An audit of service-user involvement and quality of HCR-20 version 2 risk assessments on rehabilitation and low secure wards

Abstract

AbstractThe HCR-20 is the most widely used structured professional judgement instrument for assessing risk of violence. Recent developments in secure settings have addressed service user involvement in risk assessment to empower service users, and encourage them to take responsibility for their pathway through hospital. This audit aimed to examine the quality of, and service-user involvement in, the HCR-20 assessments completed on two wards (a low secure and a psychiatric rehabilitation ward) within Somerset Partnership NHS Foundation Trust. Data from the current RiO (electronic patient record system) Risk Screen and Risk Information sections and the most up-to date HCR-20 report (if there was one) was reviewed across a number of domains. The in-house HCR-20 training programme appeared to be effective, with most assessors following the appropriate data collection process. The quality of the risk assessments was mixed with the historical section being more consistently completed than the clinical and risk sections. The results of the audit facilitated the development of standards for the completion of HCR-20 risk assessments on the two wards reviewed. Limitations of the audit in terms of generalisation are noted. Nonetheless, this audit serves to give an early impression on the extent of collaboration with service users on risk assessments.