Substantial risk to independence

Government guidance defines as substantial the following risks to health and safety, autonomy, management of daily routines and involvement in family or community life. There is, or will be, only partial choice and control over the immediate environment; and/or:

• Abuse or neglect has occurred or will occur; and/or
• Involvement in many aspects of work, education or learning cannot or will not be sustained; and/or
• There is, or will be, an inability to carry out the majority of personal care or domestic routines; and/or
• The majority of social support systems and relationships cannot or will not be sustained; and/or
• The majority of family and social roles and responsibilities cannot or will not be undertaken.

Needs that may indicate this level of risk

• Your situation, actions, or how you look after yourself, is causing serious concern that your safety will not be maintained without assistance, supervision or equipment;
• You are vulnerable to abuse, neglect or exploitation and this is likely to happen without help;
• You cannot perform or are increasingly struggling to maintain one or more essential daily activities such as changing clothes, maintaining personal and oral hygiene, obtaining and preparing food without assistance, and this is not otherwise available to you;
• You have an illness which is at risk of deteriorating to the extent that your safety or the safety of others will be at risk in the longer term if support is not provided;
• Your mobility in the home is severely restricted and you cannot access essential facilities;
• The provision of assistive equipment, or support for a short period following a crisis, accident or hospital admission, will promote your independence by enabling you to continue or resume the performance of daily routines and essential tasks such as maintaining personal hygiene, getting about safely, shopping or cooking for yourself;
• You are currently undergoing a major life transition, e.g. moving from institutional care to the community, or from your parental home to a more independent setting, and this is unlikely to be successfully achieved without assistance;
• You need support to develop or maintain life skills without which you will be unable to look after yourself or sustain any social support networks and relationships in the future;
• You have severe communication difficulties or cannot communicate without assistance
• You need support because you have few social supports or networks and the majority of these are very stressed or are breaking down;
• You are unable to sustain without assistance involvements in work, education or learning activities which are significant to promoting your independence, and this assistance is not otherwise available to you;
• You cannot perform the majority of family and other social roles without assistance, and this is not otherwise available to you;
• You are at risk of accidental harm or not having your essential needs met sufficiently because you carer is not able to carry out all necessary tasks, for example due to age or deteriorating illness;
• At least one of the above risks or needs apply to you and your care /support arrangements have broken down or are about to break down, or your carer has been assessed as unable to continue caring if support is not provided.