Assessing risk: What would you do?
Learning Objectives
After considering this resource, you should be aware of the complexities of risk assessment in social work.
One of the fundamental aspects of being a social worker is assessing the risk to an individual from a particular set of circumstances, with the ultimate aim of keeping a service user safe from harm. Risk assessment can be difficult and full of complexities though, and often presents numerous dilemmas for the social worker before a decision is reached.
This activity presents four different scenarios based on risk assessment and which increase in complexity as you proceed. Consider each one and respond accordingly to the question at the end of each case study. There is no wrong or right answer as different circumstances will change how you deal with situations. You might wish to discuss your views with other students or your practice educator or lecturer and to listen to other arguments. When you select an answer, feedback will be provided that will reflect the issues at hand.
Scenario 1
David is a fifty-four year old Welsh-speaking male living in a flat in a tight-knit community. He is well-known locally as an independent and flamboyant 'character', partly due to his extremely dishevelled and unkempt appearance, and partly due to the effects of drinking alcohol to excess. Recently, his physical health has deteriorated to the extent that he is now unable to leave his housing association flat. Alcohol is bought on his behalf by local young people. However, lately neighbours have become increasingly concerned that some of these young people are taking advantage of David - his flat is now an empty shell stripped of all his possessions and even some of the fixtures. David himself appears emaciated, although lucid and rational. He insists that he is fine, needs no help, and wishes to remain living at home. Despite this, the worried neighbours ring social services.
David's social worker, Carys, has made some enquiries into moving David into a residential home. The nearest home with vacancies is located twenty-five miles away in a predominantly English speaking area. She visits and informs David that as he cannot cope with living independently he should move to that residential home.
Do you agree with Carys's decision?
Carys assessed that David is obviously physically very weak, his ability to care for himself is extremely limited and his standard of living is, in comparison with the general population, exceptionally poor. She recognised the deterioration in David's physical health, and acknowledged the fact that David is currently unable to protect his property against theft. She assessed the risks to David as a result of his lifestyle choice therefore, and acted accordingly.
Carys should also consider David's wishes to remain living at home though. With David, she could design a package of support that would respect his independent nature and strong local connections and allow him to remain living in his flat while reducing the risks he currently faces; for example, support could be obtained from meals on wheels, the local health visitor, the GP, the housing association, Age Concern, and local drug and alcohol services (statutory and voluntary sector). Carys should also have considered the importance of language in David's case and ensure that David receives services in his language of choice.
As David gets older, Carys must reflect on the fact that his vulnerability may intensify, so she needs to ensure regular reviews of David's situation are held in order to ensure the support he receives continues to remain at the appropriate level.
Carys assessed that David is obviously physically very weak, his ability to care for himself is extremely limited and his standard of living is, in comparison with the general population, exceptionally poor. She recognised the deterioration in David's physical health, and acknowledged the fact that David is currently unable to protect his property against theft. She assessed the risks to David as a result of his lifestyle choice therefore, and acted accordingly.
Carys should also consider David's wishes to remain living at home though. With David, she could design a package of support that would respect his independent nature and strong local connections and allow him to remain living in his flat while reducing the risks he currently faces; for example, support could be obtained from meals on wheels, the local health visitor, the GP, the housing association, Age Concern, and local drug and alcohol services (statutory and voluntary sector). Carys should also have considered the importance of language in David's case and ensure that David receives services in his language of choice.
As David gets older, Carys must reflect on the fact that his vulnerability may intensify, so she needs to ensure regular reviews of David?s situation are held in order to ensure the support he receives continues to remain at the appropriate level.
Scenario 2
Luke is a twelve year old boy referred to social services by his school. They are concerned about his high rate of absenteeism and worried that he appears to be hanging around with a group of older boys known to use drugs and alcohol and to commit minor offences. Luke lives at home with his father Paul, mother Michele and younger brother Simon. Paul has recently returned from active service in Afghanistan and appears to find life at home challenging - he is unable to find employment, sleeps most of the day and drinks alcohol through the night to try and rid himself of his flashbacks to his time on active service. Michele is trying to manage a part-time job as well as caring for her two sons and consequently appears depressed and unable to cope. Family arguments are a daily occurrence and are escalating in intensity.
Colin, their social worker, decides to contact the Army Welfare Service and they offer Paul counselling to assist him in his attempts to readjust to civilian life and to try and control his flashbacks. They also offer Paul and Michele counselling for their relationship difficulties, and Paul parenting classes which may assist him in understanding how his behaviour is impacting upon the family as a whole, but Luke in particular. Colin also decides to advise Michele to visit her GP for support in relation to her depression and makes a referral for the whole family to begin family therapy with the aim of recognising and changing the dysfunctional/destructive elements.
Do you agree with Colin's course of action?
Colin has recognised that the family are in a state of dysfunction and support is required. The Army Welfare Service may be able to provide Paul with emotional and practical support to help him adjust to civilian life. Michele may benefit from support in relation to her mental health. Family therapy may be helpful in helping the whole family adjust to Paul's return home. Parenting classes may assist Paul understand how his behaviour is impacting upon the family as a whole, and on Luke in particular.
Colin should also consider the risks to Luke's health and education caused by his absenteeism and his acquaintance with the offending older boys though. Liaison with the school counsellor and one-to-one work with Luke may uncover the source of the rebellious behaviour.
