5.4 Explain risk management in relation to an individual’s behaviour

This guide will help you answer 5.4 Explain risk management in relation to an individual’s behaviour.

Risk management in relation to a person’s behaviour after an acquired brain injury (ABI) is a structured way of identifying, assessing and reducing risks. The main aim is to keep the person safe, protect others, and support their independence. Risk management in health and social care involves looking at the behaviour, the triggers, and the environment so that plans can be put in place.

An acquired brain injury is brain damage that occurs after birth. It can result from trauma, stroke, infection, tumour, or lack of oxygen. These injuries can change a person’s thinking, emotions and physical abilities. They can also cause unpredictable or challenging behaviour. This is why risk management is very important in their care plan.

Behaviour Changes After ABI

Behaviour changes after an ABI can vary between individuals. Some people may become aggressive or impulsive. Others may display inappropriate social behaviour. This is often because the part of the brain that controls judgement, reasoning and emotions is affected.

Changes might include:

• Aggression or verbal abuse
• Impulsive actions without considering consequences
• Difficulty controlling emotions
• Disinhibition (saying or doing things that are socially inappropriate)
• Withdrawal or apathy
• Restlessness or wandering

These behaviours can put the person or others at risk. Without risk management, the person may harm themselves, damage relationships, have accidents, or become socially isolated.

Purpose of Risk Management

Risk management aims to avoid harm, while still supporting the person’s freedom and dignity. It is not about taking away all risks, but about finding ways to reduce them and manage them effectively.

In the context of ABI, you might need to:

• Reduce the chance of the person hurting themselves or others
• Make the environment safer
• Support behavioural change with strategies
• Keep the person included in community and social life
• Provide staff and family with guidance on how to respond

Identifying Risks Linked to Behaviour

The first step is spotting the possible dangers linked to the person’s behaviour. This is called risk identification.

You may need to look at:

• Previous incidents of aggression or unsafe behaviour
• Changes in mood or mental state
• Environmental hazards
• Triggers that lead to problem behaviour
• The person’s own awareness of their abilities and limits

By gathering this information from observations, reports, and family input, you can build a full picture of the risks.

Assessing the Level of Risk

Once risks are spotted, they need to be assessed. This means rating how likely the risk is to happen and how serious the harm could be.

For example:

• A person with ABI who wanders into busy roads faces high likelihood and high harm risk.
• A person who sometimes shouts when frustrated may be lower harm risk, but still needs support to prevent escalation.

Risk assessment tools can be used in health and social care settings. These are structured forms or checklists. They help you record:

• The type of risk
• Who or what might be affected
• The frequency of the behaviour
• The severity of the possible outcome

Involving the Person in Risk Management

It is important to involve the person in their own risk management. Even with reduced insight, they should have a chance to share their views. This supports their dignity and encourages cooperation.

You can:

• Explain risks in a simple, clear way
• Use visual aids or examples if understanding is affected
• Ask for their input on strategies they feel comfortable with
• Respect their preferences where safe

By including them, you promote choice and control. This can help reduce behaviours linked to frustration or feeling powerless.

Involving Family and Support Networks

Families and friends often notice behaviour changes first. They can also offer valuable background information on the person’s personality and coping styles.

Involving them means you can:

• Gain insight into past behaviour and preferences
• Provide consistent responses to risk situations
• Offer them support to cope with the changes
• Build trust and shared responsibility for care

Creating a Risk Management Plan

A risk management plan is a written record of how risks will be reduced, what actions to take, and who is responsible.

For ABI-related behaviour, plans often include:

• Clear description of the behaviour and risks
• Identified triggers
• Early warning signs before escalation
• Agreed strategies to respond
• Environmental changes to reduce triggers
• Roles and responsibilities for staff and carers
• Review dates and update process

Positive Behaviour Support

Positive Behaviour Support (PBS) is a common approach. It focuses on understanding why behaviour happens and replacing it with positive alternatives, rather than just stopping the behaviour.

