Sample CPR - the Leicester City, Leicestershire and Rutland ...

CHILD’S PERMANENCE REPORT
The Adoption Agencies Regulations 2005
JANE GREEN SAMPLE CPR
Please note this is a CPR of a baby accommodated more or less from birth
(names and addresses have been changed). All CPR’s are different and there is
no definitive way to complete the form. For example the CPR of a 5-year old
child will look substantially different. There will be far more information about the
child in the CPR of an older child.
The CPR isn’t just for the adoption panel. Please remember it is the main
document about the child and is used for reference by the child in later years and
it also informs any post adoption work that may be completed in the future. It is
also the main document that adopters view when deciding whether a child is
suitable for them.
The CPR therefore needs to an accurate, comprehensive and readable
document. It needs to be clear with as much information about the child, birth
family members, sibs and half sibs, other extended family members and the
reasons why the child came into care and was placed for adoption.
The information needs to be non-judgmental and should include positives about
the birth family as well as the negative aspects. Try to put yourself in the child’s
position and think what would you want to know about your life history? It is
really important to include the views of the birth parents and even if they will not
write them down if you know what they are it is important to state this in the CPR.
You may find that it is easier to write the narrative first and then put the dates
alongside instead of being tempted to cut and paste information from court
reports etc. Note how the sample CPR tells the story and you are left in no doubt
as to why Jane is being placed for adoption.
If any expert assessments are carried out please send a copy of the report and
the conclusions to the adoption team and don’t forget to mention the existence of
these reports in the CPR.
If you need any help or advice when writing your CPR please do not
hesitate to call and speak to the Duty worker in the adoption team. Tel
2995899
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS.

Form CPR
Part A – Essential Information
Name of child: Jane Green
Date of birth:19.03.08
Name of social worker completing this report: Flora James
Name of agency Leicester City Council Children and Young People’s
Services Adoption Team
Address: Eagle House, 11 Friar Lane, Leicester LE1 5RB
Date report completed: 22.09.08
Date revised report completed:
Date of panel recommendation (if any) that child should be placed for
adoption:
The Child’s Permanence Report (CPR) comprises a Core Report and a number
of other sections which are completed and become a part of the report depending
on the circumstances of the child.
Index
Tick to indicate which sections have been completed and are included.
Part A1 The child Required Yes
Part A2 The child’s birth mother Required Yes
Part A3 The child’s birth father Required Yes
Part A4 Ability and willingness/summary Required Yes
Part A5 Adoption agency details Required Yes
Part B Other people with parental responsibility When required N/A
Part C Other relatives or other relevant people When required Yes
Part D Siblings When required Yes
Part E Wishes and feelings of the child When completed N/A
Part F The views of the birth mother When completed Yes
Part G The views of the birth father When completed Yes
Page 2
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Part A1 – The child
Surname Green
First names Jane
Other names child is known by (including familiar names)
Date of birth 19.03.08
Place of birth Leicester
Nationality British
Sex Female
Current addresses 205 High Cross Hill, Leicester. LE2 1PP
Local authority area of this address Leicester City
The carer
Name of person(s) at this address who is the main carer of the child
Jean and Fred Bull
Relationship/status of this person(s) to the child
Local Authority Foster Carers
Telephone number of carer
0116 3434344
Email address of carer
Birth parents and heritage
Ethnicity of child’s birth mother 1
White British
Ethnicity of child’s birth father 2
White British
Religion of child’s birth mother (indicate if this is active or nominal)
C of E Nominal
Page 3
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All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Religion of child’s birth father (indicate if this is active or nominal)
C of E Nominal
Has a religion been identified for the child (indicate which and by whom)?
No parents have not expressed a preference
Does the child actively participate in their religious faith?
No
Has the child been formally admitted to their religion through a recognised
ceremony (state which)?
No
Child’s first language
English
Identify any other languages the child uses in daily living
None
Legal status of child
If there is a court order in force, give name of court, date on which order
was made and type of order
Jane was made the subject of an Interim Care Order on the 20.03.08 at Coalville
Magistrates Court. This was extended on the 01.04.08 at Loughborough
Magistrates court.
Have any orders been applied for but not yet granted? If so, which orders
and at which court and date of application?
No
If the child is subject to proceedings, who are the parties to the
proceedings?
Mother Mrs Tina Green and Father Mr Simon Green
Is the child provided with accommodation under section 59(1) of the
Children Act 1989 (provision of accommodation by voluntary
organisations)?
No
Has the child any rights/claims under section 30 of the Fatal Accidents Act
1976 or any other rights to or interest in property which they may lose or
gain if an adoption order is made?
No
If yes, please give details
Page 4
© BAAF 2006
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Chronology of the child’s care since birth 3
Age of Child
(yrs & mths)
From To Placement details
Birth 19.03.08 20.03.08 Jane was cared for at home by parents Tina
and Simon Green at 480 Falcon Crescent,
Braunstone for one day.
1 day 20.03.08 07.04.08 Jane was placed with Local Authority foster
carer Jean Sharpe 500 Gallards Hill Drive,
Leicester until a longer term carer could be
identified.
19 Days 07.04.08 Present Planned move to Local Authority foster carers
Jean and Fred Bull 205 High Cross Hill,
Leicester.
Page 5
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
The child’s education
This section should include all school placements including playgroup and
nursery provision
This section is not applicable because Jane is a young baby.
From To Name of provider and address Type of educational provision 4
Does the child have a statement of special educational needs under the
Education Act 1996?
No.
If yes, include a summary of the main features and requirements. Attach
any relevant copies of the following: the Statement, Annual Review Report,
latest school and educational psychologist’s report and other relevant
reports or plans.
Not applicable.
If no, is the child receiving additional support? e.g. School Action, School
Action Plus or Behavioural Support?
Not applicable.
Page 6
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Descriptive and evaluative report on child
Please note that this section will contain significant information which is required
for referral to the Adoption Register for England and Wales.
In compiling this report, if evidence has been drawn from the reports of other
professionals, give details below. (These may be appended to this report as
sources of further information.)
Name of report Author of report Professional
position
Initial Health
Assessment
Dr. G Frank Specialist Registrar
Community
Paediatrics
Page 7
© BAAF 2006
Date of
report
16.06.08
Psychological reports Julie Jamison Psychologist 27.02.08
Parenting
assessment
Emma Don Family centre worker 08.05.08
Independent Social A.N. Other Independent Social 26.06.08
worker assessment
worker
A recent good quality photograph of the child should be attached.
Date photograph taken: 20-08-08
(The date should be written on the back of the photograph.)
Briefly describe the child’s physical characteristics 5
Jane is of White/British parentage. On the 16.06.08 she weighed 5.50kgs and
was 63cms in length. She has curly light brown hair and large blue eyes. Jane
has a fair complexion. She has a small red birth mark on the nape of her neck.
Briefly describe the child’s personality 6
Jane presents as a happy and contented baby. She responds appropriately to
stimulation and is comforted easily when distressed. She smiles readily and
laughs and gurgles and she enjoys the attention of the adults around her. Jane
is currently reaching all her developmental milestones and there are no concerns
regarding her health or development.
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Child’s history since birth 7
Jane was born at Leicester General Hospital. Tina insisted on taking her home
on the day she was born but Jane was removed from her parents care the
following day. She was placed in a Local Authority foster home but unfortunately
had to be moved 19 days later to her current foster carers owing to concerns
over birth parents proximity to the previous foster carer.
Interests, likes and dislikes 8
Jane loves adult company and especially likes to be carried over her carer’s
shoulders. She enjoys trips to the supermarket and prefers to be held as oppose
to being in her buggy as she likes to be able to see what is going on. At home
she loves to be put on the floor and she will lie back and kick her legs in the air.
She is fond of musical toys and likes to play with her baby gym. She is
inquisitive and takes an active interest in her surroundings
Health 9
Jane is meeting all her developmental milestones and although she has had the
odd cold she is a robust and healthy child. The birth mark on her neck should
fade as she gets older. See attached Initial Health Assessment report for further
details.
