Communication Support Service

Referral Form forMoving and Handling Training for staff working with an individual pupil

Date:
Name and Role of Person making referral:
Student Name:
D.O.B
Year Group:
School:

Parent/Carer/Guardian consent signed ………………………………………….. Date………….

Print Name:

I give consent for this request for Moving and Handling training for school staff working with my childto be sent to the Cornwall Council’s Physical and Medical Needs Advisory Service.

I give consent for Information from Occupational Therapists, Physiotherapists or the school to be shared with the Moving & Handling training Provider, In Safe Hands,other relevant Council agencies and Health therapists to inform the planning and delivery of Moving and Handling training for school staff working with my child.

I give consent for this request for Moving and Handling training for school staff working with my child to be sent to the provider,In Safe Hands , who are contracted by Cornwall Council to provide Moving and Handling Training.

I understand that I will be given a copy of any written records from the Moving and Handling Training Provider,In Safe Hands,and that the Council’s Physical and Medical Needs Advisory Service will open a file for my child and that this will be kept in a secure place. It will be held in a secure environment until the child’s 30th birthday in accordance with the Council’s data retention policy after which time it will be destroyed in a secure manner.

I give consent for reports written by the Physical and Medical Needs Advisory Service to be shared with other professionals to inform the types of support that may be available to my child (e.g. Speech and Language Therapist, Physiotherapist, Occupational Therapist, SEN support services).

I have read and accept the data protection information at the end of this document

Additional Parents/Guardians comments:

To be completed by school staff

Please list names ofall therapists that have worked with this pupil in the last 12months andindicate team, ie Children’ s Community Team (NHS) or Cornwall Council Disabled Children & Therapy Service
SpecificMoving and handling training required by school staff for the support of this pupil within the school environment i.e please indicate specific tasks for which training is required for example :
The safe transfer of pupil from wheelchair to specialist seating
The safe transfer of pupil from specialist seating to wheelchair
The safe transfer of pupil from seating to floor or standing frame, toilet, changing plinth
Other training needs e.g potential M&H needs in an emergency, M&H needs post seizure etc
Please indicate specialist equipment you already have in place in school to support staff in the safe Moving and Handling of this pupil eg Mobile hoist, sling , ceiling hoist
Please indicate any training needs of staff relating to Moving and Handling needs of this pupil in the event of an emergency evacuation
Numbers of staff requiring training (please also include a memberof staff who oversees Moving and Handling needs of this pupil in the event of an emergency evacuation):
How are the Moving and Handling needs of this pupil currently being supported in school?
Please give date and Provider of last Moving and Handling staff training session
Please include copies of relevant information to inform the planning of a bespoke Moving and Handling training session .
NOTE: Referrals will not be accepted without copies of all the documents outlined below
Please use tick boxes to indicate that each copy is included
□Copy of pupil’s Moving and Handling plan /passport
□Copy of school’s risk assessment for the moving and handling of this pupil
□Copy of written information from pupil’s therapist indicating this pupil’s Moving and Handling needs
□Copy of the Personal Evacuation Plan for this pupil
What outcomes do you hope will be achieved as a result of this training

Data Protection Act –Privacy Notice

We, Children, Schools and Families (CSF) Directorate, Cornwall Council, New County Hall, Truro, TR1 3AY, Data Protection Registration Number: Z1745294 are committed to protecting and respecting your privacy.

This information is being collected by the Physical and Medical Needs Advisory Service, on behalf of Cornwall Council as Data Controller for the purpose of determining the moving and handling training needs for staff working with this named pupil.

Data on you or your child may also be shared with other relevant professionals who are SEN Support Services, teachers, relevant health staff (Physiotherapist, Occupational Therapist,)and social workers, to inform their work. (Information will be shared with ‘In Safe Hands’, in order to plan and deliver Moving and Handling training. In Safe Hands will destroy the information received on referral securely once training is completed). The data held relating to the delivery of support by the Physical and Medical Needs Advisory Service to your child will be used both for the provision of services and also for performance and service planning. This information will be held in a secure environment until the individual’s 30th birthday in accordance with the CSF data retention policy after which time it will be destroyed in a secure manner.

A copy of our Privacy Notice can be found at This Privacy Notice sets out the basis by which any personal data we collect from you, or that you provide to us, will be processed by us, in accordance with the General Data Protection Regulations (GDPR) and the Data Protection Act.

For further information or assistance on Data Protection matters, please contact the Practice Development and Standards Service on 01872 327617 or e-mail .

Or the Councils Data Protection Officer .

You have the right to withdraw consent to the processing of your data at any time and your further rights as to how we handle your data can be found by following the above link. Should you wish to withdraw your consent please contact the relevant team - see contact details listed above.

If you would like this information to be provided in an alternative format please contact Physical and Medical Needs Advisory Service:

Physical and Medical Needs Advisory Service

St Austell One Stop Shop

39 Penwinnick Road

St Austell

PL25 5DR

Tel no: 01726 223363

Email:

Physical and Medical Needs Advisory Service Email: