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					                                                       Care First No:

            BATH AND NORTH EAST SOMERSET

SB4 SHORT BREAK (under 120 nights), DAY CARE AND OUTREACH REVIEW
This form is to be used to review the plans of children receiving day care, outreach or short breaks
under Section 20 of the Children Act 1989 for less than 120 days a year. (Plans and Reviews for
children looked after over 120 days a year are carried out using the LAC forms) This replaces the
C8 for children/young people receiving this type of short break.

If you require this information in a different format, please contact the Social Worker on
01225 825307

Name of Child:

Date of Birth:

Date of Review:


Name of those Participating          Designation                    Consulted    Attended    Notified of
                                                                                             Outcome




REPORT FOR REVIEW

What is the aim for this child/Young Person? (as recorded at the last review of plan)
Action undertaken since last Review or Plan?




CHANGES SINCE LAST REVIEW OR PLAN

Changes in the child's needs - to address each of the seven dimensions. Starting from the baseline of
the Initial/Core Assessment or the last Review, how have the child's needs changed?




Changes in parenting capacity - to address each of the six dimensions. Starting from the baseline of
the Initial/Core Assessment or the last Review, how has parenting capacity changed?




Changes in the wider family and environmental factors - to address each of the seven dimensions.
Starting from the baseline of the Initial/Core Assessment or the last Review, how have these factors
changed?
OUTCOME FOR CHILD/YOUNG PERSON

What is the outcome of the Plan to date for the child? Include comments on the child's personal
and social development.




Who else was consulted as part of this Review process? (Health, Education, other professionals,
any others not actually present at the Review Meeting)




Education

Date of last Statement Review (if applicable)


Child's current educational needs




Is there a Transition Plan if the young person is 14+? If so, what is it?
Any educational attainments, absence record, current statement status if any to be recorded:




Health

Date of most recent Health Review(under 120 overnights only)


Date of most recent Dental Check (under 120 overnights only)




Child's current health (Does a life-limiting form need to be completed at this stage?):




Are there any therapeutic or educational programmes in existence? Comment on any changes
(Make any necessary amendments to the Plan and Agreement or Background Information Forms)




Are there any changes to equipment needs?




Drugs taken, dosage, frequency, how given - has this changed?
(Make any necessary changes to the Plan and Agreement or Background Information Forms)
Other

Are there any changes to the child's other needs? Is there a need for preparation for
independent living? What arrangements are being made? (Record these in the Plan and
Agreement)




Placement

Give dates of stays in day care, outreach and short break (under 120 nights) placements since last
Review:




Is the child/young person happy with the placement?




Are the parents/carers happy with the placement?




Have the parents received a Consultation Document prior to this Review?




Does this continue to be the right placement to meet the child's needs and is everyone I
agreement?


Do the long-term aims of the plan for the child remain the same? State any changes to the Plan.


Transport and Finance arrangements




Any other issues




Complaints
Have any complaints been made about the service provided under this plan? (if so give detail)


Are the child/young person and parent(s) aware of the Complaints Procedure and have they
received a copy?




Are there any other changes to the Plan and Agreement? (If the Plan and Agreement changes,
the form should be amended following the review)




SUMMARY OF ALL SERVICES

Specific reports should be attached. Give a summary of the discussion at the Review Meeting,
issues raised etc.




SERVICE PLAN REVIEW

Action                          By Whom                         Date to complete or review




Child/Young Person's view of this Review and Plan




Parents' View of this Review and Plan
Social Worker          ……………………………..                                Date       ……………………….


Team Manager ……………………………..                                              Date   ………………………




Copies Sent to                                            Date




Recording

This review, any change to the Care Plan and other changes should be recorded on Care First,
and should be completed immediately after Review

For short break under 120 nights only, enter the following additional information:-

Date of last health check:
Date of last dental check:
                                            Date   Home            Placement     Elsewhere   Child Seen
                                                   Visit
Give details of visits to the
family and to the child in
placement since the last
review, stating whether the
child was seen for each visit




REVIEW SUMMARY

Date this review due   Type of review              Code          Outcome                       Date of next review



Date reviewed          Priority at review                        Code                          Review type           Code
SERVICE PLAN STATUS - Complete one of section 1, 2 or 3
1. Existing plan continues with priority:




2. Existing plan ceased - no new plan, case closed:   Date:

Outcome                                                       Record destruction date:
                                                              All services, allocations, placements should be closed

Code




3. Existing plan ceased - new plan defined            Date:

LM/Jan 03                                                              weeks.

				
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