Connected Persons/Sgo Report

CONNECTED PERSONS/SGO REPORT

PART A

1. Agency Details:
Child Care Social Worker:
Tel:
Team Manager:
Tel:
Team:
Date reported:
Fostering Social Worker:
Tel:
Fostering Team Manager:
Agency address:
2. Details of applicants and their family
First Applicant:
Name:
Address:
Tel:
Date of birth:
Marital status( Date and place of marriage/ civil partnership/ place of registration):
Ethnicity:
Nationality/ immigration status:
Employment (past and present):
Religion:
Practising/non practising:
Health (attach Medical Report):
Language used:
Relationship to child/ren:
Outcome of any previous request or application to Foster:
Leisure interests and hobbies:
Photo:
Second Applicant:
Name:
Address:
Tel:
Date of birth:
Marital status( Date and place of marriage/ civil partnership/ place of registration):
Ethnicity:
Nationality/ immigration status:
Employment (past and present):
Religion:
Practising/non practising:
Health (attach Medical Report):
Language used:
Relationship to child/ren:
Outcome of any previous request or application to Foster:
Leisure interests and hobbies:
Photo:
If the prospective connected person or special guardian is a member of a couple and applying alone, the reason for this:
Child/ren/Adults living in the applicant’s household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position in the household:
Name:
Date of birth:
Gender:
Ethnicity:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position held in household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position held in household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position held in household:
Other adults, including grown up children living elsewhere who would have significant contact with the child:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position in the household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position in the household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position in the household:
Name:
Date of birth:
Gender:
Ethnicity:
Relationship/position in the household:
Details of child/ren and their family:
Name:
Date of birth:
Gender:
Ethnicity:
Nationality:
School/Nursery:
Religion:
Practising/non practising:
Legal status:
Does the child have a disability?
If yes, please give details:
Date of placement/planned date of placement:
Name:
Date of birth:
Gender:
Ethnicity:
Nationality:
School/Nursery:
Religion:
Practising/non practising:
Legal status:
Does the child have a disability?
If yes, please give details:
Date of placement/planned date of placement:
Name:
Date of birth:
Gender:
Ethnicity:
Nationality:
School/Nursery:
Religion:
Practising/non practising:
Legal status:
Does the child have a disability?
If yes, please give details:
Date of placement/planned date of placement:
Details of birth parents:
Birth Mother / Birth Father
Name: / Name:
Date of birth: / Date of birth:
Address: / Address:
Ethnicity: / Ethnicity:
Nationality/ immigration status: / Nationality/ immigration status:
Marital status at time of child’s birth: / Marital status at time of child’s birth:
Present marital status: / Present marital status:
Child/ren’s siblings living elsewhere:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Name:
Address:
Date of birth:
School:
Gender:
Ethnicity:
Nature of relationship with carer:
Signature of applicants undertaking Regulation 24
SGO consent to the following checks being made

Criminal Records Bureau Check
Medical Checks.

Consent to contact two identified references, and ex partners if applicable.

Name:
Signature: Date:
Name:
Signature: Date:

INITIAL VIABILITY ASSESSMENT

(completed by Social Worker)

Sources on information
Purpose of assessment
Background information (carers)
Relationship with child /children and relationship with parent/s
Ability to meet individual child’s needs (health , educational ,emotional , culture and ethnicity)
Ability to safeguard child/children
Ability to manage any contact arrangements
Environmental factors (home circumstances, financial circumstance, community and extended family support
Current understanding of commitment required( taking into account possible longer term plans)
Recommendations

Part B

BACKGROUND DETAILS

(to be completed by Child/ren’s Social Worker)

Brief summary of the circumstances that led to the child/ren becoming looked after, including details of any previous placements and reasons why the child/ren were placed with this particular family or it is proposed that they should do. (Continue on a separate sheet if necessary). Include chronological history of events, includingany court involvement (the name of the court, the order made and the date on which the order was made).

Regulation 24 signature(s) …………………………………………………………………………….

(Manager’s signature)

Trigger: (consent) safeguard checks, (CRB, medical, two references, ex partner as required).

2.THE CHILDREN’S NEEDS

(completed by Child’s Social Worker)

I)Education needs:
Will the children be able to attend the same school/nursery/day care facility and maintain social and leisure activities? If not what suitable local alternative arrangements will the carer be able to make? Does the child/ren have any additional education support needs? If so, how will the carer provide this?
II)Health needs:
Does the child have any particular needs with regards to health, medical care, diet, disability? Is the carer aware of the children’s needs and will the carer be able to meet these needs?
III)Identity needs:
Does the child/ren have any particular needs with regards to health, medical care, diet, disability? Is the carer aware of the child/ren’s needs and will the carer be able to meet these needs? What aspects of the child/ren’s identity do the carers share – ethnicity, language,culture, religion?
How will the carers promote a positive sense of identity in the child/ren, particularly in those areas which they do not have in common with the child/ren?
iv) Emotional needs:
How will the carers meet the child/ren’s emotional needs – particularly those arising from separation and loss?
How will carers manage possible rejection, regression, attachment difficulties?
v) Any other identified needs:
Does the child/ren have any other specific needs? Is the carer aware of these, and how will they meet them?
vi) wishes and feelings of child/ren in regard to present care plan and in particular around contact:

