Home Visit Risk Assessment Form Name of client: ____________________________________________________________ Address of assessment: _____________________________________________________ _________________________________________________________________________ Date assessment conducted: ____________ By: _________________________________ Signed: ______________________________________ Premises risk assessment Identified risk or Risk management or hazard control hazard 1. Access to home – easy access and exit, more than one exit from the home. Doors – easily opened, unobstructed 2. Internal household- level surfaces, uncluttered (inc wires, rugs and carpet joins), adequate width/ space to work (see more) 3. Steps /stairs – non slip, level surface, solid, stair lift installed and checked in date. 4. Kitchen - Appliances and fire safety appliances present, and checked in date. Electricity outlets and gas also safe. (see more) 5. Lighting and neighbourhood– well-lit, identify dark places, assess general area safety, safe, well lit parking close to the home. (see more) 6. Pets – adequately restrained, discuss at time of introductory visit also any requirements and any care that may be associated. (see more) 7. Are there any safety concerns regarding the route from public transport stops to the home. (see more) 8. Apart from the client does anybody else live in the home? (see more) Client risk assessment Identified risk or hazard 9. Is there any history of aggressive behaviour or potential violence? From patient, client or any other close associate? (see more) 10. Is the client a risk to themselves and/or are there any other risk factors or hazards (Including mental health, substance/alcohol misuse)? (see more) 11. Assess storage of medicines and substances, ensure safety for anyone who could come in contact. (see more) 12. Check patient requirements for taking medication, ensure the care plan accounts for anything specific (see more) 13. Are there any risks requiring the use of specific PPE? Will this be supplied at the home or expected from carer? (see more) 14. Does the patient have any allergies or intolerances? Ensure these are discussed, understood and listed on the care plan. (see more) 15. Are there any other safety issues associated with the premises/person? (see more) 16. Is the client supported by any other agencies? (eg, District nurse) (see more) Details on each risk area: 1. Security key safes codes. - Do not write the codes down. - Remember to scramble numbers on leaving and putting keys back into key safe boxes. - Is there safe access to dustbins, where are they? 2. - Assess wash space; check bath aids/ bath chairs, ensure they are serviced in date, ensure those requiring charge are kept fully charged, ensure patient can get in/out of the bath and the level of assistance in hygiene required (check if OT instruction given) - Unfitted carpets/rugs, Trips and falls, Can edges be taped down or should rugs be removed? - Can the Client lift their foot above the rug? - Assess if the patient has any difficulty in using equipment (may need to refer to OT) - Ensure clear working surfaces. - Check smoke alarms are in working order. - Check if patient has or requires a working link line (red alarm bracelet or neck lanyard). - Check electrical outlets, ensure safe, working and not overloaded. - Check all services such as water, gas and electricity are functioning and with no faults, ensure service contracts underway if faults observed. 3. - Is the patient safe to go up the stairs safely. - Let the person reach the top of the stairs before going up yourself. - Check if there are non slip mats in place. - Check for stair lift and if serviced. 4. - Ensure the cooker is in order and gas is not left on. - Check if fire blankets/ fire extinguisher present and PAT tested. - Check if the Electrical appliances are all in safe working order. - Ensure a clean, hygienic and clear working environment. 5. - Double check Porch lighting / sensor lighting and street lighting around the premises, - Be aware of the structure of the front garden and if there are trees, bushes or obstructions. - Carry a torch if needed. - Check parking details eg; Driveway, Parking zones & times. 6. - Use reason when discussing animals and be sensitive as pets are a member of the family! - Check if this is a service pet. - Acknowledge any Asthma or allergies to carer. - Ensure there is no risk of animal escaping upon entering/ exiting the property. 7. When Travelling to and from workplace: - Check the location of Bus stops - How far is this from patients home? - Check time table, accounting for times, especially if travelling late at night. When escorting the patient on outings: - can the client walk to the bus stop, and are they safe to travel on a bus? - will you be required to use a wheelchair or mobility aid on the bus? 8. - Account for spouse/children, other family, friends, or share home scenarios. - Account also for others in a complex and be aware of any issues with close proximity neighbours. 9. - Be aware of anybody with criminal history. - Observed patterns of disruptive behaviour or abuse. - Drug or alcohol problems. - Dementia and other neurological condition linked to aggression - Include neighbours in your observations. 10. - Be aware of any history of mental health issues that could lead to loss of control or self harm behaviours. - Be aware if the patient is registered with the mental health nurse. - Take note of potential behaviour related signs or risky access to things such as broken furniture or windows 11. - Be aware of dangerous medicines. - Ensure all medicines out of reach, or locked away safely as required. - Check that the patient is capable of safe self-medication. - Is medicine packed in a measurable way eg; dosette boxes. 12. - There can be many differences for varied reasons. Ensure all odd instructions are well explained and noted on the medication record. - Does the care plan say to give meds now, and how exactly should these be administered. - Is the patient able to self-medicate? - Is the patient in need of alternative ingestion techniques such as crushing or peg administration? - Is the patient using a different more complex drug such as warfarin, morphine, other dangerous drugs or antibiotics that are charted differently or for short term interim use? 13. - Does the patient have any particularly bodily fluid contact requirement? - Does the patient have a communicable disease, bacteria or virus? Eg; HIV, MRSA, Shingles? - Does the patient have a compromised immune system and require extra safety from your own body bacteria (we all have slightly different stuff that makes US) eg; Chemotherapy treatment happening. - Do you need foot covers aprons, gloves (do these need to be latex free?), masks, safety eyewear? 14. - Ask after and be aware of any allergies and the response they have been known to have so that this can be managed if they come into contact. - Do you know how to use an Epipen? - Also be aware of intolerances or even just thing the patient has an aversion to and avoid these things (eg; doesn’t like mushrooms or coriander) - Common allergens are, Shellfish, peanuts/nuts, penicillin, other foods, soaps/ fragrances, latex. 15. - This is where you can share anything else that gives a sense of unease. - Note if this is a block of flats - How best to navigate the building i.e.; are there stairs or lifts? - Do you generally feel safe and with good rapport. 16. - Please give name and contact details of other persons/ organisations so that we can form a functioning care-team environment for the benefit of the patient. - Consider if the patient is working alongside: District Nurse, Social Care, Community Care agency, Volunteer groups, Mental Health Nurse, Help for the Aged, Link Line, Parkinson’s Nurse and more.
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