Risk Management, Positive Risk-Taking and Board Accountability in Adult Social Care
Risk is inherent in adult social care, particularly where services support autonomy, independence and choice. Boards are expected to demonstrate that risk is managed thoughtfully, proportionately and lawfully, with clear accountability. Effective assurance and governance arrangements align risk management with values, rights and outcomes, consistent with recognised quality standards and frameworks.
This article examines how boards oversee risk management and positive risk-taking in a way that supports people while meeting regulatory and commissioning expectations.
Why risk governance is more than risk registers
Risk governance often fails when it becomes a static exercise. Common issues include:
- Risk registers detached from frontline reality
- Overly defensive practice driven by fear of inspection
- Inconsistent application of positive risk-taking
- Limited board understanding of lived risk decisions
Boards need visibility of how risk decisions are made, reviewed and learned from.
Embedding positive risk-taking within governance frameworks
Positive risk-taking should be:
- Person-centred and rights-based
- Informed by capacity and best interests processes
- Clearly documented and reviewed
- Supported by staff competence and supervision
- Subject to governance oversight and learning
Boards should see evidence that positive risk-taking is deliberate, not accidental.
Operational Example 1: Board oversight of community access risk
Context: A supported living provider supported people with learning disabilities to access community activities independently. Incidents raised concern about unmanaged risk.
Support approach: The provider clarified its positive risk-taking framework, linking individual risk assessments to organisational risk appetite.
Day-to-day delivery detail: Staff completed dynamic risk assessments supported by clear guidance on escalation. Decisions were reviewed in supervision and recorded in care plans. Governance meetings reviewed themes, not individual blame.
How effectiveness was evidenced: The board reviewed incident trends alongside quality-of-life outcomes, demonstrating balanced decision-making.
Risk appetite and board accountability
Boards should explicitly define risk appetite across domains such as safeguarding, restrictive practice, workforce and financial sustainability. This helps leaders make consistent decisions and supports transparent challenge.
Operational Example 2: Managing workforce risk without compromising care
Context: Staffing shortages increased reliance on agency staff, raising quality and continuity risks.
Support approach: The board reviewed workforce risk appetite and approved targeted mitigation rather than blanket restrictions.
Day-to-day delivery detail: Enhanced induction and supervision for agency staff were implemented. Dashboard metrics tracked incident correlation with staffing changes.
How effectiveness was evidenced: Reduced incident rates and improved continuity indicators demonstrated effective risk mitigation.
Learning from risk events at board level
Boards should expect structured learning from serious incidents, including:
- Root cause analysis
- Thematic learning across services
- Clear improvement actions
- Embedding and assurance checks
This ensures risk governance drives improvement rather than defensive practice.
Operational Example 3: Learning from a serious incident review
Context: A serious incident involving self-harm prompted multi-agency review.
Support approach: The provider conducted an independent review and presented learning directly to the board.
Day-to-day delivery detail: Actions included revised escalation protocols, additional staff training and enhanced clinical oversight. Progress was tracked via board action logs.
How effectiveness was evidenced: Subsequent audits and incident reviews showed improved early intervention and escalation.
Commissioner and regulator expectations
Commissioner expectation: Commissioners expect providers to manage risk proportionately, supporting independence while safeguarding individuals and public resources.
Regulator / inspector expectation (CQC): CQC expects providers to assess and mitigate risks while respecting people’s rights and promoting independence.
Conclusion
Effective risk governance balances safety, rights and outcomes. Boards that define risk appetite, oversee positive risk-taking and evidence learning from risk events demonstrate mature governance and regulator-ready assurance.