Special guardians preparatory workshops referral form

Please note, you need to press the submit button at the end of this form to ensure you have referred the special guardian.

Kinship Ready connects carers with a dedicated Project Worker. The project worker will support the carer to access the Kinship Ready workshop and deliver a bespoke support package based on carer needs. Please note this support is restricted to four contacts and will require the carer to participate in the preparatory Kinship Ready workshop

Questions marked with a red asterisk (*) are mandatory.

Referrer's information

Name of local authority:

Name of programme:

Date of referral:

Your first name:

Your last name:

Job title:

Organisation / LA you work for:

Your email:

Your contact number:

Kinship carer's information

Has this carer been referred to Kinship Ready before?

What is the reason the kinship carer is being referred again? [Tick one]

First name:

Last name:

Carer's email:

Contact number:

Please ensure that the number is correct and a current active number for the carer

Preferred method of contact?

Address:

Please ensure that the address is correct, all individuals referred to Kinship Ready will receive a hard copy of the participant booklet and an introduction to Kinship care guidebook which will be sent to the address that you have provided

City:

Country:

Postcode:

Date of birth (in this format - 19/06/1965):

Gender:

Please specify "Other" gender:

Sexual orientation:

Please specify "Other" sexuality:

What is the carer's ethnicity?

Please specify "Other" ethnicity:

Does the carer currently have the child(ren) in their care?

Is the carer currently in the process of being assessed for a SGO?

Has a SGO already been granted?

How many children are being raised in kinship care by the carer?

Does the carer have any birth children also in their care?

Please detail any current support needs:

Does the carer feel confident in participating on the workshop via Zoom?

Are there any safeguarding concerns?

Please detail safeguarding concerns:

Does the carer require an interpreter?

Local authorities are responsible for providing an interpreter and liaising directly with them. Interpreters will need to attend the session with the carer and be in the same location as the carer.

Safeguarding and support

Contact ID

Are there any safeguarding concerns to report?

Date of incident or disclosure (please input in DD/MM/YYYY format):

Type of risk:

Origin of information:

Other details of origin:

Please give the name of the volunteer or social worker who reported:

Please enter the name of the project worker who reported:

Details of risk:

Please provide details of the risk or concern

Are any external services aware of the risk?

Please tick all of the External Services that are aware:

Social Care

Children's Social Care

Police

NSPCC

Other

You have indicated that children's social care is involved. Please give further details on this below:

What other agencies are involved?

Is this risk current or historic?

By current we mean an active ongoing risk where individual(s) are currently subject to risk. Historic refers to risks that are no longer an active threat (e.g. where the perpetrator of a risk has been incarcerated)

What is the priority level of this concern?

Please give details of any worry or concern:

Please enter your Kinship email address:

We need you to enter your Kinship email address to ensure that your manager is notified upon submission of the form.

Permissions and consent

I confirm that the carer named above has given consent for me to share the above details with Kinship

I confirm I have received consent

I confirm that the carer named above has given consent for Kinship to contact them through the contact methods above

I confirm I have received consent

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Please press the button below to submit.