Forms

Multi Agency Safeguarding Adults Referral Form – To be used by ALL multi-agency practitioners where there is an adult safeguarding concern. This is any worry about an adult who has or appears to have care and support needs that they may be subject to, or may be at risk of, abuse and neglect and may be unable to protect themselves against this.

Safeguarding Adults Enquiry Form – This form is used to gather information under Section 42 Enquiries and summarises the conversations had with the person about the safeguarding concern received. It aims to consider their understanding of the situation, whilst balancing any current or future risks against the criteria of a Section 42 enquiry under the Care Act 2014.

Tyne and Wear Fire and Rescue Service: Safe and Well Visit – Partner agencies and members of the public can can use this form to request a safe and well visit from the Fire and Rescue Service to identify any fire and lifestyle associated hazards in the home.

Northumbria Police Partnership Intelligence Form– For use by ALL multi-agency practitioners to share intelligence with Northumbria Police that will help in the prevention and detection of crime and positively acts to safeguard the vulnerable from abuse and neglect.

Herbert Protocol Form – In the event the person goes missing – the form will be used by the police, care workers and partner agencies to understand the person’s routines, interests and information as fast as possible. It is used by families and carers to record important information about the person being cared for.

MARAC Referral Form – Referrals can be made (and are encouraged) by any agency who identifies a victim of domestic abuse as being high risk.

Record of Actions taken to make a Best Interests Decision (MCA 2)

Safeguarding Adult Review (SAR) Referral Form – For use by ALL multi-agency practitioners to submit a referral to South Tyneside Safeguarding Adults Board for consideration of a Safeguarding Adult Review (this is where an adult has died or suffered significant harm as a result of abuse and neglect AND there is reason to believe that partners could have worked more effectively together to prevent this).

Complex Adult Risk Management (CARM)

What to expect – A Guide to Complex Adult Risk Management (CARM) Meeting (opens in Word)

CARM Referral and Risk Assessment Form (opens in Word)

Referral Notification Form (opens in Word)

Report Templates for Complex Adult Risk Management (CARM) Meeting (opens in Word)

CARM Meeting Agenda (opens in Word)

Safeguarding Leaflets

Financial Abuse Support Leaflet (Elder Abuse Organisation)

Free Guides for Later Life (Independent Age)

Lets Talk about Adult Social Care (South Tyneside)

Safeguarding: Keeping you Safe from Abuse and Neglect (Easy Read – South Tyneside)

Stop and Watch (North Cumbria Health and Care System)

Information and Support Guide for Survivors of Sexual Violence (Northumbria Police)

Safeguarding Posters

Do you Know the Signs of Abuse and Neglect?

Safeguarding is Everyone’s Responsibility – ‘Ryan says his carer hits him when he’s being difficult.’

Safeguarding is Everyone’s Responsibility – ‘Mary gave her neighbour her trust. They just took advantage.’

Safeguarding is Everyone’s Responsibility – ‘Michael’s son takes his money. He tells Michael he needs it. Michael is afraid and doesn’t know what to do.’

Safeguarding is Everyone’s Responsibility – ‘Dawn has been hiding the bruises for years. It’s never too late. Abuse ignores age.’

Safeguarding is Everyone’s Responsibility – ‘Peter’s health needs are being neglected by those who should care.’

Safeguarding is Everyone’s Responsibility – ‘Before John’s wife died, he looked a lot happier.’

Safeguarding adults at risk in South Tyneside – blue version

Safeguarding adults at risk in South Tyneside – orange version

World Elder Abuse Awareness Day 2 (South Tyneside)

Stop and Watch (North Cumbria Health and Care System)

Mental Capacity Leaflets

Caring for people who can’t make decisions for themselves: A brief guide to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (information for the public – South Tyneside Council)

Caring for people who can’t make decisions for themselves: A brief guide to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards for social and health care staff (South Tyneside Council)

Deprivation of Liberty Safeguards and You: Easy Read (Department of Health and Social Care)

Mental Capacity Act: Easy Read Summary (Department of Health and Social Care)

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