Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessing Risk Mark Hodgkinson Adult Protection and Review Officer Angus Council Objectives Help participants contribute to, or better undertake risk assessments of adults at risk. Remind you of the legal context Acquaint you with models of risk assessment To show how bias and error can occur To get you look at a risk assessment and correct errors To assist you to take defensible decisions and keep safe

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 When was the last time you took a risk? What factors did you take into account? What Happened?

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Model of Risk Chances of Something Happening Consequences if it does Level of Risk

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessment and the Law (2a) Adult Support and Protection (Scotland) Act 2007 S4 “A council must make inquiries about a person’s well-being, property and financial affairs if it is known or believed that the person is an adult at risk S12 “….order is required to establish whether the person is an adult at risk who is being, or is likely to be, seriously harmed” S20 “ The sheriff may grant a banning order only if satisfied; “that the adult at risk is being, or is likely to be seriously harmed” – We have to assess the chances of harm occurring and the degree or seriousness of the harm We must do risk assessments

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessment and the Law (2d) Mental Health (Care and Treatment) (Scotland) Act 2003 (Section 33) “The local authority shall cause inquiries to be made where it appears that the person has a mental disorder and may have been subject to ill treatment, neglect…” Social Work Scotland Act 1968 and Adults with Incapacity Act both require Local Authorities to assess / investigate

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Types of assessments Actuarial Insurance questions Relies on moving from general to specific Denies “individual circumstances” Human Rights problems Reasonably accurate

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Types of assessments Clinical Relies on clinician or practitioner assessment of an individual Does not take into account actuarial information Not noted for its accuracy

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Bias and Error in Risk Assessment What can make for bad inaccurate assessments (Group) Insufficient information Inaccurate information (major) Stockholm Syndrome Assessor’s Bias (value based) Lies Unreal Optimism

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Defensible Decisions Take all reasonable steps Assess risk Have a clear action plan in place Collect and thoroughly evaluate information Record well Keep to operational guidelines Communicate with relevant others, seek information you lack

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 What we already know Poor communication is at the root of every social care disaster Previous pattern of behaviour can be used to predict a future pattern of behaviour Similar circumstances repeating themselves can lead to similar behaviour Similar behaviours repeating themselves (nothing predicts future behaviour like past behaviour) Similar influences repeating themselves Environmental or network circumstances are similar or likely to repeat If an abuser has access to opportunity to abuse the risk is increased The rewards of the risky behaviour to the abuser should be taken into account Personality factors Motivation factors Addictions

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Components of a good Risk Assessment (Group task) Collect full information Use a chronology State the risks to the adult, where, when and in what circumstances the harm occurs or may occur Make sure you communicate with all relevant parties Evaluate (what does information mean for the adult’s safety or wellbeing) Identify potential/actual outcomes to the adult Establish a plan Clarify individual roles and responsibilities Set timescale for reviewing risk and plan Clear language Avoid jargon Understanding of the adult Ability / awareness of the adult

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessments in Adult Protection Adult Support and Protection (Scotland) Act 2007 “A public body or office holder performing a function in relation to an adult at risk must have regard to…The adult’s ascertainable wishes and feelings (past and present)…(and regard to) the adult participating as fully as possible…(and must provide)…The adult with such information and support as is necessary to enable the adult to so participate” So: Adult / Service User / Client / Patient Centred Importance of the adult’s view Importance of seeing and communicating with the adult Importance of protecting the adult from harm

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessment Dynamic – Things change Circumstances change (better and worse) Reviewing essential Set date Revisit assessment when significant change occurs

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Exercise Assess level of risk Handouts

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 When you get an adult protection referral or identify an adult at risk, what is the first question you should ask yourself? Does anything need to be done straight away?

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessing Risk Chances of harm occurring Consequences if the identified harm does occur Imminence (very important) Highest risk cases are those which; Very likely harm will occur Grave consequences if it does Harm likely to occur very soon.

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Recap Risk Assessment – mysterious? Good components Things to look out for Legal context Models of assessment to consider imminence

Mark Hodgkinson Adult Protection and Review Officer Angus Council January 2014 Assessing Risk EVALUATIONS PLEASE