Section 42 Safeguarding Enquiry Form

Section 42 Safeguarding Enquiry Form
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:
Ellie’s manager Role of Person: Health care manager
Date of referral to Adult
Social Care:
Organisation:
Phone number: Type of service:
Details of incident/suspected/actual abuse or neglect
Date of alleged
incident:
Who reported the
alert/concern?
Community Psychiatric Nurse, Karl
Time of alleged
incident:
Date of report:
Where did the incident occur?
Details of the adult at risk
Name:
Mackenzie Jones
Date of Birth:
12/6/98
Telephone: Ethnicity:
Address: bed sit at 25A Coldham Street, Bexley
What is the adult’s primary reason for needing care and support? (please tick)
Physical support: Sensory support: Support with
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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:
Any other details about the
adult at risk:
Details of the alleged perpetrator (where relevant)
Name: Karen Brocklehurst, Relationship to victim: Girl friend
Date of birth: 28 years old 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.
Karen Brocklehurst, was also short of money and Mackenzie used to always help her with the same. He in fact provided her with
all his saving and loaned her £500 that his parents had given it to him to help furnish the bedsit. But whenever he used to ask for
his money back she used to deny giving it back. Once when we went to local pub with his friends, he was unable to pay for more
drinks and when her shared this incident with Ellie she shrugged it off saying ‘can’t he take a joke’. He also had a fight with his
neighbour as he though that he tried to stole it. Due to these incidents, he was feeling quite lonely he also thought that Keren
was taking advantage of him. This incident was creating trust issues within him as he started thinking that whether he can trust
anyone or not. He shared this incident with Karl and said that he wanted things to work out with Karen.
Type 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 ✓
If other, please specify:
Exploitation is another kind of abuse that was at risk because Karen asked for loan from him and did not return him any amout
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that she borrowed.
Is the victim at risk of further abuse/neglect? (please tick) Yes No Unknown
✓
(2) What has been done to ensure the immediate safety of the alleged victim(s) and others? Completing and submitting
this form does not constitute management of immediate risks.
In order to ensure immediate safety of victim health care manager of Ellie was contacted. All the details regarding current
condition of Mackenzie was shared with them about ways in which Keren used him for financial support and when he wanted his
money back she denied and did not return it back. He also shared an incident in which when he contacted Ellie and shared his
experience where all of his friends made fun of him, she simply shrugged it despite of knowing his medical history of paranoid
schizophrenia that was diagnosed 3 years ago. Contacting Ellie’s manager was one of the safest step as her manager can look
into this matter and take required and appropriate action against Ellie due to various reasons. First she was the one who
introduced Mackenzie to Karen, despite of being his support workers she did not support him or look into this matter where
Karen used to borrow money from him earlier and when he contacted her she did not take it seriously. It was her carelessness
due to which he was feeling depressed and lonely.
Were the Police called? Yes No ✓
Please provide the outcome of the Police action and Police log number (if available):
If the incident relates to domestic abuse/violence, has the
MARAC Checklist (CAADA-DASH) been completed?
Yes No
If yes, has a referral to MARAC been considered?
Please provide details, including discussions with your
agency’s Single Point of Contact (SPOC) for MARAC:
Yes No
Please provide details of other agencies involved that will be able to help with the safeguarding adults enquiry:
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