Principles of safeguarding & protection in health & social care 205: Outcome 1
*Physical abuse: any act or maltreatment resulting in a physical injury, such as hitting, punching and kicking. *Sexual abuse: any act or mistreatment of a sexual nature imposed on someone else without his or her consent, such as rape and inappropriate touch. *Emotional/psychological abuse: any intentional act or mistreatment resulting in a mental/ emotional pain or injury, such as verbal abuse and humiliation. *Financial abuse: any misuse of someone’s money or property through theft or fraud. *Institutional abuse: any mistreatment of service users caused by poor care, support and practice which may affect the entire setting, such as lack of person centred care due to inadequate staffing. *Self neglect: any behavioural act in which the individual neglects to attend to their basic needs, such as personal hygiene. *Neglect by others: the state of being uncared for, such as ignoring a service user’s medical care needs. 2- Signs and symptoms of types of abuse:
*Physical abuse: injuries to face & head, unexplained falls, bruises. *Sexual abuse: change in behaviour, injuries to genital and anal area, difficulty in walking, and sitting, self harm. *Emotional/psychological abuse: fear, anger, low self esteem, depression, withdrawal, weight loss/gain, changes in appetite, sleep. *Financial abuse: lack of cash on day to day basis, unpaid bills, misuse of supermarkets’ club cards. *Institutional abuse: inability to make choices, agitation if routine broken, showing signs of challenging behaviour, feeling of depression if service users can’t go out due to shortage in staffing. *Self neglect: absence of hygiene, low self esteem, isolation. *Neglect by others: preventing service users to have access to services, absence of prescribed medication, isolation, and absence of personal hygiene. 3- Factors that can contribute to an individual being more vulnerable to abuse may include a learning disability, mental illness, elderly, children, homeless, being abused in the past or/and being inexperienced.
1- Actions to take if there are suspicions that an individual, a service user in particular, is being abused:
*Follow the guidelines stated in my employer’s policy.
*Report the suspicion/incident to my line manager, filling the relevant safeguarding adults from abuse form. *Make careful records of what was suspected including the date, time, and evidence if available. 2- Actions to take if an individual alleges that they are being abused: *keep the vulnerable adult safe.
* be receptive & perceptive.
*take it seriously.
*Make careful records, preferably the individual’s own words, of what was suspected including the date, time, and evidence if available.
*Report the allegation to my line manager.
3- Ways to ensure that evidence of abuse is preserved: *Statements by the victim or/and witnesses if there are any. *Physical evidence (as in to keep any tools used for the abusive incident, also not to wash the person if they’ve been sexually abused or bleeding unless it jeopardizes the wellbeing of the service user). *Use of tape records and photographs if need be.
1- National policies and local systems that relate to safeguarding and protection from abuse may include the following: * The Concerns and complaints procedure
* Risk Assessment and Management Pack
* Grievance Policy
* Disciplinary Policy
* Risk Management Strategy
* Risk Management Policy
* Client risk assessments
* Major clinical & serious untoward incident policy
* Whistle blowing policy
* Accidents, Incidents and Near Misses Guide book
* Accidents, Incidents and Near Misses reporting policy
* Claims Management Policy & Procedures
* Complaints Policy
1- Different agencies have important roles in safeguarding and protecting individuals from abuse, such as Care quality commission which regulate and inspect care providers. Medical professionals like GPs, nurses, and care managers can diagnose, examine and treat individuals who have been abused, they also record incidents and dates that may even be used as evidence. Police is also another crucial body in protecting individuals if needed as they can investigate, prosecute and prevent crimes. Social Care Council in turn can protect and safeguard vulnerable individuals and stand for their rights.
2- Winterbourne View incidents of abuse could be the best example of reports into serious failures to protect individuals from abuse as it’s been reported that there was a systematic failure to protect the vulnerable people in that care home regardless of the C.Q.C.’s inspections. The staff, as filmed on BBC’s Panorama, demonstrated all types of abuse and proved to be not fit to work in a care setting. The management, however, did not ensure that major incidents were reported to the CQC as required by law and did not take reasonable steps to identify the possibility of abuse and prevent it before it happened.
