Request for information/advice from the Post 16 setting to support
the Statutory Integrated Assessment for a young person
CONTEXT
This information is sought in accordance with the Children and Families Act 2014.
The Local Authority is seeking advice as part of an Education, Health and Care
Assessment.
Young Person's Details
Surname
Forename
Unique Pupil No.
Date of Birth
Educational
Setting
YR Group
Home Authority
Child Looked
After Yes/No
Address
Parent/Carer
Name
Relationship
Address (If
different from
above)
Phone Number
Parent/Carer
Name
Relationship
Address (If
different from
above)
Phone Number
Type of Advice
Statutory Integrated Assessment
Review of EHC Plan
Statutory Re-Assessment
Conversion advice from a Statement to
EHC Plan
Advice Givers Details:
Name
Job Title
Qualifications
Establishment
Name
Establishment
Address
Attendance Record- please provide as much information as possible
Name of
Educational Setting
Period (Dates)
Actual
Attendance (No.
of Sessions)
Possible
Attendance (No. of
Sessions)
Percentage
Attended
Section A
The Identified Special Educational Needs – What do you consider the young
person's difficulties to be which are acting as barriers to curriculum access and
progress. You may wish to complete more than one section.
Communication and
Interaction
Cognition and
Learning
Social, Emotional
and Mental Health
Sensory and/or
Physical Needs
Are there any additional significant factors – If the answer is yes please attach
copies of relevant information/advice
Health Yes/No
Attendance Yes/No
Home Circumstances
Yes/No
Social Relationships
Yes/No
Section B
Prior Attainment
Qualification Type: GCSEs/A Levels/Functional Skills/ Vocational /Other
Qual Subject/
QCF Date
Yr
Key
Awarding Grade/
Type course
Level
Group Stage
Body
Result
School/
Provider
English
Maths
Science
Diagnostic Assessment
Post 16 Baseline Diagnostic Assessments (where applicable)
Date
Age
Name of Assessment
Carried Out
By
Results
Current Programme of Study
Current Programme of Study
Element Of Study
Programme
Qual Type /Course
Title/Activity
Date
Course
Level
(QCF)
Substantial
Qualification(s)
English
Maths
Non Qualification
Activity
(Work-related learning,
tutorials, enrichment)
Total
Planned
hours
Current
Achieve
ment
Predicted
Grade/
result
Section C
Support provided and Funding – All educational settings are provided with
resources to support those with additional needs, including students with SEN and
disabilities. Please therefore identify the provision made from the schools delegated
budget to address the child/young person's needs:
SEN Delegated
Budget
£
Current support arrangements: Give details of the targeted support the
child/young person received that was additional to and different from normal
differentiated classroom/group arrangements
Type of
Provision: (In
class, group,
1:1)
Objective of
Provision
Frequency
& Duration
Delivered
by
Start
Date
Review
Date
Outcomes
(Achieved,
Partially
Met, Not
Met)
Additional Support – What additional support do you feel is required over and
above that already provided?
Outcome to
Achieve
Steps towards
Achieving Outcome
Timescales to
Achieve Outcome
Special Educational
Needs Provision
Required
Professional Involvement – List details of attached reports/evidence from
appropriate services
Service Provided By: (Name
& Role)
Name of Advice
Giver
Role
Signature
Date of
Report
Date
Assessed
Brief Description of Evidence
Attached
Date of Completion