RT2 NUMBER ______

TRUST APPROVED RISK ASSESSMENT (TARA)

Full Name: (Inc Title)
Date of Birth: / NHS Number:
Date Risk Assessment Started: / Time:
Date of previous Risk Assessment: / Location: (where it is)
Others Present
Name: / Role:
Date Risk Assessment Completed: / Time:
Completed by: / Team:
Next Risk Assessment Due :
RISK SUMMARY/FORMULATIONincluding Client and Carer/Parent Guardian View
Summary Formulation – consider the nature and degree of risk , who is at risk , how likely is it , relationship between risk and mental disorder , current social circumstances or contextual factors
Key Next steps ( full actions to be recorded in care plan)
DOMAIN: HARM TO SELF / SUICIDE
Past History:Include; incident/events, what, where, when (dates please), and who was involved, cause/trigger, consequences and risks.Consider family history of suicides
Current Situation: include service user and carer/parent/guardian views, consider STORM paperwork as alternative
Level of thoughts/plan/intent/behaviour/means to harm self. Responding to command hallucinations.Level of distress, helplessness / hopelessness. Demographic and situational risk issues e.g. age, employment, relationship status, major life events or anniversaries
Support network and coping strategies
Factors Increasing Risk:Substance use , including alcohol, illicit substances and prescribed medication, consider accidental risks
Factors Decreasing Risk:Activities, support networks
DOMAIN: HARM TO OTHERS/ VIOLENCE
Past History:Include; incident/events, what, where, when (dates please), and who was involved, cause/trigger, consequences and risksPast evidence of Carrying/using weapons or Dangerous impulsive act(s). Denial of previous dangerous acts / (offences). Lack of remorse for previous dangerous acts. Forensic history, Index offences , Admission (s) to secure settings
Current Situation: include service user and carer/parent/guardian viewsIntent or plan (inc Access to named potential victims), expression of concern from others about risk of violence. Paranoid delusions about others (inc: children). Violent command hallucinations. Preoccupation with violent fantasy.Current evidence of Carrying/using weapons. Sexually inappropriate behaviour (beliefs or thoughts). Contact with children, vulnerable and older adults
Factors Increasing Risk:Substance misuse/poor concordance/role of mental health/situational and context issues
Factors Decreasing Risk: Engagement. Abstinence from alcohol/drugs Compliance with treatment/medication
DOMAIN: SELF NEGLECT
Past History:Include; details of past neglectful situations;- what, where, when (dates please), and who involved.
Current Situation: include service user and carer/parent/guardian viewsDifficulties maintaining personal hygiene, failing to eat/ drink adequately, inappropriate clothing, Substance misuse, nutrition, physical health, dental health. Cognitiveimpairment , Difficultiescommunicating needs
Factors Increasing Risk: Financial difficulties, inadequate accommodation, lack of basic amenities, lack of supportive social contacts, major life events. Non compliance with care / treatment arrangements ( inc parental non compliance). Disengagement from services.
Factors Decreasing Risk:Reverse of above, care approach
DOMAIN: Exploitation / Vulnerability
Past History: Include; details of past neglectful situations;- what, where, when (dates please), and who involved, consequences for client and abuser, Safeguarding and police issues.Abuse by others e.g. physical / sexual / psychological / financial / domestic etc(Signs/ allegations) , Period (s) of neglect by others (inc by parent/carer) , Exploitation, Harassment / bullying. Religious / spiritual persecution , Presence of negative social contacts
Current Situation: include service user and carer/parent/guardian views Parent / carer non compliance with medical /physical interventions , Concerns about parental mental illness / substance misuse) , Significant Disability inc. Cognitive , physical and or sensory ,impact of mental health0n risk. Wandering , Absconding / missing ( inc not attending school) , Falls, unexplained injuries, mobility problems, Inability to maintain safe environment ( inc lack of parent/ carer supervision)
Factors Increasing Risk:Substance misuse , Non compliance with care / treatment arrangements ( inc parental non compliance) , Poor relationships
Factors Decreasing Risk: Reverse of above. Engagement with prevention strategies, role of safeguarding procedures
Safeguarding Issues
Do you have the details of family members including children whom the service user may come into contact with? and has anything changed ?
Are there any safeguarding issues relating to adults - Consider local safeguarding procedures and documentation
Are there any safeguarding issues relating to children- Consider local safeguarding procedures and documentation
Is the service user likely to have or resume contact with their own children or other children ( please provide details )
Does the service user have delusional beliefs involving the children ( if Yes, refer to Consultant Psychiatrist for involvement in clinical decision making)
Is there concern that the service user might harm their child / un born child as part of suicide plan ( If Yes, refer to social services immediately and refer to Consultant Psychiatrist for involvement in any clinical decision making ( ref to child protection policy for guidance)
Was the service user involved in the risk assessment (Please provide details) / YES/ NO
Does the service user agree with the findings of this risk assessment (Please provide details) / YES/ NO/ UNABLE TO AGREE
Service User / Carer / representative Signature : / Date:
Practitioner Name: / Signature:
Designation: / Date :

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