Managing transition risk in adult autism services before it escalates
Transition risk in adult autism services is rarely sudden. It builds gradually when routines change, responsibility shifts, or support gaps appear. Providers that identify and manage these risks early prevent crisis, safeguarding escalation and restrictive responses. This article focuses on how to assess and manage transition risk within assessment, eligibility and transition into adult services, and how this risk work must align with service models and care pathways to be effective.
Common transition risks in adult autism services
- Loss of routine and predictability.
- Changes in staff, location or support style.
- Breakdown of informal support.
- Housing instability.
- Delayed decision-making or unclear accountability.
These risks are foreseeable and should be actively assessed rather than reacted to.
Assessing transition risk properly
Transition risk assessment should sit alongside functional assessment. It should explicitly consider:
- What changes are coming and when.
- How the person has responded to change previously.
- What early warning signs indicate rising distress.
- What support reduces risk during periods of uncertainty.
Operational example 1: transition from family home
Context: An autistic adult is moving out of the family home following relationship breakdown.
Support approach: Risk assessment focuses on isolation, exploitation and routine collapse.
Day-to-day delivery detail: Support begins before the move, establishing routines, budgeting prompts and daily check-ins. Staff accompany the person to key appointments.
How effectiveness is evidenced: Stability indicators are tracked, showing reduced crisis contacts and improved engagement.
Operational example 2: service model change
Context: A person moves from a highly structured placement to more independent support.
Support approach: Risk enablement is used rather than abrupt reduction of support.
Day-to-day delivery detail: Support hours taper gradually, routines are rehearsed, and contingency plans are agreed.
How effectiveness is evidenced: Incident data and routine adherence demonstrate managed risk.
Operational example 3: transition between providers
Context: Commissioning change results in provider transfer.
Support approach: Joint handover and overlap period is agreed.
Day-to-day delivery detail: Consistent communication methods and shared plans are used.
How effectiveness is evidenced: Reduced complaints and stable engagement post-transfer.
Commissioner expectation
Commissioners expect providers to anticipate and manage transition risk. This includes early planning, clear ownership, and evidence that risk has been actively mitigated rather than reacted to.
Regulator and inspector expectation (CQC)
CQC expects people to be protected from avoidable harm during transitions. Inspectors will look for proactive risk management, continuity, safeguarding awareness and governance oversight.
Governance and assurance
- Standard transition risk assessment tools.
- Named transition leads.
- Management oversight of high-risk transitions.
- Learning from incidents and complaints.
What good looks like
Good transition risk management is visible in stability, reduced escalation and clear provider records. It shows that change has been planned, supported and governed rather than left to chance.