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Registration Number: {{org_field_registration_no}}

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People Taking Positive Risks Policy

1. Purpose

The purpose of this policy is to outline {{org_field_name}}’s commitment to supporting residents in making choices that involve positive risk-taking while ensuring their safety and well-being. This policy aligns with Care Inspectorate Wales (CIW) regulations and the Social Services and Well-being (Wales) Act 2014, which emphasises the rights of individuals to have control over their lives and make informed decisions. It provides clear guidance for staff on how to assess, manage, and support residents in taking calculated risks that enhance their quality of life, independence, and dignity.

2. Scope

This policy applies to all residents, staff, agency workers, families, and external professionals involved in care planning at {{org_field_name}}. It ensures that all positive risk-taking decisions are made collaboratively, balancing individual rights with duty of care. This policy applies to all areas of daily living, including mobility, activities, diet, medication self-administration, and relationships, ensuring a person-centred approach to care.

3. Principles of Positive Risk-Taking

Positive risk-taking is the process of balancing the benefits and risks of a particular choice to enable residents to live fulfilling lives. The following principles underpin {{org_field_name}}’s approach to positive risk-taking:

• Person-centred decision-making: The resident’s wishes, feelings, and autonomy must be prioritised in all risk-related decisions.
• Proportionate risk management: Risk assessments should be proportionate to the level of risk and should not be overly restrictive.
• Collaboration and shared responsibility: Decisions should be made with input from the resident, staff, families, and professionals.
• Empowerment and informed choice: Residents must be supported with clear information to make decisions confidently.
• Balancing safety with quality of life: Overprotection can be as harmful as underprotection; staff should focus on enabling residents rather than restricting them.

4. Managing Positive Risk-Taking

4.1 Identifying Opportunities for Positive Risk-Taking

Residents should be encouraged to take part in meaningful activities and experiences that enhance their well-being, even if some risks are involved. Common areas where positive risk-taking may apply include:

• Engaging in community activities, hobbies, or social events.
• Walking independently or with assistance outdoors.
• Choosing to eat certain foods that may pose choking or dietary risks.
• Self-administering medication where appropriate.
• Developing new relationships and making personal decisions about friendships or intimacy.

Staff must work closely with residents to explore these opportunities while considering their individual needs, preferences, and potential risks.

4.2 Risk Assessment and Management

Each decision involving positive risk-taking must be supported by an individual and proportionate assessment of risk. Risk assessment must form part of, and inform, the resident’s provider assessment and personal plan rather than being treated as a separate process.

The assessment must consider:

• the resident’s views, wishes, feelings and personal outcomes;
• the potential benefits to the resident’s well-being, independence, autonomy and quality of life;
• the nature and likelihood of any identified risks;
• the potential severity and consequences of harm;
• any risks to the well-being of other individuals receiving care and support;
• any relevant health or other professional assessments;
• measures that can reduce or manage the identified risks without unnecessarily restricting the resident’s rights, choices or independence;
• the steps that will be taken to support positive risk-taking and independence; and
• any contingency arrangements required should the identified risk materialise or the resident’s circumstances change.

Risk-management measures must be proportionate to the identified risk and must not impose restrictions beyond those that are necessary and lawful.

The outcome of the risk assessment, including the agreed risk-management measures and the steps to support positive risk-taking and independence, must be clearly recorded in the resident’s personal plan so that staff understand how care and support is to be provided on a day-to-day basis.

Where a resident’s needs or circumstances change, an incident or near miss occurs, new information becomes available, or the existing arrangements are no longer effective, the relevant risk assessment and provider assessment must be reviewed and revised as necessary and the resident’s personal plan must also be reviewed and revised as necessary.

The Risk Management and Assessment Policy (CHW18) must be followed alongside this policy.

4.3 Informed Decision-Making, Mental Capacity and Consent

Residents must be supported to make their own decisions wherever possible. Staff must begin from the presumption that an adult has capacity to make a particular decision unless it is established otherwise in accordance with the Mental Capacity Act 2005.

Information about a proposed choice and its associated benefits and risks must be provided in a manner that enables the resident to participate meaningfully in the decision. Information must be provided in an appropriate language, style, presentation and format, taking account of the resident’s level of understanding, communication needs and preferred method of communication. Any communication aids, equipment or other support reasonably required by the resident must be made available.