Colin has recognised that the family are in a state of dysfunction and support is required. The Army Welfare Service may be able to provide Paul with emotional and practical support to help him adjust to civilian life. Michele may benefit from support in relation to her mental health. Family therapy may be helpful in helping the whole family adjust to Paul's return home. Parenting classes may assist Paul understand how his behaviour is impacting upon the family as a whole, and on Luke in particular.
Colin should also consider the risks to Luke's health and education caused by his absenteeism and his acquaintance with the offending older boys though. Liaison with the school counsellor and one-to-one work with Luke may uncover the source of the rebellious behaviour.
Scenario 3
Adele is a twenty-four year old woman with a physical impairment and poor body image issues. She is in receipt of assistance from a support worker who once a week accompanies her to the local swimming pool to participate in a female-only aqua-aerobics class, which she enjoys. However, last week was half-term and unknown to both Adele and the support worker the class was cancelled. Adele decided to go for a swim instead, but became distressed and left when she overheard some teenage boys making fun of her appearance.
Today, Charity, the social worker, receives a telephone call from the support worker who has gone to collect Adele from her home and accompany her to the aqua-aerobics class. The support worker reports that Adele does not respond to the doorbell, and on looking through the window sees what looks like an empty pill bottle standing on the kitchen table. Charity is aware that Adele disclosed suicidal thoughts in the past, but is not known to have made any attempts.
Charity immediately informs her team manager of the situation and, following advice, calls for an ambulance and reports the incident to the police. Just as the emergency services arrive and prepare to break into Adele's home, Adele appears around the corner clutching a bottle of milk.
Do you agree with Charity's actions?
Charity's risk assessment acknowledged the impact the incident in the swimming pool on Adele's ongoing negative body image issues. Adele enjoys aqua-aerobics and Charity is aware that missing a class is out of character. Charity was also concerned by the disclosure of suicidal thoughts in the past.
However, Charity could have checked Adele's file to see if there was a mobile telephone number and tried to make contact with her on that before deciding to involve the emergency services.
Charity's risk assessment acknowledged the impact the incident in the swimming pool on Adele's ongoing negative body image issues. Adele enjoys aqua-aerobics and Charity is aware that missing a class is out of character. Charity was also concerned by the disclosure of suicidal thoughts in the past.
However, Charity could have checked Adele's file to see if there was a mobile telephone number and tried to make contact with her on that before deciding to involve the emergency services.
Scenario 4
Chaitali is a fourteen year old girl of Asian origin living with her 3 week old baby in a mother and baby foster placement. She has had no contact with her family since being thrown out of her home once her pregnancy was discovered. She is not in contact with the father of her child. Foster carers report that Chaitali appears depressed and lacking in warmth towards her baby, only undertaking the basic care tasks that are required.
Chaitali herself feels that she is a 'rubbish' mother, and often asks the foster carers to look after the baby because she feels they do it much better than her. Today, the foster carers ring Joshua, Chaitali's social worker, and say that Chaitali is planning to leave her baby with them and stay for the weekend at the flat of her new boyfriend, who in the opinion of the foster carers appears to exercise an undue influence over Chaitali. They want Joshua to ban Chaitali from seeing her boyfriend.
Joshua agrees with the foster carers that Chaitali needs to focus on her baby and bans contact with her boyfriend for one month.
Do you agree with Joshua's actions?
Joshua has acknowledged two potential risks: the risk of Chaitali not bonding with her baby, and the risk to Chaitali from her new boyfriend. Joshua acknowledges that Chaitali is legally still a child herself and under the age of consent for sexual activity. Joshua may consider the new boyfriend's powerful hold over Chaitali could distract her from her baby and impact negatively on the already weak bond between them. Joshua recognises that time and focus might be required for Chaitali to feel that she is able to perform parenting tasks appropriately. Parenting classes and toddler groups may be helpful in teaching new skills and raising Chaitali's self-esteem within a safe social environment.
Banning Chaitali from seeing her boyfriend totally though, may encourage further rebellion, so Joshua could attempt to work with her to negotiate some freedom within imposed boundaries - by imposing an early curfew for example. Joshua could also liaise with Chaitali's midwives and health visitors, as she may be in need of additional support as a result of missing her family at a particularly emotional time.
Joshua has acknowledged two potential risks: the risk of Chaitali not bonding with her baby, and the risk to Chaitali from her new boyfriend. Joshua acknowledges that Chaitali is legally still a child herself and under the age of consent for sexual activity. Joshua may consider the new boyfriend's powerful hold over Chaitali could distract her from her baby and impact negatively on the already weak bond between them. Joshua recognises that time and focus might be required for Chaitali to feel that she is able to perform parenting tasks appropriately. Parenting classes and toddler groups may be helpful in teaching new skills and raising Chaitali's self-esteem within a safe social environment.
A total ban though, may encourage further rebellion from Chaitali, so Joshua could attempt to work with her to negotiate some freedom within imposed boundaries - by imposing an early curfew for example. Joshua could also liaise with Chaitali's midwives and health visitors, as she may be in need of additional support as a result of missing her family at a particularly emotional time.
Reflective Questions
- How can social workers ensure that they are responsive to the individual needs of service users?
- Think about the various people/agencies that should contribute to the social worker's assessment of the different situations.
- Reflect upon the rights of rights of the individuals within each scenario - how can these rights be balanced with safety concerns to produce the best possible outcome?