National initiatives are all over the European countries including the UK. They promote, support and implement IHE (Integrating the Health care Enterprise) activities within the respective country. National initiatives are also responsible for representing the needs and requirements of their respective health care systems within activities of IHE-Europe. National initiatives are sponsored by professional associations and include membership and staff of these groups, as well as local hospital and vendor representatives National initiatives are implemented across the UK to support and promote anti-discriminatory practice, (actions that are taken to prevent discrimination on the grounds of race, gender, disability etc.) What is the main purpose for national initiatives?
In a care setting they promote practices in the workplaces as a way of overcoming prejudice in doing so they are trying to get rid of discrimination and promote equality for service users and for the staff who are employed in providing services for the people. How do national initiatives promote anti-discriminatory practice? National initiatives promote anti-discriminatory practice by ensuring that all the health and social care setting have conventions, legislation and regulations. These are put in place to guide the care providers in caring for the service users and putting them at the heart of service provisions. Through these legislations and regulations, service users will know their rights, therefore allowing them to be treated as individuals. These are some of the key legislation concerning discrimination against people.
This Act provides a framework to authorise and protect vulnerable people who are unable to make their own decisions. It states clearly who can make decisions at specific times and how they can go about the decision making process.it enables people to plan ahead for a time when they may lose their mental capacity. Under this Act, vulnerable individuals are protected against anti-discriminatory practice as it states that a person is not to be regarded as unable to understand relevant to a decision, if he is able to understand an explanation of it given to him in a way that is appropriate to his circumstances (using simple language, visual aids or any other means). This shows that, every individual is expected to receive fair treatment that suits the way in which they would prefer to receive care based on the decisions they will have made. This means that every individual under care will have their rights respected and not discriminated because of their differences. An example of good practice of the Mental Capacity Act principle, in hospitals when they ask the patients how they would prefer to receive their treatment. They also provide translators when they are needed. This legislation covers the way information about living identifiable persons is used and protected. All the organisations with the person’s data must apply to the Act. This is very important in health and social care sectors. Under this Act individuals are allowed to be informed by any data controller whether personal data of which that individual is the data subject are being processed by or on behalf of that controller.
This Act enables every individual to have access to their personal data when they need it. It ensures that all the private and confidentialities of service users is kept away from other people. It promotes anti discriminatory practice because individuals are valued and respected and their private information is kept safe. It ensures that no one reads the individual’s information without their concern in case they use it against them as a base of discrimination.
This Act applies to the public sector to promote equality of opportunities for people with disabilities to eliminate discrimination. It also include those who are HIV positive. It states that public bodies must promote disability equality and will produce action plans explaining how they intend to fulfil their duties. The progress is reviewed annually. All premises are made user friendly for those with disabilities for example in universities they make all the services user friendly. This duty is preventive, meaning that the public authorities will have to review all their policies practices, procedures and services to make sure that people with disabilities are not being discriminated against and ensure that all the services are planned with their needs fully considered in advance. This Act eliminates discrimination against the disabled people.it makes it unlawful to discriminate against someone with a disability. It covers access to goods, facilities, and services of organisation and other services. There has to be a full accessibility for anyone with disability. In most care settings they have implemented some ways in which they found helpful in promoting equality. For example, at Grasvenor avenue infant school where I had my work placement they provided suitable games for those children who had disabilities and these games could also be played with by every other child. The Equal Opportunities Act 2010
This Act is linked in with many other Legislations for example The Human Rights Act, Equality Act and many others that promote fairness in many different sectors. It strengthens the discrimination laws by changing some key definitions, creating new responsibilities for the commission and strengthening the commission’s role in helping government, business and the community identify and eliminate discrimination. The objectives of the Equal Opportunity Act are to encourage the identification and elimination of discrimination, sexual harassment and victimisation and their causes, and to promote and facilitate the progressive realization of equality. Under this Act every individual has equal values despite the differences. It respects and recognises diversity and it states that treating people equally does not necessarily involve treating them all the same. Their policies, procedures and activities do not discriminate, but are differentiated, as appropriate, to take account of differences of life experiences outlook and backgrounds. Its aim is to reduce and remove inequality and barriers that exists between different individuals. The policies and procedures under this legislation promote anti-discriminatory practice by ensuring that individuals are treated with dignity and value. Codes of practices and charters
These codes of conduct are established by professional bodies. They guide health and social care professionals on their roles, rights and responsibilities. They can also help those using the services to understand what to expect in the treatment from the health and social care staff. Most health and social care professionals have charters or codes of practice which members have followed. Every health and social care profession has a code of conduct as a guide for their work for example: The Nursing and Midwifery Council Code of professional conduct It states that people in care must be able to trust you with their health and wellbeing and for nurses and midwives to gain that trust and promote anti- discriminatory practice they must: Make the care for people their first concern, treating them as individuals and respecting their dignity Working as a team to promote the health and wellbeing of those under care, their families, carers and the community at large. Provide high standard of care at all times
Be open and honest and uphold the name of the profession
Nurses and midwives are expected to act lawfully, whether those laws relate to your professional practice or personal life. Acting according to the code of conduct will help to direct care providers and they will know when an act of discrimination is taking place and will manage to stop it on time.
