uidance for \schools on The Transfer Review Process 2014-16

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‘’Working together with families to meet
children and young people’s needs’’
Transferring Statements to
Education Health and Care
Plans 2014 - 2018
Guidance for schools
1
Contents
Page
Introduction – What is a Transfer?
2
What the Local Authority will do
2
Schools step by step guidance to the Transfer Process
4
Appendix 1 – Key terms and phrases
7
Appendix 2 – Transfer Process Flow Chart
8
Appendix 3 – Local Authority Template letter Transfer Notification to Parents
10
Appendix 4 – Schools Template Letter Inviting Parents to Transfer Meeting
11
Appendix 5 – Local Authority Template Letter issued with Draft EHC Plan
12
Appendix 6 – Local Authority Template Letter issued with Final EHC Plan
13
Appendix 7 – Year 11,12,13,14 choice letter
14
Appendix 8 - SENDIASS Leaflet
15
Appendix 9 – Local Authority Transition Schedule 2014-18Schools Template for
recording the Transfer meeting and Annual Reviews
17
Appendix 10 – Transfer Review/Annual Review Meeting Summary
1-5
2
Guidance for Schools on transfer reviews
This advice is for SENCOs, Head Teachers and Keyworkers in schools for completing
transfers to EHC plans
Introduction – What is a Transfer Review?
Under the Children’s and Families Act 2014 there is a requirement to conduct
transfer reviews on all children and young people with statements of special
educational needs with a view to transferring those statements to Education Health
and Care Plans where appropriate. This ‘transfer review’ process is an Education
Health and Care Assessment. All transfer reviews must be completed by 1st April
2018. The transfer review will be completed through the annual review process in the
relevant academic year. Priority will be given each year to those students moving
between phases of education and between educational institutions. The time scale
for Coventry’s transfers can be found in appendix 2.
The process MUST be person-centred, taking into consideration the needs of both
the child/young person and their parents/carers. It will allow for outcomes to be
developed for inclusion in their EHC plan and provision identified supporting the
child/young person to achieve those outcomes. This can only be achieved with the
full participation of agencies working with the child/young person.
The following guidance has been written to assist schools in carrying out their
responsibilities to ensure this process is undertaken in both a timely fashion and results
in outcomes that are SMART, aspirational and person centred.
What will the Local Authorities SEN team do to assist schools with this Process?
We will inform you which children/young people are due to have a transfer review
of their statement each academic year. We will do this by providing an accurate list
of named students at least two weeks before the start of the term in which the
transfer reviews are due to take place. We will also notify Childrens Commissioning
Groups (CCG’s) and Social Care professionals so they are aware of which reviews
are to be conducted each term.
We will highlight which children/young people need to have their transfer review
focussed on preparing for adulthood. Although this should start as soon as the
child/young person is known to us it is particularly important that reviews in Year 9
and in subsequent years focus on preparations for adulthood(8.9 SEN Disability Code
of Practice 2014).
We will notify parents/carers of the commencement of the transfer review process
giving at least two weeks’ notice. This will include information about the
Independent support available to them. (See Appendix 5)
We will request updated advice from professionals if existing information is deemed
to be out of date following the family conversation (Family conversations must to be
3
conducted in the term before the transfer review to enable enough time for all
appropriate advice to be sought).
The Childrens and Families Act 2014 provides young people (a young person who
has reached the end of compulsory school age: end of the academic year in which
they turn 16) significant new rights, Local Authorities, schools and other agencies
should engage direct with the young person rather than a parents, Mental capacity
is to be presumed unless proven otherwise. Professionals must ensure the young
person is given a choice about their SEN support needs. The Local Authority will write
to young people in year 11 to give them a choice as to whether they wish to have
their Statement transferred to an EHCP or not. It they choose not to be transferred
their Statement will be ceased. See Appendix 8 template letter.
4
What are the school responsibilities with regards to Transfer Reviews?
First and foremost, know who it is that needs to be reviewed and transferred. The
transfer review process will take a good deal of time so planning is of the essence.
Below is a basic step by step guide as to what will need to be done and by whom.
