we’re supporting people who use services, and carers

May 2011

Learning to live with risk

(1) An introduction for service providers in adult social care

Why focus on risk now?

Policy drive to give ‘choice and control’ Support for self-directed care Enabling people to take risks they choose DH framework for risk management Concerns about increasing risk Concerns about risk-averse services

Shouldn’t a good service avoid risks?

What reasons could there be to avoid supporting people who use services to

take risks?

WHERE ARE THERE RISKS?Wariness of lurking conflict!

Know the law

CIVIL Negligence Balance of

probabilities Compensation

CRIMINAL Recklessness Beyond

reasonable doubt Punishment

Some key concepts

Evidence Facts Record keeping

Blame Liability Vicarious liability

Sue Insurance Complaints Inquiries Professional misconduct

Good practice – sound and safe

Vicarious liability Employer risk Good practice Beneficial outcomes Good practice Best defence Good practice Professional standards Good records Risk decisions show

standards met Employer action Poor practice even if

no harm done

Ensuring best practice

Ensure: All reasonable steps have been taken Reliable assessment methods have been used Information has been collated and thoroughly evaluated Decisions are recorded, communicated and thoroughly

evaluated Policies and procedures have been followed Practitioners and their managers adopt an investigative

approach and are proactive

Risk guidance for people with dementia (DH 2010)

Some key concepts Supported decision

making: choice rights and

responsibility consent capacity (mental)

Action and inaction Outcomes Benefit Harm Likelihood

Sharing power

Do you know what good practice looks like? How do you involve people who use your service in

running it? You want to be innovative and cost-effective – what

steps do you take to engage the practitioner workforce in judging the risks?

Do you have a whistle-blowing policy? What is the role of managers in setting and

maintaining professional standards?

Complex decision areas

Safeguarding Carers Mental capacity Health and safety

Employers should be alert to:

Professional standards Inspectorate standards Better ways of organising work Blame Value conflicts Retention Consistency and continuity Morale and satisfaction Dangerous people Continuing professional development Celebrating good practice

Developing a model risk-taking policy

Values and principles A ‘statement of purpose’ Beneficial outcomes anticipated Professional standards Identified constraints Position on controversial issues Associated procedure Endorsements Acknowledgements Consultation Review arrangements

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