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PROSPECTIVE ADOPTER'S REPORT

INSERT NAME OF PROSPECTIVE ADOPTER(S)

PHOTOGRAPH OF PROSPECTIVE ADOPTER(S)

NAME OF SOCIAL WORKER

PROFILE OF THE APPLICANT/S
To include personality, interests and the applicant’s strengths in relation to adoption. To include a view of the type of placement best suited to the applicant(s)
(To be completed in 300 words)
Comment on whether applicants can consider fostering for adoption or concurrency


PROSPECTIVE ADOPTER’S REPORT

Part 1

Name of Local Authority / Southwark Council
Address
Social Worker’s Name
Social Worker’s Email
Social Worker’s Telephone
Manager’s Name
Manager’s Email
Manager’s Telephone
Fax / 0207 525-4449
Date Application received
Date of Report
If more than 6 months elapse between receipt of registration of interest and presentation of case to Adoption Panel, please specify the reason

APPLICANT(S) DETAILS

/ Applicant 1 / Applicant 2

Name

Gender
Date & Place of Birth
Address, including Local Authority & postcode
Racial origin and cultural and linguistic background
Registered disabled
Religion (Practising or non practising)
Relationship (if any) to the child
CHILDREN IN THE HOUSEHOLD
Name
Gender
Date of birth
Ethnicity
Relationship to applicant(s)
OTHER CHILDREN OF THE APPLICANTS (LIVING ELSEWHERE OR DECEASED, INCLUDING ADULT CHILDREN)
Name
Gender
Date of birth
Ethnicity
Whereabouts (or date of death)
Relationship to applicant(s)
OTHER ADULT MEMBERS OF THE HOUSEHOLD (INCLUDING ADULT CHILDREN LIVING AT HOME)
Name
Gender
Date of birth
Ethnicity
Relationship to applicant(s)

DESCRIPTION OF THE ACCOMMODATION AND LOCAL VICINITY

Please refer to prospective adopter(s) work book under ‘Where you live’.
Social worker’s analysis

HAS A HEALTH AND SAFETY QUESTIONNAIRE BEEN COMPLETED?

Any concerns?

HAS A PET QUESTIONNAIRE BEEN COMPLETED?

Any concerns?

STAGE ONE AND TWO LEARNING

Evidence prospective adopter(s) learning providing attendance and dates
Further areas of learning
Prospective adopter(s)views of learning
Trainer’s views including participation
Social worker’s analysis

DOMICILED / HABITUALLY RESIDENT

State whether the prospective adopter(s) is/are domiciled or habitually resident in a part of the BritishIslands and if habitually resident for how long they have been habitually resident.

Domiciled?

/

Yes

/

No

Habitually resident?

/

Yes

/

No

If Yes, how long?
If non-UK passport holders and EEA citizens, do they have permanent residency or indefinite leave to remain?

CHECKS

/

Applicant 1

/

Applicant 2

DBS* Date and outcome
Identifying information** seenand date
Local Authority
Ofsted
Employer’s reference
*CRB must be within 2 yrs. Education check for school age children, health visitor check for children under 5. Employers reference if in employment last 2 years and all if worked with children
** Identifying Information = Passport or Birth Certificate, National Insurance Number

MARRIAGE/ CIVIL PARTNERSHIP/ Partnership

If the prospective adopter:
(a) is married, the date and place of marriage
(b) has formed a civil partnership, the date and place of registration of that partnership
(c) If in a relationship and cohabiting, date of setting up household
(d) If the prospective adopter is married or has formed a civil partnership and is
applying alone for an assessment of his/her suitability to adopt, give the reasons for this.
Date seen
Marriage Certificate
Civil Partnership Certificate
Other (i.e. Decree Absolute/ Dissolution Order)

MEDICAL INFORMATION

/ Applicant 1 / Applicant 2

Name of the applicant’s GP

Address
Date seen and GP’s comments
Medical Advisor’s Comments

COURT PROCEEDINGS

Details of any previous court proceedings in which the prospective adopter has been involved including family proceedings i.e. residence/contact orders/bankruptcy
PREVIOUS APPLICATIONS
Have the applicants’, or a member of the household, ever applied to an agency to foster, adopt or child mind? Give details.
REFERENCES / Name / Date Seen / Relationship to applicant
Referee 1
Referee 2
Referee 3
Additional Referee (if applicable)
See attached summary of reference interviews
Previous partners must be contacted if children were jointly parented
Summary of school/nursery report where there are children in the household

