I know it sounds a bit like a dodgy Gary Numan track from the 1980s but it’s a question which has crossed my mind often in recent years. Risk assessment became an ever-present, apparently common sense element of the architecture of human services in the last few decades of the Twentieth Century. However, as we increasingly work to redesign that architecture to fit a brave new world where we expect our work to be guided by what matters to people (personal outcomes) and to work alongside people in a partnership between professionals and citizens, does Risk Assessment still fit (if indeed it ever did)?
The current Code of Practice (SSSC) for Social Service Workers says:
‘As a social services worker you must respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people.’
What is interesting is that it’s starting point is the rights of the people we work with including their rights to take risk. However, this is what often gets lost in practice. If you read the other descriptors in the Code the following phrases jump out at you - ‘manage actual and potential risks’, ‘risk assessment policies and procedures’, ‘minimise the risks’, ‘outcomes and implications of risk assessments’, you begin to get a hint of how and why the practice of applying this perfectly reasonable code can often be to effectively avoid risks and inadvertently reduce the chances of individuals to live their lives to the absolute full. In trying to fulfil our ‘duty of care’ do we err on the side of risk aversion? Perhaps this is hardly surprising when media and public perception often blames social services workers whenever something goes wrong - but does our system of regulation play into this public perception or could it challenge it more.
My colleague Stephen Finlayson suggests one helpful approach might be to ditch the word ‘risk’ altogether and ask people what ‘human worries’ they have in any given situation. Would good conversations with the person and those who know and love them most be more likely to make good decisions about the vast majority of day-to-day risks which emerge as social service workers support the people they work alongside to become active, contributing citizens?
Perhaps one of the very big problems is that ‘harm to themselves or other people’ is an extremely broad statement and like many aspects of risk it depends very much on whose perspective and interpretation prevails.
If I make a list of the things I routinely do in which there is an actual or potential risk of ‘harm’ to me (or in certain contexts to others) it can be lengthy. Cycling to and from work often in heavy city rush hour traffic; playing cricket with an extremely hard ball which often connects with parts of my body (or others) at speed; enjoying Indian curries rather too much and please don’t even begin to mention real ales…All of these activities contribute to my life being fulfilling and to what really matters to me - any associated risks are entirely worthwhile in my opinion. Not having to depend on services for day-to-day support I can exercise this balance of what is ‘important to me’ and what is important for me to keep me healthy and safe’ without any reference to ‘assessment policies and procedures’. Indeed I usually exercise these choices without much of a thought to be honest. This is what ‘citizens’ rather than ‘service users’ do.
However, if I was to require more support in future and need help to pursue these interests might I find myself part of support planning meeting where ‘we’ agree that one curry a month is enough given the risk that I become overweight. Or accept that only having a couple of bottles of ‘Scheihallion’ on a Saturday night avoids the risk that I don’t need to go to the toilet too often or that I might get hung-over? Or perhaps I should only watch the 20/20 cricket because I risk falling asleep too often in front of the TV watching the Test matches?
Where people need assistance to make good decisions those tasked with supporting them do need to find ways to balance what is important to and for a person. However, we need to also get better at working out when an activity and its attendant risk are really none of our business. How often when assessing risk do professionals carefully consider the impact of deciding against doing something because of the assessed risk. It is careless and definitely not person centred if you fail to give that impact of not pursuing the activity serious consideration and considerable weight when addressing that important to/for balance.
All the Health & Safety Executive advice suggests the likelihood and magnitude of the risk occurring, ought to form crucial elements in any assessment, yet we suspect that many decisions are based on unlikely catastrophic occurrences or impacts which might for most citizens be potential pitfalls well worth risking for the benefits of the outcome achieved. Surely many of these considerations if addressed in good conversations as human worries might become less likely to become inadvertent barriers to people living life? Those risks which are likely and major in their impact (the minority I would contend) are the only ones which require very careful debate, discussion and planning of safeguards.
I have heard staff describe a person they support finding a partner at a local pub then describing how they had helped the person ‘assess the risk’ of the relationship succeeding or failing before the relationship was barely underway. Surely that risk is one which in life we all encounter and then all suffer and learn from those relationships which fail. Is it really something to be risk assessed – or rather a fortunate happenstance to be celebrated with you when it works and then be offered support and solace should it end.
‘It is a risk to fall in love. But what if it doesn’t work out? Ah but what if it does?’
Things continue to go wrong in our current regulated, risk assessed system. I accept that sometimes people could have done better and that it is important we support those who most need help with daily choices and challenges. However, sometimes no amount of policies, procedures and assessments could have avoided what happened. Dare I say it – sometimes a person might learn from the experience of something going wrong.
So at Thistle we are working hard to honour our relationships with the citizens we seek to serve. We think this means supporting them to take life enhancing risks if that is necessary to do what matters to them. It means having a light, human touch to those day-to-day risks or human worries that all citizens manage on a daily basis.
‘To love is to risk not being loved in return.
To hope is to risk pain.
To try is to risk failure.
But risk must be taken because the greatest hazard in life is to risk nothing’.
Ralph W. Sockman