April 2020: Changes in relation to Coronavirus
Additional measures to reduce the risk of transmitting coronavirus need to be taken to further prevent the spread of the virus. This is especially important where face to face contact with adults, their families or other staff is required. Your line manager will give you information about how to keep yourself safe. Click on the link for information from the UK Government: How to protect yourself and others – Coronavirus (COVID-19): what you need to do and Responding to COVID-19: the ethical framework for adult social care (Department of Health and Social Care).
Safeguarding is fundamentally managing risk about the safety and wellbeing of an adult in line with the safeguarding principles (see Safeguarding: What is it and Why does it Matter?). The aim of risk management is to:
- promote, and thereby support, inclusive decision making as a collaborative and empowering process, which takes full account of the individual’s perspective and views of primary carers;
- enable and support the positive management of risks where this is fully endorsed by the multi-agency partners as having positive outcomes;
- promote the adoption by all staff of ‘defensible decisions’ rather than ‘defensive actions’.
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.
It is the collective responsibility of all organisations to share relevant information, make decisions and plan intervention with the adult. A plan to manage the identified risk and put in place safeguarding measures includes considering:
- 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?
Effective risk management strategies identify risks and provide an action or means of mitigation against each identified risk, and have a mechanism in place for early escalation if the mitigation is no longer viable. Contingency arrangements should always be part of risk management. 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.
2. Identifying Risks
As part of a person-centred approach 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 and Confidentiality);
- key elements of the person’s quality of life and wellbeing can be safeguarded.
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. Risks can be:
- real or potential;
- 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 of the categories below:
- private and family life: the source of risk might be someone like an intimate partner or a family member. Any infringement of a person’s rights in this area must be considered only in a multi-agency context with due consideration being given to Article 8 of the Human Rights Act (1998);
- community based risks: this includes issues like ‘mate crime’, anti-social behaviour, and gang-related issues (see Categories of Abuse and Neglect);
- risks associated with service provision: this might be concerns about poor care which could be neglect or organisational abuse, or where a person in a position of trust because of the job they do financially or sexually exploits someone (see also Categories of Abuse and Neglect and Allegations against People in Positions of Trust);
- self-neglect: where the source of risk is the person themselves (see Self-Neglect).
3. Risk Assessment
Risk assessment involves collecting and sharing information through observation, communication and investigation. It is an ongoing 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 ongoing 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.
Safeguarding adult at 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, 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 domestic abuse is indicated and the need for a referral to a MARAC (see Multi-Agency Risk Assessment Conferences);
- identify people causing harm who should be referred to MAPPA (see Multi-Agency Public Protection Arrangements).
It should be noted that risks may increase where information is not shared.
4. 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.
5. 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. Accessible knowledge through information and advice, assertiveness through the right kind of advocacy and support may be appropriate.
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.
It may not always be possible to reach agreement, but professionals need to evidence that all attempts to reach agreement were taken.