3. Background details of birth family (completed by Child’s Social Worker)

i) Chronology of birth family including health, education, social care involvement and
employment history where available:
(In the absence of one or both parents what steps have been taken to identify their whereabouts and when in relation to the Father what steps have been taken to determine paternity).
ii) Relationship History:
( whether the child’s parents were married to each other at the time of the child’s birth or have subsequently married and whether they are divorced or separated; where the child’s parents have been previously married or formed a civil partnership, the date of the marriage or civil partnership; where the child’s parents are not married, whether the father has parental responsibility and, if so, how it was acquired)
iii) Photo (attach):
iv) Physical description:
iv) Wishes and feelings of the family:

Part C

4. Background of carers (completed by Fostering Social Worker)

i) History of each applicant.
details of current and any previous marriage or similar relationship; personality; previous experience (if any) of caring for his/her own and other children, whether or not they have previously applied to foster or adopt, carers skills, competence and potential relevant to his/her capacity to care effectively for a child placed with them).
ii) Family Tree:
Overview of relationships within the extended family, including those in regular contact with the family and therefore when the child/ren placed; include ages of family members and any deaths.
iii) Family involvement with social care and/or previous Court proceedings involving
the care of children (including the name of the court, the order made and the date on which the order was made).
iv) Assessment of family dynamics in this placement:
Nature and quality of the relationship between the carer and the children. How long and how well have the family known the child/ren?
v) The impact of caring for the child/ren on the carer and their family, including the
impact on the carer’s own children.
vi) Family ability to manage boundaries/discipline.
vii) Nature of the relationship between the carers and the child/ren’s birth parents.
Are there any difficulties between them that could lead to divided loyalties for the
child/ren? How will carers manage this?
viii) Views of the carer’s motivation in relation to this placement?
ix) Difficulties the carers have in meeting the child/ren’s needs.
x) Details of accommodation:
xi) Analysis of Health and Safety Check:

5. Contact (completed by Fostering Social Worker)

i) What level of contact should the child/ren have with their birth parents, siblings and
other significant people in their lives?
ii) Are there any specific issues around contact eg child protection concerns, need for
supervised contact?
iii) Are the carers able to carry out contact plans in a manner that meets the child/ren’s
needs?
iv) Given that the carer is a connected person, is the social worker confident that they
will carry out contact plans as agreed and not collude with the child/ren’s family in
the event of disagreements?

PART D

6. Assessing Social Worker’s analysis (completed by Child/ren’s Social Worker and

Fostering Social Worker

7. Child Protection (completed by Fostering Social Worker/Child/ren’s Social Worker)

i) Is the child/ren on the Child Protection Register? Yes No
If yes, on what grounds?
ii) Does the carer understand and accept the concerns which have led to the child/ren
being looked after?
iii) Any steps the carer would need to take in order to protect the child/ren? Are the
carers aware of the steps they need to take and is the social worker confident the
carer would take these necessary steps?
iv) Have the family completed a safe care policy? Yes No
(Please attach

6. Assessing Social Worker’s analysis (completed by Child/ren’s Social Worker and

Fostering Social Worker

i) what is the social worker’s assessment as to whether this placement currently meets
the child/red’s needs and will continue to meet the child/ren’s needs as required?
ii) What hopes and expectations do the carers have for the child/ren’s future?
iii) Reasons for applying for a special guardianship order and extent of understanding of the nature and effect of special guardianship and whether the prospective special guardian has discussed special guardianship with the child.
iii) Which of the child/ren’s needs are being met and which will need additional support
in order to be met? How will additional support be offered? Are there any of the
child/ren’s needs that cannot be met in this placement?
iv) What are the positives/negatives for the child/ren of this placement?
v) What are the financial implications for this arrangement?
(Income and expenditure, date bank statement seen)
Comments Prospective Carers:
Signatures of Prospective Carers:
Name …………………………………………….. Date:
Name …………………………………………… Date:

8.Special Guardianship applications (only to be completed if the plan is a Special Guardianship Order).

In Respect of Local Authority completing the report:-
Name and Address:
Details of past involvement of the Local Authority with the prospective special guardian, including any past preparation for that person to be a local authority foster parent or adoptive parent or special guardian:
Where section 14A (7) (a) of the act applies and the prospective special guardian lives in the area of another local authority, details of the local authorities enquiries of that other local authority about the prospective special guardian:
vi) If in regards to SGO:
The implications of the making of a Special Guardianship order to:
i) The child
ii)The child’s parents
iii) The prospective Special Guardian and his/her family; and
iv)Any other person the Local Authority considers relevant.
The relative merits of the Special Guardianship and other orders which may be made under the Act of the Adoption and Children’s Act 2002, with an assessment of whether the child/ren’s long term interests would be best met by a Special Guardianship Order.
Signatures of Social Workers completing the report:
Name: Date:
Name Date:
Signatures of Team Manager(s):
Name …………………………………………….. Date:
Name …………………………………………… Date:

Page 1 of 20