Step 1 – The Family Conversation, My Views & information update
Section A of the Education, Health and Care Plan is called ‘The views, interests and
aspirations of me and my parents.’ The view and the family and child/young person
is the principal at the core of the Childrens and Families Act 2014. This meeting will
identify the needs of the family across education, health and social care early
meaning request for assessments, referrals and reports can be made in plenty of
time. In order to enable the full representation of these aspirations and views,
schools will need to meet with the child/young person and their family in the term
before the transfer review meeting is due to take place. For year 6 this will need to
under taken in the summer term of year 5.
It is important that the parent/carer/young person is offered independent support
through Grapevine (Tel 02476 631040) at this point. Grapevine can help to support
the family conversation process for all concerned and are experienced and a great
source of help. This will be available until March 2016. If parents/CYP are already
receiving support from the Independent Support Service this support can continue
(see appendix 9).
At this meeting you should complete the Family Conversation and the My Views
documents. If parents wish to complete these independently they can but these
documents MUST be completed to ensure the EHC assessment accurately reflects
their views. Allowing parents to see the forms beforehand will enable them to
prepare better for the conversation and think about responses in advance.
The local authority insists that any person conducting the Family Conversation must
use the templates (CLICK HERE OR PASTE THE FOLLOWING INTO YOUR BROWSER:
http://www.coventry.gov.uk/downloads/62/special_educational_needs_and_disabil
ities_support_services )
5
It is at this meeting that school should identify any information that needs to be
updated e.g. personal information, professionals’ reports.
If the school considers updated professional reports are necessary to inform the
transfer review this MUST be requested by the educational setting early enough to
ensure that the completed report is available for the transfer review. This will ensure
that any up to date advice can be provided within the 14 week timescale within
which the review must be completed.
Step 2 – Organising your transfer reviews calendar based on the transition timetable
A “Transfer review meeting” will start a “transfer review” in Coventry and will take the
same form as that of an annual review. Schools are responsible for organising the
“transfer review meeting” inviting all appropriate people including SEN Education
Officer, health, social care, any other professionals involved with the child or young
person, people requested by parents, carers or the young person in the Family
Conversation. Whilst notification of the date requires at least two weeks’ notice to all
parties, it is expected that participants will be informed of dates well in advance of
this to ensure attendance.
Please refer to the key dates in the Appendix 7 for transfer reviews so you can
organise the dates for the academic year ensuring time scales for the process can
be met. You will have a list of students due for transfer supplied to you by the LA well
in advance (at least 2 weeks before the start of the term in which the transfer
reviews are due to take place) so you can plan these dates and enable plenty of
notice to be given to families and professionals.
Once the Education Officer has the dates for the meetings, the local authority SEN
team will issue notice to parents or carers to notify the start date of the transfer
review process. The formal process is fourteen weeks.
Step 3 – The Transfer/Annual Review Meeting
Using the planned dates in step 2 the school will organise the transfer/annual review
meeting inviting all appropriate people including health, social care, any other
professionals involved with the child or young person including people requested by
parents, carers or the young person. Schools MUST give at least two weeks’ notice of
the date of the transfer review meeting. The school MUST ensure that existing advice
is circulated to all appropriate people involved with the child/young person prior to
the meeting. It is imperative that if advice is out of date e.g. specific health or social
care interventions are no longer appropriate that this is identified and recorded at
the meeting and MUST be requested at the earliest opportunity to ensure that the
EHCP is accurate and current and that any advice is available to enable the review
to be completed within the 14 weeks’ timescale.
6
Step 4 – Post meeting Process
Formal notes from the meeting using the template at Appendix 8 should be used.
This MUST be sent together with family conversation and my views to the SEN
Education Officer within two calendar weeks of the transfer review meeting.
Step 5 – The Local Authority and the Draft Plan
The Local Authority will gather the evidence required and using the information from
the transfer review meeting will prepare the draft EHC plan.
If the Local Authority decides that an EHC plan is not required as a result of the
transfer review process then the decision will be circulated to all involved within ten
weeks.
In the majority of cases a draft EHC plan will be written and circulated within eight to
ten weeks.
