasingly quiet and withdrawn within
school, both in and out of the classroom.
Baseline CAF Score
Lisa states that she feels very emotional all the time at the moment,
she often cries. Lisa states that she is very angry with her mother for
leaving and angrier with her for taking her brother away from her.
Lisa also states that she is hoping that her mum will change her
mind and come home.
Lisa and Michael both agree that their relationship is quite tense at
present; they were never particularly close. Lisa was very angry with
Michael when Julie first left because she thought that he knew Julie
was going to leave and didn’t tell her. Lisa feels she has cut herself
off from her peers because she feels isolated.
Baseline CAF Score
Lisa’s behaviour in school has become quite erratic. Sometimes
she will be very quiet and withdrawn, and at other times she can
have aggressive outbursts, shouting and swearing. Lisa states
that this happens because sometimes she feels as though
everything gets on top of her and then she explodes. Lisa has
been put on report for her behaviour and she states that she has
also been called a ‘freak’ by some of her class mates. When Lisa
is quiet she states that she just wants to be left alone because all
she can think about is her mum and brother.
Baseline CAF Score
Lisa states that before her mother left she believed that she was a
confident person; she liked school and had lots of friends. Although
she sometimes argued with her mum, Lisa states that most of the
time they got along ok. Lisa was quite independent and now feels
that she doesn’t want to go out anywhere and only feels safe when
she is at home.
Baseline CAF Score
Lisa and her father have a strained relationship at the moment. She
does not have much contact with her friends anymore; Sarah who is
her closest friend still rings her regularly and Lisa will chat to her
about school and friends, etc. but she doesn’t want to talk about her
mother. Lisa’s other friends have distanced themselves from her
because she doesn’t want to go out anymore; Lisa states she
doesn’t want to lose Sarah’s friendship.
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
Lisa states that although she is forgetting to eat sometimes, she is
capable of preparing simple meals for herself; i.e. beans on toast,
sandwiches, etc. She has taken on the responsibility of doing the
washing and cleaning in the family home and doesn't mind but she
hates doing the ironing. Michael adds that he is very grateful to Lisa
for helping out and that he tries to help as well.
Learning
Understanding, reasoning and
problem solving
Organising, making connections; being creative,
exploring, experimenting; imaginative play and
interaction
Participation in learning, education
and employment
Access and engagement; attendance,
participation; adult support; access to
appropriate resources
Progress and achievement in learning
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
Previously Lisa engaged in class group activities and contributed
useful ideas and comments. However, as previously stated Lisa is
now very quiet and withdrawn, especially during group activities,
she will disengage and rarely offers her own thoughts or
suggestions.
Baseline CAF Score
Lisa’s attendance at school was previously 98%, however over the
last 2 months this has dropped to 89% with Lisa often missing a day
or two each week. Lisa states that the reason for this is sometimes
she will be awake for most of the night and then fall asleep at about
5 or 6 o’clock. When Lisa has an emotional outburst in class, she is
sent to see myself in seclusion. However, Lisa’s outbursts have
more commonly been during lunch or break times; Lisa states that
this is because she can’t cope with the noise and chaos of these
times. Whilst in seclusion Lisa will sometimes talk about any
problems she is having.
Baseline CAF Score
Due to her non-attendance Lisa has fallen behind in some of her
subjects. When she is in school, she does her work and completes
her homework. Lisa’s maths, art and ICT teachers report that Lisa
has some work which is outstanding. Lisa states that doing her
school work helps her to stop thinking about her mother and brother.
Michael states that he is worried that Lisa is sometimes missing
school.
Baseline CAF Score
Lisa states that she would like to go to college when she leaves
school and eventually work with children. Lisa does not want to get
behind with her school work but she says that at the moment it
doesn’t seem very important.
2. Parents and carers
Basic care, ensuring safety
and protection
Provision of food, drink, warmth, shelter,
appropriate clothing; personal, dental hygiene;
engagement with services; safe and healthy
environment
Emotional warmth and stability
Stable, affectionate, stimulating family
environment; praise and encouragement;
secure attachments; frequency of house,
school, employment moves
Guidance, boundaries
and stimulation
Encouraging self-control; modelling positive
behaviour; effective and appropriate discipline;
avoiding over-protection; support for positive
activities
Baseline CAF Score
Lisa lives in a clean, warm house. She has appropriate clean
clothing. Michael states that there is always food in the freezer and
that he gives Lisa money each day to buy lunch and anything else
she may want. Lisa spends quite a lot of time at home on her own,
especially if she is not in school and also on a Saturday.
Baseline CAF Score
Michael states that he used to feel close to Lisa when she was
younger but that he finds it difficult to be openly affectionate with Lisa
as he feels a bit awkward and embarrassed. Michael also feels that
Lisa states that she was very close to her younger brother, she used
to play with him and misses him very much. Lisa is worried that her
father might leave one day to look for her mother. Michael has tried
to reassure her that he isn’t going to do this.
Baseline CAF Score
Michael states that Lisa is a well behaved young person and that he
rarely has to discipline her. Household rules and boundaries have
been embedded into the family routine; i.e. mealtimes, bedtimes,
curfews, etc. Discipline for Lisa has included being grounded and not
being allowed to use the telephone.
3. Family and environmental
Family history, functioning and wellbeing
Illness, bereavement, culture, size and
composition of household; absent parents,
relationship breakdown
Wider family
Formal and informal support networks from
extended family and others; wider caring and
employment roles and responsibilities
Baseline CAF Score
Lisa’s parents have been married for 14 years. Michael states that he
thought that their relationship was reasonably stable although they
used to argue over Micheal going to the pub. Lisa’s mother Julie left
the family home without telling anyone she was going. Lisa returned
home from school to find that both her mother and brother had left
and taken all their belongings with them. Julie had left a note saying
that she had a new boyfriend and that they had gone to live with him.
Michael knows he needs to speak to a solicitor to begin divorce
proceedings and to seek advice about seeing Robin.
Julie has rang the family home twice since and has not mentioned
wanting to see Lisa. Lisa feels that her mum doesn’t love her
anymore. Michael states that he hopes in the future that he and Julie
come to an agreement about the children so that they can all see
each other again. Michael stopped taking medication some years ago
for depression and has been feeling down but puts this down to what
has happened more recently with Julie leaving with Robin.
Baseline CAF Score
Lisa’s maternal grandmother and maternal aunt both live in the local
area. Lisa’s father does not have any contact with his family. Lisa
occasionally visits her extended family but states that they are all
busy with their own lives. Michael has a very good relationship with
the next door neighbours, they often check on Lisa when she is home
alone. Lisa knows she can go next door if she has any problems.
Housing
Water/heating/sanitation facilities, sleeping
Arrangements; reason for homelessness.
Employment and
financial considerations
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
Michael and Lisa live in a private rented house with 3 bedrooms. The
house is in good state of repairs. Both the heating and water are on a
meter. Lisa has her own bedroom and there is now a spare bedroom.
Michael is now a month behind on rent which is now becoming
unmanageable since Julie left
Baseline CAF Score
Michael states that he now has to work overtime and on Saturdays to
compensate for the income Julie contributed from her part time job,
and that he has just been given his termination of employment.
Michael is extremely worried as he will have no job in a month’s time
and is a month behind with the rent and the landlord has been very
understanding so far
Baseline CAF Score
The family home is situated in an area with many social resources;
i.e. local shops, library, leisure centre, etc. However, due to the
current situation Lisa is not accessing these facilities.
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;
Michael has had a history of depression but feels he is a able to manage this currently. Michael acknowledges
that he has got into a habit of drinking alcohol almost every night and would like some support to reduce his
alcohol consumption.
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: carers.centre@salford.gov.uk
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: privatefosteringoffice@salford.gov.uk
What are your conclusions?
Strengths and resources:
•
•
•
•
Supportive father and extended family support
Lisa is a bright and articulate young person
Previously had good school attendance and attainment
Father and Lisa want some support and want to make their relationship better
Needs and worries:
•
•
•
•
•
•
Lisa’s weight loss
Lisa’s problems sleeping and feeling tired
Lisa not having contact with her mother nor her brother
Now a single parent household
Poor school attendance and effect on Lisa’s attainment
Michael is losing his job and having money difficulties and at risk of becoming homeless
Actions
Agreed Actions (in order of priority list the actions agreed for the people present at the assessment)
Desired Outcomes
Action
Who will do this?
By when?
As agreed with the child / young person / family
Lisa to stop losing weight
Lisa to visit her G.P. to
comprehensively discuss
her worries and concerns
and ask for appropriate
help and support.
Lisa Taylor with the
support of Sam
Smith
By the end of
next week
More support for Lisa at
school in terms of her
education, behaviour,
emotional well being and
social networks
To arrange a school
meeting with all Lisa’s
teachers to discuss her
current situation and plan
appropriate support in
school.
Sam Smith
5/10/2014
Emotional support for Lisa
and Mike in relation to the
breakdown and split of the
family
To request Brief
Intervention Team because
the risk of relationship
breakdown for Lisa and
Michael.
Sam Smith
28/9/14
Michael Taylor
21/9/14
Lisa to get a peaceful
night’s sleep
Improved support for
Michael in improving his
relationship with Lisa and
support with practical
issues.
For the grandma to be
contacted to see if she can
offer Michael some
practical and emotional
support on a weekly basis
28/9/14
For Michael Taylor to
receive some advice about
getting back into work and
benefits
To make a referral to Skills
and Work in EIP and for
Michael to visit Citizens
Advice Bureau (CAB)
Sam Smith
21/9/14
Michael Taylor
28/9/14
Joined up working through
a co-ordinated response
To convene a Team
Around the Child meeting
Sam Smith
19/10/2014
Agreed review date
20/10/2014
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;
I am happy to receiving some support and would like to spend more time with Lisa.
Child or young person’s comments/wishes and feelings on the assessment and actions identified;
I want to be able to talk to somebody about how I am feeling and then maybe I will be able to sleep properly. I
don’t want to get into trouble at school and I don’t want to lose my friend Sarah. I am really missing my little
brother and all I want to do is see him again.
Full name of
child/young person
Date of birth
Lisa May Taylor
1/3/2000
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
Held on paper copy
Name Michael Taylor
Date
21/09/2014
Lisa Taylor
Assessor’s signature
Signed
Held on paper copy
Name Sam Smith
Date
21/09/2014
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.