SCIE Report 36: Enabling risk, ensuring safety: Self-directed support and personal budgets

Introduction

'There is clearly a need to ensure that the move to self-directed support is accompanied by better ways to identify and manage risks' (Department of Health/ADASS 2009)

Why is this issue important?

There are three main factors which make the issue of safeguarding and risk important to debates about the development of personalised services:

1. The possibility of increased risk for sections of the population who have already been demonstrated to be at risk of abuse or neglect.
2. The possibility that current debates on risk and safeguarding may make people using services and/or their families or carers reluctant to take advantage of new opportunities for independence, choice and control.
3. Professional risk aversion.

Professional risk aversion

This varies according to whether or not explicit policies, training and leadership exist which promote a positive, informed approach to risk taking and management.

Evidence has suggested that frontline practitioners can sometimes make generalised decisions based on assumptions about the capacity of certain groups (such as older people, people with learning disabilities and people with mental health problems) when deciding whether to offer the direct payment option.

Professional concern soundly based in knowledge of each individual's wishes, needs, strengths, circumstances and support networks is legitimate.

But denying opportunities to people using services out of ignorance, general assumptions, 'to be on the safe side', or simply because of fears of criticism or liability, is not.

Further reading

• The UK study of Abuse and Neglect of Older People – prevalence survey June 2007

Points for reflection

• What criteria do you use to assess the capacity of people who are perceived as 'vulnerable' or 'at risk' (such as older people, people with learning disabilities and people with mental health problems), when considering the direct payment option?