Risk assessment of mentally ill in-patients is an ongoing process in stated time scale. It includes risk of self harm, aggression, violence, self neglect and exploitation and abuse by others. Accurate recording is essential for patient management.

The aim was to assess the practice of risk assessment in our trust. Retrospective data of 50 consecutive admissions were collected from case notes over a period of 6 months.

28 females (56%) and 22 males (44%) of average age 41 were included in the audit. The mean duration of admission was 55 days (range 7–270 days). 11 patients (22%) had schizophrenia and 8 patients (16%) each had a diagnosis of depressive disorder and substance misuse. The other patients had diagnoses of schizoaffective, personality disorder and bipolar illness. Four patients (8%) had no risk assessment forms filled in during the admission. Out of 46 forms completed, the time and date of assessment were not recorded in 8 (17%). Completion date was recorded in 9 forms (20%) and review was done in 11 cases (24%). 45% of forms did not have the name and signature of assessor. Suicide risk, neglect and aggression/violence were documented in most forms (90%), however only 20% cases had a further action plan.

Significant number of risk assessment forms lacked important information which is crucial for risk management. This data was presented to the clinical governance team and was highlighted as a priority for improvement which has been implemented in the trust.