General social care council
The general social care council registers social care workers and regulates their conduct and training. People who work in social care sectors need codes of practices to follow and judge on them when they are inspected. The code also tells those using the service what to expect, and if they are not treated accordingly they have the right to complain. Everyone working in health and social care should know the codes of practices through training or during induction. These codes apply to everyone working in the voluntary, private and statutory sectors.
Code of practices for social care workers
It is a list of statements that describe the standards of professional conduct and practice required of social care workers as they do their daily work. The intention is to confirm the standards required in social care and ensure that workers know what standards of conduct employers, colleagues, service users, carers and the public expect of them. The code requires employers to adhere to the standards set out in the code and encourages social workers to use the codes to examine their own practice and to look for areas in which they can improve. As a service users or member of the public the code will help you to understand how social care workers should behave towards you and how social care workers should support social care workers to do their jobs. To promote anti –discriminatory practice social care workers are require to protect the rights of service users, strive to maintain the trust and confidence of service users and to promote the independence of service users. Social care workers are responsible for the safety and the health of the service users, their colleagues and their selves. Codes of practices of practice for employers of social care workers Discrimination does not only happen to the service users but it also happens amongst the employees and the employers. This is why there is this code of practice in order to promote anti –discriminatory practice. The main purpose for this code is to set down the responsibilities of employers in regulating social care workers. The purpose of workforce regulation is to protect and promote the interest of service users and carers. Employers are responsible for making sure that they meet the standards set out in this code, provide high quality services and promote public trust and confidence in social care services To meet their responsibilities in relation to the regulation of the workforce they must make sure that people are suitable to enter the workforce and understand their roles and responsibilities. They should have written policies and procedures in place to enable social care workers to meet the general social care council codes They should also provide training and development opportunities to enable social care workers to strengthen and develop their skills and knowledge. This could be done during induction as well. The employers must also put in place and implement written policies and procedures to deal with dangerous, discriminatory or exploitative behaviour and practice. For example at Magic Nursery, the employer has some procedures for safeguarding the children and the staff, stuck on the walls and on the boards in the staff room. This promotes anti- discriminatory practice as all the staff members will know what is expected of them when caring for the children.
Charters
These are documents which tell clients, patients and service users what they expect from a service. They set out the rights and responsibilities of an organisation. Examples include: The NHS charter 1998 which informs clients, patients and service users of the treatment and care they can expect from the NHS What is the main purpose of a charter?
The main purpose for charters is to inform staff and those using services about what they can expect. The Care Quality Commission which is the body that regulates standards in health and social care on behalf of the government will use the relevant charter as a starting point when they review an organisation. These charters are written by the care providers and read by anyone who implements and receives care. They are there to tackle some of the health inequalities that service users face. Charters give a clear overview of the entitlement to services that the service users have. For example if there are elderly people who are under care, there has to be a way of implementing the services to them so that they may not feel discriminated.
The NHS charter
The NHS charter is there to ensure that NHS provides the care that it is expected to provide. The constitution also contains pledges that the NHS is committed to achieve. It states all the patients and public sector’s rights and these are some of the main ones: Everyone under the NHS should know what legal rights they have Everyone has the right to receive free NHS services
You have the right to be treated in any of the European economic areas Quality care and environment
You have the right to be treated with professional standards of care by qualified and experienced staff You have the right to expect NHS bodies to monitor and make efforts to improve the quality of health care they provide. You have the right to drags and treatment that have been recommended by NICE for use in the NHS. (National Institute for Health and Care Excellence ) Respect, consent and confidentiality
You have the right to be treated with dignity and respect in accordance with you rights You have the right to accept and refuse treatment offered to you You have the right to be given information about tests and treatment options available to you. These Rights in the NHS Charter promote anti-discriminatory practice because everyone is aware of their rights and the care providers know what the service users are entitled to. Organisational policies and procedures
Managers in health and social care setting have a responsibility to support and guide professionals in their employment to ensure that they observe equality diversity and rights. Below are some of the organisational policies and procedures Positive promotion of individual rights
These can be seen in all areas of health and social care by looking at notice boards in the hallways, reception areas of staff rooms. Charters for example should be displayed for people to read in the areas they pass through Policies and procedures should also be there for health and social care professionals to read if they are unsure of anything or they can at least be shown where to find them. Staff should also receive handbooks when being inducted to a new post or role and they should receive training to ensure that all health and social care professionals are kept up to date with changes and reminded of the duty of care. An example of an induction I went for, I had applied for the role of being a relief nursery assistant. They gave me a file that had the nursery polices which I had to read and it gave me an understanding of how I was expected to care for the children.
Advocacy
This is often needed for people who are too ill or frail to speak for themselves or are not aware of their rights. Also people who are vulnerable may not be aware of their rights and they need a person to ensure that they receive what they are entitled to. A person will speak on their behalf which is common in health and social care. An advocate can be a professional worker or a relative, however the advocate must realis that they are speaking on behalf of the individual and not express their own views Advocacy promotes anti-discrimination because it gives opportunities for those who cannot speak for themselves to have someone speaking out their decisions on their behalf. It enables them to exercise their rights. Staff development and training
A health and social care professional, once fully trained, still has to be kept up to date with changes in policies and procedures as well as legislation and technology. Technology changes rapidly, as do procedures that’s why they need to continue to be trained. Equality, diversity and rights legislation are constantly updated and staff must be kept informed of changes. First Aid training is also updated regularly so staff need to go for training every year. Other care providers for example doctors undergo communication skills training and mental capacity training. This helps in boosting their knowledge on how to communicate with service users and how to treat everyone as an individual. Staff development promotes anti-discrimination as all the care providers are taught about how to care for individuals with fairness and the importance of valuing each individual and because of the work practices staff are well aware of the consequences of jeopardising care. If staff fail to abide by the policies and procedures, the results could be disciplinary action or dismissal. An example in the news, Telegraph, Published: 10 Mar 2015 12:30,” A GREENOCK care worker has been banned from looking after vulnerable people because she went to work under the influence of alcohol” This shows that every health and social care provider is expected to abide by the conduct and measures will be taken against those who fail to meet the expectations. However there are other organisational policies and procedures which are quality issues, complaint procedures, affirmative action, anti-harassment, confidentiality and human rights. They all work together to ensure a safe environment for the service users and the public. Their aim is to promote anti-discriminatory practice and support people’s rights and give everyone an opportunity to experience a better life. P5- Describe how anti-discriminatory practice is promoted in health and social care setting It is important for the care workers at health and social care settings to promote equality, value diversity and respect the rights of service users. There are many ways of how they can challenge discriminatory issues and practice in health and social care. One of the ways in which care providers promote equality, value diversity and respect the rights of service users is to always put service users at the heart of the service providing. This will mean that individual needs will be met and achieved for example; a personal eating plan for a specific individual. This makes service users happy and healthier in all areas. There are many ways in which to promote anti- discriminatory practice that are very effective. The first and most common way is staff training. It can be effective as it gives the workers an insight in how this practice is shown and ways to identify it, it informs them of how to prevent it and stop it from happening. Training gives then a clear structure to follow to deal with practice and how to avoid breaking the law. Training also puts the workers in the client’s shoes and shows them effects of discrimination in hope to deter them from doing it again. The active promotion of anti-discriminatory practice
