* PLEASE ENSURE ALL CARE DOMAINS ARE COMPLETED WITH A WRITTEN SUMMARY STATEMENT * Name of patient Date of completion Please circle C B A Evidence in records to support this level statement A, B or C in each domain Behaviour* No evidence of ‘Challenging’ ‘Challenging’ behaviour that behaviour that ‘challenging’ behaviour. follows a predictable a predictable risk to pattern. The risk self, others or OR assessment property. The risk Some incidents of indicates a pattern of assessment behaviour that can indicates that ‘challenging’ behaviour. A risk be managed by planned assessment skilled carers or care interventions are indicates that the workers who are able effective in behaviour does to maintain a of minimising but not not pose a risk to behaviour that does always eliminating self, others or not pose a risk to risks. Compliance property or a self, others or is variable but barrier to property. The person usually responsive intervention. The is nearly always to planned person is compliant with care. interventions. compliant with all aspects of care.
* PLEASE ENSURE ALL CARE DOMAINS ARE COMPLETED WITH A WRITTEN SUMMARY STATEMENT * Name of patient Date of completion Please circle statement A, B or C in each domain C B A Evidence in records to support this level Behaviour* No evidence of ‘challenging’ behaviour. OR Some incidents of ‘challenging’ behaviour. A risk assessment indicates that the behaviour does not pose a risk to self, others or property or a barrier to intervention. The person is compliant with all aspects of care. ‘Challenging’ behaviour that follows a predictable pattern. The risk assessment indicates a pattern of behaviour that can be managed by skilled carers or care workers who are able to maintain a of behaviour that does not pose a risk to self, others or property. The person is nearly always compliant with care. ‘Challenging’ behaviour that a predictable risk to self, others or property. The risk assessment indicates that planned interventions are effective in minimising but not always eliminating risks. Compliance is variable but usually responsive to planned interventions.
CHC_Referral_pack.docx