Step 6 – Consultation
The draft plan will be sent to the school that the child or young person is transferring
to (if in a transition year), the parents/young person or carers and any advice
providers (the current education provider is not included at this point) for comment
at least fifteen days before the final plan must be issued. See template letter issued
with draft plan Appendix 6
Step 7 – The Final Plan – conclusion of Transfer Review
The final plan will be issued to the parent of the child or the young person and the
governing body, proprietor or principal of any school or other institution named in
the plan and the responsible commissioning body for health care provision. Form this
point the statement is ceased and replaced by the EHC Plan. The education setting
named in the plan is responsible for ensuring that special needs provision is put in
place and any reasonable adjustments are made. See template letter Appendix 6.
7
Key Terms and Phrases
Education, Health and Care Plan: EHC plans set out how services will work together
to meet the child or young person’s needs. EHC plans are based on a co-ordinated
assessment and planning process which puts the child and young person and their
parents at the centre of decision making. They will replace the statement of special
need. The Local Authority must secure the special educational provision identified in
the plan.
Transfer Review: This is a process that MUST take place in order to transfer a student
from a statement to an EHC plan. It will also ensure smooth transition for students
transferring to a new educational setting. It includes the Family Conversation, My
Views, a transfer review meeting, a draft plan, consultation and the issuing of a final
plan.
Family Conversation: This document
must be completed to help the Local
Authority (LA) complete Sections A-D
in the EHC Plan. The Family
Conversation will seek the views of the
child or young person and their
parents or carers to enable the LA to
get a full picture of the child or young
person, what’s important to them and
their family and what their needs are
currently. This is completed with the
key worker within the school.
Independent support is available to help with this document.
My Views: This document is to be completed
with the child or young person and the key
worker within school. It gives the child or young
person a voice in the process and enables all
to see their strengths, areas they struggle in and
how they feel.
Appendix 1:
8
Transfer Process Flow chart
Local Authority issues list of students to be transferred to schools/ CCG’s/Social Care
at least 2 weeks before the beginning of each term (for year 5 moving to year 6 this
will be issued in the summer term)
School arranges dates for Family Conversations and My Views throughout the
academic year informing the Local Authority. (to take place the term before
Transfer Review meeting)
Schools plan Transfer Review Meeting dates throughout academic year and sends a
copy to the Local Authority, Social Care and CCG’s to aid planning.
Local Authority issues notice to parents of start of transfer review at least 2 weeks
before the meeting is due to take place Appendix 3
Schools issue transfer review meeting invitation letter to parents and other
professionals inviting them to the transfer review meeting using dates already
agreed. Forward copies of family conversations and my views to all agencies invited
to transfer meeting in advance Appendix 4
Transfer Review Meeting takes place – school to record all actions agreed at
meeting, targets, SMART Outcomes (using template at Appendix 8)
School forwards Information recorded at Transfer review and Family
Conversation/My Views to Local Authority within 15 days of meeting
SEN Officer uses Transfer review information to develop the draft plan – requesting
further information where required
Health, Social Care and other agencies must return advice requested to Local
Authority within 6 weeks
9
Local Authority to issue draft EHC plan or notice that EHC will not be written to be sent
out by week 10 to parents, schools and other agencies Appendix 5
Parents have 15 days to comment on content of draft plan and name a preferred
school/post 16 education provider
Local Authority to issue Final Plan by week 14 to school, parents (if student is moving
to a new provider EHC plan to be issued to the new provider) Appendix 6
Year 11/12/13/14 – Young Person Choice letter – Appendix 7
Appendix 2
10
Dear parent/carer,
Re: Transfer of NAME’s Statement of SEN to an Education, Health and Care Plan.
NAME currently has a Statement of Special Educational Needs. I am writing to notify
you that the Local Authority is required to conduct a transfer review to determine
whether the statement should be transferred to an Education, Health and Care
(EHC) Plan under new legislation which came into force on 1 September 2014.
Education, Health and Care Plans detail the special educational provision to meet
the special educational needs of a pupil to secure the best possible outcomes for
them across education, health and social care and, as they get older, to prepare
them for adulthood.
To transfer a pupil from a Statement of SEN to an EHC Plan, the local authority must
undertake a “transfer review” which is an Education, Health and Care needs
assessment. A “transfer review” meeting has been arranged for xxxxxxxxxxx(date) at
xxxxxxxxxxx(school). This meeting will be similar to an annual review meeting to
which the school will also invite relevant professionals to consider NAME’s progress
and future provision required.
