Rochdale Borough Safeguarding Adults Board
(RBSAB)
RBSAB
Safeguarding Adults
Risk Assessment Framework
January 2012
Developed by Greater Manchester Safeguarding
Adults Network of Safeguarding Leads
Page Number
Contents
2
Foreword
2
1. Purpose
2
2. Introduction
2
3. Risk assessment framework
4-5
1.
2.
3.
4.
Analysis
Evaluation
Options
Management
4. Mental capacity and risk
5-6
5. Positive risk-taking
6
6. Remaining / unresolved risk
6
7. Managing risk when support is refused
7
8. Guidance and Legislative Frameworks
7-9
a.
b.
c.
d.
e.
No Secrets Guidance
Human Rights Act 1998
Equality Act 2010
Mental Capacity Act 2005
Duty of Care
9. Contributions to this document
10
10. References
10
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Safeguarding Adults Risk Assessment Framework
Foreword
This document has been produced by the Greater Manchester Coordinators Network of
Safeguarding Leads from the local authority, police and NHS. The document aims to
provide strategic guidance and support to operational documents and tools for
identifying and managing risk within the safeguarding adults’ process. The document
aims to promote best practice and ensure the safeguarding principles of
empowerment, protection and choice are embedded and considered when undertaking
risk assessments and implementing management strategies into safeguarding adult
practice.
1. Purpose
The purpose of this document is to assist agencies in developing a consistent
approach towards risk and safeguarding adults. When there are concerns of harm to
an adult at risk, there is a delicate balance between empowerment and safeguarding,
choice and risk. It is important for agencies to consider when the need for protection
would override the decision to promote choice and empowerment. Agencies should
adopt a positive approach in the management of risk, ensuring the person’s safety is
not compromised. There should also there is a clear distinction between putting a
person at risk and enabling them to manage risks appropriately.
2. Introduction
What do we mean by risk? We all take risks every day without giving it a thought;
risk is part of life and some of us are greater risk takers than others. For some people
risks present a challenge which when overcome, enhance their quality of life. Some
people are not able to deal with the risks they encounter and therefore need
assistance with assessing and managing risk. Risk in a safeguarding context is not
about clinical / environmental risk but relates to prevention, empowerment and
protection of the individual concerned.
Risk assessments assess the risks that people are exposed to in their everyday
lives.
Risk management ensures that adequate strategies are in place to assist people to
manage those risks identified.
Risk assessment and risk management are integral to all adult safeguarding work.
Risk assessments and management plans should always be holistic and in
collaboration with the individual concerned. The individual should be central
throughout the process.
Risk assessments must take into account the fundamental needs of the individual and
include details of the individual’s views and ability in making their own decisions about
risk taking and managing, as far as possible, their own risks. A positive approach
should be adopted in managing the risks identified and a balance sought between
protection and safety and individual autonomy and self-determination.
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Risk assessment and risk management require collaboration and close cooperative
working between key agencies involved with the adult at risk. Practitioners must be
aware of the nature of risk, how to assess it and strategies that can be used to
manage it at appropriate levels. It is important to find out how risk and risk-taking are
defined, understood and put into practice by practitioners from the agencies involved,
and to come to some common understanding and agreement about levels of
acceptable risk to the individual.
A multi-agency approach to risk helps to ensure that as far as possible a
comprehensive view is obtained of the individual and their situation. If the focus is too
narrow and single-agency focused, there is a danger that key aspects may be
overlooked or that the information available will not be detailed enough to inform the
analysis of risk. Risk assessment and management should be jointly owned processes,
although a lead agency may need to be recognised and a key worker identified for the
individual.
Risk assessments should be routinely updated and reviewed throughout the
safeguarding process. The key question which continuously needs to be asked: is the
person you are supporting now safe? The key stages for updates and reviews should
be completed during the strategy stage and at case conference.
Risk assessments have come under scrutiny and their failings highlighted in a number
of high profile Safeguarding Adults Serious Case Reviews, where death of an adult at
risk has occurred. Some examples of these are:

Gemma Hayter Serious Case Review - Risk Assessments were not routinely or
systematically undertaken or used to underpin decision-making in relation to
undertaking reassessments and the closure of cases. This is especially important
when someone is reluctant to engage with services, refuses support or cancels
services. Some professional practice was too heavily weighted towards the “right
to choose” rather than the duty of care.

Fiona Pilkington Serious Case Review - Agencies responsible for assessment should
ensure that it is informed by holistic ways of viewing people and their social
context, as well as by the need to assess eligibility for services. A further
recommendation was that staff needed to undertake training & identify risk factors
as well as update their Vulnerability Policy.
3. Risk assessment framework
It is important to remember that risk assessments should be holistic and includes
observations / consideration to the environment. The risk to others should also be
recorded. On most occasions, a risk assessment will be subjective and is not an
absolute scientific process. Therefore, it is likely to be beneficial to involve more than
one person or agency so the assessment is not a single person or single agency’s
judgement about the risk and what might constitute an acceptable level of risk in that
situation. Those agencies that are involved with the individual should be included in
the assessment process. The extent of their involvement will vary from consultation to
full participation, depending on the nature of the individual’s situation, the risks
concerned and levels of involvement of the agencies.
There are four key steps to a risk assessment; consider the following:
1. Analysis
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 Involve the person and /or their advocate.
 Identify what is the risk and what are the benefits.
 Identify and describe the risk / benefits in detail.
2. Evaluation
 What is the person’s perception / view of risk?
 What is the likelihood or probability of the risk occurring again?
 What is the impact on the individual?
 Why do they want to take the risk?
 What is the severity of the risk?
 Are there any risks to others?
3. Options
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Can the risk be avoided or reduced?
Should the risk be transferred to another agency or retained?
Can the individual live with the risk?
Are there areas of disagreement?
4. Management
 What does the person want?
 Can the risk be controlled or supervised?
 Can the risk be minimised?
 Is it possible to accept or tolerate the risk - consider the use of MAPPA,
MARAC and ASBRAC.
The risk assessment has to predict the possible likelihood of harm occurring in the
future, especially if the individual chooses to remain in the abusive situation. It should
also look at ways of minimising the risk of harm or at least reducing it to acceptable
levels of risk for the individual.
Risk assessment tools tend to focus on the environment rather than the individual
because it is easier to measure environmental risk factors. However, a focus on the
individual is essential to ensure that an appropriate assessment of the current level of
risk of harm, associated factors identified and sufficient protection is provided. The
assessment should be holistic and take into account the individual’s abilities,
strengths, preferences along with their wider social and family networks and the
support available.
Degrees of potential harm also need to be considered, in order to help with a decision
about the nature and levels of risk involved. A risk assessment should consider what
level of risk do they pose to the individual and others in the future? Discussions that
take place about this must be recorded along with subsequent decisions. Recording
should be clear accurate and ideally shared with or done in conjunction with the
person concerned, as well as with other relevant agencies.
4. Mental capacity and risk
The starting point for any discussions about risk assessment should be whether the
person has full mental capacity to make informed decisions about the risks that they
face and whether their decision will have an impact (in terms of risk of harm) on
anyone else.
Adults with limited mental capacity are some of the most vulnerable and least able to
protect themselves from harm (or risk of harm) or to obtain protection via the law and
legal system.
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The process should be in the best interest of the individual concerned and the least
restrictive option. The person needs to be as fully involved as they are able to be in
the safeguarding process, with sufficient support to enable this. The use of advocates
to assist the person can be very important. However, care does need to be taken to
ensure the process does not become controlling but is supportive to the individual
concerned. It is important to focus on the outcomes that are important to the
individual and not just process-level outcomes.
5. Positive risk-taking
Positive risk taking is a process which starts with the identification of potential benefit
or harm. Positive risk taking is key to providing person-centred support for people. A
balance must be struck between protection and risk. The individual should be
encouraged to positively take risks, rather than seeking to remove all risks. It is not
possible or desirable to eliminate all risks to individuals. The desired outcome is to
encourage and support people in positive risk taking to achieve personal change or
growth. This may involve:
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Assuming that people can make their own decisions (in line with the Mental
Capacity Act) and supporting them to do so;
Working in partnership with adults who use services, family carers and
advocates recognising their different perspectives and views;
Developing an understanding of the responsibilities of each party;
Enabling people to access opportunities and take worthwhile chances;
Understanding the person’s perspective of what they will gain from taking risks
and understanding what they will lose if they are prevented from taking risk;
Understanding the consequences of different actions;
Making decisions based on all the choices available and accurate information;
Being positive about potential risks;
Understanding a person’s strengths and finding creative ways for them to be
able to do things rather than ruling them out;
Knowing what has worked or not in the past, taking into account previous
wishes / views;
Where problems have arisen, understanding why;
Supporting people who use services to learn from their experiences;
Ensuring support and advocacy is available;
Sometimes supporting short term risks for long-term gains; and
Ensuring the services that are provided, promote independence not
dependence.
