Multi agency safeguarding adults forms

To Raise a Safeguarding Concern

To raise a safeguarding concern you need to telephone Adult Social Care:

Contact centre: Tel: 0113 222 4401

In an emergency, out of hours: Tel: 07712 106378

The relevant social work team, will consider how best to respond to the concern raised and will ask you to send them the SA1 Form below.

Complete the Body Map form, only if it is helpful to illustrate any injuries.

 

 

Body MapBody MapWORD 145KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/body_map_may_2015.docxword equal-item
Supporting InformationSupporting InformationWORD 333KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA1 Supporting Information.docword equal-item

Forms for safeguarding practitioners​

​Initial enquiry

The purpose of an initial enquiry is to explore the best way of responding to the safeguardings concerns. These optional forms can be used to help record the adult's desired outcomes, actions taken and decisions made. (Multi-agency procedures Section 10).


 

 

Initial Enquiry RecordInitial Enquiry RecordWORD 90KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/Initial Enquiry (optional) September 2015.docword equal-item
Desired Outcomes StatementDesired Outcomes StatementWORD 59KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/leeds_safeguarding_adults_desired_outcomes_statement_final_180215.docxword equal-item

Risk Management Response

When a Formal Enquiry is not needed, but there are actions to needed to safeguard the adult or others, a Risk Management Response should be considered. This optional form can be used to record the actions taken. (Multi-agency procedures Section 11) 


 

 

Risk Management ResponseRisk Management ResponseWORD 90KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/Risk Management Response (optional) September 2015.docword equal-item

Strategy meetings

Strategy meetings or discussions are used to plan a Formal Enquiry. (Multi-agency procedures Section 12)


 

 

Attendance Record & Confidentiality AgreementAttendance Record & Confidentiality AgreementWORD 264KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/safeguarding_meeting_attendence_record.docword equal-item
Request For An Outcomes MeetingRequest For An Outcomes MeetingWORD 107KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2f Request for an Outcomes Meeting form.docword equal-item
Note of Strategy DiscussionNote of Strategy DiscussionWORD 121KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2A_note_of_strategy_discussion_may_2015.docword equal-item
Strategy Meeting AgendaStrategy Meeting AgendaWORD 83KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2B_strategy_meeting_agenda_may_2015.docword equal-item
Strategy Meeting MinutesStrategy Meeting MinutesWORD 168KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2C_strategy_meeting_minutes_may_2015.docword equal-item
Strategy Review Meeting AgendaStrategy Review Meeting AgendaWORD 82KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2D_strategy_review_meeting_agenda_may_2015.docword equal-item
Strategy Review Meeting MinutesStrategy Review Meeting MinutesWORD 162KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2e_strategy_review_minutes_may_2015.docword equal-item

Formal Enquiry

The purpose of a Formal Enquiry is to understand what has happened and the safeguarding needs of the adult or others.​(Multi-agency procedures Section 13)


 

 

Formal Enquiry ReportFormal Enquiry ReportWORD 181KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/Formal Enquiry Report.docword equal-item

Outcome Meetings

The purpose of an Outcome Meeting is to consider the findings of the Formal Enquiry and the person’s desired outcomes and with this knowledge, then decide how best to manage any risks to the person or others. Where a meeting is not required, this may be held as an Outcome Discussion, led by the Safeguarding Coordinator.

Arrangements/requests for an Outcome Meeting are now managed internally within Leeds City Council: Adults & Health.



 

 

Outcomes Meeting AgendaOutcomes Meeting AgendaWORD 265KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/Outcomes Meeting Agenda (16 10 17).docxword equal-item
Outcomes Meeting MinutesOutcomes Meeting MinutesWORD 364KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/Outcomes Meeting Minutes (16 10 17).docword equal-item

Review

The purpose of a review meeting to check whether the safeguarding plan is working effectively and achieving the desired outcomes of the adult at risk.   (Multi-agency procedures Section 15)


 

 

Review AgendaReview AgendaWORD 261KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA5a_safeguarding_review_agenda_may_2015.docword equal-item
Review Meeting MinutesReview Meeting MinutesWORD 395KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA5b Safeguarding Review Meeting Minutes (July 2016).docword equal-item