Home & Environmental Risk HOME & ENVIRONMENTAL RISK (QMS-F050) Contact Document Ref: QMS-F050 (Home & Environmental Risk) Version: 1.0 Confidentiality Level: MEDIUM (Internal Operations) CQC Alignment: Safe (Safe Environments) Service User Full NameService User ID NumberOperating Local Authority- Select -HaringeyIslingtonWaltham ForestBarnetOtherCare Funding & Financial Arrangements- Select -Local Authority Managed (Direct Commissioning)NHS Funded (Continuing Healthcare - CHC)Direct Payments (Personal Budgets)Self-Funded (Full Cost)OtherSECTION 1 - Property Overview & AccessProperty Type- Select -House (Detached/Semi)Terraced HouseGround Floor FlatUpper Floor Flat (with lift)Upper Floor Flat (no lift)Sheltered AccommodationOtherExternal & Lone Worker Hazards No external hazards identified Severe parking restrictions (Permits required or zero parking available) Poor street lighting / Dark communal stairwells Known anti-social behavior or high crime in the immediate vicinity Unsecured communal entrancesAre there any immediate access hazards? (e.g., steep steps, broken paving, poor exterior lighting)- Select -YesNoDetail the access hazards and required control measuresSECTION 2 - Internal Environment (Slips, Trips & Falls)Identify any internal hazards present in the areas where care will be delivered: Loose rugs/carpets Trailing wires/cables Clutter on walkways Uneven flooring Inadequate lighting None of the aboveAre the heating and ventilation systems adequate and safe? (e.g., no portable gas heaters blocking exits)- Select -YesNoSECTION 3 - Hygiene, Infection Control & PetsGeneral state of cleanliness and hygiene- Select -Good (No risks identified)Fair (Some support needed)Poor (Immediate infection control risks)Specific Environmental Health Risks- Select -Severe Hoarding (Walkways blocked, fire exits obstructed)Evidence of pest infestation (e.g., rodents, bedbugs, fleas)Hazardous waste present (e.g., soiled incontinence pads left out, rotting food)Are there pets in the property?- Select -YesNoPet Risk Control Measure- Select -Pet must be locked in another room during visitsPet is friendly and poses no riskSpecific staff allergies to considerSECTION 4 - Basic Fire Safety CheckAre working smoke alarms fitted in the property?- Select -YesNoUnsure (Requires checking)Is the service user a smoker who smokes in bed or drops cigarettes?- Select -YesNoIs prescribed medical Oxygen stored or used in the property?- Select -YesNoNot ApplicableMandatory Oxygen Safety Protocol- Select -Warning: Oxygen in use. I confirm 'No Smoking' signs are/will be made visible, and the local Fire Brigade will be alerted to log the property on their hazard database.SECTION 5 - Overall Risk Rating & Action PlanOverall Environmental Risk Rating- Select -LOW (Safe for lone working)MEDIUM (Hazards identified but controlled)HIGH (Unsafe - Immediate action required before care starts)Mandatory Action Plan / Instructions for Care WorkersAssessor NameDate of AssessmentSave Environmental Risk
