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Roxanna Sipes
DOX1169 OPAS 1848 PWD

73 yrs (2/3/1952)

060873835082 / 06768 419725

roxanna_sipes@example.com

NHS Number: 0647297450

Lives alone

Demographics missing

Progressive Supranuclear Palsy (PSP), diagnosed Oct 2024

AA: Alternative in place

Council tax: Applied/applying

Driving: Not driving

Blue badge: Does not currently meet threshold

Health & wellbeing LPA: Declined to apply

Property & finance LPA: Advice given

edit

Number	Completed at
5	3rd Jan	edit
4	23rd Jun 2024	edit
3	11th Dec 2023	edit
2	9th Jun 2023	edit
1	8th Dec 2022	edit

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Roxanna Sipes (the "Subject")

Summary of concern

Factual account of what was said or observed. Include dates, times and locations, the person's own words, descriptions of signs/symptoms etc. Refer to Policy for full guidance on recording.

Summary of any immediate actions taken

Eg. Were emergency services called? Any practical support offered etc.

Does the subject have care and support needs?

Eg. Physical or mental health condition

Notes about care and support needs

Do you feel the subject is able to make their own decisions about what happens next?

Notes about decision capabilities

What support / outcome does the subject want?

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Roxanna Sipes DOX1169 OPAS 1848 PWD

Safeguarding Concern Form About the concern

Roxanna Sipes
DOX1169 OPAS 1848 PWD

Safeguarding Concern Form

About the concern