Waltham Forest Families Directorate

Multi-agency Referral of a Professional against whom an Allegation has been made

GUIDANCE NOTES TO REFERRERS

This form should be used to make a referral to Children’s Social Care of a professional / volunteer against whom an allegation has been made in line with Chapter 7 of the London Child Protection Procedures, or ‘Keeping Children Safe in Education’ April 2014, or the DfE Guidance ‘Dealing with Allegation of abuse against Teachers and Other Staff’.

Please consider whether a separate referral using the Child in Need referral form needs to be made on any child/ren who are the subject of the allegations. Please complete as many sections as possible.

Once completed email to or fax to 020 8496 2313

and copy to the LADO at or fax to 020 8496 6915

Details of the professional/ volunteer against whom the allegation has been made:

/ First Name / Family name/ surname
Ethnicity / Language spoken / Date of birth / Gender
Home Address / Telephone
Does the professional have any children?
Details:
Do you have any concerns for these children?
Name and Address of Agency where employed/ working with children: / Role:

Details of the child who has made the allegation:

/ Ethnicity / Language Spoken
First name / Surname / Date of birth / Gender
Additional Children:
Address Postcode
Telephone
If there is no named child, who has made the allegation?
Child / Young person’s parent/ principal carers
FULL NAME / DOB
If Known / Relationship to child / Ethnicity / Gender
First Language of carers: do they require interpreter or signer : Y / N

Person making the referral…

Name :
Role: / Agency :
Address:
Postcode: / Telephone:
Please give specific details of the allegation and what has been done so far including whether the alleged perpetrator has been suspended or moved to a different place of work:
Include details of where the incident is alleged to have taken place:
What has been shared with professional?
Y / N / If no, state reason
Does child/young person know about this referral
Does parent/carer know about the referral
ARE ANY OTHER KEY AGENCIES INVOLVED IN THIS FAMILY
Insert name of professional
If involved / Tel: / Insert Name of professional
If involved / Tel:
Has the agencies Human Resources been informed?
If not why not?
What safeguarding arrangements have been put in place for the child?
Are there any other relevant concerns about this child that CSC need to be aware of?

Name Of Worker Completing this referral if different from above

AGENCY

ADDRESS

CONTACT TELEPHONE NUMBER

SIGNATURE

DATE

This form should now be emailed to -–:
and copied to the LADO
alternative contact details:
Children’s Referral and Advice Service, Upper Ground Floor, Juniper House, 221 Hoe Street, Walthamstow, E17 8PHTel - 0208 496 2310/2311/2316/2317/2307 Fax - 0208 496 2313,
Local Authority Designated Officer fax- 020 8496 6915 phone number 020 8496 3646/6310
FEEDBACK TO REFERRERS
We will ensure that your referral reaches the correct team and that you receive a written
response to your referral within 24 hours.
If you do not hear back from us regarding the outcome and/or progress of your referral,
please contact the Duty Administrator on 0208 496 2310.
If you wish to discuss the decision on your referral further, please contact the Local
Authority Designated Officer, or the Duty Child Protection Coordinator on 020 8496 3646/
8279.
If you encounter any difficulties in relation to your referral that you wish to bring to the
attention of a senior manager, please contact the Head of Service for Referral and Advice
on 0208 496 8393.

Updated April 2014