Safety and Support (SAS) Assessment for ISVAs

D1Personal & Individual Requirements D2 Harm from Other(s) D3 Health & Medical D4 Mental Health &

Psychological WellbeingD5 Coping Mechanisms, Social & Cultural Support

AgeCommunicationGender IdentitySexualityReligious/Cultural NeedsPhysical disabilitiesLearning disabilityInvolvement in Sex Work

When abuse took placeAbout the perpetrator(Unwanted) contactThose connected to the perpetratorDomestic abuseChild Sexual Exploitation (CSE)Violence Against Women & GirlsPrevious abuseClient concern

Urgent medical attentionForensic medical examinationSexual & Reproductive HealthMedical AppointmentsMedicines

History of mental health problemsCurrent mental health conditionsSelf harmSuicide

Positive coping skillsNegative coping skillsSocial NetworksCultural SupportOther areas of life

D6 Alcohol & Drug Use D7 Safeguarding D8 Criminal Justice D9 Employment & Education D10 Finance

Drug/alcohol abuseCoping mechanismsSubstance misuse services

Presence of children/vulnerable adultsClient concernsPregnant clientInvolvement of adult/children’s services

Reporting OptionsSupport during InvestigationPreparing for courtSupport at CourtAfter the trialCICA

Employment StatusEducation StatusEmployer/EducationProvider AwarenessSpecial/Mitigating Circumstances

Sources of incomeWelfare benefitsDebtsFinancial AssistanceNRPF

D11 Accommodation & Housing

D12 Immigration & Residence

D13 Risk to Professionals & Services

D14 Professional Judgment Scoring

Adequate HousingSafe & Secure HousingHomelessnessNRPF

Immigration StatusUndocumented MigrantNRPFTraffickingDetention/Deportation

Physical safety of ISVALone Working arrangementsOther service providersRefusal of service provision

Any other informationClient perception of riskNon-verbal communicationGut instinct or suspicion

0 - No risk or needs identified.1 - Mild Risk or Needs identified that can be managed by the client2 - Moderate Risk or Needs identified that can be managed by the ISVA Service3 - Significant Risk or Needs identified that require support from other services

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 1 : Personal and Individual Requirements

Age

Communication

Gender Identity

Sexuality

Religious/Cultural Needs

Physical disabilities

Learning disability

Involvement in Sex Work

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 2 : Harm from Others

When the abuse took place

About the perpetrator

(Unwanted) contact

Those connected to the perpetrator

Domestic abuse

Child Sexual Exploitation (CSE)

Violence Against Women & Girls

Previous abuse

Client concerns

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 3 : Health & Medical

Urgent medical attention

Forensic medical examination

Sexual & Reproductive Health

Medical Appointments

Medicines

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 4 Mental Health & Psychological Wellbeing

History of mental health problems

Current mental health conditions

Self harm

Suicide

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 5 Coping Mechanisms, Social & Cultural Support

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAsInformation Summary Risks Identified Actions

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Positive coping skills

Negative coping skills

Social Networks

Cultural Support

Other areas of life

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Domain 6 Alcohol & Drug Use

Drug/alcohol abuse

Coping mechanisms

Substance misuse services

Information Summary Risks Identified Actions

Needs Identified

Score

Safety and Support (SAS) Assessment for ISVAs

Domain 7 Safeguarding

Presence of children/vulnerable adults

Client concerns

Pregnant client

Involvement of adult/children’s services

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 8 Criminal Justice System

Reporting Options

Support during Investigation

Preparing for court

Support at Court

After the trial

CICA

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

D9 Employment & Education

Employment Status

Education Status

Employer/EducationProviderAwareness

SpecialMitigating Circumstances

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

D10 Finance

Sources of income

Welfare benefits

Debts

Financial Assistance

NRPF

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 11 Accommodation and Housing

Adequate Housing

Safe & Secure Housing

Homelessness

NRPF

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 12 Immigration and Residence

Immigration Status

Undocumented Migrant

NRPF

Trafficking

Detention/Deportation

Information Summary Risks Identified Actions

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Domain 13 Risk to Professionals & Services

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAsInformation Summary Risks Identified Actions

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

Physical safety of ISVA

Lone Working arrangements

Other service providers

Refusal of service provision

Needs Identified

Score

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Safety and Support (SAS) Assessment for ISVAs

This template can be reproduced, edited and is available to download with the accompanying toolkit at www.limeculture.co.uk

Domain 14 Professional Judgement

Any other information

Client perception of risk

Non-verbal communication

Gut instinct or suspicion

Information Summary Risks Identified Actions

Needs Identified

Score