Practice Standards for the Wiltshire CAF Pathway for Expectant Young Mothers voct 14, Available from:

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1 Practice Standards for the Wiltshire CAF Pathway for Expectant Young Mothers voct 14, Available from:

2 1) Why do Expectant Young Mums need a Common Assessment Framework (CAF)? Teenage pregnancy and early parenthood are widely recognised to be associated with poor health and social exclusion. There has been considerable debate over whether poor outcomes are a consequence of the mothers and fathers young ages, of their often disadvantaged circumstances, or of limited uptake of antenatal care. Current research suggests that all these contribute, but that timely access to appropriate care and support can help avoid poor outcomes and maximise young people s chances of a positive transition to parenthood. 1 2) What are the benefits of completing a CAF? A CAF: 1. Supports multi-agency working and information sharing The assessment takes a holistic approach to the young person and ensures that all of their needs are being considered. This means that only one form needs to be filled in, but can be used to refer to multiple agencies, ensuring that all supporting agencies have the information they need to help keep the young person safe and their unborn child safe. 2. Provides a safety net for young mums Once the form is handed over to the lead professional that person is able to review the CAF action plan and ensure that the young person is getting the support that they need. This support will be on-going. Where necessary the lead professional can call a team around the child meeting to ensure that agencies and professionals are working together to protect vulnerable young people, share information and provide optimum support for the young person s needs. 3. Allows informed referral to Children s Centres who are able to then contact the young person to offer on-going support. 4. Is done with the consent of the young person A CAF is always done with the consent of the young person. It means that they are aware of the support package that is being put in place and are signed up to progressing their action plan. The young person owns the CAF and having a CAF ensures they only have to tell their story once when accessing various agencies for support. 5. The CAF becomes registered centrally providing a place for future professional working with the young person to refer to. This enables professionals to get a clearer perspective on the risks for the young person. 1 Getting maternity services right for pregnant teenagers and young fathers, DCSF and DoH, cations&productid=dcsf & 2

3 3) Principles behind the CAF pathway for young mothers If you feel that a child is at risk of significant harm a referral must be made immediately to social care following your local guidelines. If a child has urgent needs the time lines and roles in this pathway should be negotiated to ensure the best outcome for the young mother. This may mean completing the CAF and TAC before 28 weeks, or the midwife retaining lead professional role past the 28 weeks defined in the pathway. This pathway provides a method of multiagency working to ensure that we are supporting young mothers effectively. A pathway does not replace the need for good working relationships between agencies. If you have a concern about a young person, talk to your supervisor, or the other professionals working in partnership with you as part of the team around the child. If you feel that a colleague is not working in the best interests of a child then this must be escalated appropriately. Please refer to the WSCB escalation procedure 4) The procedure for carrying out a Common Assessment Framework (CAF) with young mothers a) The role of maternity services Midwives take responsibility for the completion of a full CAF assessment on all young mothers who were under 18 at the point of conception, by 24 weeks of pregnancy. The assessment is for the mother, not the unborn child. A separate assessment can be done on the unborn child if appropriate. Please refer to the Pre-birth Protocol to Safeguard Unborn Babies Before the appointment in which the CAF will be completed, the completer needs to contact the CAF team at Wiltshire Council on to see if a CAF/ASSET is already in place, or whether the child is known to social care (including children in care and child protection plans). If a CAF is already in place the midwife should discuss with the current lead professional and the young person whether: The lead professional should continue in their in their role and liaise closely with the midwife and health visitor and reassess the needs of the young person and call a new TAC. The role of lead professional is handed over to the health visitor and a new TAC is called to discuss the changing situation of the young person. If an ASSET (youth offending assessment tool) is in place, or the young mother has an open case to Social Care, no CAF is needed. The midwife will need to discuss with the young person whether they can tell the current lead professional of the young person s pregnancy (Fraser Guidelines should be used, for more information go to ). If consent is given the midwife should contact the lead professional to inform them of the pregnancy. If the young person does not give consent the midwife should gain advice from the supervisor as to whether to make the referral without consent in order to 3

4 safeguard the young person. If the decision is made to override the lack of consent, the young person should be informed, and the reasons for this. It is important for the midwife to maintain a close relationship with the lead professional and the ongoing assessment/care planning process. This will allow appropriate information sharing/ multi agency working to support effective safeguarding. This process should also include the health visitor from 28 weeks of pregnancy. Referring to the Looked After Children s Specialist Nurses If the young women is a looked after child, it is important that the lead professional contact the Looked After Children s Specialist Nurse (with consent, using Fraser guidance) on , to notify them of the pregnancy. This will enable the specialist nurse to support the young person s changing health needs. The young mother s pregnancy status should be added to Carefirst (by the Social Worker) and a relationship to the unborn child should be created. Completing the CAF The CAF process always asks for the consent of the young person and therefore a young person has the right to opt out of the assessment. It is important the assessment is approached in a positive way with young mothers to be and that it is explained to them that CAF is a process to ensure that they receive all the support that they might need in preparation for their role as a parent. The CAF does not need to be completed in one session and practitioners need to find the approach that best suits their practice and the needs of the young mother. If you have any concerns over completing the CAF please contact your local CAF coordinator who will be able to support you (contact details are at the end of the document). If the midwife has immediate concerns regarding the young person and feels that they need to be visited by the health visitor before the 28 weeks stated in the young parents CAF pathway, they should contact the health visitor to express their concerns. The health visitors have some flexibility to their visiting time scales for vulnerable families. The midwife will then register the CAF by posting the CAF to: Coordination team, County Hall, Bythesea Rd, Trowbridge, BA14 8JN. At this point the young mother is unlikely to have an allocated health visitor. The lead professional should be registered on the CAF form using the name of the team leader for the appropriate health visiting team. The Midwife must then send the CAF to Health Visiting Central Admin. Central Admin will ensure that it gets to the appropriate Health Visitor Team Leader or Family Nurse Partnership Supervisor (if the young person is on the Family Nurse Partnership Prgramme (FNP)) who will allocate the young parent within their team. Contact details for Central Admin are at the end of the document. The Midwife should also make copies of the CAF, and with the young person s consent, send them to the relevant children s centre, and the young person s GP. 4

5 b) The role of health visiting/fnp Nurse Once the health visitor / FNP Nurse receive the CAF they must phone the CAF team to identify themselves as the lead professional. A health visitor will visit the young mother at around 28 weeks of gestation to establish a relationship with the young mother. As part of this meeting the CAF action plan can be reviewed and a decision made, involving the young person, as to whether a team around the child (TAC) meeting should be held. If the young parent is on the FNP programme the FNP Nurse will already be visiting the young person and will make a decision as to whether to call a TAC meeting. Holding a TAC meeting is an important part of the CAF process and enables professionals to meet together with the young parent to properly discuss and plan how support should be provided. Please refer to guidance on planning a TAC meeting available on Wiltshire pathways (details below). For further support and advice about the CAF process contact your local CAF coordinator (details below). For more information on CAF training see: 5) Core offers from other providers a) Learning providers Young parents under the age of 20 are eligible for support with their childcare costs to attend learning through Care2Learn. Learning Curve can support young parents to apply for this funding. Below is a list of courses that are specific to young parents. i. Learning Curve ( or ) run two courses: Young Mums to Be (Entry 3//Level 1 Award) is a specially designed programme for pregnant young women, that takes them through everything they need to know about their pregnancy and the early stages of baby care. Parents with Prospects Parenting (Level 1 Certificate) is designed to help young parents have the best possible relationship with their child, keep their child safe, bond with their child, and learn practical parenting skills as well as improving Functional Skills (Maths & English) b) Children s Centres It is part of the core offer for Children s Centres to provide specialist support to Young Parents. This can include Outreach visits both antenatally and postnatally, young parents groups, play opportunities, parenting courses. Please see below for contact details. a) 0-17 Early Intervention, Youth & Prevention Service, Operational Children s Services (OCS), Wiltshire Council 5