Staff must ensure that:

• the resident is given relevant information about the decision, including reasonably foreseeable benefits and risks;
• the resident is given all practicable support to understand, retain, use or weigh the relevant information and communicate their decision;
• sufficient time and appropriate support are provided wherever practicable;
• a resident is not treated as lacking capacity merely because they make a decision that staff, relatives or professionals consider unwise or risky;
• where there is reason to doubt capacity, capacity is assessed in relation to the specific decision that needs to be made and at the time the decision needs to be made; and
• the decision-making process and any capacity assessment are appropriately recorded.

Where a resident has capacity to make the relevant decision, their informed decision must be respected, including where that decision involves a level of risk, subject to the service provider’s separate legal responsibilities towards other individuals, staff and others and any other applicable legal requirements.

Where a resident lacks capacity to make the particular decision, any act done or decision made on their behalf must comply with the Mental Capacity Act 2005 and must be in their best interests. The decision-making process must consider the resident’s past and present wishes and feelings, beliefs and values, and the views of relevant persons who should be consulted.

A family member or other person must not be treated as having legal authority to make a decision on behalf of a resident solely because of their relationship with the resident. Where another person is making the decision on the resident’s behalf, staff must establish the nature and scope of that person’s lawful authority, including, where applicable, a valid Lasting Power of Attorney or an appointment by the Court of Protection.

Where the requirements for an Independent Mental Capacity Advocate apply, an appropriate referral must be made.

Any act done or decision made for a person who lacks capacity must achieve its purpose in a way that is least restrictive of the person’s rights and freedom of action. The Mental Capacity and Deprivation of Liberty Safeguards Policy (CHW39) must be followed.

4.4 Balancing Duty of Care, Autonomy and Restrictive Practice

The service provider and staff must balance their responsibilities for protecting residents from avoidable harm with each resident’s rights, autonomy, dignity, independence and freedom to make choices.

Staff must:

• avoid making assumptions about risk solely because of a resident’s age, disability, diagnosis or other personal characteristic;
• recognise that risk cannot always be eliminated and that avoiding all risk may unnecessarily restrict a resident’s independence, personal outcomes and quality of life;
• use the least restrictive lawful approach that is capable of safely achieving the identified purpose;
• consider whether the purpose can be achieved in a way that is less restrictive of the resident’s rights and freedom of action; and
• clearly record assessments, discussions, decisions, agreed measures and the rationale for those decisions.

Positive risk management must not be used to justify unlawful control, restraint or deprivation of liberty.

Where an arrangement amounts to control or restraint, it may only be used where it is necessary to prevent a risk of harm to the resident or another individual and is a proportionate response to that risk. Control or restraint must only be carried out by staff who are trained in the method being used and must be undertaken in accordance with the service’s policy on control, restraint and restrictive practice.

A record of any incident in which control or restraint is used must be made within 24 hours. The use of control, restraint and restrictive practice must be monitored and reviewed and must inform the review of the resident’s care and support arrangements where appropriate.

Where a resident lacks mental capacity to consent to arrangements for their care and support and those arrangements amount, or may amount, to a deprivation of liberty, staff must act in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. A resident must not be deprived of their liberty for the purpose of receiving care and support without lawful authority.

Where a Deprivation of Liberty Safeguards authorisation is required, the appropriate application must be made to the supervisory body and the care provided must remain within the scope of lawful authority. The Mental Capacity and Deprivation of Liberty Safeguards Policy (CHW39) and the service’s policy on control, restraint and restrictive practice must be followed.

4.5 Supporting Staff to Enable Positive Risk-Taking

All staff at {{org_field_name}} receive training on positive risk-taking to ensure they:

• Understand the legal and ethical framework around positive risk-taking.
• Have the skills to support residents in making informed choices.
• Feel confident in discussing risk with residents, families, and external professionals.
• Are aware of safeguarding responsibilities and how to manage risk safely.

4.6 Managing and Reviewing Positive Risk Decisions

Positive risk-taking arrangements must remain under review and must be revised whenever necessary to ensure that they continue to reflect the resident’s needs, wishes, personal outcomes and current circumstances.

Where a positive risk-taking arrangement forms part of the resident’s personal plan, it must be reviewed as part of the statutory personal plan review at least every three months and sooner whenever circumstances indicate that a review is required.

An earlier review must take place where appropriate following:

• a significant change in the resident’s care or support needs, health, mental capacity or circumstances;
• an incident, accident, near miss or safeguarding concern;
• evidence that an agreed risk-management measure is ineffective or disproportionately restrictive;
• a change in the resident’s wishes, feelings or personal outcomes;
• new information from the resident, their representative or a relevant professional;
• repeated use or escalation of restrictive practices; or
• evidence that the existing personal plan is no longer supporting the resident to achieve their personal outcomes.

The review must include:

• the resident’s views, wishes and feelings;
• the benefits the resident has experienced from the positive risk-taking arrangement;
• whether identified risks have changed;
• whether existing risk-management measures remain necessary and proportionate;
• whether a less restrictive approach is now available;
• relevant incidents, accidents, near misses or safeguarding information;
• relevant professional advice or assessments; and
• the extent to which the resident has been supported to achieve their personal outcomes.

The resident must be involved in the review. The placing authority, where applicable, and any representative must also be involved as required by the Regulations, except where the Regulations permit a representative not to be involved.

The provider assessment must be kept under review and revised as necessary. Following a revised provider assessment or review of a positive risk-taking arrangement, the resident’s personal plan must be reviewed and revised as necessary.

The outcome of the review, the people involved, decisions reached, the reasons for those decisions and any amendments to risk-management measures or the personal plan must be recorded.

5. Safeguarding Considerations, Incidents and Statutory Notifications

Positive risk-taking must never be used to disregard or minimise a safeguarding concern. The service must be provided in a way that ensures residents are safe and protected from abuse, neglect and improper treatment.

Where there is an allegation, evidence or reasonable concern of abuse, neglect, improper treatment, exploitation or other safeguarding harm, staff must immediately:

• take appropriate action to secure the safety and well-being of the resident and any other person who may be at risk;
• report the concern internally without delay in accordance with the Safeguarding Adults from Abuse and Improper Treatment Policy (CHW13);
• preserve relevant information or evidence where appropriate;
• ensure an appropriate referral is made to the local authority safeguarding service and any other relevant agency in accordance with the Wales Safeguarding Procedures and applicable local safeguarding arrangements; and
• make a clear record of the concern or allegation, the evidence available, actions taken, decisions made and referrals made.

Where an incident or safeguarding matter associated with a positive risk-taking arrangement is a notifiable event under the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, the required notification must also be made to Care Inspectorate Wales in the required manner and without delay unless a different statutory timescale applies.

This includes, where applicable, statutory notifications concerning:

• abuse or an allegation of abuse involving the service provider, a member of staff or a volunteer;
• a serious accident or injury to a resident;
• an incident reported to the police;
• an event that prevents, or could prevent, the provider from continuing to provide the service safely; and
• a request made to a supervisory body in relation to the application of the Deprivation of Liberty Safeguards.

Notifications to Care Inspectorate Wales must be submitted through CIW Online in accordance with current CIW requirements.

The requirement to notify Care Inspectorate Wales is separate from, and does not replace, the requirement to make an appropriate safeguarding referral to the local authority, contact the police where necessary, or notify any other statutory or professional body where required.

Following an incident, safeguarding concern or other significant event associated with positive risk-taking, the resident’s risk assessment, provider assessment and personal plan must be reviewed and revised where necessary. Any learning arising from the incident must be identified and acted upon.

The Safeguarding Adults from Abuse and Improper Treatment Policy (CHW13) must be followed alongside this policy.

6. Communicating Positive Risk-Taking to Residents and Families

It is essential to ensure that residents and their families understand the principles of positive risk-taking. This will be achieved through:

• Holding regular meetings with residents and families to discuss decision-making.
• Providing written guidance and easy-read materials on positive risk-taking.
• Encouraging open discussions on risk and personal choice.
• Addressing any concerns or objections from families by explaining the balance between safety and autonomy.

7. Related Policies

This policy should be read in conjunction with:

• Risk Management and Assessment Policy (CHW18) for structured risk assessment processes.
• Safeguarding Adults from Abuse and Improper Treatment Policy (CHW13) to ensure residents are not exposed to unnecessary harm.
• Mental Capacity and Deprivation of Liberty Safeguards Policy (CHW39) for guidance on supporting residents who may lack capacity.
• Safe Care and Treatment Policy (CHW11) for best practices in managing residents’ health and well-being.
• Health and Safety at Work Policy (CHW16) for managing workplace risk and ensuring staff safety while supporting residents.

8. Policy Review

This policy will be reviewed annually or sooner if regulatory changes, incidents, or operational needs require it. Staff will receive refresher training as needed, and any updates will be communicated clearly to ensure continued compliance with CIW regulations.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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