MAKING A REFERRAL
	Expectations of the Young person and Referring Agency
	The young person must be motivated to make changes in their life and meet as required with the SIO. They must be willing to comply with the tenancy agreement and be able to cope with the responsibilities of a tenancy and shared living. They should be able to demonstrate sufficient emotional and maturity to make a genuine commitment to participate in the various programmes of support on offer.
	The Referring Agency must be committed to working in partnership with the service. This will include ongoing exchanges of information; to attend reviews/planning meetings and maintaining agreed contact with the young person.
	We expect that the young person treats the accommodation with respect and should any non-accidental damage occur, a meeting between all parties would be arranged to discuss the future and suitability of the placement. It will also be expected that the young person contribute to the repair of the damage.
	How to make a referral
	To discuss current vacancies and the suitability of a young person any initial inquiries should be made by contacting the service by telephone, fax or email or apply below.
	Referrers are required to complete an application form, giving as much information as possible to help us make an accurate assessment of the young person. Relevant information should include detailed family background/history, housing history, assessment of support needs, details of any behavioural issues and/or offending history. Supporting documents such as psychiatric reports, statutory reviews, previous convictions, pre-sentence reports and risk assessments where relevant will also be required.
	An interview will then be arranged to discuss the young person's attitude and commitment to living semi-independently and what level of support will be required. Once accepted the young person will be placed on a waiting list until a suitable placement can be identified. Priority will be given to "matching" the young person with the property and the young people already living there.
	Finally, the young person will be invited to view the property and arrange a planning/tenancy completion meeting.

SEMI-IDEPENDENCE LIVING
CONFIDENTIAL AGENCY REFERRAL FORM

Fill in this form or download pdf file to print and return. Young person’s details Surname Forename Date of Birth Gender Male Female   Agency details   Social Worker Name Address Contact Telephone Length of time known to the young person   Please give all relevant details about the young person you are referring, including care history, family background, any episodes of violence, emotional, mental or behavioural difficulties, any health problems and offending behaviour. Please attach a separate sheet if required. NB - FAILURE TO DETAIL INFORMATION THAT MAY PUT STAFF AND OTHER RESIDENTS AT RISK COULD RESULT IN THE PLACEMENT BEING TERMINATED WITH NO FINANCIAL LOSS TO FREELANCE SOCIAL WORK SERVICES LTD. ANY DAMAGE TO PROPERTY CAUSED AS A RESULT OF NOT DISCLOSING INFORMATION AT THE POINT OF REFERRAL WILL BE THE RESPONSIBILITY OF THE REFERRING AGENCY.   What particular support do you feel the young person requires and what do you expect from this service before the young person moves on? Please attach a separate sheet if required.   What arrangements or plans are in place for the young person to move on into their own accommodation and when do you feel this will be available? Please attach a separate sheet if required.

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SEMI-IDEPENDENCE LIVING CONFIDENTIAL YOUNG PERSON REFERRAL FORM

Fill in this form or download pdf file to print and return. Personal details Surname Forename Date of Birth Gender Male Female National Insurance Telephone Number Mobile Preferred Title Mr Mrs Ms Miss Address:   How would you describe your racial origin African Asian Caribbean Chinese Irish South American White (British) White (Other) Self Defined Mixed Race If Mixed Race please define: Self Defined:   Do you consider yourself disabled? No Yes If yes please put details below.   Please give details of parents/guardian for emergencies (or state another person you would like to be contacted in case of emergency) Name: Address: Telephone: Mobile: Relationship   Please give details of any previous offending behaviour & any Orders you are on and the date it expires. Also give details of any relevant information you feel we should know about. NB NONE of this information will necessarily bar you from being offered accommodation; the information is required to match, as best as possible, the type of accommodation to meet your needs. Offence Date   Please give detail of your education/school, qualifications & whether your are currently employed (if employed, what days & hours do you work)   Why do you want this opportunity to live in semi-independent accommodation? Please state what previous experience you have had living on your own and paying bills/expenses. Also include what skills you think you will need to live independently.

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SUPERVISED CONTACT, ESCORTING AND MENTORING CONFIDENTIAL AGENCY REFERRAL FORM

Fill in this form or download pdf file to print and return. Young person’s details Surname Forename Date of Birth Gender Male Female   Agency details   Social Worker Name Address Contact Telephone Length of time known to the young person   Please give all relevant details about the young person you are referring, including care history, family background, any episodes of violence, emotional, mental or behavioural difficulties, any health problems and offending behaviour. Please attach a separate sheet if required. NB - FAILURE TO DETAIL INFORMATION THAT MAY PUT STAFF AND OTHER RESIDENTS AT RISK COULD RESULT IN THE PLACEMENT BEING TERMINATED WITH NO FINANCIAL LOSS TO FREELANCE SOCIAL WORK SERVICES LTD. ANY DAMAGE TO PROPERTY CAUSED AS A RESULT OF NOT DISCLOSING INFORMATION AT THE POINT OF REFERRAL WILL BE THE RESPONSIBILITY OF THE REFERRING AGENCY.   What particular support do you feel the young person requires and what do you expect from this service before the young person moves on? Please attach a separate sheet if required.

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