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Frank Kovacek
DOX1395 OPAS 2074 PWD

89 yrs (1/11/1935)

090844274212 / 0217003936

frank_kovacek@example.com

NHS Number: 3555031325

Demographics missing

Wernicke-Koraskoff syndrome (WKS) or other alcohol related dementia, diagnosed Aug 2024

AA: Not discussed

Council tax: Declined - No discount

Driving: Not driving

Blue badge: Advised to apply

Health & wellbeing LPA: Not got capacity

Property & finance LPA: Declined to apply

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Activity
DA Case #DC430 Green Manage
Referred to Age UK Factsheet 38: Property and paying for permanent residential care Acknowledged Reference number: nam Manage

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Frank Kovacek (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?

Demo: This is a demo site. Please only enter fake data into this site. Data may be reset at any point.

Frank Kovacek DOX1395 OPAS 2074 PWD

DA Case #DC430 Green

Referred to Age UK Factsheet 38: Property and paying for permanent residential care Acknowledged

Safeguarding Concern Form About the concern

Frank Kovacek
DOX1395 OPAS 2074 PWD

DA Case #DC430
Green

Referred to Age UK Factsheet 38: Property and paying for permanent residential care
Acknowledged

Safeguarding Concern Form

About the concern