Education 10
Not applicable Jane is a young baby.
Identity 11
Jane was born to White/British parents and she is currently placed appropriately
with White/British foster carers. Her parents have not indicated any particular
preferences with regard to religion.
Self-care skills and social presentation 12
Owing to Jane’s age she is totally dependant on her carers for all her needs.
When observed in the placement and when in the community Jane is always
clean appropriately dressed and well cared for.
Page 8
© BAAF 2006
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
She has settled into her foster placement and is well established in her routine.
Jane is generally contented and accepts affection, comfort and responds
appropriately to stimulation from the foster carers.
Jane sleeps through the night and her foster carers are just at the stage of
introducing a variety of foods to her including baby rice and mashed banana’s
and avocado’s, which she particularly enjoys.
Jane responds to the foster carers voices and smiles when she hears familiar
voices. She laughs and makes noises. She is alert and will attempt to follow the
direction of voices and other sounds.
Chronology of the decisions and actions taken by the agency with respect
to the child 13
Date Decision / Action
14.08.07 Owing to the fact that birth parents have had previous children
removed and placed for adoption a home visit was made to
discuss Child Protections concerns re Tina’s expected child.
Tina refused to discuss this issue with the social worker.
13.12.07 A further attempt was made to inform Tina that a Child
Protection Conference was being arranged. Tina stated that
she had no intention of attending.
15.01.08 Bethany Jakes Maternal Grandmother was contacted to see if
she would be willing to care for Tina’s new child. She stated
that this would not be possible because she was already caring
for her own son Danny and two of Tina’s children Jason and
Ross.
16.01.08 Further home visit to Mr and Mrs Green. No one was at home.
22.01.08 Legal planning Meeting held. Decision made to seek a further
psychological assessment of birth parents and to apply for an
Interim Care Order for expected baby Green post birth with a
view to possible placement for adoption pending the outcome
of further assessment.
22.01.08 Pre-arranged visit to birth parents they were not at home.
23.01.08 Angela Jakes Maternal Aunt was approached to see if she
would care for the expected baby. Although she stated she
would be willing to care for the baby for a few days following
birth she was unable to care on a long-term basis because she
needed to focus upon her own family..
28.01.08 Pre arranged visit to parents no one at home.
31.01.08 Parents issued with a Pre-Proceedings Fairness Letter.
Page 9
© BAAF 2006
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
06.02.08 Increasing difficulties in engaging Mr and Mrs Green. Social
worker attempted to track them down at other relative’s houses
without success.
07.02.08 Home visit to Mr and Mrs Green. Tina said that previous
concerns raised by social workers in relation to her other
children were ‘all lies’. Tina agreed to attend the Psychological
assessment requested by the Department.
13.02.08 Pre-birth Child Protection Conference held. Decision taken to
make unborn baby Green subject to a Child Protection Plan at
birth and endorse the Local Authority’s plan to make an
application for a Care Order to secure the child’s safety.
18.02.08 Visit to Mr and Mrs Green to detail the Local Authority’s plan
for the baby. Parents declared they were not in agreement
with the plan.
27.02.08 Bethany Jakes maternal grandmother was contacted to see if
she would be able to care for the baby while a court date is
awaited. Bethany declined due to her own health difficulties.
29.02.08 Strategy discussion with Service Manager. Following receipt of
the psychological assessment on the birth mother the decision
was made not to offer any further social work assessment of
the Tina and Simon and to secure a permanent placement
away from the birth parents.
04.03.08 Placement panel meeting where foster care placement agreed
once the expected child is born.
05.03.08 Home visit to birth parents only Tina was present. Social
worker explained the Local Authority’s plan which was to apply
for an Interim Care Order once the baby is born and to tell her
that the Local Authority were not proposing any further
assessment. Mrs Green was given two separate envelopes
one for herself and one for Mr Green. Each contained a copy
of the psychological assessment and a draft C1, C13, Social
Worker Initial Statement, chronology, list of solicitors and a
covering letter. Tina was advised to take these documents to
her solicitor.
12.03.08 Home visit to Mr and Mrs Green no one at home.
18.03.08 Home visit to Mr and Mrs Green no one at home. Mr Green
was located at Mrs Green’s uncle’s house but he was unwilling
to engage in conversation with the social worker.
19.03.08 Telephone call made to Mrs Green. She stated the baby was
coming. Social worker offered to collect her and take her to the
General Hospital. Tina agreed.
Jane was born at 13.50. Tina told staff she wanted to
breastfeed the baby, the hospital asked if she wanted to stay
overnight for support with this but Tina declined this offer
stating that she wanted to return home.
Page 10
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
She told staff she intended to walk the baby home in a buggy
back to her uncle’s house. Tina was advised that it was not
appropriate to do this and she agreed to the social worker
transporting her to her uncle’s house.
A late visit was carried out to Mr and Mrs Green and Jane at
their home address all were present.
20.03.08 Jane was made subject to an Interim Care Order and placed in
Local Authority foster care.
25.03.08 Contact arrangements for Jane and her parents confirmed for 5
days per week.
01.04.08 Interim Care Order extended. Paperwork requested from the
adoption team in order to have the plan for Jane to be adopted
approved.
03.04.08 Looked After Child Review held.
07.04.08 Jane moved to Local Authority foster carers Jean and Fred Bull
due to concerns about the proximity of previous carer to the
birth parents.
07.05.08 Meeting with birth parents to address their irregular attendance
at contact with Jane. They stated the reason for this was
illness and lack of money for bus fares. It was agreed contact
would remain at 5 days per week and that bus passes for them
would be provided.
12.06.08 Looked After Child Review held.
18.06.08 Meeting with birth parents to inform them contact was to be
reduced to 3 times per week due to their poor attendance.
20.06.08 Independent Social Work Assessment report received.
03.07.08 Letters sent by the adoption team to the adopters of the two
previous children of Tina and Simon to see if they would want
to put themselves forward to adopt Jane.
15.07.08 Letter sent to Bethany Jakes Maternal Grandmother and
Angela Jakes Maternal Aunt confirming that neither was in a
position to care for Jane.
18.07.08 Angela Jakes Maternal Aunt contacted the social worker
stating that she and her long-term partner Billy Jones wanted
to be assessed as long -term carers for Jane.
21.07.08 Letter received from the adopters of the two previous children
Jean and George confirming that they do not want to be
considered to adopt Jane but would be willing to include her in
the direct contact arrangement with her siblings.
21.07.08 Letter received from Bethany Jakes Maternal Grandmother
confirming she is unable to put herself forward to care for Jane.
25.07.08 Initial viability assessment visit to Angela Jakes maternal aunt
and her partner Billy Jones.
Page 11
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
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Form CPR
Part A – Essential Information
07.08.08 Decision made not to proceed with the Kinship assessment of
Angela Jakes Maternal Aunt and her partner due to concerns
raised during the viability assessment concerning Angela’s
daughter aged 9.
12.08.08 Meeting with Mr and Mrs Green to address their irregular
contact with Jane. Tina said the sessions were too early in the
day. It was agreed that contact would stay at 3 times per week
but that they would take place later in the day.
25.08.08 Visit to Angela Jakes and her partner to inform her that the
Department would not be proceeding with the Kinship
assessment of them.
Wishes and feelings of the child 14
Not applicable. Jane is a young baby and is not able to express her wishes and
feelings.
CAFCASS Guardian’s views 15
The Guardian is in full agreement with the Local Authority’s plan to place Jane for
adoption.
Page 12
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be
reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Current contact arrangements for the child
What are the current
arrangements? (Include
frequency and location)
Birth mother 1 ½ hours every Monday,
Tuesday and Friday
Page 13
© BAAF 2006
How are the current
contact arrangements
meeting the needs of
the child?
Photographs are being
taken of the contact
sessions for use in
Jane’s life story book
Birth father As above As Above
Birth mother’s current
partner
Not applicable
Maternal grandmother None
Maternal grandfather None
Paternal grandmother Deceased
Paternal grandfather None
Sibling 1 (name) Jason Brown Social worker currently
exploring with Bethany
Jakes Maternal
Grandmother who is
Jason’s legal Guardian.
Currently all of Jane’s
siblings meet for contact
once per year. It is
hoped that Jane would
be able to join this
contact.
Sibling 2 (name) Jean Sibley Adopters would support
contact arranged
between Jane and Jean.
Currently all of Jane’s
siblings meet once a year
and it is hoped that Jane
will joint his contact.
Sibling 3 (name) Ross Green Social worker currently
exploring with Bethany
Jakes Maternal
Grandmother Ross’s
legal guardian. Currently
all Jane’s sibling meet
once a year and it is
hoped that Jane will be
able to join this contact.
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
What are the current
arrangements? (Include
frequency and location)
Page 14
© BAAF 2006
How are the current
contact arrangements
meeting the needs of
the child?
Sibling 4 George Green Adopters would support
contact arranged
between Jane and
George. Currently all
Jane’s siblings meet
once a year and it is
hoped that Jane would
be able to take part in
Significant other (name
and relationship)
Significant other (name
and relationship)
Significant other (name
and relationship)
Danny Jakes Maternal
Uncle dob 30.07.99
this contact.
Social worker currently
exploring with Bethany
Jakes Danny’s mother.
Currently all Jane’s
sibling and Danny meet
for contact once a year
and it is hoped that Jane
will be able to join this
contact.
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Proposed contact arrangements for the child
The agency must consider the likelihood of any existing relationship continuing
and the value to the child of it doing so.
What are the proposed contact arrangements post-placement and post-adoption
order? Outline the way the plan is considered to meet the needs of the child and
the details of the arrangement – direct, letterbox, frequency and any other
details.
Planned arrangements and details
Birth mother Post Adoption letterbox contact once a year avoiding
Christmas and Birthday times. This is to include
appropriate letters and cards.
Birth father As above.
Birth mother’s current Not applicable.
partner
Maternal grandmother Direct contact once per year organised by the Post
Adoption Team.
Maternal grandfather None
Paternal grandmother Deceased.
Paternal grandfather Due to serious child protection concerns there are no
plans to promote contact between Jane and her
Paternal Grandfather.
Sibling 1 Jason Brown Direct contact once per year
Sibling 2 Jean Sibley Direct contact once per year
Sibling 3 Ross Green Direct contact once per year.
Sibling 4.George Direct contact once per year.
Green
Significant other
Danny Jakes Maternal
Uncle.
Significant other
(name and
relationship)
Significant other
(name and
relationship)
Direct contact once per year.
Page 15
© BAAF 2006
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
Part A2 – The child’s birth mother
Surname
Green
First names
Tina
Are these the names used at the time of the child’s birth?
Yes
If no, what were they?
Other names (including familiar names)
Jakes maiden name
Date of birth
06.01.82
Place of birth
Leicester
Nationality
British
First language
English
Current address
480 Falcon Crescent, Braunstone, Leicester
Local authority area
Leicester City Council
Identify the last known type of educational provision that she has
attended 16
Tina Green attended mainstream school but received support from the Student
Support Services. Tina was made subject to an Educational Statement of
Special Needs.
Current occupation or profession
Unemployed.
Brief details of her employment history
Tina doesn’t have an established employment history. She has never been able
to sustain any work undertaken and for the most part she has been unemployed.
Brief description of the home and neighbourhood where she lives
Tina lives in a one-bed council flat, which is on a large estate a couple of miles
outside of the City centre. The house is sparsely furnished with dog hair
everywhere. Piles of cigarette ash and beer cans litter the main living area.
Overall the house is grubby with ingrained dirt on the floors and work surfaces.
Piles of dirty pots and pans have been observed in the kitchen and decaying
items of food.
Page 16
© BAAF 2006
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
A recent good quality photograph should be attached (if appropriate)
Date of photograph:
(The date should be written on the back of the photograph.)
Briefly describe the birth mother’s physical characteristics 17
Tina is 5ft tall and of slim build with thick long dark brown hair which she usually
wears tied back away from her face. She has a sallow complexion and deep set
large brown eyes. Tina doesn’t wear make-up and is usually observed to be
wearing of jeans and a jumper. She wears a stud in the left side of her nose and
has pierced ears.
Briefly describe the personality and interests of the birth mother 18
Tina’s personality is variable she can swing from being extremely friendly and
chatty to being abusive and aggressive. When she becomes agitated she will
often shout and swear. This may have something to do with her intellectual
abilities. Tina doesn’t have many friends and she appears to struggle in relating
to her peers preferring to spend time with Simon and her uncles.
She enjoys using the internet and playing computer games and she has talked
about enjoying watching programmes about animals on the television. From my
observations Tina seems to spend most of her time with her two uncles. She
appears to enjoy their company and has spoken about going with them for days
out.
Tina was unable to talk about any other interests although I have observed her
reading magazines. She has a quick temper but soon calms down and from my
contact with her it is clear that she is heavily influenced in her thoughts and
actions by her husband Simon.
Page 17
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Form CPR
Part A – Essential Information
If the birth mother’s current partner is not the birth father of the child,
please complete
Surname
First names
Other names (including familiar names)
Status of relationship with birth mother (married, civil partnership,
cohabiting), including relevant dates
Length of relationship
Sex
Occupation or profession
Page 18
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Form CPR
Part A – Essential Information
Chronology and social history of the birth mother
Start
date
End
date
Detail any significant events – carers, place of
residence, bereavement or loss, major illness – to give a
brief social history of the birth mother relevant to this
CPR
1990 Tina Green nee Jakes has been known to the Local
Authority as a child in her own right since 1990. Social
services were involved for a number of years and initially
began as family support around Tina’s behaviour as a young
child within the home and took the form of behaviour
management and support within the family unit.
At the age of 8 Tina was sexually abused by a cousin who
was 18 years old and who later received a prison sentence
for sexually abusing her on several occasions. Tina received
post abuse therapy.
Tina was subject to a formal statement of Special
Educational Need due to her having some degree of learning
difficulties.
1996 Tina was subject to a further incident of sexual abuse
Jan
2000
involving sexually explicit images being taken of her.
Tina’s first child Jason was removed from her care in
January 2000 under an Emergency Protection Order due to
concerns about her parenting. These concerns were around
poor handling and a lack of awareness of developmental and
feeding needs. Following a period of assessment Tina was
found to be unable to consistently provide Jason with care of
an acceptable standard. Jason was made subject of a Care
Order on 24 th of January 2000 and his Maternal
Grandmother Bethany Jakes cares for him on a Residence
Order.
25.04.00 Julie Jamison Psychologist concluded in her report that Mrs
Green had borderline learning difficulties, which were further
compounded by her emotional and behavioural difficulties,
which would significantly affect her parenting capacity.
These difficulties are long standing and have been
addressed by professionals over a number of years.
21.06.02 Tina gave birth to Jean Sibley her second child. Jean was
placed in foster care on an Interim Care Order on 25.06.02.
The Department’s assessment of Tina and her then partner
Gordon Sibley concluded that any child in their care would
be at risk of significant harm and that the prognosis for
Page 19
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Form CPR
Part A – Essential Information
change was poor.
22.11.02 Julie Jamison Psychologist was unable to identify any
changes in Mrs Green’s ability to differentiate the emotional
needs of her daughter from her own. To evaluate accurately
her own limitations, to be realistic in her plans, to be honest
with herself and others, or to be less vulnerable in the
context of interpersonal relationships. In summary not
enough changes had taken place to ensure adequate care of
her daughter Jean by Mrs Green.
21.01.03 A full Care Order was granted on Jean and she was placed
with adopters on the 23.03.02 and adopted on the 26.08.03.
14.10.04 Ross was born to Tina and her partner Simon Green who
was a childhood friend. Simon was identified by the
Department’s database by another name’ Simon Doe’ a
person who had allegedly sexually abused a 7 year old
female child. Mr Green denied that he was Simon Doe.
A parenting assessment carried out at a local family centre
concluded that the couple’s commitment to the assessment
was erratic but they were punctual. They were able to meet
some of Ross’s basic care but not on a consistent basis.
Tina would often not allow Simon to complete some tasks,
stating that she would be the sole carer and that they would
do things together. They were able to show visible signs of
affection but there were many times when Tina was unable
to put Ross’s needs before her own particularly if he became
unsettled at which point she would become frustrated and
agitated. Simon was unable to challenge Tina in the areas
that were of concern.
The Psychologist concluded that Tina has borderline
learning difficulties and that this wasn’t expected to change
and that Mr Green had low average intellectual ability. As a
couple they prompted significant concerns about their ability
to distinguish fact from fantasy. With continuing support and
advice, and bearing in mind Mr Green’s greater intellectual
ability, they would probably be able to achieve adequate
physical care of Ross. However they would not be able to
provide a stable and consistent emotional environment for
him. In addition, their ability to accept the continuing level of
support they would need is doubtful.
30.04.05 Tina and Simon get married at Leicester Register Office.
14.06.05 Bethany Jakes Maternal Grandmother indicated a
willingness to be assessed as Ross’s carer.
20.08.05 Ross Green is made subject to a Care Order with the Care
Page 20
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Form CPR
Part A – Essential Information
Plan of long term foster care with supervised contact
between Ross and his parents to take place once a week for
1 ½ hours at the local family centre. In addition the Family
Proceedings Court made a Finding of Facts that Simon
Green is the same person as Simon Doe.
06.10.05 During a contact session Tina showed signs of impatience
with Ross whilst changing him and began to handle him
roughly, speaking to him aggressively and holding her fist up
to him in an aggressive manner.
14.10.06 Concerns are expressed at contact in respect of Tina’s rough
handling of Ross whilst changing his nappy. She wasn’t
vigilant and Ross wiggled from side to side, creating the
potential for him to roll off the surface. Mr Green was not
present at this session.
28.10.05 At a contact session Tina is noted to have used
inappropriate language in front of Ross and she continues to
balance him on her knee whilst changing his nappy despite
advice from the staff to the contrary.
04.11.05 Review of Arrangements meeting confirmed that Mr and Mrs
Green were in agreement with Ross being placed with his
Maternal Grandmother Bethany Jakes in a Kinship foster
care placement.
18.11.05 Tina was observed to use inappropriate language shouting
at Ross to ‘shut up’ at a contact session. She told him to
‘stop whining and winding her up’.
02.12.05 At a contact session concern was expressed that Tina was
not responding to advice on Ross’s nappy changing needs.
10.01.06 Community Midwife notifies the Local Authority that Tina
attended an ante-natal appointment. She was estimated to
be 20 weeks pregnant.
10.02.06 Parents fail to attend contact with Ross. Contact was
subsequently suspended in accordance with the centre’s
policy.
03.04.06 Home visit to Bethany Jakes, Tina has denied the fact she is
pregnant to her mother and said that she has just put on
weight.
25.04.06 Community midwife informed the Department Tina had
attended an ante-natal appointment and she was found to be
37 weeks pregnant, however given her presentation on the
day she could give birth at any time.
27.04.06 Home visit by social worker to discuss the concealed
pregnancy and the emergency protection procedures to be
put in place when the baby is born. Tina and Simon
responded in an agitated and volatile manner, with Tina
becoming upset, shouting at and talking over staff, and then
Page 21
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Form CPR
Part A – Essential Information
her mood changing to have a calm conversation about the
preparations she had made for her expected baby. She
indicated she was going to keep this one and that the Local
Authority had taken her previous children illegally. She
refused to cooperate in any discussions about the child
protection concerns in relation to her expected baby.
Simon continued to deny that he was Simon Doe and Tina
asked the social workers to leave and proceeded to call 999
reporting that she had trespassers in her home who were
trying to take her baby.
28.04.06 Home visit Mr and Mrs Green refuse workers entry. They
tear up the letter detailing the plans for the new baby. They
eventually accept another copy but object to every point.
01.05.06 George Green born at the Leicester Royal Infirmary.
Hospital staff observe Tina to shout ‘shut up’ at the baby who
appeared unsettled. Simon was present but did not
intervene. During the 4 days Tina was in hospital the staff
were concerned about her level of frustration and agitation
and her rough handling of George.
05.05.06 Angela Jakes Tina’s sister requests to be assessed as a
carer for George but later withdraws her request.
09.05.06 George is made subject to an Interim Care Order and placed
in foster care. Adopters of Jean feel they are too old to
consider taking another child.
16.03.08 George moves to live with adopters, Adoption Order granted
on the 23.10.07.
13.08.07 Department is informed Mrs Green is pregnant with a due
date of March 26 th 2008.
14.08.07 Home visit to Mr and Mrs Green to discuss pregnancy and
child protection concerns. Couple refuse to discuss the
issue.
22.01.08 Legal planning meeting decision to seek further
Psychological assessment from Julie Jamison and to seek
Interim Care Order on the expected child.
14.02.08 Pre birth conference decision taken to make expected child
subject to a Child Protection Plan at birth and to make an
application for a Care Order to secure the unborn baby’s
safety.
27.02.08 Psychological assessment concluded although she had
identified some positive changes in Mr and Mrs Green she
stated that the risk of placing a child in their care would be
high. Her reasons were parent’s failure to fully recognise the
limits of their parenting ability and their difficulty in accepting
professional advice. She also stated that it would be
Page 22
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Form CPR
Part A – Essential Information
impossible to monitor the situation safely when they are
unable or unwilling to distinguish factual from non factual
accounts.
19.03.08 Jane born at 13.50 at Leicester General Hospital.
20.03.08 Jane made subject to an Interim Care Order and placed in
foster care. Arrangements made for parents to have contact
5 times per week.
18.06.08 Contact reduced to 3 times a week due to parent’s poor
attendance.
20.06.08 Independent social workers assessment concludes that
“whilst Tina is now in a more stable relationship and home
environment than in the past that situation in itself is not
conducive to the care and welfare of a vulnerable child.
Neither parent acknowledges that their home or lifestyle
presents any cause for concern and they are totally resistant
to advice or guidance. Mr Green presents a completely
unrealistic and at times bizarre view of his world and he has
a strong influence upon his wife.
They have some sound basic ideas about parenting and a
theoretical knowledge of care but this is not translated into
realty within their own daily lives. A child in their care would
be at constant risk of illness or injury. More significantly they
do not present as a couple who are likely to deal with
problems in a mutually supportive way, nor to offer an
emotionally warm and nurturing environment they will not
reliably cooperate with professionals involved with Jane and
it would be almost impossible to ensure her welfare.”
Page 23
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Form CPR
Part A – Essential Information
Support to birth mother
Has the birth mother received counselling from an independent person in
relation to the plan for adoption? (Give details)
Mrs Green was given the information about the independent counselling service
on the 18-06-08. She has declined this service.
Has the birth mother been given an opportunity to state her views on the
adoption plan for the child?
If yes, briefly describe the outcome of this. If part F has been completed, note
this here.
If no, give reasons.
Mrs Green has refused to co-operate and provide any information in relation to
the adoption process as she disagrees with the Local Authority’s
recommendation of adoption for Jane.
Social worker has completed part F of this form, views of the birth mother from
her conversations with Mrs Green who has verbally stated her reasons for not
agreeing to the plan for adoption for her child.
Has the birth mother been shown a copy of this CPR?
If yes, note date shown and briefly describe the outcome of this. If no, give
reasons. If the birth mother has written her own account, is this included with this
report?
No Tina was offered the opportunity to view the report but she declined this offer.
Page 24
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Form CPR
Part A – Essential Information
Part A3 – The child’s birth father
Surname
Green
First names
Simon
Are these the names used at the time of the child’s birth?
Yes
If no, what were they?
Other names (including familiar names)
Aka Simon Doe
Date of birth
10.02.80
Place of birth
Leicester
Nationality
British
First language
English
Current address
480 Falcon Crescent, Braunstone Leicester
Local authority area
Leicester City Council
Identify the last known type of educational provision that he has
attended 19
Simon attended mainstream school.
Current occupation or profession
Unemployed.
Brief details of his employment history
Simon Green is currently unemployed and has not been able to evidence a
sustained period of employment. He reports that he currently ‘helps out’
Tina’s uncle who has a cleaning job. Simon has had a number of jobs
including being in the Army, but he has not been able to sustain any
occupation for a significant period of time.
Brief description of the home and neighbourhood in which he lives
Mr Green lives with his wife Tina Green see this description already detailed
Part A2 on the birth mother.
What was the status of the relationship with the child’s birth mother at
the time of the birth of the child (married, cohabiting)?
Married.
Current status of the relationship (separated, divorced, living apart) –
Page 25
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Form CPR
Part A – Essential Information
include dates
Married on 30.04.05 and still living together.
Give a brief description of the past and current relationship of the birth
parents with each other
Mr and Mrs Green initially stated that they first met in August 2004. Tina was
22 and Simon 24. Later, however they stated that they were childhood
friends. Tina also stated that Simon is the father of her first child. This
however, was not confirmed as the Local Authority cites another individual as
the father of Tina’s eldest child.
At another interview Mr and Mrs Green stated that they had met in October
2003, had a ‘one night stand’ and had been together ever since.
The couple were married on the 30.04.05.
A Psychological assessment undertaken in March 2005 describes the couple
sharing a fantasy world, which would give rise to significant concerns should a
child be placed in their care.
There are indications of genuine affection and companionship between them
and the length of this relationship demonstrates a good level of stability for
Mrs Green.
The independent social worker comments in his recent assessment June
2008 that Mr and Mrs Green do not present as a couple who are likely to deal
with problems in a mutually supportive way.
A recent good quality photograph should be attached (if appropriate)
Date of photograph:
(The date should be written on the back of the photograph.)
Briefly describe the birth father’s physical characteristics 20
Simon Green is of White British descent. He is of slim build with short dark
brown hair and large dark brown eyes with long eyelashes. He has a sallow
complexion and he has a large scar running down his right cheek, which was the
result of a fight several years ago.
Simon dresses casually in Jeans and he is usually observed to be wearing Dr
Martin boots and a woollen hat. He has several tattoos’ including a heart with
Tina’s name on it on his left upper arm and he has some crosses on his hands
and wrist, which he has done himself.
Simon wears several earrings down the lobes of his ears and he has a stud in his
left eyebrow.
Page 26
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Form CPR
Part A – Essential Information
Briefly describe the personality and interests of the birth father 21
Mr Green is quieter and more reserved that his wife. He comes across as a shy
character. He can often seem anxious and pre-occupied with his own health. He
can on occasion be jovial and tell funny anecdotes.
Simon appears to have an interest in the Territorial Army. He enjoys playing
computer games and like his wife he spends much of his time with Tina’s two
uncles. He appears to enjoy their company and has talked of going with them for
days out.
Simon has been reluctant to give any information about himself or his extended
family. He continued to deny the fact that he is also known by the name of
Simon Doe but more recently he has admitted that he has been known by this
name in the past.
Page 27
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Form CPR
Part A – Essential Information
The birth father without parental responsibility (PR)
Has the paternity of the child been confirmed?
If yes, indicate how
.
Is anybody else claiming paternity of the child?
If yes, give brief details
Is the identity of the birth father without PR known to the agency?
Does the birth father know of the birth of the child?
If no, and the agency knows his identity, has the agency decided that it is
appropriate to counsel and advise him?
If yes, what steps have been taken to counsel and advise him and are these
continuing?
Does the birth father intend to apply for parental responsibility for the
child, or for a residence or contact order?
Details
Has there been contact between the agency or any other agency and the
birth father?
If yes, give brief details
Page 28
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Form CPR
Part A – Essential Information
Birth father with parental responsibility for the child
How did he acquire parental responsibility for this child? (Please indicate)
By marriage to the birth mother (before Yes
or after the birth)
Registration on the birth certificate (only
after 1 December 2003)
Parental responsibility agreement with
birth mother – section 4 CA 1989
Parental responsibility order – section 4
CA 1989
Does he know of the plan to place the child for adoption?
Yes
Has he given formal consent to the placement of the child for adoption
(witnessed by a CAFCASS officer)?
No
Has he given advanced consent to the making of an adoption order
(witnessed by a CAFCASS officer)?
No
If he has given advanced consent, has he also given notice that he does
not wish to be notified of the application for an adoption order?
Not applicable.
Page 29
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Form CPR
Part A – Essential Information
Chronology and social history of the birth father
Start
date
End
date
Detail any significant events – carers, place of
residence, bereavement or loss, major illness – to give
a brief social history of the birth father relevant to this
CPR
See previous chronology of birth mother from 14.10.04 as
Mr Green refused to provide information on his extended
family.
In addition to noting the chronology described in the point
above the following highlight facts pertaining to Mr Green
specifically.
14.10.04 Ross was born to Tina and Simon Green, a childhood
friend. The department data-base identified Simon Green
as Simon Doe a person who had allegedly sexually abused
a 7 year old female child. Simon Green denied that he was
Simon Doe.
24.02.05 In a Leicester County Court Judgement regarding the Doe
family the Judge is recorded as stating “It seems to me that
the allegations which the Local Authority made of the ways
in which the threshold criteria in this case are satisfied
(physical abuse, sexual abuse, inadequate care, neglect of
the youngest children) are all supported by abundant and
clear evidence. The children in this family were at risk of
significant harm up to the dates when the Local Authority
was forced to intervene.
30.04.05 Simon Green formally John Doe married Tina Green at
Leicester Register Office.
20.08.05 The Family Proceedings court made a Finding of Facts that
Simon Green is the same person as Simon Doe.
27.04.06 Home visit to Mr and Mrs Green to discuss the concealed
pregnancy. Simon still continuing to deny he was Simon
Doe.
14.02.08 Prior to the pre birth conference on Jane Simon was asked
again if he was Simon Doe. He admitted that he used to be
called Simon Doe but he wanted to keep the Green name
going, as that was his mother’s name. Simon stated that he
didn’t have any nieces but that he would let the social
worker know if he found out that he had.
See Chronology of the birth mother from 22.02.08 to
date.
Page 30
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Form CPR
Part A – Essential Information
Support to birth father
Has the birth father received counselling from an independent person in
relation to the plan for adoption? (Give details)
No Simon was given the information about the Independent Counselling Service
on the 18.06.08 but he declined to take it up.
Has the birth father been given an opportunity to state his views on the
adoption plan for the child?
If yes, briefly describe the outcome of this. If Part G has been completed, note
this here.
If no, give reasons.
Yes, but Mr Green did not attend the appointment to state his views. Part G has
not been completed because he has not voiced his views about the plan for his
daughter’s adoption.
Has the birth father been shown a copy of this CPR?
If yes, note date shown and briefly describe the outcome of this. If no, give
reasons.
No. Mr Green did not attend the appointment to view the report.
If the birth father has written his own account, is this included with this
report?
Not applicable.
Page 31
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Form CPR
Part A – Essential Information
Part A4 – Ability and willingness of family
members or relevant persons to permanently care
for the child 22
For each parent or guardian or where relevant the child’s relatives, or any other
person, outline an assessment of the ability and willingness to provide the child
with a secure environment that facilitates their full development and meets their
needs. Include the care/legal options that have been explored in relation to this
carer and the reasons why the options have been discounted.
(ACA 2002 s1(4)(f)(ii))
Name:
Tina and Simon Green
Relationship to the child:
Birth parents.
Details:
Jane is Tina’s fifth child. Previous Care Proceedings resulted in her first four
children being placed away from her care permanently. There is extensive
historical evidence and assessments to suggest the Mr and Mrs Green are
unable to create a safe and stable environment for a child and that were Jane to
be left in their care she would be likely to experience significant harm.
The birth parents have been inconsistent in their engagement with the
Department over the Pre birth assessment in relation to Jane. They were not at
home on many pre-arranged visits and Tina stated that concerns raised in
relation to her other children were ‘all lies’. Mr and Mrs Green have a lack of
understanding of the child protection concerns and this increases the risk to any
child placed in their care.
Mrs Green was adamant through most of her pregnancy that she wanted a home
birth despite being advised against this due to the health risks. Only in the last
weeks of her pregnancy did she agree to a hospital birth. Her attitude to
professional advice re this issue raised concerns about her ability to heed the
advice of professionals and prioritise the needs of her child over her own needs.
Julia Jamison Psychologist concurred with the Local Authority’s view of Mr and
Mrs Green. She concluded in her most recent psychological assessment (Feb
08) that the risk of placing a child in their care would be high because of their
failure to fully recognise the limits of their parenting ability and the difficulty of
accepting professional advice. In addition she stated it would be impossible to
Page 32
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Form CPR
Part A – Essential Information
monitor the situation safely when the birth parents are unable or unwilling to
distinguish factual from non-factual accounts of events.
The Independent Social Worker also agreed with the Local Authority assessment
and the Psychologist. He concluded in his report of Mr and Mrs Green (June 08)
that there may have been a change in Tina’s situation to the extent that she is
now in a more stable relationship and home environment than in the past.
However this is not of itself conducive to the care and welfare of a vulnerable
child. Neither birth parent acknowledges that their home or lifestyle presents any
cause for concern and they are totally resistant to any advice or guidance. Mr
Green presents a completely unrealistic and at times bizarre view of his world
and strongly influences Mrs Green.
In addition the Independent Social Worker added that whilst Mr and Mrs Green
have some sound basic ideas about parenting and a theoretical knowledge of
care and hygiene this is not translated into reality within their daily lives. A child
in their care would constantly be at risk of illness or injury. More significantly they
do not present as a couple who are likely to deal with problems in a mutually
supportive way, nor to offer an emotionally warm and nurturing environment or to
prioritise their child’s needs. Most importantly they will not co-operate reliably
with the professionals involved with Jane and it would be almost impossible to
ensure her welfare.
There is also the fact that Mr Green did state that he used to be called Simon
Doe although he denies knowing anything about allegations of abuse.
Allegations were made against Simon Doe in 1997 for indecently assaulting his
7-year old niece. Mr Green is therefore an un-assessed risk to Jane.
Name
Angela Jakes
Relationship to the child
Maternal Aunt
Details:
On the 23.01.08 Ms Jakes stated that she could not care for Jane on a long-term
basis as she had to care for her own family. On the 18.07.08 she contacted the
Department stating that she and her partner wanted to be assessed as long-term
carers for Jane. An initial viability assessment was carried out which included a
home visit to the couple and a visit to Leicestershire County Council to view files
relating to Angela’s daughter aged 9.
During the initial visit Angela stated that she had changed her mind about putting
herself forward as she didn’t want Jane to be placed outside of the family. It
should be noted that she also put herself forward to care for George Jane’s
Page 33
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Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS

Form CPR
Part A – Essential Information
sibling and then withdrew her request. Ms Jakes stated that this was due to
difficulties she was experiencing with her own 9 year old daughter who used to
soil and wet herself but who was now much better.
Ms Jakes and her partner Billy Jones stated that they were trying for a baby;
however were she to become pregnant she would still want to care for Jane.
Concerns were raised about how they would cope with their 9 year old a new
baby and Jane.
Ms Jakes said that she had never had a good relationship with her sister Tina
Green. This raised concerns about how Ms Jakes would managed the
relationship with her sister if she was caring for Jane.
Information re Ms Jakes 9 year old daughter from files included in 2005 concerns
raised by school nurse re the child soiling and wetting and Ms Jakes parenting
capacity. An Initial and Core Assessment was carried out. In September 2005 a
Section 47 child protection investigation was carried out due to continued issues
with the child’s problems. Throughout the assessment there were discrepancies
in relation to how the child’s school viewed their daily contact with her and how
Ms Jakes viewed her daughter. The child made no disclosure about what issues
may be affecting her behaviour and no conclusive evidence was found of an
underlying medical condition. The family were supported under family support
and the case was closed in November 2006.
A further referral was received from the child’s school to Social Services in
December 2007 and most recently on the 24.07.08 re the child’s emotional
presentation and general well being.
On 07.08.08 the decision was taken not to proceed with a kinship assessment of
Angela jakes and Billie Jones due to the issues raised in the viability
assessment.
Name
Bethany Jakes
Relationship to the child
Maternal Grandmother
Details:
Bethany Jakes has state that she is unable to care for another baby due to her
current caring responsibilities for her own son Danny and Jason and Ross her
grandchildren. She has also recently been diagnosed with Crohn’s disease.
Page 34
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Form CPR
Part A – Essential Information
Summary of the reason why adoption is the preferred permanence plan for
the child
There is extensive historical and current evidence to suggest that Mr and Mrs
Green are unable to provide a safe and stable environment for a child and if Jane
were to be placed in her birth parents care she would be at risk of significant
harm.
Birth parents have failed to recognise the limits of their parenting ability.
Although Mrs Green is unable to heed the advice of professionals and prioritise
the needs of her child over her own agenda.
Birth parents are unwilling or unable to distinguish factual from non-factual
accounts of events.
Mr Green remains an un-assessed risk to Jane. He has stated that he used to
be called Simon Doe but states he doesn’t have any nieces and knows nothing
about allegations of abuse. The County Court made a Finding of Facts that
Simon Doe and Simon Green are one and the same person. Allegations were
made against Simon Doe in 1997 for indecently assaulting his 7 year old niece.
The Maternal extended family have been explored as potential carers for Jane
but Bethany Jakes ruled herself out due to her current child care commitments
and Maternal Aunt and her partner Billy Jones had a viability assessment carried
out but due to issues raised in that assessment were found not to be suitable.
Paternal family were ruled out as potential carers for Jane because the Doe
family are known to have significant child protection concerns and therefore
would not be able to provide a safe environment for Jane.
Adoption remains the only viable option to ensure Jane’s needs are prioritised
and met in a safe and appropriate environment.
Page 35
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Form CPR
Part A – Essential Information
Part A5 – Adoption agency details
Name of agency
Leicester City Council, Children and Young People’s Services Adoption Team
Address
11 Friar Lane
Telephone number
0116 2995988
Fax number
0116 2995900
Name of social worker completing this form
Flora James
Address if different from the one above
Leicester City Council, Children and Young People’s Services, Beaumont Way,
Leicester LE4 1 EL
Telephone number
0116 2995799
Email address
Flora.James@leicester.gov.uk
Fax number
0116 299577
Is the social worker qualified under the Restriction on the Preparation of
Reports Regulations 2005 to prepare this report?
Yes
Signature
If no, identify the person who is qualified and has supervised the
preparation of this report
Team Manger
Name
Telephone number
Email address
Signature
Page 36
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Form CPR
Part A – Essential Information
Name of team manager
Dora Francis
Address if different from the one above
Telephone number
0116 00000
Email address
Signature
Name of link social worker for inter-agency placements
Janet Roberts
Address if different from the one above
Eagle House, Adoption Team, 11 Friar Lane Leicester LE1 5RB
Telephone number
0116 299588
Email address
Janet.roberts@Leicester .gov.uk
Fax number
0116.29958900
Page 37
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Form CPR
Parts B & C – Extended family
Part B – Other people with parental responsibility
Does anyone else have parental responsibility for the child? (i.e. legal
guardian or special guardian) 23
Name NOT APPLICABLE
Relationship to the
child
How was PR obtained?