PROSPECTIVE ADOPTER REPORT

Part 2

a) The observations of the prospective adopter about their own experience of being parented and how this has influenced them.
Social worker’s analysis
b) A description of the wider family and their role and importance to the prospective adopterduringchildhood and now.The family’s likely role and importance to a child placed for adoption.
Social worker’s analysis
c) A chronology of the prospective adopter/s from birth can be seen in the work book.Are there any issues raised in either chronology?
d) Summary of the prospective adopter’s educational history and attainments and their views about how this has influenced themand shaped their current attitude to education.
Social worker’s analysis
e) Summary of the prospective adopter’s employment history and his / her observations about how this has influenced them. Details of current employment and the prospective adopter's plansabout achieving a balance between employment and childcare.
Social worker’sanalysis

RELATIONSHIPS

Outline any previous significant relationships, marriages or civil partnerships and what the applicant(s) have learnt from these.
An assessment of the current relationship, if any, including how the couple support each other and the strengths and vulnerabilities of the partnership.
Social worker’s analysis

CHILDLESSNESS/LIMITATION OF FAMILY SIZE

Reasons for wishing to adopt a child, include any issues of infertility and/ or reasons for deciding not to havebirth children.
Please refer to ‘My motivation for adoption’ in applicant’s work book
Social worker’s analysis

CHILDREN IN THE HOUSEHOLD

A record of an interview with each child, including their views on the likely impact of a child being placed for adoption in the family and the social worker’s assessment of this.

OTHER ADULT MEMBERS OF THE HOUSEHOLD

A record of an interview, including the degree of involvement they will have with the child and their views on the likely impact on themselves, and the social worker’s assessment of this.

LIFESTYLE & CULTURE

Likely impact of having a child in the prospective adopter’s life e.g. changes to daily routine, celebrations etc can be seen in applicant’s work book under ‘How will a child fit into your life’.
Brief summary and any issues raised
Social worker’s analysis

SUPPORT NETWORKS

See work book under ‘Who will help you?’

a) The views of members of the applicant's network in relation to adoption and their likely roles and importance to a child placed for adoption with the applicant(s).

Social worker’s analysis

VALUING DIVERSITY

What is the applicant’s understanding of the needs of people from a different racial, cultural, or religious background to themselves and how will they promote positive attitudes as a parent in relation to the above differences including disabilities and sexual orientation.
See applicant’s views in work book under ‘Difference and Identity’
Social worker’s analysis

PARENTING CAPACITY

Details of any experience the prospective adopter(s) has/have had of caring for children including as a parent, step-parent, foster parent, child minder or prospective adopter and an assessment of his / her ability in this respect.
Information about the prospective adopter’s capacity to:

a) Provide for a child’s needs, i.e emotional, developmental and behavioural needs.

Social worker’s analysis
b) Share a child’s history and associated emotional issues.Discuss contact and have adoption conversations with a child.
Social worker’s analysis
c) Understand and support a child through possible feelings of loss and trauma.Including anawareness of the lifelong impact of adoption throughout a child’s life andinto adulthood.
Social worker’s analysis
d) Prospective adopter(s) capacity to parent a child through concurrency or fostering for adoption
Social worker’s analysis
Has a testimonial guardian been identified?

FINANCIAL CONSIDERATIONS

Details of the prospective adopter’s income and expenditure are in the workbook.
Social worker’s analysis

OTHER

Any other relevant information, which might assist the adoption panel of the adoption agency.

SOCIAL WORKER’S ASSESSMENT AND RECOMMENDATION

Strengths of prospective adopter(s)
Limitations of prospective adopter(s)
Recommendation
I bel Applicant’s observations and comments of the report

THE RESTRICTION ON THE PREPARATION OF ADOPTION REPORTS REGULATIONS 2005

I, _ , confirm that I meet the requirements for preparing adoption reports in that one of the following is true:

(Please tick one box only)

I am a social worker, employed by a Local Authority, and have at least three years’ post-qualifying experience in childcare social work including direct experience of adoption work.

I am a social worker employed by a Local Authority and I am supervised by a social workeremployed by a Local Authority who has at least three years’ post-qualifying experience in childcare social work, including direct experience of adoption work. The name of the supervisor is ______

I am a student social worker on an approved course and am supervised by a social worker employed by a Local Authority, who has at least three years’ post-qualifying experience in childcare social work, including direct experience of adoption work. The name of this supervisor is ______

Signature:______

Signature of Supervisor ______

(only necessary if option 2 or 3 above ticked)

Date:______

I/we understand that this report is the property of Southwark Council and we agree not to copy it other than for my personal records or disclose its content without Southwark’s permission.

Applicant 1 / Date
Applicant 2 / Date
Social Worker / Date
Practice Manager / Date
Team Manager / Date

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