Application for Solihull Early Years Inclusion and
High Needs Funding 2022-2023

Solihull’s Early Years Inclusion Fund Panel is made up of professionals from the Early Years Team, 0-25 SEND Service, the Family Information Service, school nurseries and private and voluntary settings.
The panel considers referrals for early years inclusion and high needs funding based on the criteria and processes detailed at https://socialsolihull.org.uk/localoffer/education/inclusion-fund/
Please return completed forms to: Solihull Early Years Team, Council House, Manor Square, Solihull, West Midlands B91 3QB. Alternatively, this form can be scanned and emailed to eysendfundingapp@solihull.gov.uk  If you have any other queries regarding this form please call: 0121 704 6150.	

Name and address of Solihull setting	

Postcode		Telephone No:		
Date 		Date of admission to setting		
Name of SENCo	
	
Name of child	
	Date of Birth

Age in months

_____________ months	
Child’s address	

	Postcode 	

Child is a Solihull resident 	
Gender	Male ☐
Female ☐	Date child will start reception e.g. Sept XXXX		
Early Education Funding (EEF)
Tick 	2 year EEF 
3 / 4 year EEF    15 hours EEF     or  30 hours EEF  
Child age 2y+ to be considered as an exceptional case   This must be agreed by an Area SENCo/ 0-25 SEND practitioner. Name of LA SEND practitioner _____________________________________	
Please highlight the days and sessions the child attends:
Mon:	am/pm	Tues:	am/pm	Wed:	am/pm	Thurs:	am/pm	Fri:	am/pm	
Are there any other languages spoken within the home? – please provide details		
What level of funding are you applying for?   Please tick which fund you are applying for	
Level 1 – Inclusion Funding children 3-4 y/o	☐	Level 2 – High Needs Funding	☐
(Must be agreed by an Area SENCo or 0-25 practitioner – for children aged 2-4 y/o)	
Name of LA SEND practitioner supporting a Level 2 High Needs Fund submission:
.                                                                  .
	Signature of 0-25 SEND practitioner: 
	
Please attach any recent reports from external services which support this application.

Select the child’s Broad area of need as described in the SEND Code of Practice (please tick one box only)	
Communication and interaction	☐	Social, emotional and mental health	☐	
Cognition and learning	☐	Sensory and/or physical needs	☐	
Record of Diagnosis if known: 

Does the child have an EHCP?    ________        Children who are undergoing a EHCP assessment or have an EHC plan will automatically be funded at L2 and settings / schools do not need to submit an application to the Panel to receive this funding.
	
Current development level – please write some key indicators to show the child’s development in each area which can be considered alongside their chronological age
What is your assessment summary for the child in these areas – what do they need and any concerns about developmental delay? (You may find Development Matters/Birth to Five Matters/Early Support/ Every Child a Talker monitoring tool helpful as child development guides)	
Personal, social and emotional development

	
Speech, language and communication development

	
Physical development

	
Summary of child’s learning and development – characteristics of learning and key observation notable notes which help the panel to understand the child’s unique needs

	

Social Care 		Yes/No – if Yes please tick appropriate box	
Family support involvement	☐	Child in Need or Child Protection Plan	☐	
Early Help – our Family Plan	☐	Looked After Child (LAC)	☐	
Child in Need Plan	☐	Special Guardianship Order	☐	
For this section, please tick the level of support required which is ‘additional to/different from’ that which peers receive as part of your routine support for medical and health needs

Medical and Health Needs	High	Med	Low	NA	
Describe health needs below:					

Adaptations/Provisions	
Allocation of additional funding will only be considered where there is a brief explanation below of:
•	provision/adaptations already made to address the child’s needs- beyond ordinarily available provision
•	how any additional funding would be used to enhance/sustain the support already in place	
Explain what you already provide as part of your graduated response with brief details: this will also be identified in your reviewed plans (describe all those that apply, please do not tick. For example: Environmental- providing a quiet den area for the child to go to if they feel they need escape from the busy environment)
Risk assessments ____________________________________________________________
Sensory support ______________________________________________________________
Environmental audit leading to ___________________________________________________
Equipment provided ___________________________________________________________
Group sizes __________________________________________________________________
Support to engage with others ____________________________________________________
Adjusted language/ process time__________________________________________________
Transition arrangements ________________________________________________________
Visual prompts ________________________________________________________________
Auditory adjustments ___________________________________________________________
Adjusted times/ timetable________________________________________________________
Play opportunities targeted to ____________________________________________________
Activities targeted to strengths and interests _________________________________________
Social and emotional support_____________________________________________________
Links to home learning environment _______________________________________________
Other 