Another example of failing to protect individuals from abuse is that of an Essex care home that has been published in a report by CQC after a routine visit in January 2012. The report says that the provider was not meeting several essential standards inspectors looked at and a major concern was identified. These concerns included care plans were out of date, food was not wrapped and dated which could cause food poisoning, medication was not securely stored and staff were not even trained to use emergency medication for patients with epilepsy, the provider failed to notify CQC that they moved abroad in summer 2011, whilst CQC should have been let to know because if any care provider is going to be absent from the country for more than 28 days, CQC should be notified. Also, the lady who’s recently been on the BBC news that was neglected and eventually died in Stafford Hospital is another report of a big and serious failure within the NHS to protect vulnerable adults from abuse which the health secretary himself expressed his shame and disappointment. 4-Sources of information and advice about own role in safeguarding and protecting individuals from abuse may include regular trainings, supervisions, internet, my employer’s Safeguarding Adults’ Policy and my work colleagues sometimes. Outcome 4
1- Abuse is likely to be reduced if all staff, including managers and support workers, are putting the service users’ person centred values first; that is to say, meeting their own personal needs, prompting their choice and rights, as well as encouraging them to take part in activities they choose whether indoors or outdoors. 2- An accessible complaints procedure is crucial for reducing the likelihood of abuse because if staff are aware of the right procedure by reporting any suspicious incident to the relevant authority or/and manager and filling the relevant form, then the abuse is likely to be dealt with sooner, hence individuals who abuse others, on purpose especially, would think twice before the abuse is committed.
1- There are many unsafe practices that may affect the wellbeing of others such as moving and handling service users without following their care plan/guidelines, doing personal care whilst not wearing protected gloves or even not changing them whilst handling more than one service user at a time, not washing hands before and during handling food, also texting or talking on the phone while transporting service users.
2- Actions to take if unsafe practices have been identified are : *Protect: ensure the safety of service users.
*Report: the abuse to the line manager.
*Preserve: keep up the evidence.
*Record: write a statement or filling the relevant form.
3- The action to take if suspected abuse has been reported, but nothing has been done in response would be to resort to the manager next in line; that is, if the suspected abuse has been reported to my line manager and nothing’s been done, then l need to report it to my manager’s manager, if no response then to the manager of my manager’s manager and so on so forth. If necessary, l can also resort to other agencies that can seriously deal with the suspected abuse such as CQC, Social care council.
The role of the health & social care worker 206
1- A working relationship is a way of describing relationships with colleagues within work; it should be professional and to always keep in mind the duty of care. However, a personal relationship is one where somebody’s personal/private and social life are involved. 2- Different working relationships in health and social care settings may involve staff getting to know each other at their work place, staff getting to know service users, their families, staff getting to know other staff members, during annual trainings for example, staff getting to know other health professionals such as GPs, Nurses, OT, care managers within the trust, other care managers like the county council’s. Outcome 2
1- It is extremely important to adhere to the agreed scope of the job role because that increases the quality and efficiency of the care we provide in a healthy and safe manner. 2- It is also important to access full and updated details of agreed ways of working such as the folders outlining my employer’s policies and procedures, their website. 3- It is also important to implement agreed ways of working because they help towards a high quality care delivery. Outcome 3
1- It is important to work in partnership with others so as to make sure the best possible support and care is provided. This usually involves one to have good communication skills. 3-Skills and approaches needed for resolving conflicts in care can involve the following: * Stay calm.
* Follow my employer’s policies & guidelines by recording, reporting any conflicts. * Listen
* Do not assume
Communication in health & social care 301:
1- There are different reasons why people communicate. Some of the main reasons are summarized as follow: * Sharing information, facts, knowledge.
* Making relationships with others.
* Getting to know other people, understanding their opinions, feelings, needs and wants. * Forming and developing friendships, relations of love.
* Connecting with others in order to survive, as in work purposes. * Persuading others of certain things can also be a reason.
2- Communication in a work setting is crucial and can very much affect relationships amongst employees and can also affect the productivity of the business. An example of this can be illustrated in the fact that l support vulnerable, epileptic people (service users) in my job. If one of these service users had a seizure and rescue/ emergency medication had to be administered, l then would have to communicate, verbally and non-verbally, to the other member of staff taking over my shift of what happened to the service user, otherwise his/her wellbeing maybe jeopardized. i.e., the service user might be given an extra dose of medication which they should not have in compliance with the person’s care plan. Other things that can have a strong impact on relationships in a work place or even in day-to-day life, if not used significantly, would involve: listening, tone of voice, body language, observations, others’ reactions, preferences, wishes and language needs…etc therefore, these are ways and skills to establish good communication ties. Nevertheless, work place relationships become a lot stronger when people can clearly and effectively communicate what they need and allow others to do the same. Outcome 2
2- There are many factors to consider when promoting effective communication. Some of the main ones are as follows: *being aware of the individual’s environment and atmosphere. *understanding the person’s language needs, preferences and wishes. *looking at the way the person responds.
