Your family worker will work in partnership with you to provide extra support and assistance to help you make changes. This is voluntary and you can choose whether you work with them.
The Family Worker’s job is to:
• Get to know your whole family and understand all the issues.
• Work closely with all the other services who can help you. He or she will make the contacts from many services much simpler and more in step with each other.
• The family worker won’t just be talking to you, they can work with you to sort out the small practical problems in your life and with you, take steps to tackle the bigger issues.
Your Family’s job is to:
• Your family will need to want our help and to agree to work together to bring about change, but lots of families have found this really makes a big difference to getting back on track.
• Let the family worker know what is going well and when things are difficult.
Reasons for support
The families we work with usually have several things that they are concerned about. These might include:
• one or more children are not going to school every day,
• a parent or child with poor physical or mental health,
• a child with challenging behaviour,
• anti-social behaviour or youth offending,
• debt or money worries,
• problems with your home,
• bereavement or family breakdown or
• other issues.
You may have been contacted directly because the school or partner agencies are aware that you have problems that we can assist with. Or you may have already asked for help and filled in a form with someone you know like a teacher, health worker or social worker.
You have a say in what happens to your information
• You can ask to see the information stored about you at any time.
• If you would like a copy of your details, please contact your family worker. The law says that we must give you a copy of your records within 40 days of your written request.
• You can tell us if you think any information about you is wrong - we will change it.
• You can change your mind at any time about who we can share information with.
• We will keep information about you while you have a right to our support.
• You have the right to withdraw your consent at any time but this may limit the service we give you.
If you agree to work with us, you will be asked to sign this form to allow us to share some of your personal information with other agencies and services as part of your overall support plan.
Information will be shared on a “need to know” basis. We will share your information with other organisations if you agree and it is in your best interests. For example, we may share your information with:
• Other schools or children’s centres that your children attend or school support services.
• Housing, Council Services, Youth Offending Service, Police, Community Safety Team.
• School Nurse, Health Visitor, Child and Adolescent Mental Health Service.
• other professionals who can help you.

Your discussions with us are confidential, but in certain cases we might need to give information to someone else without asking you first. We will only do this in certain circumstances.
For example, if you tell your family worker:
• that you are being harmed or abused in any way;
• there is a threat to your life or safety or someone else’s; or
• you know someone has broken the law.
Your information will be kept secure and is protected by the Data Protection Act 1998.
Name:
Contact address:
Date of birth:
I know you already hold my basic details (name, address and date of birth) on your database. Yes ☐ No ☐
You can put extra information we have discussed onto your database. Yes ☐ No ☐
If ‘Yes’, can we share information with other people?
Yes ☐ No ☐
I agree to work with my family worker as explained by him/her. Yes ☐ No ☐
I fully understand the circumstances when information can be disclosed without my consent.
Yes ☐ No ☐
My family support worker has explained the contents of this confidentiality agreement to me.
Yes ☐ No ☐
Your signature(s) (parents or family members over 16 if living at home)
If only one parent or carer with parental responsibility is signing this form, please explain why:
Your family worker:
(Please print name)
Date:
Any information you provide on this form will be held by xxxxx school and other agencies strictly in accordance with the Data
Protection Act 1998 for the purpose of providing family support. Your information will not be shared with any third parties unless we are required to do so by law. If you have any questions relating to the use of your data, please telephone the school on 023 xxxx xxxx.
Parents and Family Workers should sign two copies of this form. One is for the family to keep. One will be kept by the school.