Mersey Care services can be offered support in relation to a service user remaining open to them, where the need for further understanding and conceptualization of the presenting risks is identified. The offer will vary depending on the requirements of the particular case but may include case consultation, specialist supervision, clinical risk assessment and/or independent case review. This work will be informed by the policy - Use of Clinical Risk Assessment (SA10).

Cases will be accepted, prioritized and allocated to a Tier (see table below) with consideration to the reason for the review; the existing level of understanding of risk; the immediate presentation and context of the service user; clinical judgement concerning the imminence, likelihood and severity of the presenting risks and feasibility of current plans, and the time frames in which the output of the review will most usefully take place.  

Tier one: initial case review/consultation

 Tier two: interim case review/risk consultation Tier three: comprehensive clinical risk assessment
  • Discussion with the referring professional
  • Review of relevant documents
  • Provision of a brief report including the overview of the process, content and outcome of the initital consulation/review
  • A summary of the current understanding/status of risk, highlighting the relevant information, any identifiable risk/protective factors, patterns in risk behaviour, formulations of the situations in which identified risks may occur, and considerations for crisis management and risk management plans
  • Actions and recommendation(s) for next steps, with consideration to the need for a Tier one or Tier two review, integration of outcomes with other risk assessments, activation of other SPaRCS pathways and any other identifiable options for risk monitoring, supervision, intervention, care planning and their families and/or others involved in their care as deemed appropriate safeguarding / victim safety planning. 
  • May be initiated at referral or following a recommendation of a Tier one review
  • As Tier one review but extending to offer of a risk formulation developed in collaboration with the service user, their families and/or others involved in their care as deemed appropriate
  • Most appropriate when there is a need for a timely review of the presenting risks
  • The need for a full / structured assessment (Tier three) will be considered within the recommendations of the Tier two review.
  • As Tier two, extending to include the use of structured professional judgement tools and other standardized clinical and risk assessments as required
  • Assessments may be multidisciplinary and will require synthesis of multiple sources of information including contacts with service users, families, and carers wherever possible
  • The risk formulation and associated scenarios will be considered collaboratively with the professionals involved, to inform recommendations about appropriate risk management plans. This will include specific reference to supervision; monitoring; treatment / therapeutic goals / care plans; and victim safety planning / safeguarding issues/ protective factors
  • Most appropriate when there is a need for a comprehensive understanding of risk and there are interim plans in place to support the risk management of the case while the assessment takes place, which may range from four weeks to several months, depending on the circumstances and requirements of the assessment.