CAF Form (3)

INITIAL/ REVIEW MEETING
ASSESSMENT COMPLETED / CAF / OTHER (PLEASE STATE)
DATE OF MEETING
VENUE
Prior to the meeting: Please could the Chair fill in details of ‘Attendees’ and ‘Apologies’

If completing a CAF please ensure you receive verbal consent to fill it in from a parent/guardian/young person, as appropriate.

Data Protection Notice:

Wakefield MDC, Family Servicesis the data controller. The information contained on this form will only be used for the evaluation of the CAF Model to assess progress and evidence what we are doing well and what we need to change or develop. If you have any concerns about providing this information please speak to yourworker.

(PLEASE NOTE: ALL THE CELLS CAN BE EXTENDED BY ADDING EXTRA RETURNS)

BABY, CHILD OR YOUNG PERSON BEING ASSESSED
Name
Date of Birth or Expected Date of Delivery
Male or Female
Address
(including Postcode)
Is this Address Permanent or Temporary
Telephone/Mobile Number
Ethnicity
Disability/Language or Communication Issues
PARENTS/CARERS
Name
(first person)
Address
Relationship to Baby, Child or Young Person
Telephone/Mobile Number
Name
(second person)
Address
Relationship to Baby, Child or Young Person
Telephone/Mobile Number
SIBLINGS NAMES & DATES OF BIRTH
LEAD PROFESSIONAL
Name
Job Title
Agency
Address
Telephone/Mobile Number / E-mail
PERSONS INVITED TO THE MEETING
Name of Person Chairing Meeting / Designation / Contact Number
Name / Designation / Attended / Apologies
DID THE PARENT(S)/CARER(S) ATTEND THE MEETING? / YES / NO
DID THE CHILD/YOUNG PERSON(S) ATTEND THE MEETING? / YES / NO
IF THE MEETING WENT AHEAD WITHOUT THE PARENT(S) WHY?
(Give details of why the meeting went ahead without the parents)
IF THE MEETING WENT AHEAD WITHOUT THE CHILD/YOUNG PERSON(S) WHY?
(Give details of why the meeting went ahead without the children)
COMMENTS
(brief meeting minutes, please include any disagreements)
Please give a brief overview of the issues/concerns.
What has gone well since the last meeting?
Any new issues/concerns?
Review the Plan
OUTCOMES OF THE MEETING
(please complete either outcome 1 or 2 – not both)
OUTCOME 1 - CASE CLOSED
WHEN THE CASE HAS BEEN CLOSED AN ELECTRONIC MONITORING ‘COMPLETED’ FORM MUST BE SUBMITTED
Reason for
CLOSURE
Date
Further Actions
to be taken
REFERRAL TO OTHER AGENCIES (please ü as appropriate) / Yes / No
Social Care Direct
Parental Disengagement
Other (please give details below*)
LEVEL THRESHOLD
(please indicate which level the baby, child or young person is currently assessed as being at)
1 / 2 / 3 / 4
OUTCOME 2 - CASE CONTINUING
(please ü as appropriate and enter any dates)
Yes / No / Review Date (3 Months Maximum)
CAF Meeting to be called & CAF Plan Agreed
Single Agency Action Plan
Comments
LEVEL THRESHOLD
(please indicate which level the baby, child or young person is currently assessed as being at)
1 / 2 / 3 / 4
NB: ALL CAF PLANS MUST BE REVIEWED AT LEAST THREE MONTHLY

For the purposes of monitoring and evaluation please forward this information to:

The following questions should be asked to family members at the end of each review.

1) Do you feel you were listened to?
2) Do you feel you were able to get your views across?
3) Do you feel progress was made?
4) Is there anything you think we could do differently or better?

The CAF Team

Unit 21,

Greens Industrial Estate,

Caldervale Road,

Wakefield WF1 5PH

Tel: 01924 304914

E-mail:

Web Page: www.wakefield.gov.uk/caf

CAF Form (3) 2 of 6

CAF PLAN
(When reviewing the plan actions not completed need to roll forward to next plan)
OUTCOME REQUIRED
What do we want to achieve? / MEASURE OF SUCCESS
How do we know if things have improved? / ACTION
How will we achieve this? / WHO IS RESPONSIBLE?
Who will make sure this happens / BY WHEN?
Input date not ‘ASAP’ or ‘ongoing’ / PROGRESS REVIEW
e.g. Action Completed or partially completed
Name/s of Baby, Child or Young Person
Date/s of Birth
Date of Initial CAF Plan
Review Dates (ALL dates)

CAF Form (3) 2 of 6