Children's Social Care Referral Form - Medway Council - Kent United Kingdom

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Medway Council
Children’s Social Care Referral Form
This form is to be used by all agencies when referring a child to Medway Council Children’s
Social Care.
The Kent and Medway Inter-Agency Threshold Criteria for Services for Children document
provides guidance for professionals and service users, to clarify the circumstances in which
to refer a child to a specific agency to address an individual need, to conduct a CAF or refer
to Medway’s Children’s Social Care. This document is available on the Medway Council
Web site: www.medway.gov.uk.
The document describes:
the threshold criteria for Medway Children’s Social Care;
-
how that fits within the wider context of universal services and multi-agency support;
-
the process by which Children’s Social Care assess against the threshold criteria.
-
If a professional is unclear about whether to make a referral they should first consult with
their designated Child Protection lead within their agency. Following this, a consultation
can be held with a professional within one of Medway’s Children’s Referral, Assessment and
Support Teams (CRAST). To request a consultation, contact Customer First using the details
at the foot of this page.
If a CAF has been completed then this is important information and should be attached to
the referral if consent from the child/parent has been given.
The referral form should be completed with as much relevant information as possible. If
referring more than one child in the same household, a separate referral form is not needed
for each child, but the referral must state which children are being referred for a service.
Consent should always be sought for a child in need referral and for relevant information to
be shared.
In most child protection cases, parents should be informed that a referral is being made and
what the concerns are about the child. However, there are exceptions where this is not
appropriate, namely if to inform the parent / carer would:
Place the child at increased risk of significant harm
-
Place a member of staff at risk by the response it may prompt
-
Lead to the risk of loss of evidence eg someone destroying evidence of a crime, or
-
influencing a child about a disclosure issue
In these situations, referrers should seek advice from their safeguarding lead or line
manager within their own agency and, if still unsure, consult with Medway Council
Children’s Care. To request a consultation, contact
Customer First Adults and Children’s Team
Telephone: 01634 334466 / 24 hour emergency 0845 7626777
Fax:
01634 333188
email:
ss.access&info@medway.gov.uk.
Medway Council Children’s Social Care Referral Form
1 of 8
Medway Council
Children’s Social Care Referral Form
This form is to be used by all agencies when referring a child to Medway Council Children’s
Social Care.
The Kent and Medway Inter-Agency Threshold Criteria for Services for Children document
provides guidance for professionals and service users, to clarify the circumstances in which
to refer a child to a specific agency to address an individual need, to conduct a CAF or refer
to Medway’s Children’s Social Care. This document is available on the Medway Council
Web site: www.medway.gov.uk.
The document describes:
the threshold criteria for Medway Children’s Social Care;
-
how that fits within the wider context of universal services and multi-agency support;
-
the process by which Children’s Social Care assess against the threshold criteria.
-
If a professional is unclear about whether to make a referral they should first consult with
their designated Child Protection lead within their agency. Following this, a consultation
can be held with a professional within one of Medway’s Children’s Referral, Assessment and
Support Teams (CRAST). To request a consultation, contact Customer First using the details
at the foot of this page.
If a CAF has been completed then this is important information and should be attached to
the referral if consent from the child/parent has been given.
The referral form should be completed with as much relevant information as possible. If
referring more than one child in the same household, a separate referral form is not needed
for each child, but the referral must state which children are being referred for a service.
Consent should always be sought for a child in need referral and for relevant information to
be shared.
In most child protection cases, parents should be informed that a referral is being made and
what the concerns are about the child. However, there are exceptions where this is not
appropriate, namely if to inform the parent / carer would:
Place the child at increased risk of significant harm
-
Place a member of staff at risk by the response it may prompt
-
Lead to the risk of loss of evidence eg someone destroying evidence of a crime, or
-
influencing a child about a disclosure issue
In these situations, referrers should seek advice from their safeguarding lead or line
manager within their own agency and, if still unsure, consult with Medway Council
Children’s Care. To request a consultation, contact
Customer First Adults and Children’s Team
Telephone: 01634 334466 / 24 hour emergency 0845 7626777
Fax:
01634 333188
email:
ss.access&info@medway.gov.uk.
Medway Council Children’s Social Care Referral Form
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1.
Child’s details
Full name of child:
Any alternative name:
DOB:
/
/
Age:
If unborn, estimated date of
delivery?
/
/
Tick if estimated:
Gender:
Male
Female
Unknown
First language:
Will an interpreter / signer be
Ethnicity:
required?
Yes
No
Home
address:
[Including
Postcode]
Telephone Number:
Does the child have a disability? Yes
No
If “Yes” give details of the disability?
2.
Family details (including all members of the household)
Name (indicate if
DOB /
Relationship
Address & Telephone
Ethnicity
also being referred)
Age
to the child
Medway Council Children’s Social Care Referral Form
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3.
Family details (including all members of the household) (continued)
Name (indicate if
DOB /
Relationship
Address & Telephone
Ethnicity
also being referred)
Age
to the child
4.
Significant others / extended family members / supportive adults
Name
DOB /
Relationship to
Address & Telephone
Age
the child
Medway Council Children’s Social Care Referral Form
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5.
Details of professional contacts
GP
Name:
Address:
Telephone number:
Health Visitor
Name:
Address:
Telephone number:
School
Name of School
Contact name:
Address:
Telephone number:
School Nurse
Name:
Address:
Telephone number:
Other Agency
Agency name
Contact name:
Address:
Telephone number
Agency name
Contact name:
Address:
Telephone number
Agency name
Contact name:
Address:
Telephone number
Medway Council Children’s Social Care Referral Form
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6.
Have you had a consultation with Medway Council Children’s Care?
Please include the consultation number below.
YES
/ NO
If so, what advice were you given?
If a copy is available, please note this below and send to us using the address at the end of this form.
7.
Has a CAF been started or completed in respect of this child?
YES
/ NO
Please send a copy to us using the address at the end of this form.
8.
Why are you referring this child to Medway Council Children’s Care today?
Please state how long you have known the child and in what capacity. & what are your specific
concerns? Has the child made a disclosure or suffered an injury? What do you think the family need
from Children’s Care?
9.
What information do you know about this child?
Include all relevant information about the child: Their health, education, emotional and behavioural
development; family and social relationships; social presentation; selfcare skills, any special needs etc.
If you have information such as a chronology, body maps or centile charts, please note them below and
send a copy of them to us using the address at the end of this form.
Medway Council Children’s Social Care Referral Form
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