ANNEX 9 MAPPING EXERCISE TEMPLATES
A. Excel Template
Name of Local Authority | |
Person Completing Form | |
Contact Details | |
| | Ser No 1 |
Name of Service | | |
Service Description | | |
Aim of Service | | |
Factors that intervention
aims to decrease or
bolster | | |
| | tick |
Service Type (tick one)- | Therapeutic | |
Preventative | |
Group Work | |
Individual Work | |
Other (Specify Service Type) | |
Format | Formal education classes & courses | |
Parent training and skills building | |
Advice and information interventions | |
Helplines & web based | |
Home visitation by Professionals | |
Befriending & Family Aides | |
Peer support | |
Therapy or counselling for families and individuals | |
Other (specify format type) | |
Target Group | Universal | |
Mothers or female main carer | |
Fathers or male main carer | |
Parent and Family | |
Couples | |
Ethnic/Cultural Minority | |
Low income parents/carers | |
Teenaged parents | |
Drug misusing parents | |
Domestic Abuse | |
Homelessness | |
SEN/Disability | |
Travellers | |
Other | |
Intensity of Service | Intensive (high ratio of staff 1:1, 1:2 | |
Group support (lower ratio of staff) | |
Resource (little or no interactive back-up | |
Further details of types
of support provided | Crisis support | |
Learning support to parent - parenting training | |
Learning Support - personal/social/development/assertiveness/life skills | |
Learning Support - vocational/ employment/ literacy | |
Learning Support for child - describe | |
Transport for clients to service - financial support | |
Transport for clients to service - actual transport | |
Other support | |
Referral Routes | Self referral | |
Agency referral voluntary | |
Agency referral mandatory | |
Date Set Up | Pre 01 | |
Apr 01/Mar 02 | |
Apr 02/Mar 03 | |
Apr 03/Mar 04 | |
Delivery | Funding Sector - Statutory | |
Funding Sector - Voluntary | |
Providing Agency - Health | |
Providing Agency - SW | |
Providing Agency - Education | |
Providing Agency - Youth or Criminal Justice | |
Providing Agency - Leisure Services | |
Providing Agency - Voluntary Organisations | |
Staffing - Professionals | |
Staffing - Volunteers | |
Staffing - Peers | |
Number of Places | Incl full time/part time | |
Integrated packages | |
Waiting List | No Waiting | |
Ave length of wait (days) | |
Evaluation of Service | Level 1 - association between prevention programme and an outcome measure at one point in time. | |
Level 2 - Includes pre and post intervention measures. (ie measures at 2 points in time) but no control group. | |
Level 3 - pre and post intervention measures, (ie measures at 2 points in time) and also treatment and control group. | |
Do not evaluate/no evaluation done. | |
B. Word Template
Name of Local Authority |
Name of person completing form |
Contact Details |
Briefly describe the service
1. Briefly describe the overall aims and objectives
2. What are the factors that the intervention aims to decrease or bolster
3. Service type (tick one main category)
| Therapeutic | | Preventative |
| Group work | | Individual work |
| Other (please specify) _________________________________ |
Any additional information you may wish to add?
4. Format (tick all that apply)
| Formal 'education' classes & courses | | Parent training and skills building |
| Advice and information 'interventions' | | Helplines & web-based |
| Home visitation by professionals | | Befriending and family aides |
| Peer support | | Therapy or counselling for families and individuals |
| Other (please specify) _________________________________ |
Any additional information you may wish to add?
5. Target Group (tick all that apply)
| Universal | | Parent and family |
| Mothers or female main carer | | Father or male main carer |
| Parent/main carer Couples | | Drug misusing parents |
| Ethnic/cultural minority | | Low income parents/carers |
| Teenage/young parents | | Homelessness |
| Domestic abuse | | Parents of children with SEN/Disabilities |
Other (please specify):
Any additional information you may wish to add?
6. Intensity of service (please tick)
| Intensive (high ratio of staff 1:1, 1:2) |
| Group Support (lower ratio of staff) |
| Resource (little or no interactive back-up) |
7. Further details of types of support provided (please tick all that apply)
| Crisis Support |
| Learning support to parent |
| Parenting training |
| Personal/social development/assertiveness/life skills |
| Vocational/employment/literacy |
| Learning to support child |
| Transport for clients to service |
| Financial support | | Yes | | No |
| Actual transport run by service e.g. minibus | | Yes | | No |
| Other informal/non-measurable support |
8. Referral Routes (please tick all that apply)
| Self Referral | | Agency referral voluntary |
| Agency referral mandatory (available but not yet used) |
9. Date set up (please tick)
| Pre 01 | | Apr 01/Mar 02 | | Apr 02/ Mar 03 | | Apr 03/ Mar 04 |
10. Delivery (please tick all that apply)
Funding Sector
Providing Agency
| Health | | Social Services | | Education |
| Youth or Criminal Justice | | Leisure Services | | Voluntary Org. |
Staffing
| Professionals | | Peers | | Volunteers |
11. Number of places (specify number)
| 01/02 | 02/03 | 03/04 |
Part time/full time | | | |
Integrated packages of support | | | |
12. Waiting list (specify number)
| Parent - number waiting |
| Parent - Average length of time to wait (days) |
13. Evaluation of Service (Please tick one main category)
| Level one - Association between a prevention programme and an outcome measure at one point in time (could be questionnaire at end of session) |
| Level two - Includes pre- and post-intervention measures ( i.e. measures at two points in time), but with no control group |
| Level three - Includes pre- and post-intervention measures ( i.e. measures at two points in time) and also treatment and control group |
| Do not evaluate/No evaluation done |