GO Online: Inspection toolkit

Involving people to manage risk

Protecting people from harm should be a priority for adult social care services. Practical and proactive approaches can help services quickly assess risks and regularly review and adjust them.

The following film provides a summary of this area of inspection. It can help you and your teams learn about what will be inspected and what is important to demonstrate to deliver good or outstanding care.

Involving people to manage risk

• We can evidence how we support people to understand and manage any risks.
• Our person-centred risk assessments support our people to have as much freedom, choice, and control as possible.
• We involve the people we support in deciding their own risk assessments and include them in subsequent reviews/revisions.
• We encourage people to take positive risks to maximise their control over their care and treatment.
• We ensure our risk assessments reflect current equality and human rights legislation, as well as clearly documenting the person’s capacity at the time of the assessment.
• Where needed, we’ll involve external experts and professionals to help us manage a person’s risk (e.g., the service shares their risk assessment with the person’s GP for their view).
• We update risk assessments to reflect any temporary changes, with any extra support needed clearly documented. We also ensure that any changes are effectively communicated to staff in a timely manner.
• We ensure our staff are effectively trained and competent to undertake risk assessments of the people we support.
• We ensure our staff understand the risks affecting each person, including what actions they need to take to minimise the risk of harm.
• We ensure our staff are trained to be able to undertake dynamic risk assessments to effectively manage real-time risks.
• We check that the risk assessment includes references or links to all relevant associated documents. We cross-check that there’s consistency between the information in the risk assessment and associated documents.
• We regularly review risks at staff and management meetings. This includes supervisions and, where appropriate, in handovers etc.
• If risks are identified via quality checks and other methods, we ensure these are mitigated. Similarly, if external audits such as CQC inspections identify failings, we action improvements at the earliest opportunity.
• We ensure our risk assessments include a practical level of information to ensure it’s a usable document that captures everything that’s needed. Data protection protocols are followed.
• We provide accessible information to people who need care and support about how to keep themselves safe and are empowered to report concerns.
• If restrictions are needed to protect people and staff, we ensure these are time-limited and kept under constant review.
• We do everything we can to try to identify and understand the root cause of the issues that may result in behaviours that challenge, engaging with specialists to understand how best to safely respond to this.
• We ensure any restrictive intervention must be legally and ethically justified, is absolutely necessary to prevent serious harm, and be the least restrictive option.
• Where relevant to our service, the people we support in contact with mental health services who’ve been violent or aggressive are supported to identify triggers and early warning signs for these behaviours. This is in accordance with NICE guidelines.
• Our training is in line with the Restraint Reduction Network training standards and effectively delivered by experts, with the competency of those delivering care being appropriately assessed.
• Where relevant to our service, the people we support with behaviour that challenges have a documented review every time a restrictive intervention is used. This is in accordance with NICE Quality Standards.

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