Education, Health and Care Needs Form (Post 16 Education)

Education, Health and Care Needs Form (Post 16 Education)

CONTEXT

This information is sought in accordance with the Children and Families Act 2014. In the first instance all educational settings are required to use their best endeavours to meet the needs of children and young people identified with Special Educational Needs. In providing information, the educational setting must evidence the following:

• A copy of the young person’s costed provision map provided for them under the School Support Stage of the Code of Practice 2014;
• The educational establishment’s assessment of the young person’s difficulties;
• The educational establishment’s outcomes sought for the young person;
• The external professional advice that has been sought (EP report);
• Details of the support and interventions that have been provided for the young person over time;
• As assessment by the educational establishment of the progress made or lack of progress over time;
• What additional support the educational establishment feels is required which cannot be provided through its ordinary resources.

(Please tab between text fields)

Young Person’s Full Name: / Educational Setting:
Unique Pupil No: / Home Authority:
Date of Birth: / Year Group:
Sex:MaleFemale / Key Stage:
Young Person’s Address: / Child in Care?YesNo
If yes, please give name of Social Worker:
Parent/Carer Name: / 2nd Parent/Carer Name:
Relationship: / Relationship:
Parents’ address if different: / Parents’ address if different:
Phone Numbers: / Phone Numbers:
Email: / Email:
Home Language:
Interpreter needed? YesNo

Attendance Record - please provide as much information as possible

Name of Educational Setting / Period (Dates) / Actual Attendance (No. of Sessions) / Possible Attendance (No. of Sessions) / Percentage Attended

SECTION A

The identified Special Educational Needs – What do you consider the young person’s difficulties to be which are acting as barriers to curriculum access and progress. You may wish to complete more than one section, and please indicate the main area of need.

Communication and Interaction
Cognition and Learning
Social Emotional and Mental Health
Sensory and/or Physical Needs

Are there any additional significant factors – if the answers are yes please attach copies of relevant information/advice

Health:YesNo Home Circumstances:YesNo

Attendance:Yes No Social Relationships:YesNo

SECTION B:

Attainment/Ability Assessments/Milestones Met

GCSE/A Level Grades
Date / Year Group / Key Stage / English / Maths / Science
Post 16 Baseline Assessments (where applicable)
Date / Age / Name of Assessment / Carried Out By / Results
Current Attainment Details
Date / Name of Course / Course Level / Current Grade / Predicted Grade

SECTION C:

Support Provided and Funding – All educationalsettings are provided with resources to support those with additional needs, including students with SEN and disabilities. Please therefore identify the provision made from the delegated budget to address the young person’s needs and indicate whether you have applied for additional needs funding from the Local Authority.

SEN delegated budget £Additional needs funding £

______

Current support arrangements: Give details of the target support the young person received that was additional to and different from normal differentiated classroom/group arrangements.

Type of provision: (in class, group, 1:1) / Objective of Provision / Frequency & Duration / Delivered by / Start Date / Review Date / Outcomes: (Achieved, Partially Met, Not Met)

Additional support: What additional support do you feel is required over and above that already provided?

Type of provision: (in class, group, 1:1) / Objective of Provision / Frequency & Duration / Delivered by / Start Date / Review Date / Outcomes: Sought

With reference to the SEN budget what are the financial implications for providing the additional support identified £

______

Professional Involvement – List details of attached reports/evidence from appropriate services.

Service Provided By:
(Name and Role) / Date of Reports / Date Assessed / Brief Description of Evidence Attached

Form completed by:……………………………………………………………………………………………

Signature:…………………………………….Signature:……………………………………….

Headteacher / PrincipalSENCO

Please return this form, together with the following (if applicable): school reports; EP report; costed provision map; to:

Email: (preferred method of submission) or

Post:EHC Assessment Team, Warrington Borough Council, 2nd Floor, New Town House,

Buttermarket St, Warrington, WA1 2NH

Office Use

Date Received: / Response due by:
Officer: / Panel Date:

v61

AGREEMENT OF PARENTS / CARERS / YOUNG PERSON

Parent / Carer / Young Person declaration:

(Please check boxes)

I/we confirm that me/my/our child’s educational setting has discussed this referral with me/us and I/we have been fully involved in the decision to refer
I/we understand that an Education, Health and Care Plan will be agreed by the Local Authority only in circumstances where the EHC needs assessment concludes that my/our child has educational needs which are long term, severe and complex
I/we have worked in partnership with the educational setting to help our child
I/we support the educational setting’s view that an EHC needs assessment of my/our child should be carried out
I/we agree to any assessments by professionals to take place
I/we agree with the process taking place and papers being shared with educational settings and professionals where, and when appropriate

Name(s):…………………………………………………………….………….

Signature(s):………………………………………………………………………..

Date:………………………………………………………………………..

Fair Processing Notice

Warrington Borough Council EHC Assessment Team works with a range of teams and agencies within the Council and the NHS to provide support to children and young people with Special Educational Needs and Disabilities (SEND) and their families.

These include:

• Educational Psychology Service
• Sensory Service
• Youth Offending Team
• Bridgewater Community Healthcare Trust
• Warrington Borough Clinical Commissioning Group

In order to draw up an EHC Plan the EHC Assessment Team needs to consider the child/young person’s difficulties across education, health and care where necessary. To achieve this the EHC Assessment Team will sometimes need to exchange information with other teams in the NHS and Local Authority. This includes some basic details such as name, address, date of birth and any other appropriate information that you might have given to a member of the team, for example:

• Who is in your immediate family and the type of support your family needs
• Which agencies might have helped you in the past
• Details about gender and ethnicity

This information is held securely on a number of databases on Local Authority and NHS IT systems. With your consent, we will share this information, but only if it is beneficial to you. Your information will not be passed on to anyone else unless we are legally bound to do so or if there is a risk of serious harm to you or anyone in your family. This is in line with the principles of the 1998, Data Protection Act. Under this Act you also have a right to see a copy of the information we have on your family.

In order to make sure that you get the right help at the right time, we would like to update your details on a regular basis so that our records are current. We will do this by asking you directly to let us know if any of your details have changed.

If you require any more information you can speak to one of the EHC AssessmentTeam members on 01925 444071.

v61