Rhondda Cynon Taf Team Around the Family Assessment

Request for Team Around The Family

For the child or young person who is the main focus for this request for service

Name / Contact Phone number(s) / Home:
Mobile:
Date of Birth / Male or female / FemaleMale
Previous TAF Assessment? / NoYes / Main address inc postcode
Ethnicity / 1st Language
Name of school or early years setting / Special Education Needs
Name of GP / Name of Health Visitor
Consent from the family / child / young person is needed for the information on this form to be shared. Please make sure that the section to give consent on PAGE 7 is completed.

Key Family Members

(Please include details of parents / carers and also other family members such as siblings, carers, step siblings, or other significant people who visit the home)

First Name / Surname / Relationship to child / D.O.B. / Parental Responsibility / Present at meeting / Household member
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
NoYes / NoYes / NoYes
Is a parent or carer contributing to this request? / NoYes
Is the child or young person contributing to this request? / NoYes

Person(s) coordinating this request

Name / Contact phone no.
Address
Job title/role / Agency
Is there already a key worker? / NoYes
Is yes, who are they? / Name, agency and contact details
Agencies working with the family already
Include all known agencies and key relevant points about the work done with the family or ongoing
Birth history and medical background (if appropriate)
Include outline of development delay/disability concerns, physical/sensory difficulties/language development and play skills

Family Strengths and Needs

Please comment on every element and score the level of need as follows:

1 = no needs

2 = minor needs

3=moderate needs

4 = significant needs

5 =critical / complex needs

If this request concerns more than one child or young person, indicate which strength or need relates to which child. Where possible, base your comments on evidence, not opinion. Highlight and source the information you use to support your evidence. If there are any major differences of view, for example between the carer, young person or practitioner(s), these should be recorded too.

Family Profile:

Element / Strengths and needs / Level of need
(1-5)
1 Housing / 12345
2 Income, employment and finance / 12345
3 Family history, relationshipsand well-being / 12345
4 Social and community links / supports / 12345

Child or Young Person Profile

Element / Strengths and needs / Level of need (1-5)
Health and Wellbeing / 5. General health / 12345
6. Physical development / 12345
7. Speech, language and communication / 12345
8. Emotional and social development / 12345
9.Behaviour / 12345
10. Identity, self esteem, self image and social presentation / 12345
11.Family and social relationships / 12345
12.Self care skills and independence / 12345
Learning / 13.Understanding, reasoning and problem solving / 12345
14.Attendance and participation in learning, education or work / 12345
15.Progress and achievement / 12345
16.Aspirations / 12345

Parent or Carer Profile

Element / Strengths and needs / Level of need (1-5)
17Basic care,
ensuring safety and
protection / 12345
18Setting routines and boundaries / 12345
19Emotional warmth and stability / 12345
20Physical health / 12345
21Mental health and
emotional well-being / 12345
22Drug and alcohol use / 12345
Key agencies who are also working with the child, young person or their family (if known)

Agency

/ Contact Name / Tel:

Agency

/ Contact Name / Tel:

Agency

/ Contact Name / Tel:

Agency

/ Contact Name / Tel:

Summary

Please use this page to summarise the level of need for each domain. Doing so will help to identify what needs to change, where the family may need additional support, and to structure a Team around the Family plan.The information shown here can also be re-used to identify what progress has been made at subsequent Team around the Family (TAF) review meetings.

None
1
/ Minor
2
/ Moderate
3
/ Significant
4
/ Critical/
Complex 5

Family Profile
1. Housing
2. Income, employment and finance
3. Family history, relationshipsand wellbeing
4. Social and community links / supports
Child and Young Person Profile
Health and Wellbeing
5. General health
6. Physical development
7. Speech, language and communication
8. Emotional and social development
9. Behaviour
10. Identity, self esteem, self image and social presentation
11. Family and social relationships
12. Self care skills and independence
Learning
13. Understanding, reasoning and problem solving
14. Attendance and participation in learning, education or work
15. Progress and achievement
16. Aspirations
Parent or Carer Profile
17. Basic care, ensuring safety and protection
18. Setting routines and boundaries
19. Emotional warmth and stability
20. Physical health
21. Mental health and emotional well-being
22. Drug or alcohol use

Consent

We have collected information in this TAF form so that we can understand what help your family may need. If we cannot cover all of your needs we may need to share some of this information with the other organisations so that they can help us to provide the services required.
We will treat your information as confidential and will not share it with any other organisation unless you have consented, or unless we are required by law to share it, or if you or any other person will come to some harm if we do not share it. In all cases we will only ever share the minimum information we need to share.
I understand the information that is recorded on this form and that it will be stored and used for the purpose of providing services to:
Me
The child or young person for whom I am a parent
The child or young person for whom I am a carer
NoYes / I have had the reasons for information sharing and information storage explained to me and I understand those reasons.
NoYes / I agree to the sharing of information.
I agree for a copy of this form to be sent to a TAF Panel if necessary / NoYes
Historical data may also be shared with relevant agencies in support of this TAF assessment if required / NoYes
Child or young person’s views about the assessment
Parent or carer’s views about the assessment
Signed (Child/Young Person) / Name / Date
Signed (Parent/Carer) / Name / Date
Signed (key worker or other practitioner) / Name and Agency / Date

What to do next?

A copy of this form must be sent to the TAF Coordinator for your area within 5 working days of it being signed:

If you are unsure about any aspect of this process, what to do next, or whether you should refer this family to the Team around the Family Panel please discuss this with the TAF Lead for your organisation and/or the TAF Coordinator.

You can also refer to the Team around the Family Guidance about these processes available on line at

Exceptional circumstances: concerns about significant harm to a child or young person
If at any time you have reasonable concern that a child or young person may be at risk of harm you should follow the All Wales Child Protection Procedures and contact Children’s Social Services Tel: 01545 574000

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