1A) Family, Parenting and Household Relationships Consider

Early Help

Assessment and Plan

Please complete this form electronically. Once completed the final page must be printed, signed and all documentation emailed to .uk
Family name and case file number in Liquid Logic (request from EHAAT if not known):
Main address of family: / Start Date of Assessment:
Date Assessment Completed:
Date of Initial Family Support Meeting:
Family Details
Last name / First name / Relationship / DOB
Reason for Assessment

1) Family and Environment

1a) Family, parenting and household relationships – Consider:

Household composition, separated parents and relationship between them, extended family members, (a genogram/ecomap may be useful at this point). How the family functions and relationships, significant events impacting on the household, any support networks available to the family e.g. grandparents, other family members, friends. Parenting basic care, boundaries and structure.

Assessment
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

1b)Accommodation – Consider:

Do they have basic amenities and facilities appropriate to the age and development of all family members, is the home suitable to the needs of the family, sleeping arrangements, cleanliness/hygiene and safety, any impact on the child/young person and family?

1c) Income and finance – Consider:

Any financial difficulties e.g. income available to the family, in receipt of all benefit entitlements rent/mortgage arrears, any engagement with payment reduction plans.

Assessment
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

1d) Domestic incidents – Consider:

Any incidents of reported/non reported domestic abuse against or by family members.

Assessment / Mark option with X
Yes / No / Don’t Know
Have there been any police call outs to the household for at least one domestic incident in the last 12 months?
Have any adults or young people (16 or over) been victim of reported domestic violence or abuse (e.g. MARAC) in the last 12 months?
Have any adultsor young people (16 or over) disclosed that they have been the victim of domestic violence or abuse in the last 12 months?
Have any adults or young people (16 or over) been assessed as currentlybeing at a risk of experiencing domestic violence
Have any adults or young people (16 or over) perpetrateddomestic violence or abuse (e.g. MARAC) in the last 12 months?
Please expand below
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

2) Children (unborn, infants and young people) all children in the household

2a) Health inclusive of general, emotional and social development – Consider:

Physical and emotional development, nourishment, activity, any conditions or impairments, immunisations, developmental checks and milestones, hospital admissions, mental health and/or emotional issues which impact on each child’s development and understanding (speech and language), any medical appointments, any children in receipt of disability living allowance.

2b) ASB and offending behaviour – Consider:

Has any child or young person been involved in ASB or been subject to ASB intervention in the past 6 months?

2c) Drug and alcohol use – Consider:

Is any child or young person in the household using drugs and/or alcohol either legal or illegal, describe any impact on the child/young person and family.

2d) Progress/attitude to education and learning -Consider:

All areas of child/young person’s cognitive behaviour from birth, includes opportunity for play/recreational activity, interactions with others, do they like/enjoy learning/school access to age appropriate activities, play and learning, any special educational needs.

2e)Participation in education (include all children within the household) – Consider:

Assessment
List the average school attendance over the last three consecutive school terms( e.g. Spring/Summer 2015 + Autumn/Winter 2015 + Winter/Spring 2016)for each school age child include % for each child. School attendance should be a minimum of 90%.
Mark option with X
Yes / No / Don’t Know
Over the last three consecutive school terms there have been 3 or more fixed term exclusions / 3 or more fixed term inclusions /any permanent exclusions?
Do school / nursery staff have concerns over attendance and punctuality of school (children aged +5) / Nursery children aged 3-5 or 2 year olds who are registered for 2 year offer?If yes, expand below
Are there child(ren) who are neither registered with a school nor being educated otherwise?
Please expand below
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

2f) Young people leaving education and NEET– Consider:

Any young people who are NEET(not in further education, training or employment) or are at risk of becoming NEET once they leave education.

3) Adults (parents, carers and significant others)

3a) Health inclusive of general, mental health and emotional wellbeing– Consider:

Do parents/carers have good general health, have mental health or emotional health issues which may impact on parenting, are any adults within the household in receipt of disability living allowance, any learning disabilities?

3b) ASB and offending behaviour – Consider:

Assessment / Mark option with X
Yes / No / Don’t Know
Has any adult committed a proven offence in the last 12 months?
Has any adult been assessed as currently posing a risk of causing harm to others?
Has any adult not complied with an order or licence in the past 12 months?
Has any adult been involved in ASB or been subject to ASB intervention in the past 6 months?
Please expand below
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

3c) Drug and alcohol use – Consider:

Are any adults in the household using drugs and/or alcohol either legal or illegal, describe the impact on the child/young person and family.

3d) Learning and education – Consider:

Last educational setting parents attended and views on education, any current training aspirations and life skills.

3e) Employment status – Consider:

Assessment / Mark option with X
Yes / No / Don’t Know
Are any adult members of the household (i.e. aged 18-65) claiming at least one of the following benefits: Jobseekers Allowance (JSA); Employment and Support Allowance (ESA); Income Support (IS); Universal Credit (UC); Carers Allowance (CA); incapacity Benefit (IS); Severe Disablement Allowance (SDA)
Have any adult household members received benefit sanction(s) in the last six months?
Please expand below
Strengths and Needs
Plan -To be completed during team around the family meeting if actions(s) are required following assessment
Needs / Actions / People responsible / Outcomes / Completion date
Score / 1 / 2 / 3 / 4 / 5 /  - No Issues

Following Completion of Assessment and Plan
Who will lead the plan?
Name / Agency / Position / Contact number / Contact email / Signature / Date
Which other professionals will be involved in the plan?
Name / Agency / Position / Contact number / Contact email / Signature / Date
By signing below family members agree to work with above professionals and agencies to achieve outcomes set out in the plan (where possible obtain signatures from all family members)
Name / Signature / Date
Early Help Co-ordinator Name / Signature / Date
Manager’s Name: / Signature to confirm approval of assessment and plan / Date
Agreed Date of First Review Meeting (4 to 6 weeks after Plan meeting)
Venue of Review Meeting

For use by professionals only, following assessment:

Does this family meet the criteria to be included in the Troubled Families programme?

Two or more criteria must be met.

If yes, please ensure that EHAAT is aware of this.

1. / Parent(s) and/or young people involved in crime or anti-social behaviour / Yes/No (please delete as necessary)
2. / At least one child does not attend school regularly (below 90%) / Yes/No
3. / Adult(s) out of work or at risk of financial exclusion, and young people at high risk of worklessness or are NEET / Yes/No
4. / Family affected by domestic violence or abuse / Yes/No
5. / Parent(s) and/or child(ren) with a range of health problems (impacting on family life) / Yes/No
6. / Family has an identified need in addition to the above. Please describe briefly: / Yes/No