Sandwell Young Carers - Referral Criteria

Sandwell Young Carers works with children and young people aged 5- 18, whose lives are restricted by the need to take responsibility for a person who is either: chronically ill, experiencing a mental illness has alcohol and substance abuse related difficulties, has a physical disability, is elderly or infirm or is experiencing HIV/AIDS.

The person being cared for is usually a parent, but may be a sibling, grandparent, etc. The young person will usually be involved in the provision of care, either as a primary or secondary carer. It is recognised that the young person may be in need of a break from their caring role and someone to talk to or seek support from.

The young carers may be performing any of these caring responsibilities

  • Domestic duties - shopping, cleaning, washing, changing beds, cooking, ironing
  • Household management - paying bills
  • Nursing tasks, giving medication, tube feeding
  • Personal Care, bathing, dressing, toileting, feeding
  • Providing emotional support
  • Responding to demanding behaviour
  • Interpret for someone or help them communicate

The consequences of these duties on the young carer may lead to some of the following effects:-

  • Education - attendance, concentration, completion of school/homework & attainment
  • Health (physical and mental), e.g. inappropriate demands of heavy domestic duties, such as lifting; anxiety, stress as a result of experiences
  • Social Skills e.g. isolation, difficulty in establishing and maintaining friendships and pursuing recreational activities

If, after an Initial Assessment, the Assessment Panel considers that a referred child/young person is experiencing any of the effects above due to caring roles undertaken, then the child/young person will be offered a place at the Sandwell Young Carers Centre
Our aim is to:-

  • Work in partnership with parent/guardian to sustain their responsibilities and rights
  • Work in partnership with other voluntary and statutory agencies

We will offer Services that:-

  • Develop self-help support groups for young carers
  • Facilitate opportunities for young carers to have time for themselves, away from their caring responsibilities

In line with our Ofsted Registration, Sandwell Young Carers can only accept referrals with regards to children who are 5 years of age after 1st September. Unfortunately we are unable to support any child from birth to 31st August following their fifth birthday.

New Referral Contact Form

Please do not use any special characters when completing any fields on the form ie. # ! ' " etc

Have the family given permission for this assessment
(Family must give consent for young person to join our service)

Yes No 

1.0 Young Carers Details

Surname: *
Forename: *
Date of Birth:
Gender: Male Female Neutral Prefer not to disclose
Post Code:    Borough:
Do they live in Sandwell? Yes No

1.1 Parents/Guardians Details
Name of parent(s) / Guardian(s):

Landline Number:
Mobile Number: *

1.2 Cared "for" Details
Person(s) being cared for:
Mum Dad Sibling Other
Information required for each person cared for.
Name & Condition of cared for: 
Number of persons living in the family home

2.0 Caring role:

Please record the impact of caring on their well-being below.

2.1 Health - Is their general health, hygiene, emotional health, sleeping pattern or mental health affected?
Yes No 

2.2 Education - Is their education affected as a result of poor punctuality, absenteeism, poor grades, homework issues, bullying?
Yes No 

2.3 Social Needs - Are their social skills affected in the way of making friends, taking part in after school clubs, low confidence, low self- esteem, inappropriate behaviour, keeping themselves safe?
Yes No 

2.4 Is the child's life affected by poverty, such as housing issues, benefit entitlement for the cared for and the adult carer
Yes No 

2.5 What are the 2 main presenting needs of the young carer? (please tick two)
Lack of independence & Social skills
Emotional & Well-being support
School Attendance & Performance
Child Protection Risk
Additional Support for 'cared for' individual

2.6 Does the young carers have any special needs?
Yes No 

3.0 Are any of the following in place?
TAF Yes No Don't know
Child In Need Yes No Don't know
Safeguarding Yes No Don't know
CAF/Early Help Yes No Don't know
Looked After Child Yes No Don't know

3.1 What other services have you referred the young carer/family too?

3.2 Have you advised the young carers of their rights under the Children & Families Act 2014 and the Care Act 2014?
Yes No 

3.3 Have they requested/been assessed under the above Act? (If yes, please advise of the outcome)
Yes No 

3.4 Are you aware of any other agencies who are involved with the family (please provide details)?

Referrer Details:

By submitting this form you give consent for your personal details to be recorded and stored electronically on Sandwell Young Carers databases
Referrers Name: *
Referrers title (Job Role or Parent):
Address: *
Contact Number:
All referrers please ensure that all sections are completed fully and accurately. Any missing or incorrect information will delay this referral.
Person Completing this        Form *
"Thank you for taking part in the assessment process. If eligible, your child will become a member of Sandwell Young Carers & membership pack will be sent out within the next 5 working days."