Managing Risks and promoting safety

Safety in day centres

Most of the day centres visited during the research for this handbook felt that safety was at the heart of their work and they saw the issue of safety as being one of the underpinning values of their services. The aim to provide a 'safe and welcoming' environment is, therefore, something to be taken seriously and strived for at all times.We know all too well, however, that it is a promise easy to make but much tougher to consistently deliver. For instance some of the steps taken towards making a day centre 'safe' may well undermine other attempts to keep it 'welcoming’. A traditional view of a day centre’s attempts to be welcoming might be to throw open the doors and invite all those in need of care and support, warmth, food and shelter into the building, asking no questions and assisting in the anonymity of their service users.

However, as one centre manager pointed out, "We must know who is in the building. I live in horror of there being a fire and the fire officer asking me if there is anyone left in the building and not being able to answer the question". Dilemmas similar to this have encouraged day centres to look closely at what it means to provide a safe service, and to pose questions such as: safe for whom? As has already been shown, day centres typically provide access to a whole range of support services relating to health care, resettlement, education and training, advice and counselling. These services are provided on occasions by the day centre itself or by external agencies, either statutory or other voluntary agencies that the day centre has links with and can refer service users to. But service users will only stay around to use these services if they feel safe in the project. The importance of safety for service users was highlighted in the Woodley Report (1995) which investigated the fatal stabbing of one user by another in a day centre in East London. (see our briefing on the Woodley report in this section.)

The answer to the question ‘who does a day centre need to be safe for?’ is, its staff and service users, particularly those who may be further marginalised like women, people from minority ethnic groups and those experiencing mental health problems, staff employed by other agencies and visitors. Day centres should be able to strike a balance between providing a service to vulnerable and marginalised people, some of whom many present with challenging behaviours, and the need to ensure safety for all. There must also be an awareness of the legal implications of safety and a day centres' obligations under Health and Safety legislation. As employers, there is a responsibility to promote and maintain a safe working environment for paid staff and non-employees.

Day centres, therefore, have to consider safety in its widest context, including fire safety regulations, the use of any machinery and the potential for accidents. But this does need to be balanced against providing an atmosphere which could become too preoccupied with making rules for every possible eventuality: putting locks and bars everywhere, having staff view their role as bouncers, or insisting on restrictive referral procedures and advance indepth knowledge of all potential service users. (For more information see the Risk management section and the Overview of health and safety legislation in this section).

The nature of risk

A discussion of the nature of risk, from Rogers, D (1998) Risk Assessment - Guidance Notes and Work Instructions, Birmingham, Focus Housing Group.

Even within the definition proposed here, risk is many things in many settings. The perception and evaluation of risk is individual to the individual worker, staff groups and other service users experiencing it and is readily affected by a number of factors, some of which are distinctly personal. To summarise:

For all agencies and workers the effective management of risk is one of the greatest challenges we now face.

The amount of available, quality information about a particular risk will impact significantly on how staff will regard its likely occurrence.

The more information that is presented about a particular risk the more staff members/teams will regard it as likely to occur.

The perception of risk varies depending on the degree of control staff members/teams feel they have over the management of that risk.

The perception of risk is also affected by whether the risk is viewed as individual to a particular member of staff, to the wider staff team, or beyond the boundaries of the service provision.

Within organisations risk is related to the agreed decision making process. This is a growing emphasis on individual accountability, which is then closely linked to service accountability. In all settings risk management must be seen to be doing all it can to protect the greatest number of people at all times.

However, responses to risk issues must not be solely policy driven; workers facing up to risk need appropriate tools that enable them to identify, quantify, evaluate, and plan their work around an assessed area of risk.

It is also important to lift the responsibility for risk assessment and management outside of a clinical or statutory response to risk issues. All workers need a viable methodology for presenting their own professional response to the risks they work with.

Where acknowledged risk manifests itself as an actual undesirable incident subsequent management activity should be to avoid the possibility of repetition.

Within most operational settings many small providers of service are forced to work with risk simply to justify their existence.

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