Your views and those of NAME are at the centre of this process. A lot of the
information we already have in NAME’s Statement is likely to remain accurate but we
need to see whether the advice we already have is sufficient or what new or updated
advice is required.
At the end of the transfer review process we will have been able to make an
informed decision together with you to agree you support needs moving forward.
Where these needs can be met through the Colleges’ existing special educational
needs funding we will not be issuing and Education Health & care Plan. Where the
assessment process identifies additional needs that cannot be met through the
colleges SEN funding we will issue a EHC Plan.
If you feel you need some support with this process, you can enlist the help of an
Independent Supporter. They are trained to support parents/young people through
the EHC Plan, and enable you to get your views across. Enclosed is a leaflet
explaining the ways in which they can support you, and how to contact them.
Within 10 weeks of this notice we are required to notify you if we decide not to issue
an EHC Plan or within 14 weeks of this notice we will issue a draft EHC Plan. You
have rights to appeal to the First Tier Tribunal Service if you are unhappy with the
decision reached.
SEN Management Services
Contact details…………….
Encl: Independent Support Leaflet details
Appendix 3
11
Dear parent/carer,
Re: Transfer Review Meeting Invitation.
NAME currently has a Statement of Special Educational Needs. You will have
recently received a letter from the Local Authority notifying you of the transfer review
process to consider the transfer of your child from a Statement to an Education
Health and Care Plan.
I am writing to invite you to the transfer review meeting here in school on XXXXX.
This meeting will be similar to an annual review meeting to which we will also invite
relevant professionals to consider NAME’s progress and future provision required. If
you have anyone in particular that you would like us to invite that is currently
supporting XXX then please let us know.
I would be grateful if you could confirm that you will be attending this meeting either
by telephoning me on XXXX or emailing a confirmation to XXXX
If this date is not convenient please let me know within the next 5 days so I can rearrange a convenient date and inform everyone that has already been invited to the
meeting.
Yours sincerely
SENCO
XXXX School
Appendix 4
12
Dear parent/carer,
Re: Transfer of NAME’s Statement of SEN to an Education, Health and Care Plan.
Following completion of the transfer review process I am now enclosing the draft
plan the contents of which were discussed with you during the recent Transfer
Review meeting held in school.
Although schools are assisting us in this process, your child’s special educational
needs will remain the responsibility of Coventry City Council. We are pleased that
you have been able to take part in this process and have had a chance to put your
views and your child’s views forward to inform the draft plan. We have had to work to
very tight deadlines but have done our best to ensure the draft plan reflects the
needs and aspirations of XXX. You now have an opportunity to think about what was
said and a chance to comment.
The enclosed draft EHCP has been developed using the information discussed at
the Transfer meeting held at the school and any updated information received from
appropriate professionals involved with NAME.
The plan is a draft version so that you have a chance to read it and forward any
comments before the EHCP is finalised. If your child is in a transition year and will be
moving schools then you have a chance to state your preference along with any
comments as part of this process. If your child is not moving school we will still need
to name the current school in the final EHC Plan.
Legally we have duty to issue the final EHCP within fourteen weeks from the start of
the Transfer review process. Therefore we would be grateful if you have any
comments about the enclosed plan to let us know within the next fifteen days.
If we do not hear anything by XXXX we will assume you are satisfied with the EHCP
and will issue the finalised version.
SEN Management Services
Contact details…………….
Appendix 5
13
Dear ***
Following the completion of the Transfer process I am now enclosing a copy of ***’s
final Education, Health and Care Plan for your information.
I do hope you have found the process to be supportive to you and your family and
that you feel confident that *** special educational support needs are being met. As
we would like to improve our processes your feedback is invaluable in helping us to
ensure that we can make it as easy as possible and stream lined for other families.
