Single Point of Contact (SPOC) Safeguarding Referral Form

Welcome to Croydon's Interagency Safeguarding Referral Form

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Welcome to Croydon’s Multiagency Referral Form (MARF)

This form is only for professionals and should be used to refer a child and family for one of the two following services:

1.An Early Help Best Start Family Solutions service (intensive/targeted need), where you are concerned for a child’s wellbeing and the family has asked for support that cannot be addressed by one or more organisation.
2. A Children’s Social Care (CSC) service where you are worried about the safety of a child.

If you are a member of the public please call 0208 726 6400

If you are unsure about whether or not to make a referral, or which service will best help the family and safeguard the child, please refer to the Croydon Continuum of Need on the Croydon Children Safeguarding Children Board website and speak to your designated safeguarding lead within your organisation. If you are then still unsure you can telephone the CSC Single Point of Contact (SPOC) consultation line for a consultation with the social worker or early help consultant on the numbers below:

Daytime hours:
(Monday to Friday 9am to 5pm) 0208 726 6400 main council number
(Monday to Friday 9am to 5pm) 0208 255 2888 for urgent child protection matters that require the same day intervention from a SPOC social worker;
SPOC Consultation:
(Monday to Friday 9am to 5pm) 0208 726 6464 where professionals with safeguarding responsibilities can consult early help consultants or social workers in the SPOC for advice on non-urgent cases
Out of hours:
5pm - 9am Monday- Friday, 24 hours Saturday, Sunday and bank holidays 0208 726 6400

Please note: completing this form will take several minutes. You need to ensure you have the child and families details to hand before you start.

Please make sure you have consent prior to filling in this form unless it would increase the risk of significant harm to a child in doing so.

Please ensure you complete all the required fields and press SUBMIT once the form is complete. Once the form has been submitted you will receive a thank you message confirming we have received your referral

If this form is not working, please download the MARF word version available at the bottom of the following link: https://www.croydon.gov.uk/healthsocial/families/childproctsafe/childprotect

If you are concerned about a child’s immediate safety , please call 999. If you would like to contact the SPOC please call 020 8255 2888

If your referral concerns a child who is or may be at risk of exploitation you must  complete the Child Exploitation Screening Tool

Please note:

  1. This form cannot be saved and needs to be completed in one session. This form takes approximately 10- 15 minutes to complete
  2. the details will be lost is the session is left idle for more than 15 minutes

Early Help Best Start Family Solutions Service Early Help Best Start Family Solutions service is an intensive/targeted need early help service (Croydon Continuum of Need) providing support to children and their families when they are experiencing multiple difficulties

Early Help or Children's social care service value is required
Those wishing to access Parenting Programmes only can tick below:

Children’s Social Care Service
Children’s Social Care service is statutory/ specialist need service (Croydon Continuum of Need) that assesses and provides services for children and families whose needs are complex and enduring and/or who are experiencing, or at risk of experiencing significant harm if they are not provided with statutory services

Early Help or Children's social care service value is required

About the Child

Consent
The referral must always be discussed with the child and their family and consent for the referral should always be sought from those with parental responsibility unless to do so would place the child at further risk of harm. If you are worried about a child and you are unable to contact the parents, this should not stop you from making a referral and you can discuss your concerns in the first instance with your organisation’s designated safeguarding lead and if needed the CSC Front Door Single Point of Contact (SPOC) for a consultation with a Social Worker.

Consent is required
Consent Reason is required

First name is required
Last name is required
Date of birth is required Expected format: dd/mm/yyyy Selected date is invalid Date is smaller than allowed Age should be less than 21 years
Age is required
Gender is required
Ethnicity is required
Ethnicity Other details is required
Religion is required
Religion Other is required
Disability/SEN statement is required
Disability statement description is required
Interpreter Required is required
Interpreter Language description is required

Enter the child's address

Contact number is required Contact number should contain 11 digits

Educational setting/nursery/school details

Early Help Assessment Completed is required
Lead Professional is required
Your document has been uploaded Please upload your document
Support The Family is required
Your document has been uploaded Please upload your document
Have Discussed With Mash is required
Who did you speak to is required

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Details about the family. In this section please add parents/carers and all household members including siblings.

The parents/carers/household members (where Y/N please select)

# First Name Last Name Relationship
{{$index + 1}} {{item.FirstName}} {{item.LastName}} {{item.Relationship}}
First name is required
Last name is required
Date of birth is required Expected format: dd/mm/yyyy Selected date is invalid Date is smaller than allowed Age should be less than 21 years
Age is required
Gender is required
Primary care holder to child is required
Relationship to child is required
Has parental responsibility is required
Ethnicity is required
Ethnicity Other details is required
NI Number is required

Enter the address

Contact number is required Contact number should contain 11 digits

Information about you - the professional completing this form

First name is required
Last name is required
Organisation is required
Job title is required
Agency email is required Agency email is not valid eg: @croydonhealth.nhs.uk or @met.police.uk
Contact number is required Contact number should contain 11 digits
Relationship to the child is required

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Details of Professionals involved with Child or Family

Details of any other Professionals involved with Child or Family (including GP, School, Health, Worker/Family Worker, etc.)

