3.3 Managing Risk
It is important that there are a range of risk assessment tools available locally to support staff to evidence professional judgement during their decision making. Issues around information sharing may be relevant in this context. See Section 1.1.4 for more details
3.3.1 Involving the Adult
Making Safeguarding Personal (MSP) stresses the importance of keeping the adult at the centre. Under MSP the adult is best placed to identify risks, provide details of its impact and whether or not they find the mitigation acceptable. Working with the adult to lead and manage the level of risk that they identify as acceptable creates a culture where:-
- Adults feel more in control
- Adults are empowered and have ownership of the risk;
- There is improved effectiveness and resilience in dealing with a situation;
- There are better relationships with professionals;
- Good information sharing to manage risk, involving all the key stakeholders (see Information Sharing part one);
- Key elements of the person’s quality of life and well-being can be safeguarded.
Where an adult lacks mental capacity to make decisions about risk it is vital that attempts are made to involve them in as meaningful a way as possible in the risk assessment process and to ensure that consultation with them has taken place on the matter. Although this may mean that they are involved to a lesser or limited degree than if they had capacity this will ensure that the adult is able to contribute, as much as they have capacity to do so, to the assessment and plans.
Where people choose not to engage in the risk assessment process it is important that further attempts and opportunities are made for them to revisit this decision and to take part in their risk assessment or any review of their risk assessment as required.
3.3.2 Identifying Risk
Not every situation or activity will entail a risk that needs to be assessed or managed. The risk may be minimal and no greater for the adult, than it would be for any other person. However it is important to recognise that there are also situations where what constitutes a minor risk for most people may present a significant risk to another person.
- Risks can be real or potential;
- Risks can be positive or negative;
- Risks should take into account all aspects of an individual’s wellbeing and personal circumstances.
- Sources of risk might fall into one or more of the four categories below:
- Private and family life: The source of risk might be someone like an intimate partner or a family member;
- Community based risks: This includes issues like ‘mate crime’, anti-social behaviour, and gang-related issues;
- Risks associated with service provision: This might be concerns about poor care or treatment which could be neglect or organisational abuse, or where a person in a position of trust because of the job they do exploits or abuses someone;
- Self-neglect: Where the source of risk is the person themselves.
3.3.3 Risk Assessment
Risk assessment involves collecting and sharing information through observation, communication and investigation. It is an on-going process that involves persistence and skill to assemble and manage relevant information in ways that are meaningful to all concerned. Risk assessment that includes the assessment of risks of abuse, neglect and exploitation of people should be integral in all assessment and planning processes, including assessments for self-directed support and the setting up of personal budget arrangements. Assessment of risk is dynamic and on-going and a flexible approach to changing circumstances is needed. The primary aim of a safeguarding adults risk assessment is to assess current risks that people face and potential risks that they and other adults may face. Specific to safeguarding, risk assessments should encompass:
- The views and wishes of the adult;
- The person’s ability to protect themselves;
- Factors that contribute to the risk, for example: relevant history, personal, environmental;
- The risk of future harm from the same source;
- Identification of the person causing the harm and establishing if the person causing the harm is also someone who needs care and support;
- Deciding if the situation the adult is in may be supported by a referral to a specialist group or specialist forum such as:
- If domestic abuse is indicated may be a need for a referral to a MARAC;
- Where an adult is experiencing a high level of risk and a high-risk panel or a community multi-agency risk assessment is an appropriate measure
- Where there is a need for a referral to MAPPA indicated
- Where the risk may increase if information is not shared
3.3.4 Risk Management
The focus must be on the management of risks not just a description of risks. Employers need to take responsibility for the management of risk within their own organisation and share information responsibly where others may be at risk from the same source. The Local Authority is ultimately accountable for the quality of Section 42 enquiries, but all organisations are responsible for supporting holistic risk management, with the adult and in partnership with other agencies.
It is the collective responsibility of all organisations to share all relevant information, make decisions and plan intervention with the adult.