PBS for ABI might involve:

• Identifying the function of the behaviour (e.g. attention seeking, escaping a situation)
• Using reinforcement for positive behaviours
• Teaching alternative skills or coping mechanisms
• Providing meaningful activities to reduce boredom or frustration

Reducing Environmental Risks

Sometimes behaviour is made worse by the surroundings. Adapting the environment can prevent incidents.

Examples:

• Removing sharp objects or harmful substances
• Providing quiet spaces to reduce sensory overload
• Changing seating arrangements if the person becomes aggressive in groups
• Using locked cupboards for dangerous items
• Clear signage to reduce confusion and wandering

Recognising Triggers

Triggers are events or situations that lead to behaviour changes. Understanding them is key to prevention. Common triggers for ABI include:

• Feeling overwhelmed in noisy areas
• Being rushed or pressured
• Lack of structure to the day
• Tiredness or hunger
• Pain or discomfort
• Misunderstandings due to communication difficulties

By recognising these, you can remove or adapt situations to prevent the behaviour starting.

Responding to Behaviour Safely

If challenging behaviour does occur, staff and carers must respond in a way that keeps everyone safe and avoids making the situation worse.

Good practice includes:

• Staying calm and speaking in a steady voice
• Giving personal space
• Avoiding confrontation or shouting
• Using distraction techniques
• Calling for backup if needed
• Only using physical intervention as a last resort and in line with training and policy

Balancing Safety and Independence

Completely removing all risk can limit the person’s quality of life. People learn and grow from manageable risks.

With ABI, the goal is to reduce unnecessary harm while allowing them to engage in daily life. For example:

• Letting them cook with supervision rather than banning kitchen use
• Encouraging community visits with support staff present
• Supporting them to travel on familiar routes with a buddy system

Documenting and Reviewing

Risk management is ongoing. Behaviour can change over time with ABI recovery or deterioration.

You need to:

• Document all incidents and responses
• Record any changes to triggers or behaviour patterns
• Review risk assessments at agreed intervals
• Adapt plans if they are not working or new risks appear

Good records support continuity of care and legal compliance.

Legal and Ethical Duties

UK health and social care workers must follow certain laws and professional standards. These include:

• Health and Safety at Work Act 1974 – creating a safe environment
• Care Act 2014 – safeguarding adults at risk
• Mental Capacity Act 2005 – protecting rights of those lacking capacity, using the least restrictive options
• Data Protection Act 2018 – keeping records confidential
• Human Rights Act 1998 – including the right to liberty and respect for private life

Following these keeps practice lawful and ethical.

Training and Support for Staff

Working with people with ABI can be challenging. Staff need the right skills and knowledge to manage risks.

Training may cover:

• Understanding ABI and its effects on behaviour
• Positive Behaviour Support methods
• De-escalation techniques
• Safe physical intervention
• Recording and reporting procedures
• Safeguarding duties

Support through supervision and peer discussion can help staff stay confident and avoid burnout.

Specialist Input

Some individuals will need specialist assessments to manage behaviour safely. Professionals who can help include:

• Clinical psychologists – assessing triggers and behaviour patterns
• Occupational therapists – adapting the environment and daily tasks
• Speech and language therapists – supporting communication to reduce misunderstandings
• Neurologists – identifying medical causes for behaviour changes

Linking with these specialists can make the risk management plan more effective.

Crisis Planning

For individuals with a high risk of sudden dangerous behaviour, a crisis plan is important. This sets out immediate steps to take to keep everyone safe during incidents.

A crisis plan might include:

• Who to call for urgent help
• Safe spaces for the person to go
• Steps to calm the situation
• Emergency medical information
• Roles of each team member

Final Thoughts

Risk management for ABI-related behaviour is about balance. You want to control possible dangers, but you also want the person to have as much independence and choice as they can manage.

By taking time to understand their specific triggers and needs, you can help prevent challenging behaviour. A clear plan, good communication, and teamwork are key. This is not a one-off task. You must keep reviewing and adapting your approach. Over time, risk management done well can help the person live more safely, get along better with others, and enjoy a better quality of life.