* being observant.
1- People from different backgrounds may use and/or interpret communication methods in different ways. For example, the tone of voice of some people who grew up in some parts of Africa can be used quite high during communication, and it may even be interpreted as being rude. Also, the use of body language in another country may not be the same as in the UK. Hence, if used, it may send mixed, confusing messages.
2- Barriers to effective communication:
* Culture as in speaking poor English or a different language. * Impairments as in deafness or/ and blindness.
* Health issues as in mental health problems.
* Strong accents as in speaking to a Geordie (Newcastle) or someone with a lisp. * Religion as in men unable to support women.
* Use of figure of speech.
5- Extra support or services to enable individuals to communicate effectively can be achieved via other professionals’ advice and guidance, trainings, supervisions, Internet, phone.
1- Confidentiality is the act of not sharing personal information or details that concern someone to someone else. It also means keeping things private on a need to know basis only. 2- Ways to maintain confidentiality in day to day communication : *Ensure you write up reports/records in private.
*All file and documents are correctly labelled confidential. *Not talking when can be overheard.
*Using passwords on computers
*Using locked cabinets and cupboards.
*Only authorised people to have access to files/records.
Personal development in health & social care 302:
1-Duties and responsibilities of my own work role:
* Support people with learning disabilities to maintain daily living skills. *Comply with all the Trust’s policies and procedures whilst supporting service users. *Maintain health and safety, confidentiality, food hygiene, moving and handling, communication, infection control, fire safety, medication, safeguarding vulnerable people. 2-Expectations about my own work role:
*To deliver high quality standards.
*To accomplish NVQ3.
*To attend regular trainings, supervisions and team meetings. Outcome 2
1- Reflective practice is crucial in continuously improving the quality of service provided because of the following: *Improves practice.
*Helps identify ways of working that have positive and negative impact on others. *Helps deal with situations and routines l have experienced before. *Develop better knowledge, skills and understanding.
3- One’s own values, beliefs and experiences definitely affect one’s work either positively or negatively though it should not be the case for a negative impact, at least. For example, l might be a preacher in church, yet that does not mean l should preach whilst at work.
1- My own knowledge, performance and understanding come from the fact that l follow the Trust’s policies and guidelines which enable me to deliver good care quality standards in my job, such as feedback to my work colleagues which is a good practice.
1- Sources of support for planning and reviewing own development can be trainings, supervisions, books, internet, observations, and team meetings. Outcome 5
1- Learning activities, such as trainings, do affect one’s practice in the sense that not only does the person refresh his/her knowledge, but also develops new skills.
2- Recording progress in relation to personal development can be achieved by complying with the PDP standards; these may include codes of practice, regulations, meeting agreed objectives, meeting planned activities, meeting deadlines when doing activities.
Equality and inclusion in health & social care 303:
*Diversity is the state of being diverse, varied, different and unique. *Equality is the state of being equal or the same especially in rights, status and opportunities. *Inclusion is the state of being included in a group regardless of gender, disability, religion.
2- Discrimination can lead to some very serious effects which can be physical and emotional: * Physical as in sleeplessness, loss of appetite, loss/gain of weight, deterioration of health. *Emotional/ psychological as in low self esteem, insecurity, lack of confidence, isolation, stress. 3- Inclusive practice promotes equality and supports diversity. For instance, when l play a Dominoes’ game with a service user/disabled person that they enjoy, l then automatically include him/her in the game, thus he/she feels that we are both equal despite the disability, background, sex. Outcome 2
1- Legislations and codes of practice relating to equality, diversity and discrimination are strictly put in my work place and they are zero tolerance. 2- I supported a Muslim service user who did not eat pigs and l had to respect that by never offering him any pork products. In doing so, l respected his beliefs and culture. Outcome 3
3- Challenging discrimination is not easy, but it needs to be done so that those who discriminate others should be punished hence change their behaviours in the future hopefully. This can be done via whistle blowing the act of discrimination to the line manager if it happens in my work setting or to the relevant authority if it happens elsewhere.