Embedding the 6 safeguarding principles in the risk assessment process ensures the person’s wellbeing is balanced with the duty to support them to keep themselves safe and to empower them. The principles also uphold defensible decision-making and positive risk management with the professionals involved. The Safeguarding principles in relation to managing risk are set out here:
Adults are encouraged to make their own decisions and are provided with support and information.
I am consulted about the risks and consequences I am facing, the options available to me and my decision directly informs what happens next.
Strategies are developed to prevent abuse and neglect that promotes resilience and self-determination.
I am provided with easily understood information about the risk and what steps I can take to reduce or remove it and what I can do to seek help.
A proportionate and least intrusive response is made balanced with the level of risk.
I am confident that the professionals will work in my interest and only get involved as much as needed. I am confident that the risks will be reviewed as needed to ensure that they meet my changing needs and/or wishes.
Adults are offered ways to protect themselves, and there is a co-ordinated response to adult safeguarding.
I am provided with help and support to keep myself safe. I am supported to take part in reviewing this to make sure that it continues to help keep me safe, in the way that most suits me.
Local solutions through services working together within their communities.
I am confident that information will be appropriately shared in a way that considers its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation
Accountability and transparency in delivering a safeguarding response.
I am clear about the roles and responsibilities of all those involved in the solution to the problem.
A plan to manage the identified risk and put in place safeguarding measures includes:
- What immediate action must be taken to safeguard the adult and/others;
- Who else needs to contribute and support decisions and actions;
- What the adult sees as proportionate and acceptable;
- What options there are to address risks;
- When action needs to be taken and by whom;
- What the strengths, resilience and resources of the adult are;
- What needs to be put in place to meet the on-going support needs of the adult;
- What the contingency arrangements are;
- How will the plan be monitored and reviewed? How often should this occur as the frequency of review may increase or decrease depending upon the severity of the risk
Positive risk management needs to be underpinned by widely shared and updated contingency planning for any anticipated adverse eventualities. This includes warning signs that indicate risks are increasing and the point at which they become unacceptable and therefore trigger a review.
Effective risk management requires exploration with the adult using a person-centred approach, asking the right questions to build up a full picture. Not all risks will be immediately apparent; therefore, risk assessments need to be regularly updated as part of the safeguarding process and possibly beyond.
Where a safeguarding situation for a person involves a range of agencies, it is vital that good communication and partnership working remain a principal aim in working with the person and the best way to support them with the risks they are facing.
3.3.5 Reviewing Risk
Individual need will determine how frequently risk assessments are reviewed and wherever possible there should be multi-agency input. These should always be in consultation with the adult at risk.
3.3.6 Risk Disputes
Throughout these policies and procedures risk assessment and risk management is carried out in partnership with the adult, wider support network and others. The decision to involve others or not is in itself a decision which may give rise to risk, and the individual may need support to make this decision.
The professional views of risk may differ from the views of the adult. Perceived risks have implications for the safety and the independence of the individual, but they also have implications for the accountability of professionals. This highlights the importance of training and/or regular practice in making independent decisions by adults. Supported decision-making and maximised involvement whether from accessible knowledge through information and advice or assertiveness through the right kind of advocacy and support may be appropriate, particularly for people assessed as lacking capacity or having fluctuating capacity.
Professionals need to embrace and support positive risk taking by finding out why the person wishes to make a particular choice, what this will bring to their life, and how their life may be adversely affected if they are not supported in their choice. The promotion of choice and control, of more creative and positive risk-taking, implies greater responsibility on the part of the adult and greater emphasis on keeping them at the centre of decision making, however adults deemed to lack capacity should also be supported by a creative and positive risk taking process where this is appropriate and in keeping with the principles of the Mental Capacity Act (2005).
It may not be possible to reach agreement, but professionals need to evidence that all attempts to reach agreement were taken. Where there are concerns about people making unwise decisions, or there is high risk that requires wider collaboration, Multi-Agency Risk Panel (sometimes referred to as High Risk Panels or Risk Enablement Panels) is one model used to support safeguarding adults’ processes. A Multi-agency risk framework (and risk assessment tool) is another model that is widely used to support safeguarding adults’ processes or situations where the adult of concern may not wish to be fully involved in the possible support arrangements available to them at that time.