18.1 EHCP blank - Pre 16 (Last Update 28 October 2016)

Blank EHCP - Pre 16Name

Date of Birth

Address

Contact Number

Setting/School/College

NHS Number

Unique Pupil Number

Social Care Reference

Is this child/young person looked after?Full Care Order, Interim Care Order, Section 20 or other

Name of Parent/Carer who has parental responsibilityAddress

Contact Number

Date of Final Plan

Scheduled Review Date

Version Number

(A) Views, Interests and Aspirations

<Child/Young Person’s Name> story, his/her views, interests and aspirations:

<Child/Young Person’s Name> communicates by:

Family story, including their views, interests and aspirations:

Support Network (family and friends)

How has <Child/Young Person’s Name> and her family participated in the development of this plan?

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(B) Strengths and Special Educational Needs

Please describe the needs that have been identified in the EHC Assessment (in priority order for each section where possible) in the following areasCommunication and interaction

Strengths:

Special Educational Needs:

Cognition and learning Strengths:

Special Educational Needs:

Social, emotional and mental health

Strengths:

Special Educational Needs:

Sensory and/or physical needs

Strengths:

Special Educational Needs:

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(C) Health Needs which relate to Special Educational Needs

Please describe the needs that have been identified in the EHC Assessment (in priority order, where possible)

(D) Social Care Needs which relate to Special Educational Needs

Please describe the needs that have been identified in the EHC Assessment (in priority order, where possible)

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(E) Outcomes – Summary

Provision to be provided byRef Outcome

Think long term, ultimate aspirations from YP & Parents.Need to consider these main headings, but use and amend as appropriate.

NB the PFA outcomes listed below E1, E2, E3 and E4 MUST be included in all year 9 plan’s

Educationx

Healthx

Social Carex

E1 Employment: For (YP name) to access employment opportunities within their locality

E2 Independent living – To learn key life skills (e.g cooking, cleaning, self-care, money skills, travel skills) for supported or independent living

E3 Community inclusion – (YP name) to access/ continue accessing community inclusion through local visits, weekly supermarket shop, attending social groups/ clubs in his/her area.

E4 Health - e.g to take medication/ improve diet/ opportunities to exercise, reduce incident of self harm

E5

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(F) Special Educational Provision *Note: Health or social care provision which educates or trains a child or young person must be treated as special educational provision and included in Section F.

Communication and Interaction: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)

Over the next 12 months

(F) Special Educational Provision By Whom

(G) Health Provision By Whom

(H) Social Care Provision By Whom

Cognition and Learning: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)

Over the next 12 months

(F) Special Educational Provision By Whom

(G) Health Provision By Whom

(H) Social Care Provision By Whom

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Social, Emotional and Mental Health: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)

Over the Next 12 months

(F) Special Educational Provision By Whom

(G) Health Provision By Whom

H) Social Care Provision By Whom

Sensory and/or Physical: Outcomes and ProvisionOutcome Ref Insert the Outcome from the Summary Table at (E)

Over the next 12 months

(F) Special Educational Provision By Whom

(G) Health Provision By Whom

(H) Social Care Provision By Whom

(G) Health Provision - Any Health Provision reasonably required by the learning difficulties or disabilities which result in <child/young person’s name> having Special Educational NeedsOutcome Ref Insert the Outcome from the Summary Table at (E)

(G) Health Provision By Whom

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(H1) Social Care Provision - Any Social Care Provision which must be made for a child/young person under 18 resulting from section 2 of the Chronically Sick & Disabled Persons Act 1970 Outcome Ref Insert the Outcome from the Summary Table at (E)

(H1) Social Care Provision By Whom

(H2) Social Care Provision - Any other Social Care Provision reasonably required by the learning difficulties and disabilities which result in <child/young person’s name> having special educational needsOutcome No: Insert the Outcome from the Summary Table at (E)

(H2) Social Care Provision By Whom

(I) Education Placement

Final EHC Plan onlyName of Placement Type of Placement

Arrangements for Review

Date/Frequency of Review

Name of Person Co-ordinating ReviewContact Details

Next Key Transition PointsEHCP 0-25 v1 September 2014 8

Key Transition Date

(J) Personal Budgets

Have the family/young person made a request for a Personal Budget? Yes / NoSource How will the

Personal Budget be used?

Which outcome will this support?

Amount £

Education

Health

Social Care

Total Amount £

(K) Advice & Information - Contributors to the EHC Assessment and Plan

Name Position Contact details (address/telephone/email)

Report Attached Y/N

(inc date)

Attendance at meeting

Y/N

Signature on behalf of local authority

Date

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Appendix A

Progress and Assessments – Early Years

Communication and Language

Personal, Social and Emotional Development

Physical Development

Literacy Mathematics

Understanding the World Expressive Arts and Design

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Progress and Assessments – School Age

National Curriculum AssessmentPlease complete fully (include previous year’s levels)

Y1 Y2 Y3 Y4 Y5 Y6 Evaluate progress

English

Speaking / Listening

Reading

Writing

Overall Subject level

Mathematics

Science

Standardised test results and/or Entry Assessment

Date of Test Name of Test/Assessment Results Administered by (name and role)

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National Curriculum Assessment

Please complete fully (include previous year’s levels)

Y7 Y8 Y9 Y10 Y11 Y12 Y13 Evaluate progress

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English

Speaking / Listening

Reading

Writing

Overall Subject level

Mathematics

Science

Standardised test results and/or Entry Assessment

Date of Test Name of Test/Assessment Results Administered by (name and role)

Progress and Assessments – Post 16

GCSE results or relevant accreditation

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Foundation or level 1/2 course

Other accreditation

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