Gender
Date of birth
Ethnicity
Nationality
Address
Page 38
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Form CPR
Parts B & C – Extended family
Part C – Other relatives or other relevant people
Details about any other relatives or any other person considered relevant 24
Name Ms Bethany Jakes
Relationship to the
child
Maternal Grandmother
Gender Female
Date of birth 03.07.59
Ethnicity White/British
Nationality British
Address 300 Howard Hill, Leicester
Name Ms Angela Jakes
Relationship to the
child
Maternal Aunt
Gender Female
Date of birth 09.06.80
Ethnicity White/British
Nationality British
Address 296 Well Lane, Leicester
Page 39
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Form CPR
Part D – Siblings (full and half)
Part D – Siblings (full and half) 25
Sibling 1
Surname Brown
First names Jason
Date of birth 21.11.99
Place of birth Leicester
Sex Male
Ethnicity White/British
Nationality British
A recent good quality photograph should be attached if appropriate
Date of photograph:
(This should be written on the back of the photograph.)
Briefly describe the child’s physical characteristics
Jason is a White/British child of slim build with dark brown hair, dark brown
eyes with a pale complexion.
Birth mother’s full name (surname first)
Tina Green
Birth father’s full name (surname first)
Sam Brown
Current carer’s name (where appropriate)
Bethany Jakes
Current carer’s address (where appropriate)
300 Howard Hill, Leicester
Relationship/status of current carer to child
Maternal Grandmother
Is this sibling currently “looked after”?
No
Name and address of the local authority that has responsibility for this
sibling
N/A
Is this child provided with accommodation under section 59(1) of the
Children Act 1989 (accommodated by a voluntary agency)?
No
Legal status of sibling
Residence Order to Bethany Jakes
Is there a court order in force?
Yes
Page 40
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission
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Form CPR
Part D – Siblings (full and half)
If yes, type of order
Residence Order, Contact Order
Name of court
Leicester Family Proceedings Court
Date on which order was made
12.06 03
Has an order been applied for and not yet granted? Please give brief
details
What is the current plan for this child? Give brief details 26
Remain with Maternal Grandmother on a Residence Order
If the plan for this child is adoption, indicate if this sibling to be placed
with the child subject to this CPR?
Give a brief physical description of this sibling (unless this child is
subject to a CPR being considered at the same panel)
Brown hair, dark brown eyes, slender build, 5ft tall.
Outline the nature of the relationship of this sibling with the child subject
to this report, including the length of the relationship, where and when
they have lived together, the frequency of the contact and the quality of
their relationship
Jane had contact with Jason when she was 2 days old at Maternal
Grandmother’s house. Jason demonstrated affection and emotional warmth
for his baby sister. Given Jane’s age and the limited amount of time spent
together they are unable to form a sustaining and lasting relationship.
Currently all of Jane’s siblings meet for contact once per year and it is hoped
that Jane would be included in this contact post adoption.
Part D – Siblings (full and half) 25
Sibling 2
Surname Sibley
First names Jean
Date of birth 21.06.02
Place of birth Leicester
Sex Female
Ethnicity White/British
Nationality British
A recent good quality photograph should be attached if appropriate
Date of photograph:
(This should be written on the back of the photograph.)
Page 41
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Form CPR
Part D – Siblings (full and half)
Briefly describe the child’s physical characteristics
Jean is of slim build with blonde hair and brown eyes. She is of average
height for her age and she wears glasses as she is short sighted.
Birth mother’s full name (surname first)
Tina Green
Birth father’s full name (surname first)
Ron Sibley
Current carer’s name (where appropriate)
Child is adopted
Current carer’s address (where appropriate)
Confidential
Relationship/status of current carer to child
Adoptive parents
Is this sibling currently “looked after”?
No
Name and address of the local authority that has responsibility for this
sibling
Not applicable
Is this child provided with accommodation under section 59(1) of the
Children Act 1989 (accommodated by a voluntary agency)?
No
Legal status of sibling
Adopted
Is there a court order in force?
Yes
If yes, type of order
Adoption Order
Name of court
Leicester Family Proceedings Court
Date on which order was made
26.08.03
Has an order been applied for and not yet granted? Please give brief
details
Not applicable
What is the current plan for this child? Give brief details 26
Not applicable
If the plan for this child is adoption, indicate if this sibling to be placed
with the child subject to this CPR?
Page 42
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Form CPR
Part D – Siblings (full and half)
Give a brief physical description of this sibling (unless this child is
subject to a CPR being considered at the same panel)
See above description under child’s physical characteristics.
Outline the nature of the relationship of this sibling with the child subject
to this report, including the length of the relationship, where and when
they have lived together, the frequency of the contact and the quality of
their relationship
Jean has not had any contact with Jane to date.
Currently all of Jane’s siblings meet for contact once a year and it is hoped
that Jane will join this contact post adoption.
Part D – Siblings (full and half) 25
Sibling 3
Surname Green
First names Ross
Date of birth 14.10.04
Place of birth Leicester
Sex Male
Ethnicity White/British
Nationality British
A recent good quality photograph should be attached if appropriate
Date of photograph:
(This should be written on the back of the photograph.)
Briefly describe the child’s physical characteristics
White/British child. Fair complexion, light brown hair and dark brown eyes.
Birth mother’s full name (surname first)
Tina Green
Birth father’s full name (surname first)
Simon Green
Current carer’s name (where appropriate)
Bethany Jakes
Current carer’s address (where appropriate)
300 Howard Hill, Leicester
Relationship/status of current carer to child
Maternal Grandmother
Page 43
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Form CPR
Part D – Siblings (full and half)
Is this sibling currently “looked after”?
No
Name and address of the local authority that has responsibility for this
sibling
Not applicable
Is this child provided with accommodation under section 59(1) of the
Children Act 1989 (accommodated by a voluntary agency)?
No
Legal status of sibling
Residence Order to Bethany Jakes
Is there a court order in force?
Yes
If yes, type of order
Residence Order, Contact Order
Name of court
Leicester Family Proceedings Court
Date on which order was made
22.02.06
Has an order been applied for and not yet granted? Please give brief
details
What is the current plan for this child? Give brief details 26
Child to remain with Maternal Grandmother on a Residence Order
If the plan for this child is adoption, indicate if this sibling to be placed
with the child subject to this CPR?
Not applicable
Give a brief physical description of this sibling (unless this child is
subject to a CPR being considered at the same panel)
See description under physical characteristics
Outline the nature of the relationship of this sibling with the child subject
to this report, including the length of the relationship, where and when
they have lived together, the frequency of the contact and the quality of
their relationship
Given Jane’s age and the limited time spent together Ross and Jane have not
been able to form a sustaining and meaningful relationship.
Currently all of Jane’s siblings meet for contact once per year. It is hoped that
Jane will join this contact post adoption.
Page 44
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Form CPR
Part D – Siblings (full and half)
Part D – Siblings (full and half) 25
Sibling 4
Surname Green
First names George
Date of birth 01.05.06
Place of birth Leicester
Sex Male
Ethnicity White/British
Nationality British
A recent good quality photograph should be attached if appropriate
Date of photograph:
(This should be written on the back of the photograph.)
Briefly describe the child’s physical characteristics
George is of White/British descent. He has a fair complexion, light brown hair
and large brown eyes.
Birth mother’s full name (surname first)
Tina Green
Birth father’s full name (surname first)
Simon Green
Current carer’s name (where appropriate)
Child is adopted.
Current carer’s address (where appropriate)
Confidential
Relationship/status of current carer to child
Adoptive parents
Is this sibling currently “looked after”?
No
Name and address of the local authority that has responsibility for this
sibling
Not applicable
Is this child provided with accommodation under section 59(1) of the
Children Act 1989 (accommodated by a voluntary agency)?
No
Legal status of sibling
Adopted
Is there a court order in force?