Principles for implementing duty of care 304:
1- Duty of care in my own job role means that l have to adhere to all of my employer’s policies and guidelines including health & safety, safeguarding adults, food safety and simply deliver a high quality person centred care. 2- Duty of care does contribute a great deal to the protection of vulnerable individuals in the sense that when l follow infection control procedures, for instance, by washing hands accordingly and wearing gloves, l then protect those vulnerable individuals from catching an infection, and it’s the case for all of the other protocols and policies so to speak. Outcome 2
1- There are a number of occasions in which potential conflicts or dilemmas do arise between the duty of care and an individual’s rights. For example, l once was supporting an epileptic individual who had a drop seizure, as a result he injured his back and the paramedics had to be called, the service user refused to let me phone the ambulance, however l did call the ambulance because l felt it was my duty of care to do so hence keep the service user safe. Therefore, despite the fact that that service user refused treatment which was one of his rights, yet my duty of care had to override his choice on that occasion.
2- Managing risks associated with conflicts or dilemmas between an individual’s rights and the duty of care is not always easy, but we should always consult our care manager, attend regular trainings, and liaise with individual’s families to make them all aware.
3- There are several sources of where to get additional support and advice regarding conflicts and dilemmas. These can be: managers, colleagues, health professionals, internet, learning disability team, and other organisations. Outcome 3
1- How to respond to complaints :
*Stay calm and acknowledge the complaint.
*Try to resolve the complaint directly with the complainant. *Be aware of differing views of what happened and what was said. *Reassure the complainant.
*Follow my employer’s complaint procedure that’s already in place. *Report the complaint to my line manager and keep any documents recorded.
The main points of agreed procedures for handling complaints are: *Receipt and acknowledgement.
Promote person centred approaches in health & social care 305: Outcome1
1- Person centred values must influence all aspects of health and social care because the individuals we look after are the core of this sector and by respecting them as individuals and promoting their choices and rights we are then, as service providers, somehow and somewhat delivering the best quality care.
2- Care plans are crucial in applying person centred values as they provide a lot of information about the individual. And knowing the individual’s likes/dislikes, medical needs…etc it makes it easier for the support worker to promote person centred values.
1- Factors that affect the capacity of an individual to express consent could be someone with a learning disability, someone who lacks mental capacity, and someone who does not communicate verbally or non-verbally, or even someone with a language barrier.
2- There are many activities service users attend such as going to a day care or club, however if they choose not to go at times simply because they don’t want to , then we ought to respect their choice and not force them to go.
3- Steps to take if consent cannot be readily established would depend on each situation and how risky the situation is. For example, if the service user refuses to take his medication, l would then try to encourage him with all ways possible and if he/she is still rejecting the medication, l would then fill in the relevant form and ring my line manager as well as his/her GP to let them know and take their advice into consideration. Outcome 4
1- Different ways of applying active participation to meet individual’s needs could lie in the use of encouragement and praise while supporting an individual to make choices because encouragement and praise give the individual confidence to continue to make choices about other aspects of their lives.
4- Describing how to support an individual to question or challenge decisions concerning them that are made by others would depend on the mental capacity of the individuals l support. But, l would say that l need their permission first and get them to express exactly what they want or need. Then, l can offer them more information and suggestions, and a plan to challenge such decisions. Outcome 6
1- Identity, self image and self esteem are all linked because low or high self esteem comes from a positive identity and identity is what the individual thinks about himself/herself, and self image is how the person wants to be presented and seen by others.
2- Factors that contribute to the wellbeing of individuals lie in the way they were brought up, the food they eat, the friends they have, the activities they go to, the medication they take and the care they receive. Outcome 7
1- Most risk assessments in health and social care have the following : *the individual’s details
*people who contributed to the risk assessment, signature and review date *background to the risk assessment (what complications the individual has) *risk grade (whether it’s high or low)
*strategies to minimize it
*what’s important to the individual (the activity)
*what’s important for the individual (to be safe, usually) *staff responsibilities
*occurrence (high or low)
*consequence of the risk
*impact on others
*the individual’s plan (staff support)
2- Risk taking can sometimes be related to rights and responsibilities, but risk assessments are put in place to evaluate the degree of the risk hence minimize or even eliminate it.
3- Risk assessments need to be regularly reviewed because individuals’ needs do change and what might be hazardous now may not be in six months time for instance.