EHA Action Plan with confidentiality,sign in and closure feedback form
Early Help Action Plan
Actions agreed for practitioners, for the child/young person and for family members
:
For Internal Use
Name of Family:
URN (if appropriate):
Lead Professional or
Key Worker:
Relevant Agencies
Involved:
Date Focus of
Engagement/Outcome Star
Score
Action Who will do this?
By what date?
Version 4
August15
Comments from Review discussion
Signed off as
Achieved
(dated)
Early Help Action Plan
(Continued)
Date Focus of
Engagement/Outcome
Star Score
Action Who will do this?
By what date?
Comments from Review discussion
Signed off as
Achieved
(dated)
Signature of child/young person indicating consent to the Early Help Action Plan: …………………………………….. Date: ……………………………….
Signature of parent/carer indicating consent the Early Help Action Plan: …………………………………………………. Date: ……………………………….
Management Counter-signature (if required )…………………………………………………………………………………….. Date: …………………………………
Review date: …………………………… Reviewed by: ……………………………………………………. Result of Review: ….. ..………………………….
Review date: ……………………………
Review date: ……………………………
Reviewed by: …………………………………………………….
Reviewed by: …………………………………………………….
Result of Review: …..…………………………….
Result of Review: …..…………………………….
Multi Agency Meeting
Confidentiality Agreement
Date:
Venue:
Confidentiality
You have been invited to attend a meeting that include officers from Staffordshire County Council and other agencies. All agencies are considered to be Data Controllers under the Data Protection Act 1998 (DPA) and are also bound by the common law duty of confidentiality. Attendees are likely to discuss a wide range of issues and exchange personal and sensitive information relating to individuals to identify their service needs and risk of harm.
Attendees are required to share all relevant personal information and should be confident that it would only be used for matters discussed and decisions made within the meeting.
In appending my signature to this statement and attending the meeting and future multi agency meetings, I agree to maintain confidentiality and abide by the obligations under the Data Protection Act at all times. I shall only disclose information shared during the meeting when it is necessary to do so and as required by law.
I sign to confirm that I take full responsibility for any actions agreed by myself as part of the case discussions within this meeting, if I am aware of any outstanding issues, I will put them forward to the
Chair for discussion at future meetings.
Name Agency and Contact Details Signature
EARLY HELP ACTION PLAN: REVIEW
Date ……………
It is important to review progress with the Early Help Action Plan at regular intervals, and to record how the child / young person, family and practitioners feel that the plan is working.
Where a review results in a change to the Action Plan, complete the review form and continue with the Action Plan, recording new actions and outcomes.
Child/Young Person Name DOB Date that Team Around the
Child work has been completed
Present at the review:
Name of the Lead
Professional
Name
Service Contact Details
Service/Relationship to the child
Contact Details
Review notes and comments by the Lead Professional including Outcome Star scores:
Child/Young Person’s comments on the review and any further actions identified:
Parent/Carer comments on the review and actions identified:
EARLY HELP PLAN: CLOSURE AND FEEDBACK
If it is agreed that the aims of the Early help Action Plan have been achieved it is important to give the child / young person and their family the chance to tell us how they feel about the process. All parts of the form must then be sent to the relevant LST inbox.
CHILD/YOUNG PERSON FEEDBACK: If a decision has been taken to close the Early Help
Assessment, the child/young person should tick the statement which most applies.
1. I still don’t think I’ve had all of the help that I need and would like the support to continue.
2. I’m satisfied with the support I’ve been given and the changes that have happened in my life but still have some worries about what will happen without extra support.
3.
I’m very happy with the support I’ve been given and the changes that have happened in my life. I think it is the right time for the extra support to end.
Name: ………………………… Signature: ……………………………………… Date: …………….
Any other comments:
PARENT FEEDBACK: If a decision has been taken to close the Early Help Assessment, the parent/carer(s) should tick the statement which most applies.
1. I am unhappy with the decision to end the additional support.
2. I am satisfied with what has been achieved and do not object to this process ending.
3.
I am very happy with what has been achieved and it is the right time for the support to end.
Name: ………………………… Signature: ……………………… Date: …………….
Name: ………………………… Signature: ……………………… Date: …………….
Any other comments:
