DCIQ: Cranstoun Incident Reporting Form

Cranstoun Incident Reporting Form

Incident Definition: An event, omission, or circumstance which could have or did result in unnecessary damage, loss, or harm to clients, staff, visitors, or members of the public.

Fields marked with a red asterisk * are mandatory

If you have any questions regarding incident reporting please speak to your line manager or email the Care, Quality and Governance Team at cqgteam@cranstoun.org.uk

1. Incident details
2. - Incident date (dd/mm/yyyy)
    You must enter a value in this field
  - Incident Affecting
    You must enter a value in this field
  - Category
    You must enter a value in this field
  - Sub category
    You must enter a value in this field
  - Who was the victim of the incident?
    You must enter a value in this field
  - Was the drug involved a controlled drug?
    You must enter a value in this field
  - What substances were involved or suspected to be involved?
    Select all that apply
    You must enter a value in this field
  - Other, please specify
    You must enter a value in this field
  - Description
    Do not list any identifiable information of any person. To record details of a person affected or involved, please select 'Yes' in the appropriate box under Additional Information below.
    You must enter a value in this field
  - Action taken
    Enter action taken at the time of the incident
    You must enter a value in this field
  - Were the police called?
    You must enter a value in this field
  - What time were the police called? (hh:mm)
    You must enter a value in this field
  - Did the police attend?
    You must enter a value in this field
  - Police attend time (hh:mm)
    You must enter a value in this field
  - Police actions
    You must enter a value in this field
  - Crime number
    You must enter a value in this field
1. Safeguarding
1. Services & Locations
  
  Type and select Cranstoun in the fields below for a full list of services and locations to appear. Alternatively start typing the service name or location and select from the options provided.
2. - Service
    Start typing the name of your service and select the most relevant.
    You must enter a value in this field
  - Location
    Start typing the location of the incident, e.g. Home working
    You must enter a value in this field
1. Incident Result and Severity
2. - Result
    You must enter a value in this field
  - Severity
    You must enter a value in this field
1. Additional Information
2. - Were any employees involved in the incident?
    You must enter a value in this field
  - Were there any witnesses present to the incident?
    You must enter a value in this field
  - Were there any other contacts involved in the incident?
    You must enter a value in this field
  - Are there any documents to be attached to this record?
    You must enter a value in this field
  - Has there been, or is there likely to be public interest relating to this incident?
    You must enter a value in this field
1. People Affected
1. Employees
1. Witnesses
1. Contacts
1. Documents
1. Details of person reporting the incident
1. Your manager
2. - Your Manager
    If you are a manager reporting this incident then please enter yourself in this field.
    You must enter a value in this field

Incidents

Cranstoun Incident Reporting Form