Adult support and protection: learning review guidance

Annex 3

Request for Information to Allow Consideration to be Given to the need for an Adult Protection Learning Review

This request for information follows a referral for consideration to be given to the need for a Learning Review in relation to the adult named below.

• Please respond within 2 weeks, returning the completed form to xxxx
• Please provide a brief account of your agency's contact with the adult named below, and provide your reflections on the key practice issues listed.

Enter name & return address of person initiating the request for information Enter date of request

Name of adult

Date of birth

Date of death (if applicable)

Adult's address

Brief details of the immediate precipitating factors leading to the referral for consideration of a Learning Review

…to be completed by the person initiating this request for information…

Summary of involvement with the adult:

Background history:

Key practice issues:

Please provide information on:

• Recognition and assessment of Risk and need in relation to the adult
• Information sharing in this case
• Strategies and actions to minimise harm
• Timely and effective action taken
• Multi-agency responses
• Evidence of planning and reviewing
• Quality of record keeping
• Appropriate use of legal measures
• Any good practice identified
• Any areas identified for practice improvement

Parallel processes

Are you aware of any current or planned reviews being undertaken for this case? If yes, please give details.

Are you aware of any criminal proceedings associated with this case? If yes, please give details.

Report completed by:

Name:

Title:

Agency:

Email address:

Date: