Mappa guidance 2012 4th edition part 2 – appendices and forms table of contents

səhifə	9/13
tarix	25.06.2016
ölçüsü	2.11 Mb.

1 ... 5 6 7 8 9 10 11 12 13

Part 1 identification To be completed at admission to hospital

1. CATEGORY OF OFFENDER
The patient must fall into one of the MAPPA Categories summarised below. Please tick one box below.
1. Registered sexual offender
2. Violent or other sexual offender who has been sentenced to 12 months or more custody for a Schedule 15 offence under the Criminal Justice Act 2003 and is transferred to hospital under s.47/49 MHA 1983, or is detained in hospital under s.37 with or without a restriction order under s.41
2. OFFENDER INFORMATION
Last name:
First name:
Date of birth:
Aliases:
Last known address before hospitalisation:
Gender:
Ethnicity:
3. DETAINED IN HOSPITAL
Name of responsible clinician:
Hospital:
Please indicate the relevant section of Mental Health Act

Part 2 Notification of Discharge Planning to be completed at stage at which the patient is assessed as ready to take unescorted leave.

4. Details of
Details of community leave arrangements (include dates and addresses)
Details of permanent release / discharge if known (include dates and addresses)
Date of next CPA if applicable:
Date of next tribunal if applicable:
5. CONVICTION / CAUTION INFORMATION
Index offence:
Date of conviction / caution:
Sentence:
6. VICTIM CONCERNS
Has the victim asked to be kept informed of relevant dates and decisions by the Hospital Managers?	YES / NO
If YES:
Please state what information has been provided
7. CONTACT DETAILS OF LEAD CLINICIAN

NOTIFICATION TO JOBCENTRE PLUS

MAPPA J

as soon as restrictions are known, and
when there is a change to the restrictions
when there is a change to the Offender Manager

1. THE JOBSEEKER
Last name:
First name:
Middle name:
Date of birth:
Aliases including nicknames:
Gender:
Current address:
Postcode:
Telephone number:	(h)		(m)
Disability / Diversity considerations:
2. NOTIFYING AGENCY
Notifying agency:	Probation / Police
Name:
Grade:
Office:
Telephone number(s):	(w)	(m)
Email address:
Date Jobseeker informed of Jobcentre Plus notification: (In exceptional circumstances where Jobseeker not informed, give date of discussion with Jobcentre Plus Designated Officer / SPOC)
Does the offender present a risk of serious harm to Jobcentre Plus staff or other employment and training providers?	YES / NO
If YES: Describe the nature of the risk of serious harm and contact the Jobcentre Plus Designated Officer / SPOC to discuss.
3. MAPPA POINT OF CONTACT
Name:
Grade:
Office:
Telephone number(s):	(w)	(m)
Email address:
4. INITIAL RESTRICTIONS / CHANGE OF RESTRICTIONS which will affect the employment / training of the Jobseeker
Initial Restrictions / Change of Restrictions [delete as appropriate]		Date restriction ends




Date notification emailed to JCP Designated Officer/SPOC:
Date by which JCP Designated Officer / SPOC should contact lead agency to discuss (within 5 working days, if notification restriction/change of restrictions):
5. NO RESTRICTIONS APPLY
complete only when there is serious concern regarding employment and the need to protect the public from serious harm
Date discussed with Jobcentre Plus Designated Officer / SPOC:
Information shared:

AUDIT OF LEVEL 2 AND LEVEL 3 MAPPA CASES

MAPPA K

Tick the box next to the statement that you most agree with. Only tick one box for each question.

At the end, add up the scores that have a tick next to them and insert the total score in the box provided.

1 ... 5 6 7 8 9 10 11 12 13