Rights at risk: Service user version

RIGHTS AT RISK:

Shared rights, risk and recovery assessment and plan

Rights at risk: Service user version

What is this plan about?

This assessment is used with people who come to this service. It is being done to make sure that people get the right support to be healthy and safe.

We will work with you and anybody else you want to be involved to try to keep you safe and well. We will mainly be thinking about how things have been in the last six months. Together we will think about if there is anything which is affecting your safety and we will think about how we can improve this. We will also think about what has been going well and what you have been doing to look after yourself. We will use these things in your care plans.

This plan will also consider your human rights. We will tell you more about these. We want to support you to make sure that your human rights are respected at all times.

Rights at risk: Service user version

EXPLAINING RISK AND RIGHTS

What is a risk?

Everybody takes risks on a daily basis. When we are talking together about risk, we are thinking about the things which may affect your safety, or someone else’s safety. We will be focussing on risks which might cause harm to you or harm someone else, either physically or emotionally. We will also be talking about how we can work together to help you to feel safe and supported.

Taking some risks is a good thing and helps us to improve our lives. We want to help you do that in a way that keeps you and the other people in your life safe.

What are human rights?

Everybody has human rights. This plan will help you and your staff think about your human rights. It will also ask you to think about other people’s human rights. The government, hospitals and social services must consider your human rights. These are your human rights that are protected by the Human Rights Act:

  • The right to life
  • The right not to be tortured or treated in an inhuman or degrading way
  • The right to be free from slavery or forced labour
  • The right to liberty
  • The right to a fair trial
  • The right to no punishment without law
  • The right to respect for private and family life, home and correspondence- This right means:
  • Family life: you have the right to develop “ordinary” family relationships and the right to ongoing contact when the family is split up.
  • Private life: you have the right to psychological and physical integrity. This means having control over your own body and life. Consent and dignity are an important part of this right, including the right to participate in important decisions about care and treatment.
  • Home: you haverespect for the home you already have, whether this is the house you own or another place you call home (e.g. a care home or hospital ward).
  • Correspondence: you haveuninterrupted, uncensored communication with others.

The right to respect for private and family life, home and correspondence is a 'qualified' right. This means that your right to private and family life, home and correspondence can be restricted for one of the reasons set out in the right itself.There must be a law that allows the restriction, and the restriction must be necessary – that is, responding to a pressing social need – and proportionate to achieving this aim.

  • The right to freedom of thought, conscience and religion
  • The right to freedom of expression
  • The right to freedom of assembly and association
  • The right to marry and found a family
  • The right not to be discriminated against in relation to any of the rights contained in the European Convention.
  • The right to peaceful enjoyment of possessions
  • The right to education
  • The right to free elections

We want to support you to make sure that your human rights are respected at all times. It can be helpful to think of your human rights in relation to five important principles.

  • Fairness
  • Respect
  • Equality
  • Dignity
  • Autonomy

We call these the FREDA principles.Ultimately, we want to make sure that you are treated in a way that respects your human rights, and these principles can be helpful in understanding how human rights should protect you.

To do this, each question in this assessment, and in your plan, reminds you to think of these principles and looks at your human rights. We have emphasised the FREDA principles, even though these are human rights values rather than the law because this is a way of making often complex legal concepts more accessible.

Rights at risk: Service user version

Some things you should know before we start:

Before we start there are some things you should know:

  • The things which will be discussed as part of this assessment are confidential and will not be discussed with others. However, there may be times when they do need to be discussed with others. This has to be done if there are concerns that you or somebody else may get hurt. So what is discussed is on a strictly need – to – know basis. If your mental health practitioner does have these concerns and needs to share them with somebody to try and help with this, then they will try their best to tell you before they do.
  • Once this assessment is complete, your mental health practitioner will either scan the completed assessment into a computer and put it on your electronic clinical records or it will be filed in your paper clinical records and locked away in a secure place. Only people who are involved in your care can see these records.

Rights at risk: Service user version

RECORD SCORING SHEET

We will look at different risks and see how worrying they are.
“This does not concern me” (score of 1 or 2)
Me and other people are NOT WORRIED about this
“This concerns me somewhat” (score of 3 or 4)
Me and other people A BIT WORRIED about this
“This is a big concern for me” (score of 6 or 9)
Me and other people are REALLY WORRIED about this

Rights at risk: Service user version

WHAT WILL STAFF LOOK FOR?

Staff will look at the LIKELIHOOD of the risk happening and how SEVERE it will be if it does happen.
LIKELIHOOD
They will decide if they think the risk will happen in the next six months. It will be scored 1, 2 or 3.
1. Staff don’t think that risk will be a problem for you
2. Staff think that the risk MIGHT happen
3. Staff think that the risk WILL happen in the next six months
Severity
The severity means how much of a problem the risk will be for you or others if it happens. It will also be scored 1, 2 or 3.
1. It won’t be much of a problem for you
2. It might be a serious problem for you
(e.g. you might have to go to the doctors)
3. It will be a major problem for you
(e.g. you or somebody else might have to go to hospital or to the police)
The staff will multiply the two numbers together.



Rights at risk: Service user version

RIGHTS AT RISK: Shared rights, risk and recovery assessment and plan

Completion Date:Staff Name:

Name:D.O.B:Age:

Gender:Ethnicity:Religion:

Occupation:Relationship status:

Address:

Level of support: Who do you live with?

Level of risk will be assessed within the context of this support.

Who has filled this in?

Name / How do I know the person? / Signature of the person

Shared rights, risk and recovery assessment

Section 1: Advanced statement

Rights at risk: Service user version

Advanced statement

Why are we asking about this?

If you have made an advanced statement it can help us to support you in the way you want to be supported.

