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Request for Statutory Assessment

Pupil Name: …………………

Template to assist a school to complete an online application

Request for Statutory Assessment for a student with Education, Health and Care Needs

This form is for educational settings to complete for a pupil at their establishment who they consider requires a statutory assessment of their special educational and disability needs.

Before completing this form please ensure that you have read the relevant areas of the SEND Code of Practice Jan 2015 chapters 5, 6 and 9 (further education settings should refer to chapter 7 and 9 of the code of Practice.)

Context

Information is sought in accordance with the Children and Families Act 2014. In the first instance all educational settings are required to use their best endeavours to meet the needs of children and young people identified with Special Educational Needs.It is expected that a person centred review meeting would provide evidence of:-

The child/young person’s additional support plan provided for them under the Additional Support Stage of the Code of Practice 2014

The educational establishments assessment of the child/young person’s difficulties

The educational establishments outcomes sought for the child/young person The external professional advice that has been sought Details of the support and interventions that have been provided for the

child/young person over time An assessment by the educational establishment of the progress made or lack

of progress over time – two years evidence is helpful. What additional support the student needs that the educational establishment

feels is required which cannot be provide with reasonable adjustments .

Evidence you must provide

It is very important that you provide appropriate and relevant evidence which includes:

external professional advice – please provide a copy of the original documents in their entirety when a diagnosis is made, rather than quoting from them.

details of SEN Support and the interventions that have been put into place details of the progress made over a period of time following an “assess, plan,

do and review” model.

EHC Assessment request for ___________ 2 | P a g e

You will also need to provide evidence that you have the consent of the parents or the pupil (if aged over 16) to apply for this request for statutory assessment. (See Children and Families Act 2014).This can be any format that you choose to use in school, but you will need to upload it to attach it to the online form. Occasionally parents withhold consent, so you will need to offer the explanation as to why the parents are not willing.

Other evidence that you may have and should provide.

The annual report to parents (last 2 years) A report from the school setting out the pupil's additional needs The pupil's attendance record (last 12 months) The pupil's educational progress data (minimum of last 12 months) A provision map or any other evidence of individual educational planning One page profile Evidence of specialist teacher support ( e.g. teacher of the deaf) Health care plan Educational psychology support Community Paediatrician involvement Health professionals’ support Speech and language therapist support Occupational therapist support Social worker support Physiotherapist support CAMHS support Behaviour specialist support Specialist support service support Evidence of other support relevant to the educational need of the child.

You can embed your supporting evidence within the online form but there is a size limit of 4MB in total. You can also e-mail the evidence to your EHC team but will need to ensure the file name matches the online form reference. Should you have any large documents that you are unable to compress to a size that will fit either of these methods, then you can transfer using AVCO. See the attached appendix for naming protocols and instructions if needed. We recommend compressing the files to reduce the size if at all possible and using the online form and the e-mail option.


NB This form is to aid you complete the online RSA only – you can copy your text from this document into the online form.

Section 1:Parental Consent (or if the student is over the age of 16, their consent) evidence required (mandatory)

Section 2Referrer’s details (mandatory)this should be the school Senco or the person responsible for SEN in the setting. Educational setting details to be completed


Notes

Section 3

Student information (mandatory)

Surname First name: Preferred name:

Home address:

Date of Birth: Gender: Year

Group:

Child in care of

Northamptonshire

County Council? :

Yes/No Child in the care

of other local

authority?

Yes/ No

What is the social

care status of the

student? (e.g. full

care order, section

20) *

Please provide

the authority’s

details

Social workers details

First name Surname

e-mail address

telephone contact number


Current Educational Setting:

Start date: End date:

Previous Educational Setting:

Start date End date


Section 4

Parent carer details

Please note that for pupils aged 16 and over who have completed statutory

education (year 11), all correspondence will be addressed to them.

Surname: First name:

Home address:

Telephone no: Email:

Relationship to child:

Surname: First name:

Home address:

Telephone no: Email:

Relationship to child:


Section 5

Specialist professionals

Education psychologist

Community Paediatrician

Other health professional

Specialist teachers

Speech and language therapist

Occupational therapist

Physiotherapist

Social worker

Specialist Support Services (NCC) including Portage

Behaviour specialist

CAMHS

Other

you will need to provide the names of the specialists involved and the dates of their involvements. You will need to attach the most recent report that you have from these professionals as part of your supporting evidence. Please provide copies in their entirety rather than quoting from them. Have them ready to upload either to the online form, to e-mail to your team or via AVCO if the file size is greater than your e-mail server will allow. (see appendix for naming protocol and for large documents)


Section 6

Other support that the student may receive

1. Does the pupil have a Health-care plan? yes / no

2. Is the pupil receiving any other health provision e.g. respite care? yes/no

3. Are you aware of any other social care provision the pupil is receiving? e.g. Short Breaks yes/no

4. Does the pupil have a current early help assessment (EHA)? yes/no

5. Does the school or setting currently access High Needs Funding for this student? Yes/No

Please provide as much information as possible including dates and funds or high needs reference number if known *

6. Has a high needs funding application been refused? yes / no

Date and reasons for rejection


Please provide details (maximum 2000 characters)


Section 7

Information about the student’s special educational needs.

Please describe the child/young person’s educational, health and care needs and the provision that is being made to meet them, with reference to the Northamptonshire SEN Descriptors where relevant.

Cognition and learning needs

Communication and interaction needs

Physical or sensory impairment

Social, emotional and mental health

Please explain the pupil's needs

Please provide a brief summary of the difficulties the pupil has in accessing education and making progress


Maximum 2000 characters

http://www3.northamptonshire.gov.uk/councilservices/children-families-education/SEND/send-information-for-professionals/send-descriptors/Pages/default.aspx

Continue as needed

Please add any comments to explain the pupil's needs

Additional information

Would you like to add any other evidence to support this request?





Checklist of evidence

Parental consent to request a statutory assessment of special educational needs

The annual report to parents (last 2 years) A report from the school setting out the pupil's additional needs The pupil's attendance record (last 12 months) The pupil's educational progress data (last 12 months) A provision map or any other evidence of individual educational planning Up to date One page profile Specialist professionals reports to the school (external professional advice) SEN Support and interventions Specialist Teacher Health-care plan Educational Psychology report Community Paediatrician Health professionals Speech and Language Occupational Therapy Physiotherapy Social Work CAMHS Behaviour specialist Specialist Support Services Other


Using AVCO to securely transfer large files of supporting evidence for a Request for Statutory Assessment of Special Educational Needs

* NB you only need to do this if you have not embedded your supporting evidence in the online form or e-mailed them to your EHC team.

To transfer the supporting documents for a Request for Statutory Assessment (in conjunction with the RSA on-line form) securely to the Local Authority you will be able to use the AVCO Client which is used widely in schools to securely transfer documents such as salary reconciliations, Free School Meal data, Census data and common transfer files for admissions.

NB This system will not work on computers or laptops using Windows XP and arrangements need to be made in school to upgrade. It should be noted that Microsoft withdrew support in 2016 for this version

You will need to Use the AnyComms client – the Bursar or Business Manager will have this installed. You can ask your peripatetic technician, or IT support services to install it onto other computers in the school, unless you arrange for your office staff to complete this part of the process for you.

Please save your files in a folder and send them in a “zip file”

On your desktop (or other preferred network area) create a folder called

RSA_school intials_FIRMSTEP REF No_supporting evidence (e.g. RSA_EBPS_ EC12345678_supportingevidence). Save all your documents into the folder. When you have saved all your files, press and hold (or right-click) the folder, select (or point to) Send to, and then select Compressed (zipped) folder. A new zipped folder with the same name is created in the same location. Use this folder to send via AVCO.

You will need to use this naming convention so that the folder will be recognised by the system and transferred. We need you to include the online form reference number so that we can identify the files when they arrive. It will help us if you identify the file contents by report type. Such as parents reports, or Speech and Language report.

To transfer your ‘Supporting Evidence files back to Northamptonshire County Council, please follow these instructions.

1. Ensure that the ‘Supporting Evidence’ zip file is in the following format ‘RSA_school initials _Firm step reference number_ evidence type.zip Eg: RSA_EBPS_ EC12345678_supporting evidence.zip

2. The file should be saved in the AVCO/Anycomms folder ‘SIMS/Transfer/Out’

3. Now run the AnyComms ‘Utilities’ Icon (see the screen shot below). The Icon will be renamed to ‘SEN’ for future transfers.

How to run AnyComms

To run AnyComms, click on Start button using your mouse, click on the All Programs button (this may vary depending on your Windows


Operating system), go to the AnyComms Client folder on the menu bar, and chose the ‘Utilities’ icon in the start bar menu. (When it has been used for the first time, the folder name will be changed from “Utilities” to “SEN” automatically and the next time you want to transfer a RSA supporting document you will use the SEN folder. )

4. Left click on Start Call and the programme will run. Once running, the programme will take a few minutes to complete. You can continue working on your workstation or server during this time.

The documents will then be securely transferred to the Local Authority followed by a transfer log on your screen confirming which files have been sent, which you can save for your records if needed. All files will then transfer to the Archive folder within Anycomms that you can revisit if needed.

At the end of the file exchange, a transmission report will be displayed in the form of a pop up window (see the screen shot below). This will state which files, if any, have been transferred back to NCC.

To close this report, simply click on the red (X) button in the top right corner of the window.

You’ll now notice the start menu reads ‘SEN’ for future transfers


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