Emergency Sheet ‘GRAB SHEET’ I have a learning disability Further details can be found in the ‘About me - health overview’ section Name .................................... Known as .......................... Date of Birth .......................... Address ............................ ............................................ Post code .......................... NHS Number ........................ N.I. Number........................... GP name and address .......................................................... ................................................................................... Ethnicity ............................. Religion ................................ Spiritual/Cultural needs ....................................................... ................................................................................... I receive benefits o YES o NO Details .......................................................................... For more information contact: Name ....................................... Who is? ............................Tel No ................................... Or Name .................................... Who is? ............................ Tel No .......................................................................... I need reasonable adjustments with Details on Health Overview page Helping me to understand you o Helping you to understand and communicate with me o Eating/Drinking o Taking medication o Toileting o Other supported needs o Tetanus injection dates:....................................................... I believe I am allergic to these drugs: ...................................... .................................................................................. I believe I am allergic to these foods: ..................................... .................................................................................. Continued Overleaf
Transcript
Emergency Sheet ‘GRAB SHEET’I have a learning disabilityFurther details can be found in the ‘About me - health overview’ sectionName .................................... Known as ..........................Date of Birth .......................... Address ........................................................................ Post code ..........................NHS Number ........................ N.I. Number...........................GP name and address .............................................................................................................................................Ethnicity ............................. Religion ................................Spiritual/Cultural needs ..........................................................................................................................................
I receive benefits o YES o NODetails ..........................................................................
For more information contact: Name .......................................Who is? ............................Tel No ...................................OrName .................................... Who is? ............................Tel No ..........................................................................
I need reasonable adjustments with Details on Health Overview page
Helping me to understand you oHelping you to understand and communicate with me oEating/Drinking oTaking medication oToileting oOther supported needs oTetanus injection dates:.......................................................I believe I am allergic to these drugs: ........................................................................................................................I believe I am allergic to these foods: .......................................................................................................................
Continued Overleaf
My first language is ..........................................................
I need an interpreter/carer to help communicate o YES o NO (tick as appropriate)
I am Left Handed o I am Right Handed o(tick as appropriate)
There are previous or current risk in any of the following areas? (tick all boxes as appropriate)
Self harm / self injury? o YES o NO
See Health Overview page ....................................................(Detail which page)
Aggression towards others? o YES o NO
See Health Overview page ....................................................
Swallowing difficulties? o YES o NO
See Health Overview page ....................................................
Epilepsy? o YES o NO
See Health Overview page ....................................................
Mental health? o YES o NO
See Health Overview page ....................................................
Any other relevant issue? o YES o NO
See Health Overview page ....................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
My signs of being unwell or in painIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
What I am like when I am well (this is how I behave,communicate,move):
...................................................................................To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
(please detail a quick overview and record which health overview pages have been completed with additional details)
This is a guide only please ask to see my current medication record
Key ProfessionalsIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
GP ...............................................................................
Social Worker ..............................................................Address: ........................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Information for people with learning disabilities and their carers
People with learning disabilities do not always receive good health services.
The Purple Folder will help people with learning disabilities get good health care.
People choose to have a Purple Folder. If people are unable to make a decision about having a Purple Folder, it should be completed in the person’s best interest.
The Purple Folder may need to be completed with the help of a carer or trusted friend.
The Purple Folder should be taken to all health care appointments. Ask for your Health Appointment Record in the Purple Folder to be completed every time you meet with a health professional.
If you need to change any of the pages in your Purple Folder the telephone number is on the back cover of this folder. New pages will be sent out.
Keep a note of this number
01438 845372. Telephone it if you lose the Purple Folder and you will be sent a new one. Please be aware that they are expensive to produce and we all have a responsibility to ensure public money is used wisely. Bearing this in mind, please look after this folder to ensure you do not need another folder in the future.
The information in the Purple Folder has to be correct. It needs to be checked at least every year.
Always remember to bring the Purple Folder home from your health appointments. Keep the Purple Folder safe.
This folder contains important information that supports effective health care for people with learning disabilities.
This folder MAY be completed by people without healthcare training and MUST be supported by other health records
CONFIDENTIAL
My Purple Folder
(and my Health Action Plan ‘HAP’)
Health Liaison TeamThe learning disability nurses within the health liaison team
can be contacted by telephone on
01438 845372Monday to Friday 09.00 to 17.00
or by email
[email protected] reorder new sheets or a new purple folder please telephone 01438 843848
Paid carersIt is part of your responsibility to advocate for the person you are supporting and as such you will need to encourage reference to the Purple Folder and completion by health professionals.
