Taking risks is an inherent part of the human psyche, but when the individual concerned requires the support of social care workers, assessing what level of risk is acceptable becomes crucial. In such cases the responsibility lies not just with the individual, but also with the care worker tasked with looking after them. Part of the challenge of providing such people with choice and control in their lives, however, involves ensuring that they are made aware of and fully understand the risks they are exposed to, thereby recognising these individuals as ‘experts in their own lives’.
Personalising care involves balancing the empowerment of the individual with the practitioner’s duty of care. It means taking account of the rights of individuals to live their lives as independently as they are able, which includes allowing them to expose themselves to a degree of risk, while minimising the possibility of them suffering significant harm.
This person-centred approach to caring involves assembling a group of people made up of professional carers, along with members of the subject’s family; a ‘relationship circle’. They are tasked with gathering together information on the individual; identifying the precise nature of the risk to be evaluated; proposing a solution that minimises the risk involved and implementing the procedure. An essential part of the process is that all those in the ‘relationship circle’, along with the individual concerned, clearly recognise what the risks are and understand what each of them is responsible for in terms of managing risk effectively.
The key points in this process are:
- Acquiring a clear understanding of what the individual aims to achieve.
- Why it is so important to the individual.
- What would be considered a successful outcome?
- A history of the risk.
- Using decision-making tools to ascertain staff responsibilities and roles.
- Determining who is responsible for making key decisions relating to the risk.
Why take any risks?
The primary aim of the person-centred approach is to enable care workers to improve the quality of life of each of their clients by allowing them to make decisions that are important to them. It is also essential, however, that everyone is kept as safe as is reasonably-possible within a free society.
Rather than having unhappy but safe clients, the person-centred approach encourages carers to work towards a situation in which the client is happy and both they and the community in which they live are safe.
It is clear that every case will be different and that where there is a risk of significant harm the wider the ‘relationship circle will be, therefore additional expert advice may be required. The assessment should be based on what the consequences would be to the individual, his or her family and the wider community, of not taking the risk rather than the other way round.
Person-centred approach in action
In Italy, the mother of a young boy was concerned that her son, who had learning difficulties, was becoming more and more isolated from society. A training and education worker who met the family suggested trying the person-centred approach and the three of them organised a relationship circle in the boy’s home. As a result, the boy went on to become an active member of the town orchestra and subsequently got a job with the village community group.