Early Help Assessment
This is the Waltham Forest Early Help Assessment Form to provide early help for children and their families.
This form should be completed and sent alongside supporting documents to the Early Help Team:
Email: [email protected] |Tel: 0208 496 1517
Please refer to the Early Help Assessment Guidance.1 when completing your assessment.
If at any time during the course of this assessment you feel that a child in the family has been harmed or abused or is at risk of arm or abuse, you must follow
the local safeguarding children board procedures.
If you require further support or guidance in completing this assessment, please refer to the Early Help webpage;
http://www.walthamforest.gov.uk/earlyhelp
Or contact the Early Help Co-ordinators:
Email: [email protected] |Tel: 0208 496 1517

For urgent matters, please contact the Waltham Forest Multi-Agency Safeguarding Hub (020 8496 2310 Monday to Thursday, 9am-5.15pm and Friday,
9am-5pm 020 8496 3000 Out of hours
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Section (a) – Contact Details
Details of the person completing this assessment
Agency / Team / Setting:
Parent / Guardian:
must have Parental responsibility
Contact No.
Role / Job title:
Address:
Name:
Address:
Contact Number/s:
Date of this request:
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Consent / Information sharing
Early help is consent based. Consent must always be sought unless it puts a child at further risk to do so.
Has the child/young person consented to the request being made
Yes
No
Yes
No
Yes
No
Yes
No
If no, please state the reason
Does the child/young person know about this referral?
If no, please state the reason
Does the parent/carer know why the referral being made?
If no, please state the reason
Does the parent/carer understand and agree to agencies sharing information?
If no, please state the reason
Details of the Lead Professional
Name:
Role / Job title:
Agency / Team / Setting:
Address:
Contact Number/s:
Date of this request:
Type of assessment:
Initial
Review:
Date of assessment:
Section (b) – Family Details
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Subject and child (ren) within the family
Framework-I
No:
UPN
First name
Surname
DOB / EDD
Age
Gender
Address
Ethnicity
Religion
EHC plan
in place
Details of other household members – living in the household
First name
Surname
DOB /
EDD
Age
Gender
Address
Relationship
with subject (s)
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Parental
Responsibly?
Ethnicity
Religion
Present /
engaged in
assessment
Details of significant adults/others not living the household
First name
Surname
DOB /
EDD
Age
Gender
Relationship
with subject (s)
Address
Parental
Responsibly?
Are there any known disabilities for any family members? If yes, please state
Are there any communication needs for the family? Does the family require an interpreter? If yes, please state
Legal status / Immigration status of the family
Section (c) – Presenting needs and Assessment
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Ethnicity
Religion
Present /
engaged in
assessment
Please select all needs identified for the Family
Sexual Exploitation
Unacceptable Behaviour ,home/school/setting
Disability
Sexual Harmful behaviour
Community based Anti-social Behaviour
Illness
Extremism / Radicalisation
Beyond Parent Control
Forced Marriage
Trafficking
Missing from Education, Including elected home
education
Honour based violence, Including Female genital
mutilation , forced marriage
Gang affiliation
Missing from Home
No recourse to public funds
Young Carer
Drugs / substance abuses
Homelessness
Learning disability
Alcohol Abuse
Under 16 Pregnancy
Financial support
Domestic Abuse / Violence
Other:
Family Breakdown
Self-Harming
Other:
Mental Health
Private fostering arrangement / Special guardianship
Other:
Weight / Height / BMI concerns
Unaccompanied Asylum Seeking Children
Other:
Mental Health needs
Out of work Benefits
Domestic Abuse / Violence
Drugs / substance abuse
Disability/ Additional Needs
Self-Harming
Alcohol Abuse
Intentionally Homeless
No recourse to public funds
Other:
Other:
Other:
Please select all needs identified for the Parent/s
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Please provide a description of the families need/s
People present and/or engaged in this assessment:
Assessment tools / Reports / Measures used in support of this assessment; please indicate and attach supporting documents to your referral
Who is it for in the family?
What tool/report has been used?
Date completed:
Assessment information
Child:
Health:
general health; height and weight;
allergies; illnesses, Physical
development
Speech and language:
speaking, understanding, listening,
communication
Social development:
sense of identity, peer relationships,
social presentation, family
relationships, place within family
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Completed by:
Behavioural development:
following boundaries/rules, attitude,
problem solving
Personal and Emotional
development:
self-confidence, self-worth, selfimage, emotional well-being, selfcare, independence
Academic progress:
current attainment levels,
achievements, weaknesses, progress,
areas for improvement, strengths,
favourite subjects
Participation in Education;
attendance, willingness to engage,
involvement levels, attitude to
learning
Aspirations:
goals, targets, interests,
Parenting what is the parenting like for each child?
Child:
Ensuring basic care and protection:
Safety, food, personal hygiene,
clothing, meeting medical needs,
.
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Emotional warmth and stability
Attachment, engagement,
relationship, language/attitude,
reliability
Guidance and boundaries
Routines, guidance, behaviour
management
Notes/Comments/other relevant
information
Section (d) – Conclusion and outcomes
Following the assessment, have you identified any other presenting needs? Please refer to Guidance. 4 for needs and identify below
Adult involved in crime /
antisocial behaviour
Adult perpetrator of domestic abuse
Child missing education
Trafficking
Adult involved in drug abuse
Adult with terminal illness
Child sexual exploitation
Teenage pregnancy
Adult involved in alcohol abuse
Adult with mental health
Child perpetrator
School attendance below
Adult on out of work benefits
Adult with disability / illness
Child victim of domestic abuse
Previously looked after child
Adult victim of domestic abuse
Child mental health
Child abuse, please identify
Family member in prison
____________________________
What are the young person’s / subjects / child’s views/comments:
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What are the parent/s views/comments:
What are your conclusions and analysis: What are the child/young person and/or
family strengths and resources? What are their needs?
What are you worried about? What needs to change?
What are the outcomes to be achieved? Please check all that apply
Improved family functioning
Reduced anti-social behaviour
Parent pathway to work
Improved mental health
Reduced offending
Child/ Young person pathway to work
Improved school attendance
Reduced school exclusions
Child/ Young person in education and Training
Improved speech and language
Reduced risk taking behaviour
Adult in education and Training
Improved parenting
Reduced sexualised behaviour
Child/Young person free from bullying
Improved management of behaviour / boundaries
Reduced substance misuse
Access to Short Breaks
Improved care arrangement (stable)
Reduced safeguarding concerns
Present to Fair Access Panel
Improved housing and conditions / housing advice &
information
Reduced isolation
Present to Childcare Panel
Improved presentation
Reduced debt
Access to Family Functional Therapy
Improved health and well being
Removed gang affiliation
Access to parenting programme
Other__________________________________
Other___________________________________
Other___________________________________
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Section (E) – Early Help Plan
Signpost to service/s
Please identify below
Signpost to team
Please identify below
Early Help In-house
Escalate to Children’s Social Care
Please contact your allocated Early Help
Coordinator if you would like
advice/guidance in supporting this family
OR support to Chair complex cases.
Please complete a request marked for protection and
send it to: [email protected]
The MASH team will not accept this assessment form
as a referral.
Professionals notes / Comments
Please identify the professional/s involved in this plan
Name
Role / Service / Agency
Email
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Telephone no.
Action Plan
Who is this action for?
What is the action?
Must be SMART
What is the outcome to
be achieved?
Who will be responsible
for completing this
action?
Arrangements for review
Planned date:
Planned time:
Planned location:
Chair:
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When should it be
completed by?
Comments
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