Things we need to think about:

  • Things which help
  • People you want involved
  • People you don’t want to be involved

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life

Please use the assessment manual as it provides key prompt questions.

1)Advanced statement / Human rights implications:
Notes / FREDA:
Article 8:

Rights at risk: Service user version

Shared rights, risk and recovery assessment

Section 2: Risk to self

Rights at risk: Service user version

1) Physical health

Why are we asking about this?

People with mental health issues are more likely to experience physical health problems. Physical health issues can affect your wellbeing and we want to make sure that we support you to get your needs met.

Things we need to think about:

  • Diabetes
  • Epilepsy
  • Medication
  • Pain/other physical health problems
  • Smoking
  • Exercise
  • Diet
  • Has this been a risk in the past?

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life
  • Article 14: Freedom from discrimination in relation to these other human rights
  • Article 3: Right to be free from inhuman or degrading treatment
  • Article 2: Right to life

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

1)Physical Health / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 8:
Article14:
Article 2:
Article 3:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

2) Taking medication

Why are we asking about this?

We need to know if you are taking your medication because sometimes when people stop taking medication, they become unwell again or taking medication can cause side effects.

Things we need to think about:

  • Concordance
  • Side effects
  • Is it helping?
  • Has this been a risk in the past?

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life
  • Article 2: Right to life

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

2)Taking Medication / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 8:
Article 2:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

3) Mental health and wellbeing

Why are we asking about this?

Mental health issues can affect every aspect of your life, including the way you think, feel, and behave. If you do have a mental health difficulty, getting help can help you to feel better or learn how to cope with it. First we have to understand what is going on for you so that we know how best to help you.

Things we need to think about:

  • Mood/anxiety
  • Sleep
  • Sleep
  • Hearing voices
  • Seeing things other people cannot
  • Irritability/ anger
  • Paranoia/feeling suspicious
  • Isolating yourself
  • Having mental healthdifficulties in the past
  • Stigma
  • Has this been a risk in the past?

Remember to think about FREDA

What human rights do we need to think about?

  • Article 5: Right to liberty and security
  • Article 8: Right to respect for private and family life
  • Article 3: Right to be free from inhuman or degrading treatment
  • Article 14: Protection against discrimination in relation to these other human rights

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

3)Mental Health / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 5:
Article 8:
Article 14:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

4) Self-neglect (not looking after myself)

Why are we asking about this?

People may feel unable to care for themselves because they either feel physically unable to do so or they do not have enough motivation. In the long run this may cause problems such as malnutrition and dehydration etc. We need to know if this a problem for you, so we can think about how best to support you.

Things we need to think about:

  • Diet
  • Drinking fluids
  • Personal hygiene
  • Household chores
  • Looking after your physical health
  • Has this been a risk in the past?

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life
  • Article 3: Right to be free from inhuman or degrading treatment
  • Article 2: Right to life

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

4)Self-neglect (not looking after myself) / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 8:
Article 2:
Article 3:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

5) Self-harm (hurting or harming myself)

Why are we asking about this?

Sometimes people who struggle with their feelings hurt themselves to communicate these feelings or cope with them. Sometimes this can result in people hurting themselves more than they intended to. It is important for us to know if this is a problem for you to ensure we help you to stay safe and help you to find other ways of coping with your feelings.

Things we need to think about:

  • Hurting yourself in the past
  • Cutting yourself
  • Burning yourself
  • Swallowing objects
  • Hitting yourself
  • Coping skills
  • How hurting yourself helps
  • Anything which works instead

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life
  • Article 3: Right to be free from inhuman or degrading treatment
  • Article 2: Right to life

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

5)Self-harm (Hurting or harming myself) / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 3
Article 2:
Article 8:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

6) Suicide

Why are we asking about this?

When people are struggling with their mental health, they may have no hope that things can or will get better and may start to think about suicide. We want to work with you to help things improve and to support you to stay safe.

Things we need to think about:

  • Having a family history of suicide
  • Having tried to take your own life in the past
  • Current thoughts or plans
  • Hopelessness
  • Impulsivity (doing things without thinking)
  • Being part of a high risk group

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life
  • Article 2: Right to life
  • Article 3: Right to be free from inhuman or degrading treatment

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

6)Suicide / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 8:
Article 2:
Article 3:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

Rights at risk: Service user version

7)Interpersonal difficulties

Why are we asking about this?

Sometimes people find it difficult to develop and maintain relationships, especially if their trust has been broken or they have experienced trauma in the past. Sometimes people have learnt and get stuck in the same patterns of relating to the people around them, even when these ways of relating cause problems. Difficulties with relationships can cause stress and can contribute to mental health difficulties. Equally when people are distressed their relationships can be affected.

Things we need to think about:

  • Your relationships
  • Your feelings
  • Boundaries
  • Communication
  • Has this been a risk in the past?

Remember to think about FREDA

What human rights do we need to think about?

  • Article 8: Right to respect for private and family life

Please use the assessment manual as it provides key prompt questions which ensure accurate scoring.

7)Interpersonal difficulties / Likelihood / Severity / Total / Human rights implications
Notes
Does this person have a low risk because of current intervention? / FREDA:
Article 8:
Service user rating
“This does not concern me”
“This concerns me somewhat”
“This is a big concern for me”

8) Engagement (not wanting help from Services)

Why are we asking about this?

There are many reasons why somebody may not want help from services and avoid their appointments. However, sometimes this can contribute to them feeling worse because they are not getting the help they need. We would like to think about if there are any reasons why you do not want help from services so, together, we can consider how to overcome these problems.

Things we need to think about:

  • Missing appointments
  • Absconding
  • Mental health
  • Has this been a risk in the past?

Remember to think about FREDA