Layla Hussein

In progress

Referred 7 days ago · BCC Adult Social Care · Owner Nadia Karim · 52 Anderton Road (Reliance)

Referral

Referral source

BCC Adult Social Care

Referrer

Ian Featherstone · adultsocialcare@birmingham.example.gov.uk

Placing authority

Birmingham City Council

Current situation

Other supported housing

Local connection

Yes

Reason for the referral

Moving on from a registered setting in Sparkhill with a social worker in place. Adult Social Care hold her risk history.

Case note

Half the form filled in with her social worker on the phone. Adult Social Care still to send the risk history.

Tenant — identity

7 of 7

Full name

Date of birth

NI number

Gender

Ethnicity

Contact number

Tenant — physical descriptors (SD3)

4 of 5

Skin tone

Hair colour

Eye colour

Height (cm)

Build

Referral (SD2)

4 of 4

Referral agency

Referrer name

Reason for referral

Referral date

Property

1 of 4

Room address

Building address

Fire assembly point

Fire exit locations

Charges (weekly)

0 of 6

Basic rent

Eligible service charge

Ineligible service charge (total)

Ineligible — utilities

Ineligible — support

Total weekly charge

Max arrears (= 2 × ineligible total)

Staff / provider

2 of 2

Support worker name

Support provider

Dates

1 of 1

Agreement date

Pack

10 sheets

Standard pack · SD1–SD10

SD1 Licence agreementNeeds 5 details
SD2 Referral, risk & GDPR consentNeeds 1 detail
SD3 Missing person profileNeeds 2 details
SD4 Confidentiality agreementReady
SD5 Authorisation to actNeeds 1 detail
SD6 Fire evacuation planNeeds 2 details
SD7 Fire safety inductionNeeds 1 detail
SD8 Service charge scheduleNeeds 3 details
SD9 Resident rights & responsibilitiesNeeds 1 detail
SD10 Photo ID consentNeeds 1 detail

Activity

Referral received
15 Sep 2026
BCC Adult Social Care · other supported housing
Ian Featherstone