1.	Child/young person's Name:

2.	Name of Staff:

3.	Have the actions from the last review been completed?
	YES
	NO

	If NO why not?

4.	What has been successful for the child/young person since the last meeting?

5.	What are the main issues of concern that still need to be addressed?

Care Plan

6.	Do you know what the care plan is for the child/young person?
	YES
	NO

7.	Is this in line with the internal Placement Plan?
	YES
	NO

8.	Are you updated regularly by the Social Worker in respect of the current plan?
	YES
	NO

9.	Are your objectives/outcomes clear?
	YES
	NO

10.	Do you feel anything needs changing or amending in the plan?
	YES
	NO

	If YES what?

12.	What impact are the current arrangements having on the placement?

13.	Do you have the appropriate paper work in place?
		Yes		No
	Personal Education Plan (PEP)	Personal Education Plan (PEP) Yes		Personal Education Plan (PEP) No
	Medical Consent	Medical Consent Yes		Medical Consent No
	Core Assessment	Core Assessment Yes		Core Assessment No
	Placement Information Record (PIR)	Placement Information Record (PIR) Yes		Placement Information Record (PIR) No
	Placement Request	Placement Request Yes		Placement Request No
	Risk Assessment	Risk Assessment Yes		Risk Assessment No
	Looked after Child (LAC) Health Assessment	Looked after Child (LAC) Health Assessment Yes		Looked after Child (LAC) Health Assessment No

HEALTH

15.	Are there any physical health concerns you currently have in relation to the child/young person?
	YES
	NO

	If YES what?

17.	Are they registered with a Doctor?
	YES
	NO

18.	Are they registered with a Dentist?
	YES
	NO

19.	Are there any issues around emotional health or behaviour?
	YES
	NO

	If YES please explain

21.	Do you require further support in managing this?
	YES
	NO

EDUCATION

23.	Is the child/young person in education?
	PART TIME
	FULL TIME
	NONE

24.	Do you understand the targets in the Personal Education Plan (PEP) if they have one?
	YES
	NO

25.	Are there current issues regarding behaviour in School/College
	YES
	NO

	If YES please explain

27.	Are there any other concerns about the child/young person while at School/College
	YES
	NO

	If Yes what?

29.	Are there any transport issues?
	YES
	NO

	If YES what?

31.	Do you know your expectations around support in the unit e.g. homework, attendance?
	YES
	NO

SUPPORT SERVICES

14.	What support services or other agencies are currently involved?
		YES
	Youth Offending Team (YOT)	Youth Offending Team (YOT) YES
	Parent Support Worker (PSW)	Parent Support Worker (PSW) YES
	Community Support Team (CST)	Community Support Team (CST) YES
	Sessional Support Services (Sessional)	Sessional Support Services (Sessional) YES
	Drug Alcohol Rapid Response Team (DARRT)	Drug Alcohol Rapid Response Team (DARRT) YES
	Action For Children (Action for Children)	Action For Children (Action for Children) YES
	Child Adolescent Mental Health Services (CAMHS)	Child Adolescent Mental Health Services (CAMHS) YES
	Advocacy (Tros Gynnal)	Advocacy (Tros Gynnal) YES
	Family Group Conferences (CWLWM)	Family Group Conferences (CWLWM) YES

	Any Other:

32.	Are there any issues with the input from these agencies
	YES
	NO

	If YES please explain

34.	Do you require further services or support from any other agency or support service?
	YES
	NO

	If Yes please explain

CONTACT

37.	Do you know what the current contact arrangemtns are for the child/young person?
	YES
	NO

38.	Is this manageable within the unit?
	YES
	NO

	If NO please explain

40.	Does contact impact on the placement?
	YES
	NO

	If YES please explain

42.	Does the contact plan need updating?
	YES
	NO

43.	Is communication going well with the family in relation to the placement and contact?
	YES
	NO

	If NO please explain

45.	Are there any issues with family or friends that are having a negative impact on the placement?
	YES
	NO

	If YES please explain

47.	Date completed (DD/MM/YY format):