Details of Child/Ren/Young Person

Child Protection Plans

Date and Venue of Supervision
Named Professional
Discipline
Safeguarding Team Representative

Details of Child/ren/young person

Childs Name
DOB
Reason for Initial Child Protection Conference (ICPC)
Date of Initial Child Protection Conference (ICPC)
Review Date

Were you formally invited to ICPC?

…………………………………………………………………………………………………

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 4 – Child Protection Plans – V03-Iss2 – Nov 17

Part of NTW(C)04 – Safeguarding Children Policy

Was a request made for you to provide a written report for ICPC?

…………………………………………………………………………………………………

Did you submit a written report for ICPC?

…………………………………………………………………………………………………

If so in what format?

…………………………………………………………………………………………………

Did you attend conference?

…………………………………………………………………………………………………

Or did you send a representative?

…………………………………………………………………………………………………

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 4 – Child Protection Plans – V03-Iss2 – Nov 17

Part of NTW(C)04 – Safeguarding Children Policy

Did you send apologies if you were unable to attend?

…………………………………………………………………………………………………

Were you supported by NTW during the preparation and attendance of the conference?

…………………………………………………………………………………………………

Did you agree with the outcome decision? (Category of abuse)

…………………………………………………………………………………………………

Are you a member of the core group?

…………………………………………………………………………………………………

If no please explain reasons why?

…………………………………………………………………………………………………

Do you feel a valued member of the core group and do you feel the core group process is effective in achieving the aims/objectives/recommendations of the CP Plan?

…………………………………………………………………………………………………

Do you feel supported by NTW in your attendance and contribution to the core group process?

…………………………………………………………………………………………………

Do you think there is anything else that NTW could be doing to support you?

…………………………………………………………………………………………………

Do you feel able to challenge decisions within the core group?

…………………………………………………………………………………………………

What is the arrangement within the core group for the recording/minute taking?

…………………………………………………………………………………………………

How and where do you record attendances at conferences/core group meetings?

…………………………………………………………………………………………………

What information might you record following these meetings, (recommendations, action plans)

…………………………………………………………………………………………………

Has the work you have undertaken as a member of the core group had an impact on the outcomes for the child/adult/family?

…………………………………………………………………………………………………

DATE OF THE NEXT CP REVIEW:………………………………………………………

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 4 – Child Protection Plans – V03-Iss2 – Nov 17

Part of NTW(C)04 – Safeguarding Children Policy

PREPARATION PRIOR TO SUPERVISION

Brief family history:

…………………………………………………………………………………………………

Reasons why family was referred to case conference:

…………………………………………………………………………………………………

Access to RIO or paper copies of patients records/children services documentation e.g. Strategy conference minutes/CP plans/core groups etc.

…………………………………………………………………………………………………

OUTCOME OF SUPERVISION

Evidence seen:

…………………………………………………………………………………………………

Action for professional:

…………………………………………………………………………………………………

Action for Supervisor:

…………………………………………………………………………………………………

Signatures:

Name:…………………………Sign:………………………………Date:……………………

Next Review due:

…………………………………………………………………………………………………

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 4 – Child Protection Plans – V03-Iss2 – Nov 17

Part of NTW(C)04 – Safeguarding Children Policy