6. Remaining / unresolved risk
It will never be possible to eliminate all risk of harm in any environment. A brief
summary of what risk will remain following the planned action should always be
documented. There may be a certain level of risk which cannot be addressed due to
the lifestyle choices of the adult at risk. If so, practitioners should take into account
and record the views of the adult, the carers and other professionals about whether it
is an acceptable level of risk. Practitioners should record whether the person has
made an informed choice, and whether the remaining risks have been explained and
understood.
A record of the monitoring and review arrangements for the unresolved risk, including
timescales, should be made. Specifically, agencies should ensure their monitoring
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arrangement also identifies contingency plans to be put in place if the remaining risk
rises to an unacceptable level.
7. Managing risk when support is refused
There are various situations where this could happen. When an adult at risk refuses to
accept support designed to reduce risks to their health and safety, it is important for
practitioners to continue to monitor the situation and show evidence of the steps
taken to encourage the person to engage with support. It will be important to involve
multi-agency professionals in this process and to consider what alternative forms of
support are available.
Having established an alternative risk management plan, the adult at risk resistance
to engagement should be tested by the re-introduction of the new plan by the person
or the agency most likely to succeed.
If the plan is still rejected, another multi-agency meeting should be held to discuss
the remaining risks, any alternatives that have not yet been tested and the monitoring
review arrangements for the adult.
It may be necessary to take legal advice to ensure practitioners and agencies have
met their duty of care as far as is reasonable and to inform the plan at review.
With regard to safeguarding adults, practitioners are well placed to identify individuals
who may be at risk and who are at risk of harming others. Practitioners should also be
able to recognise failing services, uncover evidence of actual abuse and have a
responsibility to report these issues and seek protective responses where necessary.
8. Guidance and Legislative Frameworks
There is a range of guidance and legislative frameworks which provide support. These
should be taken in to account when undertaking risk assessments and implementing
strategies to manage those identified risks.
The legislative frameworks ensure that individuals are consulted, their rights are
protected and any proposed actions are in accordance with their wishes or in their
best interest.
a. No Secrets Guidance
The ‘No Secrets’ document from the Department of Health provides guidance and sets
out principles which agencies should adhere to in the prevention and response to
abuse of an adult at risk. The principles need to be considered when undertaking risk
assessments and also give reference to further frameworks for consideration, as part
of strategies to ensure the safety and wellbeing of adults at risk.
Some of the principles which are key to risk assessment and risk management are:
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Actively promoting the empowerment and well-being of vulnerable adults
through the services agencies provide;
Acting in a way which supports the rights of the individual to lead an
independent life based on self determination and personal choice;
Recognising people who are unable to take their own decisions and / or to
protect themselves, their assets and bodily integrity;
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Recognising that the right to self determination can involve risk and ensure that
such risk is recognised and understood by all concerned, and minimised
whenever possible (there should be an open discussion between the individual
and the agencies about the risks involved to him or her);
Ensuring the safety of vulnerable adults by integrating strategies, policies and
services relevant to abuse within the framework of the NHS and Community
Care Act 1990, the Mental Health Act 1983, the Public Interest Disclosure Act
1998 and the Registered Homes Act 1984 (the provisions of which will be
extended by the Care Standards Bill).
Ensuring that when the right to an independent lifestyle and choice is at risk the
individual concerned receives appropriate help, including advice, protection and
support from relevant agencies; and
Ensuring that the law and statutory requirements are known and used
appropriately so that vulnerable adults receive the protection of the law and
access to the judicial process.
b. Human Rights Act 1998
The Human Rights Act, 1998 gives further legal effect to the fundamental rights and
freedoms contained in the European Convention on Human Rights. These rights not
only impact on matters of life and death, they also affect the rights people have in
their everyday life: what people can say and do, their beliefs, their right to a fair trial
and other similar basic entitlements. Most rights have limits to ensure that they do
not unfairly damage other people's rights. Adults have the responsibility to respect
other people's rights, and in return they must respect theirs. Every Adult has a right:
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To
To
To
To
To
To
To
To
To
To
To
To
Dignity;
Receive Equal Treatment;
Fulfilment;
Autonomy;
Individuality;
Esteem;
High Quality of Life;
Freedom of Emotional Expressions;
Life;
Access to all Personal Records;
not to be Subject of Discrimination; and
Privacy.