We would be grateful if you could spend a few minutes giving us feedback about
your experience of the new processes. You can do this online at the following link:
http://www.coventry.gov.uk/localoffer
If you have any concerns or disagree with any part of the final Education, Health and
Care Plan you can get advice or support from the SEND Information, Advice and
Support Service. They can be contacted at Limbrick Wood Centre, Thomas Naul
Croft, Tile Hill, Coventry, CV4 9QX, telephone: 024 7669 4307. A mediation service
is also available details of which can also be found on the Local Offer website at:
http://www.coventry.gov.uk/sendeducation
Using either of these services does not prevent you from appealing to the Special
Educational Needs and Disability Tribunals Service about the plan at the same time;
your rights are not affected and an appeal to the Tribunal can run at the same time
as any disagreement resolution. You have 2 months of the date you receive this
letter to appeal. You can find out further information from HM Courts & Tribunals
Service, Special Educational Needs &Disability Tribunal, 1st Floor, Darlington
Magistrates’ Court, Parkgate, Darlington, DL1 1RU, helpline 01325 289350, fax 0870
739 4017 or e-mail sendistqueries@hmcts.gsi.gov.uk. Website: www.sendist.gov.uk
If you have any questions, now or at any time, about the plan itself, your case worker
*** can be contacted at SEN Management Services, CC2.3, New Council Offices,
Earl Street, Coventry CV1 5RS or on telephone number 024 7683 ***.
Yours sincerely
For the Director of Education & Inclusion
Appendix 6
14
Dear ***
I am writing to you as you will soon be finishing year 11/12/13/14* and moving to a new
college/school. I am sure you are looking forward to a new challenge in the next phase of
your education or training helping you to prepare for adulthood and independence.
For us to identify your support needs moving into your next educational provision we will be
undertaking an education health and care needs assessment. We want to ensure that your
views are at the heart of this process and are taken into account about decisions regarding
your future.
At the end of the transfer review process we will have been able to make an informed
decision together with you to agree you support needs moving forward. Where these needs
can be met through the Colleges’ existing special educational needs funding we will not be
issuing and Education Health & care Plan. Where the assessment process identifies
additional needs that cannot be met through the colleges SEN funding we will issue a EHC
Plan.
If you would like support through the transfer process you can contact Grapevine the
Independent Support Service on 02476…
If you have any questions, now or at any time, about this process, your case worker *** can
be contacted at SEN Management Services, CC2.3, New Council Offices, Earl Street,
Coventry CV1 5RS or on telephone number 024 7683 ***.
I wish you every success in the future.
Yours sincerely
For The Director of Education and Inclusion
Appendix 7
15
Appendix 8
Special Educational Needs and Disability
Independent Supporters
Available to assist Parents, Carers, Children and Young People
Between September 2014 and March 2016 the Government has made
funding available to provide specialist individual support to parents,
carers, children and young people who are involved in an
Education, Health and Care (EHC) Needs Assessment.
Trained Independent Supporters will work with you throughout the
assessment period. They can explain each stage, help you to get your
views across and ensure you take an active lead role in this process.
Independent Support in Coventry will be provided by Grapevine and the
SEND Information, Advice and Support Service (formerly Parent
Partnership Service). If you would like to find out more please contact:
Grapevine will work with families who are
transferring from a Statement to an EHC Plan
and new assessments of pupils aged 16yrs
and over.
nbaker@grapevinecovandwarks.org
Tel: 024 7663 1040
SEND Information, Advice and
Support Service (IASS) will work with
families of pupils up to the age of 16yrs who
are new to the EHC needs assessment
process.
www.coventry.gov.uk/iass
Tel: 024 7669 4307
16
What does an Independent Supporter do?
Independent Supporters will provide parents and young people with time
limited help to support the parent or young person during the EHC needs
assessment and planning process.
The role of the independent supporter is to:
 Help the parent or young person understand the local
referral process and local offer
 Act as a named contact person for the parent or young
person throughout the EHC assessment and planning
process
 Focus on the main task of helping parents and young
people to transfer a statement of SEN to an EHC plan
(transfer reviews)
 Work with parents of children who are new EHC
referrals, and/or young people (and their parents) who
are coming up to school leaving age and would have
had a Learning Disability Assessment under the old
system
 Liaise across a range of local services with the parent
or young person to help gather information required for
an EHC plan
 Provide information to parents and young people on
personal budgets
 Signpost parents and young people to local
Information Advice and Support (IAS) services
(formerly Parent Partnership Service) when the issue
is outside the remit of Independent Supporter.