6 OCS provide an offer of appropriate targeted youth support to pregnant teenagers and teenage parents, in close partnership with other relevant agencies. We would expect to be working as part of a team around the child (both mother and son/daughter) as part of the CAF process. The offer includes: signposting to other relevant service provision, higher level targeted youth support, and support for those who are not in education, employment or training (NEET) or are at significant risk of NEET. OCS staff may also be able to facilitate positive activities being accessed through a range of provisions within each community area. 6) Quality Assurance The CAF team quality assure every CAF assessment to provide support to the lead professional and to track the interventions for children and young people with additional needs. 7) Supporting year olds The current CAF pathway is to support young mums who were under 18 at the point of conception. For those aged 18 to 20 a referral form has been provided in the appendix of this document which midwives can complete and submit to Children s Centres, with the young person consent, to request support. 8) If the young person miscarries A referral can be made to the Young Person Outreach Nurse, Vicky Storey, on or secure victorialofts@nhs.net. 9) Key Contacts Health Visiting Central Admin gwh.wiltscchsafeguarding@nhs.uk or Central Referral Admin, Wiltshire Children', Safeguarding Admin, 1st Floor, Wilton Health Centre, Wilton Market Place, Wilton, Salisbury, Wiltshire, SP2 0HT Area CAF Coordinator Team To find if a CAF/ASSETT/Child protection plan is in place contact CAF Helpline Monday- Friday caf@wiltshire.gov.uk Address to send CAFs for registration: Coordination team, County Hall, Bythesea Rd, Trowbridge, BA14 8JN Coordinator Area Direct Line Mobile Helpline Michele Riley West Mon & Fri Dawne Dawes South tbc Tuesday Vicki Marsh East Wednesday Paul Holdsworth North Thursday North covers Calne, Corsham, Chippenham,Malmesbury and Wootton Bassett community areas 6

7 West covers Bradford on Avon, Melksham,Trowbridge, Westbury and Warminster community areas East covers Devizes, Marlborough, Pewsey and Tidworth community areas South covers Amesbury and Durrington, Downton, Mere, Tisbury & Wilton, & Salisbury community areas Children s Centres Sure Start Children s Centres in Wiltshire September 2011 Centre and address Contact details Five Wishes Children s Centre, Kitchener Rd, Amesbury, SP4 7AA Bulford Children s Centre Hubert Hamilton Road, Bulford Camp, Salisbury, SP4 9JY Clearbury Children s Centre, Breamore Rd, Downton, SP5 3HN Little Folly Children s Centre, Winding Way, Bemerton Heath, Salisbury, SP2 9DY Salisbury City Children s Centre,24 St Edmund s Church Street, Salisbury, SP1 1EF Mere Footprints Children s Centre, Springfield Road, Mere, BA12 6EW Wilton Children s Centre, 9 West Street, Wilton, SP2 0DL Tisbury Children s Centre, Weaveland Rd, Tisbury, SP3 6HJ Elim Children s Centre, The Factory, Dews Road, Salisbury, SP2 7SN Bradford on Avon Community Children s Centre, Frome Rd, Bradford-on-Avon, BA15 1LE Kings Park Children s Centre, Lowbourne, Melksham, SN12 7ED Canberra Children's Centre, 56a Spa Road, Melksham, SN12 7NY Studley Green Children s Centre, Westfield Rd, Trowbridge, BA14 9JQ Bellefield Children s Centre, Windermere Rd, Trowbridge, BA14 8TE Longfield Children s Centre, Broadcloth Lane, Trowbridge, BA14 7HE Happy Feet Children s Centre, Princecroft Primary School Site, Princecroft Lane, Warminster, BA12 8NT White Horse Children s Centre, Eden Vale Rd, Westbury, BA13 3NY Calne Community Children s Centre, Prince Charles Drive, Calne, SN11 8TG

