Safeguarding Summary Form

Safeguarding Summary
Initial Information
Name of Service User*

First NameLast Name
Postcode*
Date of Incident*

DayMonthYear
Date
Summary of Safeguarding*
Carer(s) Involved*

Actions Required
Carer Actions*

Provide Additional TrainingConduct SupervisionConduct SpotcheckConduct Carer Performance ReviewDisciplinary procedureNoneOther
Client Actions*

Review Care PlanConduct SupervisionConduct QAConsult with FamilyReview MAR/Comm SheetsNoneOther
Additional Information*
Has a safeguarding meeting taken place? What careplan information was updated? Have family been involved? How long will you be reviewing carer performance?
Should be Empty: