Assessing risk is a crucial part of the care model for care and support services across the country – to ensure people are properly cared for both physically and mentally. It also facilitates the implementation of plans to mitigate those potential risks and reduce harm by ensuring staffing levels and interventions are appropriate. The Social Care Institute for Excellence recommends a strength-based approach to encourage “positive risk-taking” – identifying what risks matter most to people who depend on care and how to appropriately manage them.
We are firmly into the UK’s harshest winter months, amid a sharp rise in loneliness and mental health challenges during the pandemic. The healthcare system is struggling to meet the surges in demand, with people now routinely waiting 12-24 months to be seen. Effective prioritisation based on robust and consistent assessments of risk is crucial. How can healthcare providers ensure risk assessments are carried out consistently and effectively and what tools can be put in place to promote best practice for those most in need?
Unifying tools for risk assessment sector-wide
There are currently a wide variety of tools and templates being used by many healthcare providers across the UK to support risk assessment and management planning. This includes a mixture of both specialist and non-specialist global, national and locally-designed tools. This situation inevitably leads to a lack of consistency between the same services in different areas, as different tools vary in their appropriateness for clinical risk assessment. There’s also a big disparity between different healthcare organisations as to how well-equipped their staff feel in carrying out good risk assessments.
Standardising risk tools and templates is important, but so is ensuring that practitioners have the right knowledge, skills and confidence to carry out assessments. Training is a big part of successful risk assessment and more often than not, learning how to properly carry out assessments and create risk management plans is not covered in general training.
When serious incidents occur – where an individual’s safety or life has been put at risk – it’s not unusual for serious incident reviews and external enquiries to find that local processes are poorly-designed and unclear. This lack of clarity quickly leads to a variable quality in the recording of information about risk, and subsequently to different decisions being made about how best to manage risk for that individual. That’s why training, ongoing education and clinical supervision are key to increasing the effectiveness of clinical work and risk assessment practice.
Risk is a dynamic process, influenced by any number of variables within a given situation. Risk fluctuates and is continually shaped by the experiences, perceptions, and interactions that an individual has. Regularly reviewing and updating risk assessments and management plans is therefore a vital part of good practice – and practitioners need to feel confident to do this.
An evidence-based assessment tool for the future
A robust, evidence-based, and well-maintained recording tool for risk that’s tried and tested across the UK is certainly of great benefit and reassurance to an organisation – but it cannot operate by itself to ensure good practice in risk assessment without the relevant training on how to use it. Just as a top-of-the-range musical instrument is only truly effective if the owner learns to play it properly.
The combination of a good tool with high quality training will go a long way in mitigating against serious untoward incidents occurring – but also means that if a serious incident does occur, subsequent investigations are less likely to point to an organisation’s risk recording and management processes as an issue.
Across many healthcare settings, such as care homes, a high-quality risk assessment tool can help practitioners maintain stronger levels of clinical decision making. By working through a broad and consistent set of potential risk factors, practitioners are far less likely to overlook less obvious components which significantly influence risk management strategies and therefore risk outcomes.
A good risk tool will also outline options to support an individual such as the details to be covered within a behavioural support plan. This means that risk can be managed more effectively within an individual’s usual environment, reducing the need for highly specialist interventions and possible hospital admissions.
Lastly, an effective risk tool should be flexible enough to be digitised and integrated with existing IT systems. Not only does this benefit practitioners’ day to day processes, but it also eliminates the need for paper-based processes which have often led to lost or misplaced risk assessments or handwriting which is difficult to read.
Industry-wide collaboration to form long-term best practice
We are optimistic that many serious incidents can be prevented in the future through combining the use of high-quality risk tools with a commitment to consistent, ongoing programmes of clinical risk training.
An organisation-wide commitment to develop and maintain a clear policy regarding what is expected of staff in relation to recording and reviewing information about risk is needed for all organisations involved in assessing clinical risk across the health and social care sector. The commitment should extend to ensuring all relevant staff receive regular clinical risk training – to promote long-term best practice which positively impacts the well-being of individuals within healthcare settings.
About the author:
Oliver Brown, Head of Product at Imosphere, says that although a robust and well-maintained recording tool for risk is of great benefit to healthcare practitioners, functional training is key to ensuring good practice in risk assessment is maintained throughout the sector.
