Risk Assessment in the Fife Forensic Learning Disability Service (FFLDS). Mike Doyle
17
Risk Assessment in the Fife Forensic Learning Disability Service (FFLDS). Mike Doyle Forensic Psychologist, NHS Fife FFLDS: Supporting People to Build Good Lives
-
Upload
burton-rhodes -
Category
Documents
-
view
38 -
download
0
description
Risk Assessment in the Fife Forensic Learning Disability Service (FFLDS). Mike Doyle Forensic Psychologist, NHS Fife. FFLDS: Supporting People to Build Good Lives. Fife Forensic Learning Disability Service 1999 – present ! Multi-agency & multi-disciplinary. - PowerPoint PPT Presentation
Transcript of Risk Assessment in the Fife Forensic Learning Disability Service (FFLDS). Mike Doyle
Risk Assessment in the Fife Forensic Learning Disability Service (FFLDS).
Mike Doyle
Forensic Psychologist, NHS Fife
FFLDS: Supporting People to Build Good Lives
Fife Forensic Learning Disability Service
1.1999 – present !
2.Multi-agency & multi-disciplinary.
3.Introduced ‘Significant Risk Advisory Group’ in Scotland
All management plans and decisions will be based on a risk assessment which is of the appropriate level to
support such a decision or plan. The actions to be taken will be clearly
documented and their rationale will link explicitly to risk assessment. The
risk assessment and management processes will be dynamic, with the
capacity to respond to changes in risk. Care will be taken to maintain the
dynamic link between risk assessment and planning through ongoing
assessment and review. The level and immediacy of any response to change
will be proportionate to the significance and risk. Reductions and
increases in restrictions or interventions will be justified and
supported by a suitable reassessment of risk.
FRAME: Framework for Risk Assessment Management and Evaluation – Risk Management Authority
Objectives:
Complete a ‘needs analysis’ to examine the numbers of risk assessments of different types that are likely to be required by the forensic service, and how often they would require to be updated.October 2012
o 31 Community forensic LD cases
21 on Criminal/Civil orders underpinning community placement/treatment
o 8 Fife Forensic In-patients – Levendale
o 10 Regional Forensic In-patients - Daleview
o
FFLDS Risk Assessment Review
Needs Assessment
Location N New /year Updates
Community 18* 2 16
Levendale 8 1 7
Daleview 10 2 8
Mayfield** 1 1 0
Total 37 6 31
* Counting only clients/pts on criminal/civil orders** Assuming one pt per year from Assessment Unit -> FFLDS
Assume 40 Hours per new risk assessment 6 * 40 = 240 HoursAssume 15 Hours per update 31 * 15 = 465 Hours
Total 705 Hours
Assume remaining 20 community clients require Level 1 or Level 2 risk assessment/risk management plans 20 @ 10 hours = 200 Hours 905 Hours
FFLDS Risk Assessment Review, July 2011
Discipline NHours/Discipline/ Year*
Forensic/Clinical Psychology
2 480
Forensic Nursing
4 480
Psychiatry 2 160
Total 8 1120
* Assuming 4 hours per week per full-time post for 40 weeks per year
Risk Assessment Demand
Initial decisions based on an awareness of the risk
Case management with due attention to risk
Risk management that is actively alert to risk
FRAME: Framework for Risk Assessment Management and Evaluation – Risk Management Authority
• Comprehensive File Review• Current Clinical Assessments• Client/Family/Practitioner Interviews• Multi-agency Risk Management Planning
• Review of Available Files • Recent Clinical Assessments• Client/Family Interviews• Multi-agency Input
• Referral Information• Client/Family/Practitioner Interviews
FFLDS Proposed Tiered Risk Assessment
FFLDS: Supporting People to Build Good Lives
Weekly multi-agency/disciplinary
meetings
Specialist Forensic
Health/Social Work
Practitioners
Specialist Forensic
Care Providers
Information Gathering & Sharing
Architecture of FFLDS
Risk Assessment &
Risk Management Planning
Case Formulation &
Treatment Planning
Enhanced Care Programme Approach
Weekly multi-agency/disciplinary
meetings
Specialist Forensic
Health/Social Work
Practitioners
Specialist Forensic
Care Providers
Analysis & Synthesis
Architecture of FFLDS
Specialist Forensic
Care Providers
Specialist Forensic
Health/Social Work
Practitioners
Risk Assessment &
Risk Management Planning
Enhanced Care Programme Approach
Learning Disability Significant Risk Advisory Group
LD-SRAG
Weekly multi-agency/disciplinary
meetings
Governance & Scrutiny
Case Formulation &
Treatment Planning
Social Work Senior Manager
Architecture of FFLDS
NHS Fife LD ServiceLearning Disability Management Team
Learning Disability Significant Risk Advisory Group
The objectives of the Significant Risk Advisory Group are To evaluate, oversee and endorse risk assessments and risk management proposals in respect ….of individuals, who pose a significant risk to the community. Endorsement will be undertaken by Health and Social Work Services managers. To advise agencies/individual workers where individual care plans presented are deemed unsatisfactory and to refer back for appropriate amendment;
To act as a point of expert resource for workers seeking guidance in the support and management of individuals causing serious concerns.
LD-SRAG Constitution
Learning Disability Significant Risk Advisory Group
The objectives of the Significant Risk Advisory Group are To evaluate, oversee and endorse risk assessments and risk management proposals in respect ….of individuals, who pose a significant risk to the community. Endorsement will be undertaken by Health and Social Work Services managers. To advise agencies/individual workers where individual care plans presented are deemed unsatisfactory and to refer back for appropriate amendment;
To act as a point of expert resource for workers seeking guidance in the support and management of individuals causing serious concerns.
LD-SRAG Constitution
‘I beseech you, in the bowels of Christ, think it possible you may be mistaken.”Cromwell
Learning Disability Significant Risk Advisory Group
Membership
Fife Council Social Work Fife Council Criminal Justice Services NHS Fife Fife Constabulary (Offender Management Unit) Fife Council Housing Dept.
Quorum NHS General Manager or deputy Service Manager Social Work Adult Service or deputy Fife Constabulary Representative or deputy Community Protection Team Representative or deputy
If an individual under review has a mental illness, a psychiatrist must be in attendance if decisions regarding risk management are necessary
Meetings 1st Thursday each Month..
Specialist Forensic
Care Providers
Specialist Forensic
Health/Social Work
Practitioners
Risk Assessment &
Risk Management Planning
Case Formulation &
Treatment Planning
Enhanced Care Programme Approach
Learning Disability Significant Risk Advisory Group
LD-SRAG
MAPPA
Weekly multi-agency/disciplinary
meetings
Health & Social Work
Management Structures
FFLDS Risk Assessment Review 2010 – 2011. Meeting demand for risk assessments
Completing and maintaining risk assessments on even only ‘high risk’ cases requires considerable resources and likely requires input from multiple disciplines.
A ‘tiered’ approach is required to match level of risk with rigour of risk assessment
Architecture of FFLDS as relates to risk assessment & risk management.
FFLDS structure provides forum for information sharing and agreeing protocols
Process of incident recording and ‘brief reviews’ provides firm basis for updating of risk assessments on regular bases
Role of Learning Disability Significant Risk Advisory Group; the LD-SRAG.
Provides independent scrutiny & check on risk management planning & organisational underwriting of risk management plans,
Works best when ‘serviced’ by a specialist forensic practitioners