How will you enhance support already in place if funding is allocated? How will this help?
Environment enhancement_______________________________________________________
Additional supervision to ________________________________________________________
Additional meetings to___________________________________________________________
Respond to child’s unique fascinations and motivation by ______________________________
____________________________________________________________________________
Alternative ‘safe’ activities to support schema/ interests _______________________________  ____________________________________________________________________________
Implementation strategies linked to developmental stage such as _____________________ _________________________________________________________________________
 Other [including specialist advice]

Training you will access:

Dingley’s Promise Training Modules (link) have been accessed by the setting
 Introduction to Inclusive Practice                               Early Years SEND Transitions
 Managing behaviours that challenge                         Having difficult conversations 

Evidence of Graduated Approach	
Level 1: At least one reviewed plan has been submitted along with this application 
Level 2: At least 2 reviewed plans have been submitted along with this application            or
             A reviewed plan and a new plan has been submitted along with evidence of significant specialist involvement (reports from external support as listed below in specific others)  
	
Identify external support for the child and involved with SEN advice for planning
(NB there must be evidence of parental involvement and of at least one external agency directly involved or referred to)

Significant= multiple agencies involved	Tick as applicable  
Health visitor 
Early Years Area SENCo  Solihull LA/ other_________
0-25 SEND team Solihull LA/ other____________ [delete] 
Specific others: 
Speech and language therapy 
Physiotherapy 
Occupational Therapy 
Educational psychologist 
SISS -Sensory and Physical Impairment (SPI) Team
SISS- Autism Team
Specialist Assessment Service- Autism
   / Complex Medical Needs 
Community Paediatrician 
Other _
Level 2 submissions: If 2 reviewed plans are not submitted the setting must send 1 reviewed plan, a new plan and reports or evidence of agreed involvement from at least 2 of the above agencies.	

Checklist:
•	Application -all details are completed (…history of support, planned use of funding, professionals involved)  
•	Agreement from parents -consent form signed 
•	LA SEND Area SENCo or 0-25 SEND have agreed to support the application – either as communicated to panel or signed page 2 
                        Exceptional case (child does not receive EEF) but is aged between
                          3 and 4 years old -Level 1 or 2-4y- Level 2
                        Level 2 – higher needs identified (as banding document)
•	Reviewed plans evidence the graduated approach-  1 plan     2 plans 
•	External agency involvement -reports included (this should include various professionals and not multiple reports from one service)

PARENTAL CONSENT FORM
Any information provided will be used by the Early Years Inclusion Fund Panel to help us make decisions about whether your child qualifies for additional funding to support their emerging SEND. Your information will be treated as confidential and stored in a secure way. It will only be shared with other council services and partner organisations to ensure our records are kept accurate.

We may also need to share your information for the prevention and detection of fraud and/or other crimes or as the law requires. For further information about how we use your information please refer to the Council’s Privacy Statement on www.solihull.gov.uk 

Your records will be kept for 25 years for audit purposes and in the event we need to provide information about the service you have received.	
•	I confirm I understand why you want my information and I have had the opportunity to consider this.	Yes
☐	No
☐	
•	I agree that the information will be shared with other professionals who are already involved with my child, or other agencies that may become involved in the course of any support offered to my child. This will be done in accordance with Solihull Metropolitan Borough Council’s Information Sharing Protocols. This will only be information that is relevant and necessary and will only be shared with people who need that information at that time. 	Yes
☐	No
☐	
•	I understand I can opt out and withdraw my consent at any time by contacting the Early Years Team on 0121 704 6150 or via email at eyenquiries@solihull.gov.uk 	Yes
☐	No
☐	
•	I give my consent for you to record and hold my information for the purposes explained to me.	Yes
☐	No
☐	

Name of parent/carer:	…………………………….………………………….………
(please print)

Signature:			…………………………………………………………….….

Email address:		………………………………………………………………..

Date:	………………………………