Title Page

  • Rent account reference

  • Audit Title

  • Name

  • Address

  • Date of review

  • Date of last review

  • Date for next review

  • Review completed by

  • Location

Support plan review

  • Check the areas below if there has been a change

  • Risk assessment

  • Health

  • Mobility

  • Sensory

  • Finance

  • Daily living skills

  • Medical/care

  • Personal details

Outcomes/Actions

  • Outcomes update

  • Actions and targets

  • Have you any comments, compliments or suggestions that would help improve our service?

  • Comments

Risk Assessment

  • Does the client present a known risk to her/himself or others?

  • Mental Health/Neglect (self and/or home)

  • Abuse (physical, mental, financial, substance)

  • Physical Safety or at risk from others

  • Suitability/location of furniture within the flat <br>(risk of client getting trapped/burnt)<br>

  • Cultural/Social Isolation (Encourage & support any interest in hobbies)

  • PEP completed (tenants signature)

  • Add assessment of risk?

  • Assessment of risk

  • Action required

  • Low Level Risk
    A low level risk would be one where no further action needs to be taken at the current time or an action needs to be noted for checking on the next visit. This would include incidents such as:
    Client describing loneliness and mild depression

    Medium Level Risk
    This is where an action or incident is noted and discussed with the client and an action needs to be taken within a month of the assessment. Scheme Support Officer will check up on the client in one month. This would be an incident such as:
    Client advises they have considered using drugs or alcohol to ease their depression.

    High Level Risk
    If a client is identified as high risk there will be an immediate and urgent action to take. This will need to be dealt with as a priority and may include liaising with other agencies to enable to risk to be reduced. For example: Scheme Support Officer discovers the client has tried to harm himself or herself or take their own life.

  • This assessment is to ensure that the safety of the Scheme Support Officer and Client is maintained whilst the support service is carried out.

  • Overall client risk rating

Health, safety and security risk assessment

  • Where is the support visit conducted?

  • Is a joint visit required?

  • Has tenancy audit been conducted?

Disclaimer

  • If any major changes a new Support Plan must be completed.

    My Support Plan has been reviewed by me and the Scheme Support Officer and I agree with its contents, which includes the individual risk assessment.

    In order to ensure needs and support planning are client focused, it is your choice whether your support plan is reviewed on a 6 monthly or annual basis.

  • Please indicate your review choice. (Please remember you can ask us to review your Support Plan at any time).

  • Client/Advocate signature

  • Interviewing officer's signature

  • Would the client like a copy of the support plan?

  • THIS IS A CONFIDENTIAL DOCUMENT COVERED BY THE SAME REGULATIONS AS YOUR ORIGINAL SUPPORT PLAN. IF YOU WOULD LIKE MORE INFORMATION ON THE DATA PROTECTION ACT AND FREEDOM OF INFORMATION ACT 2000 ACCESS TO INFORMATION PLEASE ASK YOUR SCHEME MANAGER

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.