# Name Organisation Name Organisation Relationship
{{$index + 1}} {{item.FirstName + " " + item.LastName}} {{item.Organisation}} {{item.OrganisationType}} {{item.Relationship}}
First name is required
Last name is required
Organisation Type is required
Organisation is required
Job title is required
Contact number is required Contact number should contain 11 digits
Relationship to the child is required

Reason for Concern

Reason for Concern (if your concern is about a vulnerable adult/carer we still need you to complete this section) or any other factors to take into consideration


Does the family share your worries? Please describe facts including frequency, severity and impact. What are the specific behaviours of the parent/child/young person that may pose a risk to their safety?
Your Concern is required

How is this affecting the child’s health, development and well-being? Provide information in relation to the child’s Education (Attendance, Support, Attainment), Health (Emotional and Physical) and Social Development (Developing positive and healthy relationships) What are you worried will happen if nothing changes?

Impact on child is required

What are the strengths/support systems within the family, the things they do well, the resources within the family, the resources within the family that reduce the risk and the times where risk has been present but the parents/carers have been able to manage/reduce this risk?
Working well for child is required

What needs to happen next to ensure the child is safer and ensure the parents/carers can keep the child safe?
Your Concern is required

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Section Reason for Concern continue...

What has led to you making this referral? Please tick all that are applicable.

Further information is required
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'Yes' should be selected for at least one option

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Summary

Section 1 - About the child

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{{wizardObj.model.ChildInfo.ContactNumber}}
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{{wizardObj.model.ChildInfo.Age}}
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{{wizardObj.model.ChildInfo.Ethnicity}}
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{{wizardObj.model.ChildInfo.Religion}}
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{{wizardObj.model.ChildInfo.Disabilities}}
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{{wizardObj.model.ChildInfo.InterpreterRequired}}
{{wizardObj.model.ChildInfo.InterpreterLanguage}}
{{wizardObj.model.ChildInfo.CroydonICSNo}}

Educational setting/nursery/school details

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{{wizardObj.model.ChildInfo.SettingAddress.addressLine1}} {{wizardObj.model.ChildInfo.SettingAddress.addressLine2}} {{wizardObj.model.ChildInfo.SettingAddress.town}} {{wizardObj.model.ChildInfo.SettingAddress.postcode}}
{{wizardObj.model.ChildInfo.SettingTelNo}}
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{{wizardObj.model.ChildInfo.NurseryTeacher}}
{{wizardObj.model.ChildInfo.NurseryTeacherContact}}
{{wizardObj.model.ChildInfo.EarlyHelpAssessmentCompleted}}
{{wizardObj.model.ChildInfo.LeadProfessional}}
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[Attached]
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[Attached]
{{wizardObj.model.ChildInfo.HaveDiscussedWithMash}}
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{{wizardObj.model.ChildInfo.SignificantInfo}}

Section 2 - Details of the family - Father/Mother/other siblings or family members and/or significant others/adults (including perpetrator if applicable)

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{{item.LastName}}
{{item.DateOfBirth}}
{{item.Ethnicity}}
{{item.Gender}}
{{item.PrimaryCareHolder}}
{{item.Address.addressLine1}} {{item.Address.addressLine2}} {{item.Address.town}} {{item.Address.postcode}}
{{item.ContactNumber}}
{{item.Relationship}}
{{item.SpecialNeeds}}
{{item.InterpreterRequired}}
{{item.ParentCarerFirstLanguage}}
{{item.ParentalResponsibility}}
{{item.NINo}}

Section 3 - About You

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{{wizardObj.model.YourInfo.LastName}}
{{wizardObj.model.YourInfo.Organisation}}
{{wizardObj.model.YourInfo.JobTitle}}
{{wizardObj.model.YourInfo.Email}}
{{wizardObj.model.YourInfo.ContactNumber}}
{{wizardObj.model.YourInfo.Relationship}}
{{wizardObj.model.YourInfo.Address.addressLine1}} {{wizardObj.model.YourInfo.Address.addressLine2}} {{wizardObj.model.YourInfo.Address.town}} {{wizardObj.model.YourInfo.Address.postcode}}

Section 4 - Details of Professionals involved with the Child or Family (including GP, School, Health, Worker/Family Worker, etc.)

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{{item.LastName}}
{{item.OrganisationType}}
{{item.Organisation}}
{{item.Relationship}}
{{item.ContactNumber}}

Section 5 - Reason for Concern (if your concern is about a vulnerable adult/carer we still need you to complete this section) or any other factors to take into consideration

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Is there suspected or a history of…

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Croydon's Interagency Safeguarding Referral Form

Thank you for submitting a Safeguarding Referral to Croydon’s Single Point of Contact (SPOC).

We will make a decision in relation to the status of this referral within one working day. You will be notified of our decision no later than three working days following the submission of your referral. We will contact you using the email address you have provided

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