Client Home Risk Assessment Lydian Care Client Risk Assessment Step 1 of 2 50% Office Details:This client risk assessment is to be completed by managers or seniors when inside the client's home.Date Client Check Completed:(Required) DD dash MM dash YYYY Home Care Manager:(Required)Carol SavageRachel DeeryLinda SpenceArea Client is Based:(Required) Downpatrick Crossgar Killyleagh Ballygowan Saintfield Comber Belfast Newcastle Castlewellan Seaforde Drumaness Ballynahinch Senior Carer Completing Check:(Required) Senior Email:(Required) Entering your e-mail address here you will receive a copy of the submitted form.Client Details:Client's Name:(Required) First Last Client's Date of Birth:(Required) DD slash MM slash YYYY To be used as a unique identifier for the client - will be listed in their careplan.Risk AssessmentsHow do carers gain access to client's home? IE: Keypad or does the client let the carers in?Does the client have Tiled/Carpet/Wooden floors or any mats within the home where we deliver care? detail here.(Required)Does the outside of the client's home have sufficient lighting for carers entering and leaving the home?YesNoUnable to determineDetail if there is any potential tripping hazards or concerns on how carers have to enter the clients home.(Required)For example - steep steps to climb before gaining access. If none state no potential hazards.1. Fire Safety/Risk AssessmentIs the client aged 60 or over?(Required)YesNoHave a disability or impaired mobility?(Required)YesNoeither unable to walk or difficulty in walking for example in a wheelchair or requires a hoist for moving and handling.Have a health condition that would impact upon their ability to acknowledge or respond to an emergency within the home?(Required)YesNoSuch as a hearing or sight issue or suffers from a form of dementia.Do they have a working smoke alarm in the house?(Required)YesNoeither check or ask the client if they have a working smoke alarm fitted.Detail:(Required)Detail above if there is any evidence or History of fires Client not careful with smoking materials Scorch marks on bedding, clothing and/or carpets Client Leaving cooking unattended Large quantities of loose papers/stored/hoarded items in rooms Use of candles unguarded/close to combustible materials. Decision to refer to Northern Ireland Fire & Rescue Service?(Required) Yes No 2. Internal risk assessmentArea Internal(Required)Detail the internal areas for example Hallways /Passageways, Rooms within the home where care is delivered.Potential Hazards(Required)Where are the potential hazards such as obstruction/Mats/Tripping etc..Risk(Required)Where is there potential risk for example Upstairs carpet,etc.. Potential risk to:(Required)who is the potential risk to for example is it the Care Staff/Client or both. Does the client have equipment in their home?(Required) Yes No Detail all equipment in client's homeEquipmentChecked DateDue Maintenance on Add Removeenter each equipment item in the text box above - then click the plus button to add more.Is the equipment maintained and checked?(Required) Yes No 3. Client Movement Assessment/Mobility Assessmentdetail below the movement of the client and whether its Unaided or with an aid? What Aid /Equipment? With Supervision? With support 1 or 2 persons? Movement - Walking(Required)Movement - Washing(Required)Movement - Chair to standing(Required)Movement - Transfers Chair to bed, Bed to chair, Chair to toilet/commode(Required)Movement - Bed to standing(Required)Movement - Rolling bed(Required) Movement - Positioning in bed(Required)Movement - Wheelchair Transfers(Required)Client Name First Last Clients Signature(Required)please draw your signature like you would on a piece of paper in the box above. If client unable to sign please put an X above as the person completing the form.Senior's Name(Required) First Last Senior Carer Completing Form Signature:(Required)please draw your signature like you would on a piece of paper in the box above.
