Safeguarding Adults Initial Enquiry Form and Mental Capacity Assessment

Section 42 form for academic year 22_23
The section 42 form and answers to the tasks should be submitted as one complete document on Turnitin.
Task 1: Safeguarding Adults Initial Enquiry Form
This form is to be used to notify Adult Social Care of suspected or actual instances of abuse or neglect and is the
start of a Safeguarding Adults (Section 42) Enquiry under the Care Act.
This form should be completed as fully as possible in order that robust decisions can be made about the progression,
or otherwise, of the Safeguarding Adults Enquiry.
Person completing the
form:
This form is
completed by
the Social care
worker.
Role of Person: The social care worker has to
discover the person who is in need of
support.The social care worker gives
practical and emotional support to
broad range of peoples. These worker
frequently work promote and protects
the individuals well-being.
Date of referral to Adult
Social Care:
08 October
2022
Organisation: Social care worker organisation
Phone number: xxxxxxxxxxx Type of service: Social services
Details of incident/suspected/actual abuse or neglect
Date of alleged 06 October 2022 Who reported the alert/concern? Paramedics

incident:
Time of alleged
incident:
10:30 AM Date of report: 08 October 22
Where did the incident occur? The incident has occurred in the Sarah Howes house as she fell down from
the stairs.
Details of the adult at risk
Name: Sarah Howes Date of Birth: 12/10/63
Telephone: xxxxxxxxxx Ethnicity:
Address: 87B Coldhabour Lane, Croydon
What is the adult’s primary reason for needing care and support? (please tick)
Physical support: Sensory support: Support with memory and
cognition:

Learning disability
support:
Asperger’s syndrome
support:
Autism support:
Mental health support: Social support (includes
support for carers/substance
misusers):
No support reason:
Other health condition: Please
specify:
Sarah Howes is diagnosed with the Huntington’s Disease recently and losing her
weight constantly. Her speech has become slurred and it is difficult to be get
understand.
Any other details about the
adult at risk:
Sarah Howes has a personal nature of being possessiveness, jealousy and aggression. She has Erratic
behaviour and high temper. She lives in unhygienic and messy lifestyles which is responsible for her fall
and will worsen her health condition in the future.
Details of the alleged person or service which is the cause of the risk (where relevant)
Name: Sarah Howes Relationship to victim: self
Date of birth: 12/10/63 Ethnicity:
(1) Please give a detailed description of the incident (including times), all people involved, witnesses and any other
comments you feel are relevant. If the concern relates to physical abuse please provide a body map.
(Maximum 200 words)

Sarah Howes lives on first floor private rented one bedroom flat. She is recently diagoned with the Hungiston’s diseases, she is
losing her weight fastly and have slurred speech which is difficult to get understand. Few days ago she fell down from the stairs
in her own home and hurt her right wrist. The paramedic team arrives and decided that her wrist was bruished. The paramedic
team is also concerned with the untidiness in her home. There are high level of, mess on the floor which may be the reason of
her falling from the stairs. There are also dirty food containers in the home lying which may lead to the vermin. The para medic
was concerned and asked Ms Howes that she will like to consult a social care worker and also get help in the shopping which is
the only concern of the Ms Howes. At first she agitated but soon after she agreed. When the social care arrives she take some
time to persuade her to let the social worker get in. The social care also notices that the flat smells and the paper and the empty
food wrappers are piled all over the house. As per the social worker, Ms Howes looks quite agitated and paces all around
unsteadily. She seems vert wary about the social workers. When the social worker asked her she says she is okay in managing
but her only worry is she can not carry the shopping with the sore wrist. When social worker asked her more she said she is sad,
lonely and also isolated. She misses her husband and both the daughters. She is worried about the future with the daughters.
Types of abuse (tick all that apply):
Physical Sexual Psychological/emotional
Financial/material Neglect/omission Discriminatory
Organisational/
institutional
Self-neglect Domestic abuse/violence
Modern slavery Radicalisation/extremism Other
Specify evidence for the type(s) of abuse ticked:
Sarah howes is emotionally abused as her husband get separated without her will which hurts her very much. She misses are