• Living Alone Participant Risk Assessment

  • Participant Details

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  • Participant Requirements / Preferences

  • Known Medical Conditions or Allergies

  • Emergency Contacts

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  • Support Worker Details

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  • RISK ASSESSMENT DETAILS

    Persons Involved in Risk Assessment

  • Daily Personal Activities – for participants living alone

  • Information Sharing and Privacy

  • STEP 1. IDENTIFY RISKS

  • Tick all applicable risk - Risk factors

    Daily Personal Activities Support – for participants living alone

  • Note: If supports will be delivered by the sole support worker, and any of the above risks apply, a Monitoring and Supervision Plan must be created.

  • STEP 2. ADDRESS RISKS IDENTIFIED IN STEP 1

    RISK MANAGEMENT PLAN (See APPENDIX for Consequence Rating Table and Example Risk Management Plan)

  • Likely Effect Level

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  • Likely Effect Level

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  • Likely Effect Level

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  • Likely Effect Level

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  • Likely Effect Level

  •  - -

  • MONITORING AND SUPERVISION PLAN

    Risk Monitoring and Supervision – Participants Living Alone – Sole Support Worker

  • Participant Risk*

  • Monitoring Types and Frequencies

  • Communication with participant*

  • Communication with participant*

  • Communication with participant*

  • Communication with participant*

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  • Clear
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  • Should be Empty: