we’re supporting people who use services, and carers november 2011 keeping risk person-centred an...
TRANSCRIPT
we’re supporting people who use services, and carers
November 2011
Keeping risk person-centred
An introduction for service providers in adult social care
Adult deemed to be at risk Any person 18 years of age and over who is
or may be in need of social care services (including services due to their role as carer) by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or serious exploitation.
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
Vision for adult social care seven principles
1. Prevention: empowered people and strong communities will work together to maintain independence. Where the state is needed, it supports communities and helps people to retain and regain independence
2. Personalisation
3. Partnership
4. Plurality
5. Protection: there are sensible safeguards against the risk of abuse or neglect. Risk is no longer an excuse to limit people’s freedom
6. Productivity
7. People
Think local act personal
Risk management and protection/ safeguarding should be addressed in a balanced way across all sections of the community, avoiding an approach that views people in receipt of social care funding as most at risk.
Know the law
CIVIL Negligence Balance of
probabilities Compensation
CRIMINAL Recklessness Beyond
reasonable doubt Punishment
Assessing risk
Wider context
Wishes of
individual
Duration
Frequency
Legal
frameworkImpact
Intent
Risk to the
person and
others
Consent
Mental
capacity
Vulnerability
How serious?
Adapted from Hughes J (2006)
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)
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?
Tool to audit power(Braye and Preston-Shoot, Empowering practice in social care, OUP 1995)
Human rights are
upheld
People’s
strengths are
recognised
Access to information
and advice is
given
There is involvement
in decision-making
Staff are honest
and reliable
Staff are trustworthy
and supportive
Negotiation and
fairness about
decisions
People treated with
respect
and dignity
Difference and diversity
celebrated
Person-centred services
Person-centred approach to riskSmull and Sanderson, Essential Lifestyle Planning, 2005
Differences in power and status affect the context in which people influence risk decision-making
Six personalised safeguarding responses
Monitor and review
Outcomes
Assessment and
investigation
Strategy discussions
Referral and
decision
Alert
Person-centred services
Person-centred risk assessment
Who is the person? Where are we now? Where do we want to be? What have we tried and learned already? What shall we do next?
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
Useful links
Vision for social care
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508http
Person-centred assessment http://www.thinklocalactpersonal.org.uk/Browse/safeg
uarding/?parent=8625&child=3681
www.skillsforcare.org.uk