1. Purpose and principles
ExcelCare Agency provides personal care without nursing to adults in their own homes. Risk cannot be removed from someone's own home, and it should not be: a life with no risk is not a life of quality. Our task is to understand risk, reduce it where that is possible, and support the person to make informed choices about the risk that remains.
Our approach is risk enablement:
- the person is at the centre of every assessment and their views are recorded in their own words
- risk is balanced against independence, dignity and quality of life
- decisions are made with the person, and where they lack capacity, in their best interests under the Mental Capacity Act 2005
- assessments are practical and specific to the individual home and routine
2. Types of risk assessment we hold
| Assessment | Owner | Review |
|---|---|---|
| Person-centred risk assessment (individual needs) | Care staff with manager | Annually and after any change |
| Home environment risk assessment | Care staff | At first visit, annually, and after any incident |
| Moving and assisting assessment | Senior carer | Annually and when mobility changes |
| Medication risk assessment | Senior carer | Annually and after any medicines error |
| Moving and handling of equipment (hoists, aids) | Manager | Six-monthly inspection |
| Lone working and personal safety | Manager | Annually |
| Fire risk and escape in the home | Care staff | At first visit and annually |
| Infection risk | Senior carer | At each review |
| Safeguarding risk | Manager | At each review and on any concern |
| Business and organisational risk register | Registered Manager | Quarterly |
| Display screen and workstation | Office staff | Annually |
3. The five-step method
- Identify the hazard — what could cause harm, to whom, and when.
- Decide who might be harmed and how — the person, staff, family, visitors.
- Evaluate the risk and decide on controls — eliminate, substitute, reduce, or accept with monitoring. Controls must be things we actually do, not aspirations.
- Record the findings — assessment, date, assessor, person's views, controls, residual rating.
- Review and update — at the stated review date, after any incident, and whenever the person's needs or home changes.
4. Rating risk
Risk is rated by combining likelihood (1 rare to 5 almost certain) with impact (1 negligible to 5 severe) on a 5x5 matrix.
| Score | Rating | Required response |
|---|---|---|
| 1–4 | Low | Manage within the care plan; review at the normal interval |
| 5–9 | Moderate | Written controls, named owner, review date |
| 10–15 | High | Manager sign-off, monthly review, consider referral to a specialist |
| 16–25 | Critical | Care cannot proceed until controls are in place; escalate to the Registered Manager and, where needed, the local authority |
5. Positive risk taking
Where a person chooses to accept a risk — for example, continuing to smoke at home, declining a walking aid, or refusing a visit at a particular time — we:
- discuss the risk with them in plain language and record their decision
- offer alternatives without pressure
- agree a plan that reduces harm as far as the person will accept
- record the decision and the person's capacity to make it
- review the decision regularly
A documented, informed decision is not a failing. An undocumented one is.
6. Dynamic risk assessment
At every visit, staff assess the situation on arrival: has anything changed? Are there new hazards — a fall, a smell of gas, a new pet, a person who is more unwell than usual? Staff have the authority to stop a task, leave a situation and call for advice. A dynamic assessment that changes the plan is recorded and reported to the office the same day.
7. Escalation
Any risk rated high or critical, any new hazard that cannot be controlled within the care plan, and any situation where staff feel unsafe is escalated to the Registered Manager immediately. Where an employer cannot control a risk to staff, the visit is suspended until it can be made safe.
8. Organisational risk register
The Registered Manager maintains a risk register covering strategic and operational risks: staffing capacity, regulatory compliance, information security, finance, safeguarding, and business continuity. Each risk has an owner, a rating, controls, and a review date. The register is reviewed quarterly by the Board and updated after any significant incident.
9. Training and competence
All staff complete risk assessment training at induction and annually, covering the five-step method, dynamic assessment, lone working and the use of the matrix. Competence is observed during shadowing and spot checks.
10. Monitoring
The management team audits a sample of risk assessments monthly for completeness, quality of controls and evidence of the person's involvement. Audit findings, incident trends and register movements are reported to the Board quarterly.