The Children & Families Assessment
Personal Details
Name:
Address:
Tel No:
Age:
Ethnicity:
First Language:
Gender:
DOB:
Religion:
Communication
Needs:
CLA Legal
Status:
Non CLA Legal
Status:
Immigration
Status
Looked after
placement type:
Child/Young person’s family/significant relationships:
P Number
Name
Relationship
Please name the people who hold parental responsibility for the child/young person:
Communication needs (including language) regarding any of the people to be included in this
assessment:
Legal status/immigration status information regarding any of the people to be included in this
assessment:
Professional Involvement
Professionals Involved:
Name
Relationship
Consultation with professionals:
Assessment Plan
Reason for undertaking this assessment/presenting issues:
Dates Child & Family Seen
Date child/young person first seen:
Date(s) child/young person interviewed:
Seen by:
Date
Child Seen
Date(s) family members have been interviewed:
Seen by
Child Seen Alone
Date
No access visits (if applicable)
Complex Needs
Complex Needs:
Disability
Name of child(ren) with disability:
Date of birth of child(ren) with disability:
Disability and special need:
What is the impact if the child’s disability on the family?
What are the child’s needs that are above and beyond a typical child of the age and any risks
associated with this?
Please provide a record of support services that are currently in place:
Please provide a record of support services that are required:
What is the most appropriate way to communicate with the child?
Do any other people in the household have a disability?
What benefits are the family in receipt of in relation to the child’s disability?
Does a Continuing Care triage need to take place?
Child Protection
Is this work being completed as part of a
Section 47 enquiry?
Will this assessment be used for an Initial
Child Protection Conference?
Date of planned conference?
Has a genogram been created?
About the Child & Family
Family history and functioning:
Parents profile:
Hint: Include any involvement for parent with children’s services as a child
Relationship history:
Hint: Include any incidents of domestic abuse with either parent.
Support network:
Details of previous and current agency/professional intervention:
Hint: Include if child/young person is involved with the criminal justice system and when last
supervised by the Youth Offending Service
Child's profile:
Please comment on:
 Health
 Education
 Emotional & Behavioural Development
 Identity
 Family & Social Relationships
 Social Presentation
 Self-care Skills
Parenting capacity & understanding of the child's needs:
Whilst research shows that the following are most likely to affect parenting capacity please include
consideration of any additional attributes or strengths:
 Physical Illness
 Mental Illness
 Learning Disability
 Substance/ Alcohol Misuse
 Domestic Abuse
 Childhood Abuse
 History of Abusing Children
Environmental factors:
Please consider the issues that relate to the following and if the ethnicity, religious practice and
culture of the child/young person's family may impact on these:
 Family History & Functioning
 Wider Family
 Housing
 Employment
 Income
 Family's Social Integration
 Community Resources
Risk Assessment Record
Name of person presenting
risk:
Date of birth
Address:
Risk from others?
Details:
Risk to others?
Hint: include any relevant convictions & charges
Details:
Underlying risk factors
Details
High risk indicators details:
Resilient/Protective factors:
Hint: Consider the families desire and ability to make and sustain changes and support required.
Current level of risk:
Rationale (outcome of risk analysis)
Hint: Consider how risk can be reduced, protective factors increased and likelihood of success.
Initial Risk Management Plan:
Information sources for this assessment:
Social workers assessment of the situation
Family strengths, vulnerabilities and protective factors:
Analysis and professional judgement:
Hint: What would be the impact to the child if nothing changes
Recommendations including outline plan and what outcomes we want for the children:
Views of all parties
Views of child on the assessment:
Views of parent on the assessment:
View of carer and significant others on the assessment:
Checklist of Services
Is a referral being made to family group
conference?
Is a graded care profile being undertaken?
Is a referral to EIP required?
Is a referral to Outreach service required?
Is a referral to CIN Coordinator’s required?
Has a DASH been completed?
Is a referral to MARAC required?
Assessment Factors Identified
Hint: Where applicable please ensure details of any concerns are address in your assessment.
Based on factors of concern identified during assessment process select wither Yes or No for
each section
Child
Parent or Carer
Other Household
Member
Concerns about
alcohol misuse
Concerns about drug
misuse
Concerns about
domestic violence
Concerns about
mental health
Concerns about
learning disability:
Concerns about
physical disability of
illness
Young Carer: Are there concerns that services may be required or the child’s health
or development may be at risk due to their caring responsibilities?
Privately Fostered: Are there concerns that services may be required or the child
may be at risk as a privately fostered child?
UASC: Are there concerns that services may be required or the child may be at risk
of harm as an unaccompanied asylum seeking child?
Missing: Are there concerns that services may be required or the child may be at
risk of harm due to going/being missing?
Child Sexual Exploitation: Are there concerns that services may be required or the
child may be at risk of harm due to child sexual exploitation?
Trafficking: Are there concerns that services may be required or the child may be at
risk of harm due to trafficking?
Gangs: Are there concerns that services may be required or the child may be at risk
of harm due to involvement in/with gangs?
Socially unacceptable behaviour: Are there concerns that services may be required
or the child may be at risk due to their socially unacceptable behaviour?
Self Harm: Are there concerns that services may be required or the child may be at
risk of harm due to suspected/actual self-harming?
Based on Factors of Concern Identified during assessment process select either Yes or No for
each section:
Neglect
Emotional Abuse Physical Abuse
Sexual Abuse
Type of abuse or
Neglect
Identified
Other: Are there concerns about other factors which are not covered by the above
options?
If required, please enter details here of the other factors of concern identified in previous
question:
No Factors Identified: Only enter Yes if there is no evidence of any of the factors
above and No Further Action is being taken. Otherwise, please enter No.
Was Homelessness the main reason for referral?
Manager Section
Does this assessment need to continue beyond 15 days?
If Yes why?
Was this assessment completed within 45 working days:
If No, please select reason why:
If this assessment has identified needs that cannot be met
and/or resourced, does the Commissioning Team need to
be informed?
Manager Comments /decision:
Completion/Authorisation
Completed By
Authorised By
Completed Date
Authorised Date