Michelle Frayne

In progress

Referred 8 days ago · St Basils · Owner Chloe Bennett · 24 Barrows Road (Dawson's)

Referral

Referral source

St Basils

Referrer

Callum Beattie · referrals@stbasils.example.org

Placing authority

Birmingham City Council

Current situation

Family breakdown

Local connection

Yes

Reason for the referral

Asked to leave the family home in Kingstanding after a long breakdown with her mother. Three weeks in the St Basils hub.

Case note

Started the form at the St Basils hub. Got her identity and contact details down before she had to leave; parked until Thursday.

Tenant — identity

7 of 7

Full name

Date of birth

NI number

Gender

Ethnicity

Contact number

Tenant — physical descriptors (SD3)

0 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 6 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
14 Sep 2026
St Basils · family breakdown
Callum Beattie