General Risk Assessment - TCO

GENERAL RISK ASSESSMENT

SERVICE USER NAME:
DATE OF BIRTH:
ADDRESS:
TELEPHONE / MOBILE:
GP NAME & ADDRESS:
SOCIAL WORKER / INTERNAL CARE COORDINATOR:
NEXT OF KIN / ADVOCATE (NAME & CONTACT):
DATE OF ASSESSMENT:
COMPLETED BY:
POSITION:
NEXT REVIEW DATE:

MOBILITY AND SAFETY

CONSIDERATION | YES | NO | ACTION REQUIRED (if yes)
  • Can the Service User walk outdoors independently? ☐ Yes ☐ No
  • Does the Service User need help getting in and out of bed? ☐ Yes ☐ No
  • Has the Service User experienced any falls previously? ☐ Yes ☐ No
  • Can the Service User move independently between a bed and chair when positioned adjacent to one another? ☐ Yes ☐ No
  • Does the Service User need support when repositioning themselves in bed? ☐ Yes ☐ No
  • Is the Service User able to navigate uneven surfaces while walking? ☐ Yes ☐ No
  • Can the Service User move around inside their home without assistance? ☐ Yes ☐ No
  • Does the Service User require help when transitioning between sitting and standing positions? ☐ Yes ☐ No
  • Is the Service User capable of using stairs? ☐ Yes ☐ No
  • Is the Service User capable of covering distances beyond 10 metres on foot? ☐ Yes ☐ No
  • Does the Service User use any equipment to support mobilising? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

MANAGING HOUSEHOLD TASKS

  • Can the Service User take care of washing dishes? ☐ Yes ☐ No
  • Can the Service User handle grocery shopping independently? ☐ Yes ☐ No
  • Can the Service User manage laundry (washing and drying)? ☐ Yes ☐ No
  • Can the Service User do their own ironing? ☐ Yes ☐ No
  • Can the Service User handle vacuuming and dusting? ☐ Yes ☐ No
  • Can the Service User keep bathroom fixtures clean (basin and tub)? ☐ Yes ☐ No
  • Can the Service User maintain toilet cleanliness? ☐ Yes ☐ No
  • Can the Service User take out rubbish and recycling? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

OVERALL HEALTH STATUS

  • Does the Service User use hearing aids? ☐ Yes ☐ No
  • Does the Service User experience any difficulty with hearing? ☐ Yes ☐ No
  • Does the Service User have trouble being understood when speaking? ☐ Yes ☐ No
  • Does the Service User find it difficult to understand what others are saying? ☐ Yes ☐ No
  • Does the Service User have their sight? ☐ Yes ☐ No
  • Does the Service User wear glasses? ☐ Yes ☐ No
  • Are there any issues with the Service User’s vision or eye health? ☐ Yes ☐ No
  • Can the Service User use the toilet independently? ☐ Yes ☐ No
  • Does the Service User experience urinary incontinence? ☐ Yes ☐ No
  • Does the Service User experience bowel incontinence? ☐ Yes ☐ No
  • Does the Service User have ongoing bowel issues (constipation, diarrhoea)? ☐ Yes ☐ No
  • Does the Service User have a catheter or colostomy bag? ☐ Yes ☐ No
  • Does the Service User live with any physical disabilities? ☐ Yes ☐ No
  • Does the Service User live with any mental disabilities or cognitive impairment (e.g. dementia)? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

SKIN INTEGRITY

  • Is the Service User’s skin frequently damp (sweat, urine, faeces)? ☐ Yes ☐ No
  • Does the Service User have any breaks in the skin (pressure ulcers, wounds, cuts)? ☐ Yes ☐ No
  • Does the Service User spend most of their time in bed? ☐ Yes ☐ No
  • Does the Service User typically have dry skin? ☐ Yes ☐ No
  • Does the Service User have difficulty moving around? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

MENTAL CAPACITY

  • Can the Service User understand and comprehend information provided? ☐ Yes ☐ No
  • Can the Service User evaluate information when making choices? ☐ Yes ☐ No
  • Is the Service User able to remember information? ☐ Yes ☐ No
  • Is the Service User capable of expressing decisions? ☐ Yes ☐ No
  • Does the Service User recognise the potential consequences of their decisions? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

DIET AND NUTRITION

  • Does the Service User need assistance selecting meals or drinks? ☐ Yes ☐ No
  • Does the Service User need help shopping for groceries and essentials? ☐ Yes ☐ No
  • Does the Service User need help preparing meals and drinks? ☐ Yes ☐ No
  • Does the Service User have difficulty chewing or swallowing? ☐ Yes ☐ No
  • Does the Service User require tube feeding? ☐ Yes ☐ No
  • Does the Service User need assistance with eating or drinking? ☐ Yes ☐ No
  • Does the Service User have specific mealtimes to be followed? ☐ Yes ☐ No
  • Does the Service User need guidance on safe food handling? ☐ Yes ☐ No
  • Does the Service User need support understanding healthy eating? ☐ Yes ☐ No
  • Does the Service User have dietary restrictions (e.g. diabetes, IBS, food allergies)? ☐ Yes ☐ No
  • Are there religious or cultural foods to avoid? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

BEHAVIOURAL SAFETY & PROTECTION

  • Does the Service User display behaviours that put staff at risk? ☐ Yes ☐ No
  • Does the Service User have mental health concerns affecting behaviour? ☐ Yes ☐ No
  • Does the Service User have issues with alcohol or substances? ☐ Yes ☐ No
  • Does the Service User have a history of aggression or violence? ☐ Yes ☐ No
  • Does the Service User have a history of self-harm? ☐ Yes ☐ No
  • Does the Service User show signs of being at risk of abuse or harm? ☐ Yes ☐ No
  • Is there a specific person suspected of causing harm? ☐ Yes ☐ No
  • Does the Service User have cognitive impairment affecting safety awareness? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

COSHH (CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH)

  • Will staff need to use cleaning products during visits? ☐ Yes ☐ No
  • Are cleaning products stored incorrectly or not in original containers? ☐ Yes ☐ No
  • Are cleaning products inaccessible when needed? ☐ Yes ☐ No
  • Is ventilation inadequate where cleaning products are used? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

MANAGING FINANCES

  • Does the Service User need assistance signing documents (contracts, timesheets)? ☐ Yes ☐ No
  • Does the Service User need help managing finances? ☐ Yes ☐ No
  • Does the Service User need carer support with financial tasks (shopping, paying bills)? ☐ Yes ☐ No
IDENTIFIED RISKS:
MITIGATIONS / ACTIONS:

SIGNATURES

Service User Signature:
Date of Assessment:
Assessor Name:
Next Review Date:
If the Service User is unable to sign, obtain the signature of their Next of Kin (NOK), appointed Advocate, or representative with LPA (Health & Welfare).