8 Spring Rise Children s Centre, Frogwell, Chippenham, SN14 0DG Kings Rise Children s Centre, Lodge Rd, Chippenham, SN15 3SY The Rise Children s Centre, St Paul s Primary School, The Oaks, Chippenham, SN15 1DU Cricklade Children s Centre, Bath Road, Cricklade, SN6 6AX Corsham Children s Centre, Kings Avenue, Corsham SN13 0EG Malmesbury Children s Centre, Tetbury Hill, Malmesbury, SN16 9JR Wootton Bassett Children s Centre, Byron Avenue, Wootton Bassett, SN4 8BA Devizes South Children s Centre, The Green, Devizes, SN10 5AA Devizes North Children s Centre, c/o Devizes South Children s Centre, Southbroom Infants School, The Green, Devizes SN10 5AA The Corner House Children s Centre, George Lane Car Park, Marlborough, SN8 4BY Windmill Hill Children s Centre, Wylye Road, Tidworth, SP9 7QR Pewsey Children s Centre, Wilcot Road, Pewsey, SN9 5EW Integrated Youth Service Kevin Sweeney, Multi Disciplinary Team Manager, Integrated Youth Service, Wiltshire Council, kevin.sweeney@wiltshire.gov.uk Health Visiting Please contact your local Health Visitor or Ann Knight, Public Health Manager, Wiltshire Community Health Service ann.knight@gwh.nhs.uk Maternity Services Paula Lockyear, paula.lockyear@gwh.nhs.uk Royal United Hospital Katy Crabbe and Hannah Boyd: katy.crabbe@salisbury.nhs.uk and hannah.boyd@salisbury.nhs.uk Salisbury Foundation Hospital Trust Alison Morton, Alison.Morton@smnhst.nhs.uk- Great Western Hospital 8

9 For further information on the Wiltshire CAF pathway for expectant young mothers please contact Katie Currie, Public Health Specialist Healthy Child Programme and Adolescent Wellbeing 9

10 Appendix 1 10

11 Appendix 2 Common Assessment Framework Health Emotional & social development. Parents / Carers Family & Environmental Development of Child or Young Person Basic care & ensuring safety Behavioural development. Self-esteem, self-image and identity. Emotional warmth & stability Family & social relationships. Guidance, boundaries & stimulation Self-care skills & independence.. Learning. Family history, functioning & wellbeing Wider family Housing, employment & financial considerations Social & community factors & resources 11

12 Appendix 3 Referral Form from Wiltshire Midwife to Wiltshire Children s Centre for Parent aged Name of Mum to be: DOB: Address: Phone numbers: Name and base of midwife: We would also like to support dads to be, if the dad is present please complete this section Name of Dad to be: DOB: Address: Phone numbers: I give consent for my details to be sent to my local Children s centre so that they can register me and contact me for further support/courses/groups/play opportunities etc... signed by mother to be Signed by Dad to be (if completed form) signature of Midwife.date EDD (use sticker if appropriate) Reason for referral (please summarise issues identified): For information only 12

13 Appendix 4 Version Control for the Wiltshire young parents CAF pathway Version number October 14 Jan 14 Changes made to Practice standards FNP added Contact detail updated Wording altered to reflect changes in pathway and highlight the importance of the relationship between the Midwife and Health Visitor. 18 Wording altered to better reflect midwife role referral form altered Changes made to pathway FNP added Contact detail updated Midwife takes responsibility for registering the CAF using the name of the responsible Health Visitor team leader as lead professional. Links to Prebirth Protocol to Safeguard Unborn Babies. Ratified through WSCB. Wording altered to better reflect midwife role. 17 Further contact information added. Formatting changes, wording changed for readability. Flexibility of health visitor to visit early when necessary added. 16 Addition of information for working with children known to social care and youth offending. More information on consent before sharing. Date published and location of publication October 14 WSCB website Wiltshire Pathways Sent to heads of: maternity, health visiting, school nursing, and children s centre commissioner, and young parents support network for distribution. January 14: WSCB website Wiltshire Pathways Sent to heads of: maternity, health visiting, school nursing, and children s centre commissioner, and young parents support network for distribution. Wiltshire Pathways, 1 st March Sent to heads of: maternity, health visiting, school nursing, and children s centre commissioner, and young parents support network for distribution. September 2012 to MSLC, supporting young parents network, CAF team, wiltshirepathways.org Not formally published, internal amendment made and consulted with at young parents CAF pathway review meeting, and MSLC media and information group Gateway panel removed 15 Initial published document July 2011as part of the multiagency threshold document on Wiltshirepathways.org 13