The Importance of Risk Assessments in Care Planning

Hannah Morris
Care Home Fees Associate Lawyer

When a close relative or friend is being admitted to care, a care plan will be written that focuses on their specific areas of need. These can either be basic needs, such as mobility, nutrition, continence, personal care and medication administration, or they can cover more complex areas, such as social integration, maintaining relationships and risk to skin integrity.

Not every resident of a care home is the same or needs care in relation to the same presenting needs. It’s therefore vital that a full risk assessment is carried out for each individual resident, so the risks specific to them are identified. With this information, a personalised care plan can be devised to minimise the risks and meet the appropriate level of care.

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Risk Assessments are a Legal Requirement

Undertaking risk assessments is a legal requirement for care homes and these are regulated by the Health and Safety Executive (HSE). The HSE has provided guidance to care homes outlining specific risks to be considered, such as moving and handling, slips and trips, challenging behaviour, falls and fire. However, this isn’t an exhaustive list.

HSE guidance also recognises the requirement for individual assessment, stating that some care home residents will be more vulnerable than others. Identifying what risks may be relevant to individual residents and carrying out assessments of those risks means there can be a balance between preventing harm to residents and maintaining their freedom and autonomy.

This is an important process, as failing to adequately assess risk can result in injury or death to residents and prosecutions against care homes. It must also be recognised that a person’s needs may change over time. That means care plans and risk assessments must be regularly evaluated and updated to make sure ongoing care remains appropriate.

Who Enforces Standards in Care Homes?

The Care Quality Commission (CQC) is the independent regulator of health and social care services in England. They monitor, inspect and regulate the quality of care provided to residents by care homes. By law, all care homes must meet a minimum standard of quality and safety to be registered with the CQC and therefore be able to provide care.

One of those standards is that residents must be assessed to make sure they are safe and receiving the appropriate care. The practice of care homes compiling a record of what care has been provided to a resident can ensure that there is continuity of care both within and between care homes.

However, in order to provide adequate ongoing care, it’s important to have the resident’s needs assessed, so plans can be made for how those needs should be met, and to continue evaluating how effective that care has been.

The assessment process enables evidence-based care to be provided, that is specific to the resident and effective in meeting their needs. This personalised care planning system also ensures the most appropriate use of limited care resources.

Care home records can cover a large number of topics, including medication records, records of professional visits, records of communications with relatives, referrals to other organisations and a daily record/account of the care provided.

Who Funds the Care?

When a relative is admitted to a care home, a major concern can be, not only that the correct care is being assessed and provided, but who funds that care? An NHS Continuing Healthcare Funding assessment considers this point; looking at whether the NHS should be funding care or whether the resident’s ability to pay will be means-tested.

In order to answer the funding question, the assessors must be able to identify the resident’s overall need and care requirements. Ensuring that care homes undertake full risk assessments and record them accurately can therefore assist in the correct funding decisions being made.

In a large number of retrospective funding cases, success can be limited by poor record keeping from care homes or unavailability of those documents at the time of assessment. It’s therefore important to check your relative’s care home is compiling and retaining detailed and accurate records; of the risks identified, the planned care and daily entries to report the outcome of that care on a daily basis.

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