4
Coventry City Council Calendar of Transfer Deadlines2014-2018
2014-15
2015-16
2016-17
15th
February
2015
31st May
2015
Summer
Term
15th
February
2015
31st
March
2016
Summer
Term
Year 6’s
with
Statements
transferring
to
Secondary
School
Year
11,12,13,
14 moving
on and
transferring
from their
current
educational
setting
Complete
Step 1 in
the
guidance
for
current
Year 5’s
in
preparati
on for
year 6
transfer
Year 6’s with
Statements
transferring
to Secondary
School
Year 9’s
Complete
Step 1 in the
guidance for
current Year
5’s in
preparation
for year 6
transfer
Year 11
moving
on and
transferri
ng from
their
current
education
al setting
Year
12,13,14
moving
on
Appendix 9
15th
February
2016
31st
March
2016
Year 6’s with Year 9’s.
Statements
transferring
Year
to Secondary 11,12,13
School
14’s
Moving
and
transfer
ring
from
their
current
setting
2017-18
Summer
Term
15th February
2017
31st March
2016 2018
Complete
Step 1 in
the
guidance
for
current
Year 5’s
in
preparati
on for
year 6
transfer
Year 6’s with
Statements
transferring to
Secondary
School
Nursery,
Reception,
Year 1 and
Year 2, 3, 4,
5’s –anyone
who was not
assessed
under the new
framework
and was
issued a
statement
1
My Annual/Transfer Review
Meeting Summary
(insert Name)
(Insert School/College)
(Insert Date of Meeting)
My next meeting will take place on: (insert)
Appendix 10
2
Parent/Carer consent to share information with other agencies and the Local Authority (YP if over 16 yrs)
Name………………………
Signed…………………………………
1
This is who attended my annual review/transition review meeting
Name
Relationship to me
2.
Changes to my personal information: Yes/No
Please note these changes:
This is how I think things are going:
What’s going well:
(Views of all)
What could be better:
(Views of all)
This is how I feel about
my life at the moment:
(Child/Young Person’s
views mandatory)
This is what I want for
myself in the future (my
aspirations):
YR9 onwards mandatory
(Careers advice attached where available)
Date…………………….
Report provided – Y or N
3
This is what my family
think of my life at the
moment:
(Parent/carer relative views)
This is what my family
want for me in the
future:
(Parent/carer relative views)
Attendance:
This is what my school
think about my progress
Academic progress:
and what I need to do
next (include targets):
Social Progress:
Inclusion in school life:
This is what my social
worker thinks:
(delete row if n/a)
This is what my careers
adviser thinks:
(delete row if n/a)
This is what my health
professionals think:
(delete row if n/a)
This is the support my family
would like, to help them to
help me progress and
achieve my goals:
4
My Action Plan: This includes my overall outcomes (what I need to achieve to help me in adulthood).
Targets: My targets are the steps I need to take to help me achieve my goals (outcomes). My action plan records my progress against
my agreed targets from last year (taken from my current EHC Plan, Statement of SEN or IEP) including my successes. My current
targets include those agreed throughout the year and at my meeting
(insert/delete rows and sections as appropriate)
The support I need for: Education and learning (for life and work)
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive(d) to help me
achieve my target:
Progress
The support I need for: Communicating and interacting with others
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive to help me
achieve my target:
Progress
The support I need for: Friendships, relationships and being part of my community
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive to help me
achieve my target:
Progress
5
The support I need for: My social, emotional and mental health needs
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive to help me
achieve my target:
Progress
The support I need for: My independence and personal care needs (delete if n/a)
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive to help me
achieve my target:
Progress
This is the support I have/will receive to help me
achieve my target:
Progress
This is the support I have/will receive to help me
achieve my target:
Progress
The support I need for: My physical needs (delete if n/a)
Intended Overall Outcome:
Date
set:
Target:
The support I need for: My sensory needs (delete if n/a)
Intended Overall Outcome:
Date
set:
Target:
6
The support my family needs, to help them to support me
Intended Overall Outcome:
Date
set:
Target:
This is the support I have/will receive to help me
achieve my target:
Progress
The support (health provision) I need for my health/medical needs (delete if n/a)
Date
set:
Intended Outcome:
This is the support I have/will receive to help me
achieve my target:
Progress
The support I need for my social care needs (delete if n/a)
Date
set:
Intended Outcome:
This is the support I have/will receive to help me
achieve my target:
Progress
Other information, including actions required e.g. additional assessment advice required/agreed.(if there are changes to health or
social care advice/intervention then please state here)
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