What Is a Risk Assessment in Care? Purpose, Types and How CQC Expects Them to Work
What a care risk assessment is, the types you need, how to balance safety with people’s rights and choices, and what Regulation 12 expects.
A risk assessment in care identifies what could harm a person or others, how likely and serious that is, and what will be done to reduce the risk. CQC Regulation 12 requires risks to health, safety and welfare to be assessed and mitigated, with risk assessments completed and reviewed regularly by competent people and including plans for managing risks, balancing people’s safety with their rights and preferences.
Risk assessments are everywhere in care, and they are often done badly: either so cautious they remove choice, or so generic they protect nobody. This guide explains what they are for, the types, how to write one that works and how CQC judges them.
Key takeaways
- The purpose is to keep people safe while respecting their rights, choices and independence.
- Regulation 12 requires risk assessments to be completed and reviewed regularly by competent people, with plans to manage risks.
- Assessments should balance needs and safety with rights and preferences, not default to restriction.
- Incidents should lead to reassessment.
- Risk assessments must link to care plans and be known to staff.
In this guide
What It Is and What It Is For
A risk assessment is a structured look at a hazard: who might be harmed, how, how likely and how serious it would be, what controls exist and what more is needed. In care it covers people’s health and safety, such as falls, pressure ulcers, choking, medicines, wandering, self-harm and infection, and also risks to staff and the environment.
What Regulation 12 Says
CQC’s guidance says risk assessments relating to health, safety and welfare “must be completed and reviewed regularly by people with the qualifications, skills, competence and experience to do so” and “should include plans for managing risks”. Care planning should be based on risk assessments “that balance the needs and safety of people using the service with their rights and preferences”. Providers must do all that is reasonably practicable to mitigate risks, adopt control measures and review them as practice changes, and use risk assessments to make adjustments to premises, equipment, training, processes and practices (CQC: Regulation 12).
Types of Risk Assessment
| Type | Examples |
|---|---|
| Individual | Falls, moving and handling, pressure area, nutrition and choking, medicines, mental health and behaviour, infection risk, going out independently |
| Environmental | Premises, water temperature, fire, equipment, garden and access |
| Home visit (lone working) | A person’s home environment and staff safety in domiciliary care |
| Dynamic | Ongoing in-the-moment judgement by staff when a situation changes |
| Transfers | Moving between services, hospital or respite. CQC says appropriate risk assessments must be done on transfer |
Balancing Safety With Choice
Over-protective assessments can breach dignity, person-centred care and the Mental Capacity Act. A person with capacity has the right to make decisions others think unwise. Good practice is to record the risk, what the person wants, what is being done to reduce harm and why the decision was made. Where a person lacks capacity, decisions must be made in their best interests. See person-centred care and MCA and DoLS in practice.
How to Write a Useful Risk Assessment
- Identify the hazard in this person’s real situation, not generic wording.
- Say who is at risk and how they could be harmed.
- Rate likelihood and severity, and say how you decided.
- List controls already in place and additional actions.
- Include the person’s views and any choices that involve accepted risk.
- Assign owners and review dates, and review after any incident.
- Make sure staff know it, and that the care plan reflects it.
Learning From Incidents
CQC guidance says incidents must be reviewed and thoroughly investigated by competent staff, monitored to make sure action is taken, and used to prevent recurrence. Every serious incident should trigger a review of the relevant risk assessments. See the incident log and what to do after a medication error.
CQCLogic’s incident management log records incidents with flags for RIDDOR, CQC and safeguarding, and its audit schedule and governance meeting tools help you review the trend. It does not hold individual risk assessments, so keep those in your care records system.
Turn incident learning into tracked actions
See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
What is a risk assessment in care?
A structured look at what could harm a person or others, how likely and serious it is and what will be done to reduce it, recorded with owners and review dates.
What does CQC Regulation 12 require for risk assessments?
Risk assessments must be completed and reviewed regularly by competent people and include plans for managing risks, and should balance safety with people’s rights and preferences.
How often should risk assessments be reviewed?
CQC says regularly, without giving a number. Review at set intervals by risk, and always after an incident, a change in needs or a move between services.
What is positive risk-taking?
Supporting a person to do something that carries risk because it matters to them, by understanding the risk, agreeing controls and recording the decision, rather than simply restricting the activity.
What is a dynamic risk assessment?
An ongoing assessment by staff of changing circumstances at the time, such as a person becoming distressed or a hazard appearing, with immediate adjustments.
Who should carry out a risk assessment?
People with the qualifications, skills, competence and experience to do it, involving the person and others who know them.