Positive Risk-Taking in Older People’s Services: Moving Beyond Risk Avoidance
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Positive risk-taking in older people’s services is not about ignoring hazards or lowering safeguarding standards. It is about recognising that a life stripped of choice, activity and personal control can be just as harmful as unmanaged risk. In regulated services, the challenge is enabling older people to live full lives while demonstrating to commissioners and inspectors that risks are identified, assessed, reviewed and actively managed. This requires a shift away from defensive practice towards proportionate, evidence-led risk enablement.
This article sits alongside wider work on person-centred planning and quality, safety and governance, where positive risk-taking is a practical expression of values rather than a theoretical concept.
Why risk avoidance undermines quality of life
In many older people’s services, risk avoidance becomes embedded through fear of complaints, safeguarding alerts or inspection outcomes. Over time, this can lead to restrictions on mobility, community access, daily routines and even personal relationships. While often well-intentioned, these restrictions can increase dependency, accelerate physical decline and negatively impact mental health.
Positive risk-taking reframes risk as something to be understood and managed, not eliminated. It accepts that some level of risk is inherent in living, and that older people have the right to make informed choices, even when those choices involve uncertainty.
Operational example 1: Supporting independent mobility
Context: An older person living in extra care housing wished to continue walking independently to local shops following a minor fall.
Support approach: Rather than banning unsupervised outings, the service completed a falls risk assessment, consulted occupational therapy, and agreed a graded enablement plan.
Day-to-day delivery: Staff supported practice walks, reviewed footwear, adjusted timing to avoid busy periods, and introduced a personal alarm.
Evidence of effectiveness: Incident logs showed no further falls, while wellbeing reviews recorded improved confidence and reduced anxiety.
Operational example 2: Managing dietary risk
Context: An individual with swallowing difficulties wanted to continue enjoying certain foods outside recommended textures.
Support approach: The service worked with speech and language therapy to agree risk-managed exceptions documented within the care plan.
Day-to-day delivery: Staff followed agreed preparation guidance, ensured the person ate when alert, and recorded outcomes.
Evidence of effectiveness: No choking incidents occurred, and satisfaction feedback improved significantly.
Operational example 3: Enabling social relationships
Context: A resident wished to continue seeing a long-term friend despite family concerns.
Support approach: Risks were assessed collaboratively, boundaries agreed, and safeguarding advice sought.
Day-to-day delivery: Visits were supported initially, then stepped back as confidence grew.
Evidence of effectiveness: Safeguarding reviews confirmed risk reduction and improved emotional wellbeing.
Commissioner expectation
Commissioners expect providers to evidence that positive risk-taking is embedded through assessment, documentation and review, not informal staff discretion. Enablement plans should clearly link risk decisions to outcomes and cost-effective independence.
Regulator expectation (CQC)
CQC expects services to show how restrictions are the least restrictive option and how people are supported to take risks safely, aligned with Regulation 9 (person-centred care) and Regulation 10 (dignity and respect).
Embedding positive risk-taking in practice
Effective services embed positive risk-taking through training, supervision and governance. Risk decisions are reviewed regularly, incidents are analysed for learning, and staff are supported to apply professional judgement rather than defaulting to blanket restrictions.
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