Yes
Page 45
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Form CPR
Part D – Siblings (full and half)
If yes, type of order
Adoption Order
Name of court
Leicester Family Proceedings Court.
Date on which order was made
23.10.07
Has an order been applied for and not yet granted? Please give brief
details
Not applicable
What is the current plan for this child? Give brief details 26
Not applicable
If the plan for this child is adoption, indicate if this sibling to be placed
with the child subject to this CPR?
Give a brief physical description of this sibling (unless this child is
subject to a CPR being considered at the same panel)
See description given under child’s physical characteristics.
Outline the nature of the relationship of this sibling with the child subject
to this report, including the length of the relationship, where and when
they have lived together, the frequency of the contact and the quality of
their relationship
George has not had any contact with Jane to date.
Currently all of Jane’s siblings meet for contact once a year. It is hoped that
Jane will join this contact post adoption.
Page 46
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Form CPR
Part E – Wishes and feelings of the child
Part E – Wishes and feelings of the child 27
CHILD’S NAME: Jane Green
Your social worker will have talked to you about adoption. They should have
told you what this means. They should also have told you what they are going
to do to find you adoptive parents.
If you feel you still do not understand what adoption means, you should ask
to be told again until you feel you understand.
It is very important for the adults who are making decisions about this to
understand what you think and feel about adoption.
You may want to write what you think about adoption in your own words. You
can do this below. You may want an adult to write this for you. You might
have lots to say. You may have very little to say. It is up to you, but whether
it is a lot or a little, it is always very important. You can use extra paper if
you like.
What I think about being adopted
Jane is too young to give her views.
What I think I want my adoptive parents to be like
Page 47
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Form CPR
Part E – Wishes and feelings of the child
Here are some other important things that you may want to say
something about
You may go to a church, temple or mosque. You may say prayers. If this is so,
it is important that social workers know about this so that your adoptive
parents know about this too.
Do you go to a church, temple or mosque or say prayers?
Do you want to say any more about this?
There are lots of important things about you. This might include the place
where you were born or have lived, the festivals or celebrations you like, the
clothes you wear, the kinds of people you like to be with, the food you like or
the food you don’t like or don’t eat.
It will be very important to make sure that your adoptive parents know
these things about you.
Ask somebody who knows you well to think about how you might write
some of this down
After you are adopted, it may be possible for you to stay in touch with
people who are very important to you now. Your social worker can explain how
this can happen.
You may want to say something about each of these people and how you want
to stay in touch with them.
Write down the names of the people who you want to stay in touch with
below. If you want somebody else to help you do this, ask them.
Page 48
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Form CPR
Part F – Views of the birth mother on the Child’s Permanency
Report
Part F – Views of the birth mother on the Child’s
Permanency Report 28
Your name:
Tina Green
The name of your child:
Jane Green
I have been shown the details about me as recorded in my Child’s
Permanency Report.
Tina did not take up the opportunity to view the CPR however she has
expressed her views to me her social worker verbally and I have competed
this section on Tina’s behalf.
I agree with what has been written
No
I would like to add the following information
Tina refused to provide any information or to look at the CPR because she is
totally opposed to the Local Authorities plan to place Jane for adoption.
I disagree with the information for the following reasons
Tina has stated to her social worker that the assessments of her and Simon
are wrong. Her view is that Jane should be at home with herself and her
husband. She feels that none of her children should have been taken away
from her and she feels that she is able to care for her children
Page 49
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written
permission of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased
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Form CPR
Part F – Views of the birth mother on the Child’s Permanency
Report
(Any additional comments should be recorded separately and signed and
dated)
I have been given written information about the adoption process
YES
This information was given to Mr and Mrs Green on the 10.07.08
I have been offered/had independent counselling to support me in
understanding why adoption is the local authority’s preferred plan for
my child
YES
Independent counselling was offered to Tina but she refused to take it up.
Signature:
Date:
Page 50
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Form CPR
Part F – Views of the birth mother on the Child’s Permanency
Report
You may want to seek advice and support from somebody who is experienced
in adoption matters and can help you with this. It is also important for you to
understand that, whilst the adoption agency must take into account your
wishes or feelings, the adoption agency and the adoptive parents cannot be
required to follow them.
Your name:
Tina Green
The name of your child:
Jane Green
What things would you like your child/children and the adopters to know
about your childhood and the way that it has influenced you? In time, it
will be very important for your child to have a better understanding of
your life, and why it has sometimes been difficult for you to manage.
This will be easier if he or she has a picture of both the good things and
the difficult experiences you may have had whilst growing up.
I am unable to compete this section because Tina has refused to comment
upon her own childhood.
From the department’s knowledge of Tina it would appear that she suffered
some adverse experiences in her family including sexual abuse. She
attended mainstream school but had a Statement of Special needs owing to
some learning difficulties.
It is clear from all the reports and assessments that have been carried out that
Tina has unrealistic expectations of her parenting ability and she fails to
accept or understand the reasons why she has not been able to provide a
safe and secure environment for any of her children.
Page 51
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Form CPR
Part F – Views of the birth mother on the Child’s Permanency
Report
Do you have any wishes or feelings about your child/children in relation
to the plan to place them for adoption?
Tina doesn’t want her child to be placed for adoption.
Do you have any wishes or feelings about your child/children in relation
to their future religious or cultural upbringing?
From my conversations with Tina she has not given any opinion about her
wishes for Jane’s future religious or cultural upbringing.
Are there any other comments you would like to make about the way
you would like your child/children to be brought up in their adoptive
family?
Unfortunately because Tina has not been able to come to terms with the fact
that Jane is being placed for adoption she has not been able to address this
section of the report.
Page 52
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Form CPR
Part F – Views of the birth mother on the Child’s Permanency
Report
Page 53
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reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written
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BAAF Form CPR
Part G
Note: wherever possible, and if the agency considers it appropriate, this record should
be completed by the birth father in his words. It may be used as an important source of
information for the agency in making its decisions and, when and where appropriate, for
the child and the adoptive parents in understanding the child’s background. It is
important that the birth father understands the importance of these questions and the
reasons that they are being asked. The form should be used wherever possible within
the context of a counselling interview(s) (required in Regulation 14, AA Regulations
2005).
If you do not understand the questions you are being asked or need help in answering
them, you should seek advice and support from somebody who is experienced in
adoption matters and can help you with this. It is also important for you to understand
that, whilst the adoption agency must take into account your wishes or feelings, the
adoption agency and the adoptive parents cannot be required to follow them.
Name of birth father
Simon Green
Name of child
Jane Green
What things would you like your child/children and the adopters to know about your
childhood and the way that has influenced you? In time, it will be very important for your
child to have a better understanding of your life and why it has sometimes been difficult
for you to manage. It will help if your child has a picture of both the good things and the
difficult experiences you may have had whilst growing up.
Simon has found the whole adoption process difficult to accept and he has not given
any information about himself, his childhood or his extended family.
From the reports and assessments completed it is clear that he has problems telling
fantasy from reality and he does have some degree of learning disability although he is
thought to have a higher IQ than his wife Tina.
Page 54
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the publishers. A
Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6-10 Kirby Street, London EC1N 8TS.

BAAF Form CPR
Part G
Do you have any wishes or feelings about your child/children in relation to the plan to
place them for adoption?
Simon has not been able to express any feelings about the plan for Jane to be placed
for adoption other than he wants to care for her himself.
Do you have any wishes or feelings about your child/children in relation to their future
religious or cultural upbringing?
Simon has made not comments upon this question.
Are there any other comments you would like to make about the way you would like
your child/children to be brought up in their adoptive family?
Once again Simon has in the main refused to engage with social workers and has
therefore not been able to make any views that he has known.
Page 55
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the publishers. A
Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6-10 Kirby Street, London EC1N 8TS.

BAAF Form CPR
Part G
Page 56
© BAAF 2006
All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the publishers. A
Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF.
Published by BAAF, Saffron House, 6-10 Kirby Street, London EC1N 8TS.