Name of Child : …………………………………………

Name of Professional/Agency sending form:
Date Sent: /

Child Protection Review Case Conference Report Form

Please type this form electronically wherever possible

FAMILY COMPOSITION - Adults

Name / DOB / Address & Tel. No. / Relationship to child(ren) / Parental Responsibility
Yes/No / Ethnicity / First Language

FAMILY COMPOSITION - Children

Name / Male/Female / DOB / Address & Tel. No. / School & Contact Name / General
Practitioner / Ethnicity / First Language

A COPY OF THIS FORM MUST BE RETAINED IN THE CHILD’S RECORDS

This report should not be used for any purpose other than that for which it was written without the permission of the author or their line manager

Child Protection Plan set at last meeting with progress on each point:

Task / Progress / Work Outstanding / Anticipated Finish Date
Professional analysis of impact of significant events & actions taken since last conference:
Child/young person’s developmental needs, views, wishes and feelings:
(must include health, education, emotional & behavioural, identity, family & social relationships, social presentation, self care skills)
Capacity of parents/carers and other family members to ensure child’s safety from harm and to promote health and development. Must include strengths and weaknesses in the following dimensions:
•basic care skills
•ensuring safety
•emotional warmth
•stimulation
•guidance and boundaries
•stability
Professional Analysis:
Views, wishes and feelings of parents/carers and other significant family members:
“While professionals should seek, in general, to discuss any concerns with the family and, where possible, seek their agreement to making referrals to Social Services, this should only be done where such discussion and agreement seeking will not place a child at increased risk of significant harm” Working Together to Safeguard Children 1999
If in doubt as to whether to speak to the parents, consult within your own agency or Social Services Department
Professional analysis of progress on child protection plan & assessment of child’s current needs and risks:
Proposed plan for protection/care/future support (it is important to identify the need, how this need will be met & by whom, what outcome is anticipated and the review process)
Identified need / How need will be met / Outcome expected / Timescale
Chronology of agency contact since last conference:

Signature:Date:

Name (please print):

1

NSCB1a/Jan 2012