Multi agency safeguarding adults forms

Tell us your concern

You can tell us your concerns by either:

  • Telephone: Adult Social Care Contact Centre on 0113 222 4401 
  • Where urgent and outside of these hours ring the Emergency Duty Team on 07712 106378

Or, Organisations may complete the form below and send via secure email to: Leedsadults@leeds.gov.uk

Only complete the Body Map form where it is helpful to illustrate any injuries.

 

 

Body mapBody mapWORD 145KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/body_map_may_2015.docx153541docxword equal-item
SA1) Tell us your concern formSA1) Tell us your concern formWORD 145KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA1) LSAB Tell Us Your Concern Form (April 2019).doc340992docword equal-item

Forms for safeguarding practitioners​

​Information gathering

Information gathering is a process of finding out more information to decide whether further actions are needed within these multi-agency policy and procedures. The completion of a form may not always be needed but can support the safeguarding coordinator to make a decision based on further information, such as the person's wishes, desired outcomes and the actions already taken to support the person at risk.

Leeds City Council users: if you have difficulties downloading a Word Document, please visit our guidance page for help.​​​

 

 

Information Gathering FormInformation Gathering FormWORD 100KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/LSAB Information Gathering Form (April 2019).doc102400docword equal-item

Planning meetings

All safeguarding responses need to be planned by the Safeguarding Coordinator. A meeting may not always be required but will sometimes be helpful in the circumstances. The person's wishes, desired outcomes and the nature of the risks will be key to planning responses. Where a meeting is not required, this may be held as a Planning Discussion led by the Safeguarding Coordinator.

 

 

Safeguarding Meeting Attendance recordSafeguarding Meeting Attendance recordWORD 264KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/safeguarding_meeting_attendence_record.doc276480docword equal-item
SA2b) Planning Meeting MinutesSA2b) Planning Meeting MinutesWORD 333KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2b) LSAB Planning Meeting Minutes (April 2019).doc149504docword equal-item
SA2a) Planning Meeting AgendaSA2a) Planning Meeting AgendaWORD 108KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA2a) LSAB Planning Meeting Agenda (April 2019).doc111104docword equal-item

Safeguarding response

Safeguardings responses can take a range of forms according to the person's wishes, desired outcomes and the nature of the risk and concerns. These templates can be used to support the undertaking and recording of safeguarding responses as advised by the Safeguarding Coordinator.

Record of Safeguarding Response is a generic form that can be used where it is helpful, to record a variety of risk management actions and interventions 

Formal Report is intended to be used where a more formal fact finding and analysis of concerns is needed, as may well be the case where their are concerns about organisations or the actions of employees/volunteers.

Leeds City Council users: if you have difficulties downloading a Word Document, please visit our guidance page for help.​​​

 

 

SA3a) Record of Safeguarding ResponseSA3a) Record of Safeguarding ResponseWORD 123KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA3a) LSAB Record of Safeguarding Response (April 2019).doc125952docword equal-item
SA3b) Formal ReportSA3b) Formal ReportWORD 149KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA3b) LSAB Formal Report (April 2019).doc154112docword equal-item


Outcome Meetings

The purpose of an Outcome Meeting is to consider the findings of the safeguarding response, the person’s desired outcomes and with this knowledge, 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.

Leeds City Council users: if you have difficulties downloading a Word Document, please visit our guidance page for help.​​​



 

 

SA4b) Outcome Meeting MinutesSA4b) Outcome Meeting MinutesWORD 181KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA4b) LSAB Outcome Meeting Minutes (April 2019).doc158208docword equal-item
SA4a) Outcome Meeting AgendaSA4a) Outcome Meeting AgendaWORD 111KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA4a) LSAB Outcome Meeting Agenda (April 2019).doc116736docword equal-item

Outcome review

The purpose of an Outcome Review meeting to check whether the safeguarding plan is working effectively and achieving the desired outcomes of the adult at risk. A Outcome Review meeting may often not be required but should be considered where it is necessary to achieve positive outcomes for a person or people at risk.

Leeds City Council users: if you have difficulties downloading a Word Document, please visit our guidance page for help.​​​

 

 

SA5a) Review AgendaSA5a) Review AgendaWORD 113KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA5a) Review Agenda (April 2019).doc116224docword equal-item
SA5b) Review MinutesSA5b) Review MinutesWORD 155KBhttps://leedssafeguardingadults.org.uk/Documents/Safeguarding/SA5b) LSAB Review Minutes (April 2019).doc159232docword equal-item