A separate record of any health consultation needs to be kept in accordance with your employer’s recording policies. Records should make reference to completion of the Purple Folder.
StorageIn Adult Care Services or commissioned supported living services, the Purple Folder needs to be securely stored. If the Purple Folder is lost, then staff MUST treat this as a breach of data protection and activate the appropriate procedure relating to mislaid documents. The local Adult Disability Teams must also be informed of any loss (see contact details at the end of this folder).
Review of Purple Folder Information in the Purple Folder will change. It is crucial that the Purple Folder is kept up to date and regularly reviewed.
The person supporting completion of the Purple Folder must complete the bottom sections of all health information pages. These pages must be reviewed at least annually. The review of each page will include:
• All information sections fully completed• All writing legible• Completion in ink• Health information correct• No crossings out• No erasing
Any amendments or corrections should be completed on a new sheet available through contacting the Health Liaison Team (details on the back cover of this Purple Folder ). Place old pages in your filing system. After the third review the page needs to be filed and a new page requested from the Health Liaison Team (see back cover of this Folder).
This Purple Folder is not to be used to file old health information or appointment letters!
Information for Health ProfessionalsThe information within the Purple Folder is designed to help you to deliver person centred care. It contains information that will be needed for treatment/care plans and for risk assessments.
The Purple Folder may not have been completed by a health trained professional. Care should be taken to identify who has helped the person with learning disabilities (the patient) to complete each of the sections and to make sure the information contained is cross referenced with the patient’s current medical records.
lPeople with a learning disability will have difficulty in understanding complex information and may have difficulty with recall.
lYou should always verify relevant information with the person with learning disability and any accompanying carer.
lShould in-patient care be required, it is important that the Purple Folder is used with the patient and carer and its content used to inform care plans and risk assessments.
The content and utilisation of the Purple Folder should be highlighted to all professionals involved in providing hospital care.
Information for Health Professionals
Mental CapacityYour delivery of care MUST follow the principles of the Mental Capacity Act (2005):
• Every adult MUST be presumed to have capacity to make their own decisions unless proved otherwise
• You MUST encourage and support people to make their own decisions
• People have the right to make unwise decisions
When someone is assessed as lacking capacity• Decisions/actions on their behalf MUST be done in their
‘best interests’
• Decisions/actions MUST be carried out in the least restrictive manner
Assessing capacityCan the patient:
• Understand the information given to them?
• Retain the information given to them?
• Weigh up/balance the information to make a decision?
• Communicate their decision?
Record your actions relating to the above in clinical notes.
Information for Health Professionals
The Health Appointment Record (HAR)The health professional has the responsibility of explaining any treatment/care plans and outcomes to individuals/ carers. The Health Appointment Record (HAR) is used to provide an overview of the current treatment and proposed follow-up care.
l Health professionals (primary, secondary and tertiary) have responsibility for completion of the HAR at each consultation.
l At the time of discharge from in-patient care, the hospital staff will have the responsibility of ensuring that the HAR has been discussed with the patient/carer and legibly completed. A discharge summary needs to be provided, discussed and stored within the ‘Discharge Summary’ section of the Purple Folder. NHS care notes need to reflect these actions.
The Purple Folder belongs to the person with a learning disability/carer.
It contains important personal information. It is the responsibility of the NHS provider to ensure the Purple Folder is used, safely stored in accordance with hospital policy and appropriately completed with a record contained with the NHS patient notes.
In the event of the Purple Folder becoming mislaid within an NHS setting, staff MUST treat this as a breach of data protection and activation of the relevant ‘mislaid document policy’ needs to occur, with a record kept in the patient’s NHS notes. The local Adult Disability Team should be notified (see contact details at the end of the folder).
Information for health care staffBy law - (Equality Act, 2010) all staff have to consider how their care and support are delivered and adjusted to ensure fair, equitable healthcare.
CONSIDER THE REASONABLE CHANGES YOU CAN MAKE:
T – time: For instance providing a longer appointment time or having a first or last slot consultation.
E – environment: Think about the effects of where and how you are delivering your care and support. For instance is there an alternative to waiting in a busy, noisy waiting area?
