Introduction
Risk is the possibility of harm occurring and the severity of that harm. Risk assessment is the process of identifying risk and enabling decisions to be taken about whether new or improved risk controls, or protective measures, are required. Effective person-focused risk assessment relies on the active participation of all agencies/teams involved. Legislation requires that risk assessment be “suitable and sufficient”. This means that the degree of effort put into risk assessment needs to be proportionate to the risk involved.
Informal risk assessments are carried out every day upon both professional and personal experience, enabling risk to be recognised and necessary precautions to be taken. These everyday judgements and decisions are an individual’s responsibility and a core professional competence which underpins everything we do. Formal risk assessments are a documented evaluation of risk including potential severity of consequences and the likelihood of such an occurrence along with the preventative and protective measures in place to control the risk. The aim is to weigh up whether existing support is adequate or whether more should be done to reduce the risk to an acceptable level through improved protective measures or contingency plans.
Risk assessments must be shared between all agencies/ teams involved to ensure the consistency of response and of care provided. A multi-agency risk assessment enables commitment of all involved to implement and comply with any protective measures agreed as essential to ensure the health and safety of the adult, staff, and any other persons who could be affected. In respect of environmental or low-level personal risks the risk assessment forms may be completed by one member of staff. The multi-disciplinary risk assessment must be completed by a multi-disciplinary group.
The Risk Assessment form should be used to identify and evaluate all significant risks associated with the adult, and to record all agreed protective measures necessary.
It is recognised that it can be a challenge to balance the positive benefits of taking risks with protection. The principles of the Health and Social Care Standards must be adhered to.
Self-Neglect Risk Assessment Form
This risk assessment form should be completed either prior to or during a multi-agency meeting by the lead agency. It is important that those who are aware of the risks are part of the risk assessment process. This may include professionals, hands-on carers, the police, legal advisers, family members, the adult themselves. The person organising the risk assessment should take time to consider who should be invited to ensure that an open and honest discussion takes place. They should carefully consider the pros and cons of having family members and the adult themselves present as this may impede full discussion or may cause the adult undue distress.
This Multi-agency Risk Assessment is a generic process which facilitates the sharing of concerns, the agreement of how risk can be managed and the acceptability or not of the presenting risks. It is possible, as part of this process, that the need for other specialist risk assessments may be identified.
Where a potential or actual risk has been identified on the Multi-agency Risk Assessment form this should then be transferred to the Risk Management Plan using the same issue number. In the “risk present” box where a risk is present, you should identify who is at risk using the following keys:
S = staff member; C = client; O = other.
The details of the risk should be noted. The existing control measures which are currently in place should then be recorded in the “existing control measures” column. In this column you should also evaluate and clearly record the effectiveness of these existing measures – are the measures: effective, partially effective or not effective at all. Using the Risk Assessment Matrix identify the most predictable severity of the consequences of the event in question and note this. Similarly note the level of likelihood of the event occurring. You will then be able to identify the risk rating by finding where the “likelihood” column and the “consequences” row cross over. For example, an event which is likely to occur which has a moderate level of severity of consequences has a risk rating of high.
There may be times when the ability to reduce the risk is not possible e.g. when the maximum amount of support is already in place. This should be clearly recorded and if necessary escalated as per local processes.
Additional measures required to minimise risk should then be identified. It is perhaps helpful to think about what you can eliminate, reduce or further control the risk. Are there ways of improving monitoring, procedures, recording, communication, training, systems of work or organisational management. This will, along with existing controls, define how you will reduce and maintain the risk to a minimum.
The final risk rating completed using the same method as above by anticipating the impart the measures will have once they are put in place.
Where the final risk rating is high or above local escalation process will apply.
Self-Neglect Risk Management Plan
The Risk Management Plan can then be completed at the multi-agency meeting taking into account the Risk Assessment. This details the actions to be carried out to ensure the additional control measures are put in place, by whom, the target date for completion and the actual date completed. Some actions may be required on an ongoing basis.
The Risk Management Plan should also include who is responsible for reviewing the risk assessment and the target date for this.
When reviews are carried out, the date it was due to happen, the date it was actually carried out and by whom should be noted in the review table. The Risk Management Plan should be updated to take account of any changes necessary following the review. The Risk Assessment can be shared with other professionals/staff involved in an individual’s care if appropriate.