Adult Care Risk Assessment
  • Adult Care Risk Assessment

    Adult Care Risk Assessment

  • Manchester & Stockport Office

    107 Wellington Road North
    Stockport, SK4 2LP

    Tel: 0161 975 5999
    (9am – 5pm Monday to Friday)

    Out of Hours: 07713 161 542
    (5pm - 10pm Monday to Friday)
    (7am - 10pm Satursday & Sunday)

    Rochdale Office

    160 Oldham Road
    Rochdale, OL11 1AG

    Tel: 01706 355 588
    (9am – 5pm Monday to Friday)

    Out of Hours: 07900 741 032
    (5pm - 10pm Monday to Friday)
    (7am - 10pm Satursday & Sunday)

    Liverpool Office

    136 Mill Lane
    Old Swan
    Liverpool, L13 4AH

    Tel: 0151 318 2255
    (7am – 10pm Monday to Sunday)

     
  • Date of Assessment
     / /
  • Support Plan

  • Date of Birth
     / /
  • Gender
  • Next of Kin & Emergency Contact

  • Next of Kin

  • Emergency Details same as Next of Kin?
  • Emergency Details

  • Access Information

  • Is a keysafe in place?
  • Care and Medicine Information

  • Rows
  • Will the service User require any help with oral medication?
  • Are all medications in a blister pack?
  • Do you have any allergies to medication?
  • Does the medication need to be stored/locked away?
  • Where is the medication stored?
  • Reason for Medication Storage
  • Is the service user aware of what their medications are for?
  • Is the service user aware of the potential consequences of taking too much or not enough?
  • Is the service user aware of why the medication is not stored with them?
  • Has the service user expressed any concern, resistance, or distress about this?
  • Has a Mental Capacity Assessment been carried out regarding medication management?
  • Is there evidence of best interest decision-making if capacity is lacking?
  • Has the service user given informed consent to medications being locked away?
  • Who has access to the medication?
  • Mobility & Dexterity

  • Do you use mobility aids?
  • Is there a stair lift in situ?
  • Date of last service
     / /
  • Is Service User bed bound? Or long-term in bed?
  • Is there is a hoist in situ?
  • Date of last service
     / /
  • Is there a profiling bed in place?
  • Are there any pressure sores?
  • If yes, please indicate where
  • Is the skin dry or moist?
  • Are there signs of friction or shearing?
  • Can they reposition themselves?
  • Are they pad-wearing, catheterised, or incontinent?
  • Please state
  • Please ensure a bodymap is provided within the file

  • Are you supported by District Nurses?
  • Are medications given by district nurses?
  • Do you have any specific conditions that are receiving specialist help, which HG Care needs to know about?
  • Pharmacy Information

  • Doctor Information

  • All About Me

    This section will enable us to have a clear picture of your lifestyle, preferences, wishes and daily routines. 
  • Male / Female carer preferences?
  • Any other information we need to know? (e.g. funeral arrangements, solicitors etc…)
  • Whats Important to me?

  • Are you able to express your views?
  • Hobbies and interests

    Outline previous work or social interests, hobbies, leisure pursuits, family background, cultural/religious beliefs 
  • Personal Care and Well-being

    Are you able to do the following unaided?
  • Do you have?
  • Do you need support with oral hygiene? For example, teeth brushing or supporting with dentures?
  • What Equipment is used?
  • Are there any signs of:
  • Are you registered to a dentist?
  • Do you wear dentures all day?
  • Do you remove dentures at night?
  • Do you clean your dentures independently?
  • Do the dentures fit properly?
  • Do the dentures cause pain or discomfort?
  • Do the dentures have visible build-up or staining?
  • Getting in/out of bed
  • Washing (including shaving)
  • Getting Dressed
  • Putting on shoes
  • Using the toilet
  • Communication

  • Do you use spectacles?
  • Do you have a hearing aid?
  • Are you registered blind?
  • Do you require assistance with communication?
  • Managing Continence

  • Do you have a continence management issue?
  • Mental Health and Cognition

  • Has mental capacity been determined by the social services support plan?
  • Does the service user have capacity under the Mental Capacity Act?
  • If No, is a family member/representative present during assessment?
  • Do you have any problems with cognition, i.e. memory loss, forgetfulness or confusion?
  • Does anyone have Power of Attorney?
  • Do you have an End of Life plan?
  • If yes, Is there a no resuscitation plan in place?
  • If yes, has a copy of the purple form been provided?
  • Please ensure a copy of the purple form is provided

  • Eating and Drinking

  • Can you prepare/reheat a meal?
  • Can you prepare/reheat a snack?
  • Can you prepare a hot drink?
  • Can you pour a hot drink from a flask?
  • Do you require assistance to eat?
  • Do you require assistance to drink?
  • Do you have any requirements about food or drink? These may be medical, religious, cultural or lifestyle requirements?
  • Do you require fluid thickeners?
  • Are there any concerns about nutrition or hydration?
  • Are you at risk of choking and will need monitoring whilst eating?
  • Are fluid balance charts required
  • Religious Observations

  • Do you require assistance with practising their religion?
  • Visit Information

  • Please describe how you would like to be supported on each visit

  • Are there any Social Visits?
  • Would the carer need to drive?
  • Do you use public transport?
  • Do you get a Taxi?
  • Are there any items you need to take with you?
  • Do you need to take any medications with you?
  • Any special instructions for when you are out?
  • Are there any Cleaning/Laundry Visits?
  • Which task need to be performed?
  • Environment / Home Risk

    This assessment is to be carried out to ensure that your home is safe for staff to attend and that there are no risks to you whilst we deliver your service. Your assessor will ask you some questions and check different working areas in your home for safety
  • Outside the home

  • Is the pathway leading to the house clear and safe?
  • Is there outside lighting to the property?
  • If there is a key safe or key code for access is this accessible and in a well-lit area?
  • Are there any other concerns regarding the outside of the property?
  • Inside the home

  • Are there different floor levels in the home?
  • Do you use more than one floor?
  • Floor Covering in Downstairs Hallway
  • Floor Covering in Living Room
  • Floor Covering in Kitchen
  • Floor Covering in Bathroom
  • Floor Covering in Main bedroom
  • Are these floor coverings considered to be of sound maintenance?
  • Are there any other concerns regarding the inside of the property?
  • Smoking risk assessment

    Please remind the service user that, as from July 1st 2007, there were new laws about no smoking in public and work places. At HG Care Services, we understand that this is your home and you have a right to smoke. Equally, our staff have the right to a smoke free work place. This assessment is designed to help establish a workable situation suitable for all. 
  • Do you or anyone in the house smoke?
  • If yes, do they smoke?
  • Do they use any other smoking products?
  • Where does the person usually smoke?
  • Is the smoking area well-ventilated?
  • Are there fire alarms in place?
  • If no, please inform Social Services

  • Please identify any risks to the service user
  • Do you or any other smoker in the home agree not to smoke 30 minutes prior to the call and when HG Staff are in the home?
  • If NO, do you agree to our staff opening a window or door for the duration of the call to enable ventilation to the area they are working, ensuring that these are closed before leaving the property?
  • Household Safety Hazards

  • Loose, worn or torn carpets
  • Cluttered potential tripping areas
  • Slippery floors
  • Heavy and unsteady furniture
  • Poor ventilation
  • Cluttered wardrobes / store cupboards
  • Kitchen

  • Cooker taps left on
  • Loose pan handles
  • Drying clothes on cooker door
  • Household cleaners not stored correctly
  • Bathroom

  • Unsafe handrails to bath
  • Unsafe handrails to toilet
  • No slip mat in bath
  • Electrical

  • Unguarded open fires
  • Issues with location of portable heaters
  • Multi-plug adapters
  • Electrical appliances and lighting
  • Trailing wires
  • Stairs/pathway

  • Unsafe steps
  • Uneven paths
  • Entrance handrails unsafe
  • Moving & Handling Assessments

