This short podcast on behalf of the West Sussex Safeguarding Adults Board, is about safeguarding risk assessment. This is the process of working with an adult to maximise safety and, to reduce future risk. Risk assessment is an integral part of safeguarding processes and professionals should consider and adopt a flexible solution-focussed approach to mitigating risk.
Risk assessment is a theme that has been identified in Reviews undertaken by the West Sussex Safeguarding Adults Board, with recommendations made to develop and improve practice and process. This podcast will give you information and advice on key areas to ensure that your practice is current, and will inform you of where you can go to seek further information. This podcast and the accompanying learning briefing are not designed to replace any advice, guidance or processes within your own organisation, but to offer an overview of the key areas for consideration.
With this in mind, I would like to tell you about the 6 key steps to completing a Risk Assessment:
- The first, is to seek the outcomes desired by the Adult. This simply means, what they would like to do or to happen. If the Adult lacks capacity any decisions must be in their best interest. I will tell you a little more about capacity and best interest, later in the podcast.
- The second, is to identify what is causing the risks.
- The third, is to assess the risks and the steps necessary to minimise these.
- The fourth, is to develop a risk assessment or plan, which reduces the risk to an ‘acceptable level’ and includes a contingency plan.
- The fifth, is to make a record of the risk assessment or plan and share this with those involved in the Adult’s care.
- And finally, the sixth, is to review the risk assessment or plan at regular intervals and if risks change. There should be a specified professional or professionals identified to complete the review.
Overall, risk assessment processes should support positive risk management and promote empowerment and control by the Adult. It is important to remember that despite the potentially negative outcomes of risk taking such as; exposure to danger, loss, threat, damage or injury, there can also be positive benefits, such as increased independence, enhanced quality of life and improved wellbeing. The potential benefits of taking risk should be identified and weighed up against potential harm.
As professionals, we must always ensure that our work is in accordance with our duty of care to the people we support, colleagues, our employer, and the public. This duty of care does not mean that we must protect Adults from all possibility of harm, but that our actions are proportionate and reasonable. To do this we need to ensure that we always act in the best interest of others, not acting or failing to act in a way that results in harm and, that we act within our professional competence.
So, what happens when an adult lacks capacity for a specific decision. If this is the case they must be supported by a representative or advocate. This could be a family member, friend, or a professional advocate. Any risk assessments measures agreed upon should conform to Mental Capacity Act principals, which means that the measures should be recognised, in the Adults best interest, necessary to prevent harm to the Adult, and proportionate to the likelihood and seriousness of harm.
So, what are some of the other things we need to think about:
The first, is that any complex cases or cases involving significant risks may often need a multi-agency approach. This must be underpinned by clear and timely information sharing and shared risk assessing which results in a multi-agency risk management plan. If any risk specifically relates to self-neglect, then the Sussex Self-Neglect Procedure should be followed. To ensure your practice is current please see our self-neglect learning Briefing, and listen to the accompanying 7 minute self-neglect podcast.
The second, is how we should record information about risk as it is vital that this information is recorded accurately. We must ensure that dates of incidents and risks are documented, so it is clear if the risk is current or historical. It is important that all information is recorded correctly as this may affect future decision making. The level of detail recorded should be accurate, thorough and proportionate to the risk of the potential harm. Any risks recorded must differentiate between direct evidence, for example something you have seen yourself, anecdotal evidence such as something you have been told by someone else and, opinion. It is important to avoid opinion-based statements that are not backed by evidence.
The third, is consideration of the risks to others. There may be identified risks that involve the Adult, which may also have an implication for others. If the identified risks may relate to another Adult who has care and support needs, it is important that these are considered and raised with Adult Social Care. If there is abuse or neglect or, the suspicion of abuse or neglect towards the Adult or, another Adult with care and support needs, this must be reported online as a safeguarding concern to West Sussex County Council. If the risk may negatively impact on children living with, or in contact with the Adult, information must be shared with Children’s Services. In an emergency, where somebody’s life is at risk or there is immediate risk of injury or serious harm, the emergency services should be contacted.
And finally, the last thing to consider is the closing of the case for an Adult where risk remains and or where Adults are not engaging. For Adults who are difficult to establish and maintain contact with and or who are choosing to live with risks and or, are declining support, it is recognised that assessing and managing risk is challenging. To minimise risk, best practice requires:
- making sure all avenues for contacting the Adult, including via other professionals and those known to them, have been explored; sometimes this will be on a repeated basis.
- accurate, comprehensive and clear recording in risk assessments
- escalation if risk elevates
- management oversight to consider any other avenues to support.
- and signposting to other resources which may be accepted by the Adult.
If risk remains high despite multi-agency risk assessment and planning and, all available options to support have been explored, please consider a referral to our Board’s Multi-Agency Risk Management Subgroup known as MARM.
To support learning, improvement and keeping practice current, our Board continues to create a range of learning briefings and podcasts. We have these for all published Safeguarding Adults Reviews to make sure you know quickly and easily, what improvements need to be made to minimise the risk of similar safeguarding incidents reoccurring. On our website you’ll also find useful links to all our published Reviews, information for professionals, and further podcasts.
Thank you for your time to listen to this podcast. We do appreciate you recognising the importance and value of good quality risk assessments in helping to deliver consistent safeguarding support to those with care and support needs in West Sussex.