A – attitude: Reflect positive attitudes! Think about what the health outcomes would be if the person didn’t have a learning disability and ensure you take every step to achieve this same outcome.
C – communication: Remember that you have a responsibility under the Accessible Information Standard (2016) to ASK, RECORD, FLAG, USE and SHARE a persons preferred method of communication. It may be easy read, simple language, pictures, signs or symbols. Have you checked their Summary Care Record to see if they have an Additional Information page?
H – help: Remember to contact The Community Learning Disability Nurses in the Adult Disability Teams – for help with meeting primary healthcare needs.
OR
The Health Liaison Team - for help with meeting secondary healthcare needs.
Contact numbers at the back of the Purple Folder.
Health Appointment RecordTo be completed by the health professional on each visit to a GP / Nurse / Hospital / Dentist / Optician
Please provide only basic information to identify the health issue and the health service provided (with the individual’s consent). Please avoid recording details of sensitive health information.
Name ......................... I like to .........................be called
Date of birth: ..........
If any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
Date Name of Health Professional Profession Contact Details Reason for Appointment and Outcome Signature
Date Name of Health Professional Profession Contact Details Reason for Appointment and Outcome Signature
Health Appointment RecordTo be completed by the health professional on each visit to a GP / Nurse / Hospital / Dentist / Optician
Please provide only basic information to identify the health issue and the health service provided (with the individual’s consent). Please avoid recording details of sensitive health information.
Name ......................... I like to .........................be called
Date of birth: ..........
If any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
Date Name of Health Professional Profession Contact Details Reason for Appointment and Outcome Signature
Date Name of Health Professional Profession Contact Details Reason for Appointment and Outcome Signature
Health OverviewPlease request the involvement of any accompanying health professionals.
For people in supported living, this section needs to be additionally signed by the manager.Name of Manager:..........................................................Signed by Manager:........................... Date:.......................
If any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
Health Area Tick ‘yes’ or ‘no’ Tick if you have emergency medication
Communication
Epilepsy n Yes n No nMental health / fears n Yes n No n
Diabetes n Yes n No nAllergies n Yes n No n
Alcohol / drugs n Yes n No
Mobility n Yes n No
Equipment / aids n Yes n No
Eating / drinking n Yes n No
Toileting and Continence n Yes n No
Hearing problems n Yes n No
Eyesight problems n Yes n No
I need help with... n Yes n No
End of Life Plan n Yes n No
Dementia Support n Yes n No
Name ......................... I like to .........................be called
Date of birth: ........
Continued OverleafThis folder must be reviewed at least annually.
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:...............Role: Carer/health professional/other professional ...........................................Reviewed by Name:.................................. Date:.............................. Role: Carer/health professional/other professional ...........................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:............Role: Carer/health professional/other professional ......................................
Reviewed by Name:.................................. Date:.................. Role: Carer/health professional/other professional ......................................Reviewed by Name:.................................. Date:......................... Role: Carer/health professional/other professional ......................................Reviewed by Name:.................................. Date:.......................... Role: Carer/health professional/other professional .......................................
CommunicationIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
Name ......................... I like to .........................be called
Date of birth: ..........
This is how I like health professionals to communicate with me
Face to face appointments:Detail how you express yourself verbally. Do you use signs or gestures? Do you use photos or symbols? Do you use objects of reference? Do you dislike eye contact or physical contact?
Receiving appointment invitations:Details the best way for you to receive information. Is it by letter? Easy Read letter? Letter sent to someone else? Telephone call? Text?
Information for Health ProfessionalUnder the Accessible Information Standard (2016) all health and social care staff are required to ASK, RECORD, FLAG, USE & SHARE a person’s preferred method of communication. Have you checked their Summary Care Record to see if they have an Additional Information Section?
CommunicationAdditional information about communication to help make things easier for me:...................................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Annual review Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
EpilepsyIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely. (tick as appropriate)
I have epilepsy o YES o NO
I have an epilepsy management plan o YES o NOIf yes, please include a copy in this section of the Purple Folder
I have epilepsy rescue medication o YES o NO
This is what I believe happens when I have a seizure: .............
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Behaviours and Mental HealthIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
Please be aware that the following routines are important to me:
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
Behaviours and Mental HealthAdditional information to help health professionals understand my behaviours and mental health and what they can do to help me.
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
FearsIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
DiabetesIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
(tick as appropriate)
I believe I have Type 1 Diabetes o YES o NO
I believe I have Type 2 Diabetes o YES o NO
I take medication by mouth for my diabetes o YES o NO
I have an injection for my diabetes o YES o NO
AllergiesI believe I am allergic to the following:
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Mobility and Getting AroundIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
I have problems with my: (tick as appropriate)
Face o YES Details You can help me by:
o NO .................... ...................... .................... ...................... .................... ......................
Neck o YES Details You can help me by:
o NO .................... ...................... .................... ...................... .................... ......................
Spine o YES Details You can help me by:
o NO .................... ...................... .................... ...................... .................... ......................
Hands/Arms o YES Details You can help me by:
o NO .................... ...................... .................... ...................... .................... ......................
Legs / Feet o YES Details You can help me by:
o NO .................... ...................... .................... ...................... .................... ......................
(Please give details of how you are when you are well and known changes when you are unwell or in pain)...........................................................................................................................................................................................................................................................
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
Mobility and Getting AroundAdditional information to help health professionals understand how I am when I am well and what they can do to help me when I am unwell or in pain.
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Equipment / Aids If any information changes do not cross out or erase. Complete a new sheet and store the old one securely.I regularly require the use of:
For Example Equipment / Aids Tick as appropriate
Walking stick/aids o YES o NO
Hearing aid o YES o NO
Glasses o YES o NO
Dentures o YES o NO
Wheelchair o YES o NO
Standing frame o YES o NO
Specialist seating o YES o NO
Pressure mattress o YES o NO
Hoist o YES o NO
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
Equipment / AidsAdditional information.
Please give details of how you are with this equipment/aids when you are well and what changes may happen when you are unwell or in pain....................................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Equipment / AidsIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely. I regularly require the use of:
For Example Equipment / Aids Tick as appropriate
Foot straps o YES o NO
Wrist straps o YES o NO
Wedges/cushions o YES o NO
Helmet o YES o NO
Splints o YES o NO
Breathing equipment o YES o NO
Suction o YES o NO
Tube feeding/Pump o YES o NO
................................
................................
Other: please give details o YES o NO
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
Equipment / AidsAdditional information.
Please give details of how you are with this equipment/aids when you are well and what changes may happen when you are unwell or in pain....................................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Eating and DrinkingIf any information changes do not cross out or erase.
Complete a new sheet and store the old one securely.
Tick all that apply
I have guidelines to help me when I eat o YES o NODetails:..............................................
I have guidelines to help me when I drink o YES o NODetails:..............................................
I am fed through a special tube o YES o NODetails:..............................................
I have difficulties with food and drink o YES o NOfalling out of my mouthDetails:..............................................
I have difficulties with chewing o YES o NODetails:..............................................
I get food stuck in the roof of o YES o NOmy mouth and cheeksDetails:..............................................
I have difficulties swallowing food o YES o NODetails:..............................................
I have difficulties swallowing fluids o YES o NODetails:..............................................
I sometimes inhale food and drink o YES o NODetails:..............................................
I have other eating and drinking problems o YES o NODetails:..............................................
WARNING SIGNS OF SWALLOWING PROBLEMS (DYSPHAGIA)If I gag, cough, choke or sound very gurgly, do not put more food or drink in my mouth. Stop! Wait until my mouth is empty and I am breathing normally again. PLEASE SEEK ADVICE FROM SENIOR STAFF! These symptoms will require a swallowing assessment
Name ......................... I like to ...................... Date of birth: ............ be called
Continued Overleaf
I need a modified diet o YES o NODETAILS (Pureed, mashed, chopped or other): Tick as appropriate
When I am unwell/in pain or in unfamiliar places I will need this extra help with eating and drinking. (Consider for example if you are in hospital bed with a tray of food under a lidded plate without someone to help)...................................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Using the Toilet & Continence (Having a wee and poo)
If any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
How I communicate when I need the toilet.
When I need the toilet I usually communicate this by
Name ......................... I like to ...................... Date of birth: ............ be called
Continued Overleaf
Continued Overleaf
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Continence Bowels/Faeces (poo)I usually have a poo
o once every 3 days o once every 2 days
o once a day o twice a day o more than twice
Detail any known changes when you are having difficulties with your bowels/ pooing or are unwell.
Hearing problemsIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely. Tick as appropriateI believe I have a hearing problem o YES o NO
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
Hearing / Eyesight problemsAdditional information to help health professionals understand how my hearing and eyesight is usually and what they can do to help me.
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
When I am in an unfamiliar place I need help with...If any information changes do not cross out or erase. Complete a new sheet and store the old one securely. You can help me by: Tick as appropriateDressing myself o YES o NO ...................................
...................................
...................................
Washing myself o YES o NO ...................................
...................................
...................................
Using the toilet o YES o NO ...................................
...................................
...................................
Sleeping o YES o NO ...................................
...................................
...................................
Cleaning my teeth o YES o NO ...................................
...................................
...................................
Other o YES o NO ...................................(Please give details) ...................................
...................................
Name ......................... I like to ...................... Date of birth: .......... be called
Continued Overleaf
I need help with...Additional information.
Please give details of how you are at home with dressing and washing when you are well and any extra help you may need when you are unwell/in pain....................................................................................
To the best of my knowledge this is an accurate account. Support to complete this section has been provided by: Name:.................................. Date:.............Role: Carer/health professional/other professional ........................................
Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................Reviewed by Name:.................................. Date:............................ Role: Carer/health professional/other professional ........................................
Involvement checklistIf any information changes do not cross out or erase. Complete a new sheet and store the old one securely.
As the owner of the Purple Folder – you should be involved in filling out and keeping your Purple Folder up-to-date.Was the owner of the Purple Folder: Tick as appropriate
1. Involved in its completion? o YES o NO If not, why? .............................................................. .............................................................................
2. Informed that the Purple Folder needs to be o YES o NO shown and the outcomes recorded at all NHS consultations? If not, why? .............................................................. .............................................................................
3. Informed and reminded that the Purple Folder o YES o NO contains confidential information and needs to be kept safe and secure? If not, why? .............................................................. .............................................................................
4. Informed that if the Purple Folder gets mislaid o YES o NO that the local Adult Disability Team needs to be informed. (See contact details at the end of this folder). If not, why? .............................................................. .............................................................................
Signed by owner of Purple Folder: ..........................................Print name: ......................................... Date:.................
Signed by person who helped with completion: .............................Print name: ......................................... Date:.................
For people in Supported Living - Name of manager: .......................Signature: ........................................... Date:.................
Name ......................... I like to ...................... Date of birth: .......... be called
GENERAL NUMBERSPurple Folder re-order 01438 843848POhWER - advocacy - Independent Mental Capacity 0300 4562370East and North Hertfordshire Clinical Commissioning Group (ENHCCG) 01707 685000Hertfordshire Valley Clinical Commissioning Group (HVCCG) 01442 898888Hertfordshire Community NHS Trust 01707 388000Hertfordshire County Council 0300 123 4040Herts Help 0300 123 4044
HERTFORDSHIRE GENERAL HOSPITALSWatford General Hospital 01923 244366St Albans City Hospital 01727 866122Hemel Hempstead General Hospital 01442 213141Hertford County Hospital 01438 314333Mount Vernon Cancer Centre 01923 826111Lister Hospital (Stevenage) 01438 314333QE2 Hospital (Welwyn Garden City) 01438 314333
HERTFORDSHIRE MENTAL HEALTH Hertfordshire Partnership NHS Foundation Trust 01727 804674
LEARNING DISABILITY SERVICES Health Liaison Team 01438 845372Hertfordshire Learning Disability Partnership Board 01438 844083
Health and Community Services Adult Disability Teams (ADTs) Dacorum 01442 454444 East Herts & Broxbourne 01438 843111 Hertsmere 01442 454242 North Herts & Stevenage 01438 843222 St Albans 01442 454300 Watford & Three Rivers 01442 454343 Welwyn&Hatfield 01438843600
0-25 Together Central Team 01438 844660 (Option 1, Central Services)
Adult Care Services - Customer Service Centre 0300 123 40 42(outofofficehours)
Care Information
For more information about local community services you can contact https://www.hertfordshire.gov.uk
telephone HertsHelp on 0300 123 4044 or drop into your local library. ABUSE hurts: If you are worried about someone you know who is at risk of harm, neglect or being mis-treated, please telephone in confidence Adult Care Services (ACS) 0300 123 4042 to report your concerns.