  • Is there a history of falls?
  • Is a Moving & Handling Assessment Required?
  • Does the person have swollen, fixed or flaccid limbs?
  • Is the person’s skin condition poor?
  • Does the person find moving painful?
  • Is the person’s hearing impaired?
  • Is the person’s sight impaired?
  • Does the person have communication difficulties?
  • Does the person suffer from involuntary movements or spasm?
  • Does the person display poor coordination or balance?
  • Is there any equipment to consider? (eg catheters, oxygen cylinders etc)
  • Does the person’s clothing or footwear present a risk?
  • Is the person unable or unwilling to co-operate?
  • Is the person’s behaviour unpredictable?
  • Does the person have difficulty in following instruction?
  • Is the person anxious?
  • Does the person display challenging behaviour?
  • About the Care Setting

  • Is space restricted?
  • Is the lighting adequate for the tasks?
  • Is the temperature comfortable to work in?
  • Are there constraints on the carer’s posture?
  • Is the bed or chair the wrong height to get on/off independently?
  • Is there a risk of slips, trips or falls?
  • Would the environment restrict the use of hoists or other equipment?
  • About the tasks

  • Does the task involve any bending, stooping or twisting?
  • Does it involve frequent repetition?
  • Does it involve holding a position for extended periods?
  • Does it involve over-reaching?
  • Does it involve lifting?
  • About the carers

  • Are family or other informal carer’s involved?
  • Are other care agencies involved?
  • Is more than one carer needed for the tasks?
  • Are special skills and knowledge required?
  • Are particular physical attributes necessary?
  • Accessibility

  • Do you have any accessibility requirements or need information in an alternative format?
  • If yes, please select the formats you require
  • Care Service Contract          

  • Agreement between HG Care Services (hereinafter called "The Organisation"), and you (Hereinafter called "The Client"), relating to the provision of care provision and support.
     
    In all cases the word “visit” will relate to the undertaking of care duties at the address, as agreed and specified in the appropriate Client Care Plan.


    The Organisation agrees to undertake Client visits at times agreed on the care plan.
     
    The fee rates for services provided will be subject to assessment of individual requirement
     
    Cost of service:
    ** If you require additional support outside of local authority care plan. **
     
    If you are funding privately, the cost of care will be calculated as follows.
     
    Total day-time hours x cost per hour
               
    Total Cost starts from £25.00 per hour, subject to review and complexity.
     
    Bank Holidays and public holidays, including Christmas Eve and New Year’s Eve, will be charged at double the rates quoted in part 3
     
    Terms & Conditions for Payment of Fees:
     
    Payment of fees for services provided will be the responsibility of the Client or authorized representative.
    Fees will be invoiced directly to the Client on a monthly basis, at the end of the month in which care services have been provided. Payment is required in full within 30 days of the date of the invoice.
     
    6.     The Organisation undertakes to provide sufficient staff resources to ensure that the Client’s needs are met. In this respect the following are relevant:
     
    a.     The Organisation will do all it can to ensure compatibility between Care Worker and Client, an arrangement which is satisfactory to both parties. Where unforeseen circumstances such as staff sickness or other absences require a replacement Care Worker to undertake the care duties, the Organisation will ensure continuity of compatibility as far as possible.
    b.     The Organisation’s Care Staff will at all times carry with them proper means of identification. This will include Identity Cards or badges, and compliance with the Organisation’s Uniform Policy unless the Client has specifically requested otherwise.
     
    7.     Cancellation of Visits by the Client:
     
    The Client or his / her authorised representative is required to give a minimum of 48 hours’ notice directly to the office to cancel a visit. Cancellations made in less than 48 hours will attract the usual service charge for the visit.
     
    8.     Cancellation of Care Service Contract:
     
    This Care Service Contract may be cancelled by either party by giving appropriate notice in writing. A minimum of 2 weeks’ notice of cancellation is required.
     
    Call times
     
    Whilst we always undertake to provide a punctual service and to arrive at the scheduled call times, the nature of our work means that staff are subject to traffic conditions as well as irregular and acute work requirements which may arise earlier on any particular day. Notwithstanding, we expect 100% of calls to be within thirty minutes of the scheduled time.

  • On behalf of the organisation

  • Date
     - -
  • On behalf of the client

  • Date
     - -
  • Should be Empty: