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My Risk Assessed Day

March 5, 2015

I stayed at the flat last night and thinking of my day ahead, I thought it would be a good idea to revisit my risk assessment to monitor how I square on the risk assessment ratings system.

1. Mr Neary woke independently and made himself a cup of coffee & toast. Risk of self injurious behavior as he was only wearing his pants. Risk factor: 6. Mr Neary seeks to legitimize his immoral pants wearing behavior by arguing that there is nobody else in the placement & the curtains are drawn.

2. Mr Neary returned to bed with his breakfast unsupported and consumed his breakfast whilst browsing the internet on his tablet. Risk of scalding. No parental control on tablet is a concern. Personal hygeine needs reviewing as bed sheets haven’t been changed for 8 days. Risk factor: 8

3. Mr Neary telephoned his son. Good social interaction, although repetitive nature of conversation may need SALT intervention.

4. Personal Care (unsupervised). Despite previous concerns, Mr Neary still hasn’t purchased a bath mat, so a stand up strip wash would be more appropriate. Mr Neary also still chooses to shave his head with a wet razor where an electric razor might reduce the risk of severe bleeding. We have major concerns that Mr Neary does not take our concerns seriously and we may have to instigate compulsory positive behavior support around personal care. Risk factor: 10 Intolerable.

5. Mr Neary will spend the morning seeing clients in his private counselling room. After 4 months in this accommodation, Mr Neary hasn’t fitted a panic alarm. We also have concerns that sitting in a chair for four hours may cause health issues and have recommended a personal fitness programme.

6. Mr Neary will go to Tesco for weekly shop. He is able to carry out this activity independently but may need input from dietician as chocolate content remains high.Risk factor:7. Not convinced Mr Neary sees the importance of a healthy balanced diet. May be need for educational intervention.

7. Mr Neary will return to his family placement and engage in verbal interaction with son and support staff. Again, appropriateness of conversation questionable as dialogue likely to focus on a complete reenactments of the Mrs Richards episode of Fawlty Towers. No immediate risk but review of suitability of social interaction planned for three months.

8. Whilst son has bath, Mr Neary will spend an hour on administration of personal budget and staff payroll. For some reason, despite this useful addition to his community programme, Mr Neary feels resentment!!! May be an issue around his blood pressure which requires monitoring. Risk factor: 1.

9. Mr Neary & son will spend remainder of evening engaged in collaborative music DVD participation. Son will need reassurance about Vince Clark’s career pre Erasure. Mr Neary will be unsupported during this time and although he categorically disputes this we believe he is at risk of challenging behavior. It is important & relevant to note that one Thursday in 1998, son kicked Mr Neary whilst watching The Tamperer featuring Maya. Risk factor: 10.

10. Mr Neary & son will retire to bed at 10. Mr Neary & son will discuss how both will access the community tomorrow. Mr Neary will then engage in a meditation programme before sleep. The solitary nature of this program me raises concerns as Mr Neary is reluctant to reveal to professionals its nature, therefore a sleep medication intervention may be more appropriate.

Clearly Mr Neary does not lack capacity, so therefore a best interests decision is not applicable in this case. However, as this posting shows, Mr Neary is prone to making unwise choices. This morning, he chose to write this blog post when his independence programme clearly states he should have been running the hoover around. Until Mr Neary can understand that with choice comes responsibility, we will have to keep his “high risk” classification and work closely with him until such time as he sees the error of his ways.

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From → Social Care

11 Comments
  1. anonymous permalink

    http://cepuk.org/2015/03/04/maudsley-debate-long-term-use-psychiatric-drugs-causing-harm-good/

    CEP is therefore pleased to announce that Kings College London has agreed to host a Maudsley Debate starting at 17.30 on 13 May 2015 entitled: ‘This house believes that the long-term use of psychiatric medications is causing more harm than good’.

    • Pauline Thomas permalink

      Thanks for the info about the Maudsley debate. It enabled me to put my pennyworth into the replies on the site.

      • simone aspis permalink

        I must attend – I am a PHD Education student at KCL – must attend – Who knows whether disabled students will be able to attend with Government’s attacks on disabled students allowance (oh I am a serial receipant – completing several post grad courses as mature student) – that are subject to judical review on April 20th and April 21st

      • simone aspis permalink

        where is the debate taking place – room, campus and time and date – some of this information is up aready

  2. Sally permalink

    Ah, I think risk assessments are needed, especially for people who have impaired judgement and abilities.The question of what someone can be left to do comes up all the time in mental health and learning disabilities and dementia care. Independence can be used as an “out.” The wretched people mentioned in the media a couple of weeks ago living in terrible conditions in flats they couldn’t manage alone would have been left like that under the argument that they had the right to live independently. Never mind about capacity.
    However, as your spoof shows, risk assessments can also be unhelpful, meaningless,nit picking, used to prevent people from doing things rather than looking at what sort of extra help they will need to do things safely. My son will run in front of cars, do things on public transport which could well lead to him getting attacked, spend all funds on custard creams, put papers on top of gas burners. He will NOT learn from his mistakes as others with capacity will. He will not easily understand why he is hurt and he will likely do the same risky thing the next time. He won’t learn anytime soon, and he won’t easily generalise. Learning about risk doing X probably won’t lead him to deduce risk when doing Y.
    And I can’t let him set fire to himself under the idea that he has a right to live the life he wants. Nor can he be put in a place where he is allowed near a cooker unsupervised.
    I dutifully filled out piles of risk assessments until I twigged that we were not going to get additional help to do these thing safely but I would get a po faced lecture and another mountain of forms.
    So its difficult. I want my son to have a rich full life but I don’t want him hurt under the idea that he will somehow earn to be safe through the experience.

  3. TRS permalink

    You failed to comment in any risks associated with blog entry. I think we should be fully informed.

    • “Mr Neary doesn’t always make the wisest of choices. For example, today he chose to write a blog post instead of going round with the hoover. Mr Neary has to understand that with choices comes responsibility.

  4. When I first learnt about risk assessments the whole point of them was to ensure that people got to do MORE, that excuses weren’t made and that obstacles were overcome.
    After leaving that job & moving away I was shocked to find out that what we’d been doing wasn’t the norm and that mostly others seemed to only use them to ensure people did LESS; to identify risks – or rather excuses with no intention to overcome them.
    Containment, control and power struggles deny people choice and the basics of being human – lives part lived 😦

  5. My favourite bit “For some reason, despite this useful addition to his community programme, Mr Neary feels resentment!!!”

  6. Love this and the previous blog. You capture the essence of nonsense that sums up risk averse practice and manage to include humour to boot. I can’t get rid of the vision of you in WHSmith trying to light your own farts & the Tesco risk assessment definitely chimed with my shopping trolley containing far too much alcohol & treats for my own good! Would you be OK with me using some of this in teaching (first year social work students)?

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