Balancing Risk and Choice in Person-Centred Planning for ABI
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Risk and choice are inseparable in person-centred planning for acquired brain injury services. Individuals may express strong preferences while also experiencing impaired insight, impulsivity or reduced risk awareness. Commissioners and inspectors expect ABI providers to demonstrate how choice is respected without exposing people to unmanaged risk or unnecessary restriction.
This article explores how ABI services can balance risk and choice effectively. It should be read alongside Positive Risk-Taking & Risk Enablement and Person-Centred Planning & Strengths-Based Support.
Why risk and choice are tightly linked in ABI
ABI can affect judgement and impulse control, making risk enablement more complex than in other settings.
Commissioner and inspector expectations
Two expectations are consistently applied:
Expectation 1: Proportionate risk enablement. Inspectors expect providers to avoid blanket restrictions.
Expectation 2: Clear decision rationale. Commissioners expect risk decisions to be clearly explained and reviewed.
Operational example 1: Risk-enablement planning
An ABI service developed individual risk-enablement plans linked directly to personal goals.
Documenting risk and choice decisions
Documentation should show how risks were explored, mitigated and reviewed rather than avoided.
Operational example 2: Decision logs
A provider introduced decision logs showing how choice, risk and mitigation were balanced.
Reviewing risk as recovery changes
Risk tolerance should change as skills and insight improve.
Operational example 3: Scheduled risk reviews
A service implemented scheduled reviews tied to progress milestones, reducing unnecessary restrictions.
Evidencing balanced practice
Providers should evidence:
- Individualised risk assessments
- Choice discussions and mitigation plans
- Regular review and adjustment
Risk and choice as person-centred practice
In ABI services, balancing risk and choice is central to dignity, recovery and quality. Providers that evidence this balance demonstrate confident, inspection-ready practice.
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