Assessment in social work: a guide for learning and teaching
The nature of assessment: Risk assessment
Risk assessment is a significant component of many assessments and requires discussion in its own right. Risk is mentioned only briefly in the analysis above but risk issues could feature in all of the definitional types.
Risk is an aspect of assessment in a number of social work textbooks, more notably those published in the UK (Crisp et al, 2005). Risk is also a common feature of the four assessment frameworks reviewed by Crisp and colleagues, a fact that reflects the authorship of the frameworks by UK government agencies and the resolve of governments to place issues of risk at the forefront of policies in social care and health. This resolve gains strength from the significance attached to risk issues in several public inquiries. In England, the Victoria Climbié Inquiry reported on the essential elements of future good practice in childcare, stating the importance of training in risk assessment and risk management (Secretaries of State, 2003, para 17.61). In Northern Ireland, lack of awareness of risk factors at management and operational levels were defined as significant failings in the cases of the children David and Samuel Briggs (DHSSPS, 2005). These examples illustrate the concern over children at risk, but worry about risk also, for example, ‘permeates assessment work with older people’ (Nicholls, 2006, Sec. 3).
Risk can be defined as ‘the possibility of beneficial and harmful outcomes, and the likelihood of their occurrence in a stated timescale’ (Alberg et al in Titterton, 2005).
The aim of risk assessment is to consider a situation, event or decision and identify where risks fall on the dimensions of ‘likely or unlikely’ and ‘harmful or beneficial’. The aim of risk management is to devise strategies that will help move risk from the likely and harmful category to the unlikely or beneficial categories. An enlarged idea of risk management based around the concept of ‘safeguarding incidents’ introduces the idea of professional and organisational learning from near misses (Bostock et al, 2005).
Most models of risk assessment recognise that it is not possible to eliminate risk, despite the pressure on public authorities to adopt defensive risk management (Power, 2004). There are attempts to counter these defensive tendencies via person-centred risk assessment (Titterton, 2005) and the urging of some service users who advocate non-paternalistic models of assessment and care and seek support for calculated, beneficial risk-taking (Department of Health, 2005). There is also growing institutional resistance represented by the Better Regulation Commission, which has declared that ‘enough is enough’ and argue that it is time to reverse the incremental drift into disproportionately burdensome risk regulation (Berry et al, 2006).
Crisp and colleagues note the increased emphasis on risk assessment in the UK in recent years and their review includes two textbooks in which this is the main subject. As with definitions of assessment, no common approach to risk was found. Treatment of risk varied from the detailed, including case examples, to the brief, with some books not mentioning risk at all in the context of assessment (Crisp et al, 2005, p 21). This finding suggests that educators need to choose teaching texts carefully if important subject matter is not to be omitted.
A key purpose of all four assessment frameworks is the identification and management of risk. However, the objectives of the frameworks are different and therefore the nature of risks that are of concern are different too. The frameworks for assessment of children and families and of older people addressed service-user vulnerability and avoidance of significant harm, and, in relation to older people, loss of independence. The guide on carers’ assessment focuses on the risk of breakdown of the carer role (Crisp et al, 2005, p 47). This finding suggests that the learning offered by each framework differs and any one may be insufficient to cover the necessary range of the subject.
The requirements of the social work degree directly support attention to learning on risk assessment. Key role 4 of the NOS and the social care code of practice both cover assessment of risk. Reflecting the less risk-averse approach described above, however, both the NOS and the codes also expect social workers to respect risk-taking rights and to help inform risk-taking. Service user and carer interests, consulted on their expectations for the NOS, sought support for appropriate risk-taking (TOPSS UK Partnership, 2004, para 2j). The NOS augments these liberal aims with a set of expectations that both contextualise the risk assessment role and convey its complexity. Social workers are expected to balance rights and responsibilities in relation to risk, regularly re-assess risk, recognise risk to self and colleagues and work within the risk assessment procedures of their own and other organisations and professions (Key role 4).
Questions for educators
- In what ways does teaching on risk feature in the programme?
- Is there an opportunity to explore the contested nature of risk and the different perceptions among different groups about risk and its significance?
- Bearing in mind both the variable levels of attention to risk that may be found in textbooks and the different kinds of risk that preoccupy assessment frameworks, what are the main teaching and learning sources?