Significant past history Please arrange to fax medical summary, current medication, recent clinic reports and discharge letters. If AIHVS or ambulance please fax consultation or leave summary in house. Has client consented to Home First YES NO - Please seek informed consent involvement? Is client confused? YES NO If YES - Is this normal? For how long? Next of Kin & Contact no. Does client live alone? YES NO If NO - Who else in home? Are they main carer for someone else? Is client mobile and able to open YES NO front door? If NO, how is access gained? Keysafe number? Does client have current input from: ICT (DN, Therapy) HCS (SW) HPFT (CPN, EMDASS) Care package Details of any pets in the house. Details of any safeguarding issues. Details of known risks to staff. Most appropriate discipline to lead Nursing Therapy on this referral? Social Care Mental Health Telephone details taken by…………………………….
Significant past history Please arrange to fax medical summary, current medication, recent clinic reports and discharge letters. If AIHVS or ambulance please fax consultation or leave summary in house. Has client consented to Home First involvement? YES NO - Please seek informed consent Is client confused? If YES - Is this normal? For how long? YES NO Next of Kin & Contact no. Does client live alone? If NO - Who else in home? Are they main carer for someone else? YES NO Is client mobile and able to open front door? If NO, how is access gained? Keysafe number? YES NO Does client have current input from: ICT (DN, Therapy) HCS (SW) HPFT (CPN, EMDASS) Care package Details of any pets in the house. Details of any safeguarding issues. Details of known risks to staff. Most appropriate discipline to lead on this referral? Nursing Therapy Social Care Mental Health Telephone details taken by…………………………….
HomeFirst%20Rapid%20Response%20.docx