If human rights and freedoms are breached, people have a right to an effective
solution in law, even if the breach was by someone in authority.
c. Equality Act 2010
The Equality Act, 2010 provides protection from unlawful discrimination in relation to
the following characteristics:
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Disability;
Gender reassignment;
Pregnancy and maternity (which includes breastfeeding);
Race;
Religion and belief;
Sex; and
Sexual orientation.
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Agencies and their staff can be held legally responsible for what they have done if
anyone does something which is considered as unlawful discrimination, harassment or
victimisation of an individual.
d. Mental Capacity Act 2005
The Mental Capacity Act, 2005 provides a statutory framework to empower and
protect vulnerable people who are not able to make their own decisions. It makes it
clear who can take decisions, in which situations, and how they should go about this.
It enables people to plan ahead for a time when they may lose capacity.
The whole Act is underpinned by a set of five key principles:
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A presumption of capacity - every adult has the right to make his or her own
decisions and must be assumed to have capacity to do so unless it is proved
otherwise;
The right for individuals to be supported to make their own decisions - people
must be given all appropriate help before anyone concludes that they cannot
make their own decisions;
That individuals must retain the right to make what might be seen as eccentric
or unwise decisions;
Best interests – anything done for or on behalf of people without capacity must
be in their best interests; and
Least restrictive intervention – anything done for or on behalf of people without
capacity should be the least restrictive of their basic rights and freedoms.
Additional safeguards have also been introduced in law to protect the adult’s rights
and ensure that the care, treatment or protection received is in their best interests.
The Deprivation of Liberty Safeguards framework (for Hospitals and Care Homes)
needs to be followed where intervention results in a deprivation of the person’s
liberty. Referrals to the Court of Protection may also need to be considered. The Court
of Protection is a specialist court for all issues relating to people who lack capacity to
make specific decisions. The Court can make decisions and appoint deputies to make
decisions in the best interests of the person who lacks the capacity to do so.
e. Duty of Care
A number of professional bodies have developed code of practices, which provides
guidance to their members on how they should respect individuals they provide a
service to. Some of the guidance reflects the principles from the safeguarding adults’
framework and considerations to be taken when completing risk assessments and risk
management processes. These include:
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Promoting the independence of individuals whilst protecting them as far as
possible from danger or harm (GSCC);
Respecting people as individuals and act to identify and minimise risk to the
individual (NMC); and
To be personally responsible for making sure that you promote and protect the
best interest of the people you provide care for (HPC).
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9. Contributions to this document
The following people and authorities have contributed to this document:
Jane Robinson
Bolton Council
Christine Murnane
Bury Council
Adele Owen
Greater Manchester Police
Gaynor McGinty
Manchester Council
Pauline Cusack
Oldham Council
Jane Timson
Rochdale Council
Keith Bonner
Salford NHS Trust
Adele Summers
Stockport Council
Pam Gough
Tameside Council
Janet Cooling
Trafford Council
Michael LeStraad
Trafford NHS Trust
Elaine Lamprell
Wigan Council
10. References
In the development of the framework a number of the documents/ articles were
reviewed:
 DoH (2000) No Secrets: guidance on developing and implementing multiagency policies and procedures to protect vulnerable adults from abuse. DoH,
London
 SCIE (2011) Report 41: Prevention in adult safeguarding. Social Care Institute
for Excellence, London.
 DoH (2007): Independence, Choice and Risk: a guide to best practice in
supported decision making. DoH, London.
 Research in Practice for Adults (Ripfa): Safety Matters: developing practice in
safeguarding adults. George Julian, Bridget Penhale.
 ADASS West Midlands (2011): A positive approach to risk and personalisation:
A Framework. ADASS West Midlands; Joint Improvement Partnership; and
North West Midlands.
 City of Plymouth (Undated): Safeguarding Adults Guidance for Risk
Management Tool Draft. City of Plymouth website.
 Gateshead Council (Undated): Positive Risk Taking Policy. Gateshead Council
website.
 Link to Gemma Hayter SCR information http://www.warwickshire.gov.uk/Web/corporate/wccweb.nsf/Links/0C9B7D1DF19DA5
1680257944003F4A04/$file/GH+SCR+Public+Summary+(APPROVED+19.10.11).pdf
 Link to Fiona Pilkington SCR information 10
http://www.hounslowhomes.org.uk/equalities_overview_report__fiona_pilkington_progress_plan_nov_2010.pdf
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