Ethical principles
Ethical means what is wrong or right. Ethical issues are those issues which relate to moral and responsible ways of working to promote independence, autonomy, and equal opportunities, justice, confidentiality and anti-discriminatory practice. There are four key ethical principles that should be taken into account in health and social care sectors and these are: 1. Justice: people must be treated with fairness and equality regardless of their background. This means that no matter how different a person if from the rest of the individuals, he or she should receive the same care as everyone else who is receiving care. However there are some individuals who have special needs therefore the care maybe adjusted to meet their special needs. For example if a service user is a vegetarian and the rest of the people in the hospital eat meat, that person should be provided with a vegetarian meal in order to meet his needs 2. Autonomy: A person’s choice must be respected. Every individual even in health care settings have the right to make their own decisions. Even if they need an advocate they still need to make their own decisions and an advocate is only there to speak on their behalf. Even in cases where a person lacks mental capacity, they are given the opportunity to choose for example what they would prefer eating, what to wear and the way in which they would like to receive their treatment. 3. Beneficence: This involves risks and costs, the health care professionals should act in a way that benefits the patient. A patient should be at the center of the work of care providers. It is important that they provide the patient with access to all the services. Service providers should provide excellent care to the patients and pay more attention to their needs ensuring that they are not at risk of any harm or abuse for example ; service providers should not let another colleague verbally harass a service users 4. Non-maleficence: Any harm caused by a treatment or intervention should not out weight the benefits of that treatment. It implies that the harm should not be disproportionate to the benefits of the treatment, respecting the principles of non-maleficence may in certain circumstances mean failing to respect a person’s autonomy. For example, it may be necessary to provide to provide treatment that is not desires in order to prevent the development of a future, more serious health problem. The treatment might be unpleasant but it would involve less harm to the patient than would occur, were they not to have it. Putting the individual at the heart of service provision
To put the individual at the heart of service provision, the health and social care sector needs to: Provide active support consistent with the beliefs culture and preferences of the individual. For example if a patient is from a different religion, e.g. Muslim, the care provider should be there to remind them when its time for them to pray in order to show them that they value and respect them for who they are. Support individuals in expressing their needs and preferences, they do this by commutating to people in preferred ways whether it be Arabic to sign language. If they are unable to provide this service they should find someone who can, i. e. a translator Empower individuals, carers might show this by encouraging an individual client to make decisions and take control of her/his own life. They can do this by involving the services user in conversations which relate to their care and lifestyle, giving them the opportunity to reply and respond. This will build their self-esteem and confidence in their ability to make a decision. Promote individuals’ rights, choices and wellbeing. The service providers can help to promote individuals’ rights by informing them about the sort of rights they have and listening to their choices on how they would prefer to receive treatment At Belfield Montessori Infant school, the staff made sure that they asked the parents the kind of food they would prefer their children to eat. They did this as a way of giving them the power to decide. Providing Active support consistent with the belief, culture and preferences of the individual. Active support means helping the individual as much as possible and taking their beliefs, culture and preferences into account when making decisions. For example, if an individual who is being cared for follows the Muslim faith, the carers should ensure that halal meat is available on the menu and they can have an area to pray if they wish. At The Totteridge Academy they have a prayer room that is available for the students who pray 5 times a day. This shows that they value every individual and their beliefs without discrimination. Another example is if a person with a learning difficulty comes into a residential care setting for respite. The service providers need to pay attention to them and that any support they might need with their reading, socialising or personal care is met with diligence and sensitivity. They may also need the support of an advocate. The main forms of support may be: Advice and guidance –rights
Medical and care planning information
Physical support- dressing ,personal care
Social support, talking to them when they need someone to talk to Mental health support- coping strategies, coming up with activities that them involved
Supporting individuals to express their needs and preferences This is another way of promoting anti-discriminatory practice as carers support the preference of each individual. It means supporting an individual who is deaf in expressing their needs and preferences by organising communication support including British sign language interpreters, Deaf-blind interpreters, lip –speakers, note-takers and speech –to-text reporters or the person may not be able to speak the local language. Or the person may not be able to speak the local language and interpreter may need to be found. This could be a friend or an employee, a relative or a person from their community- anyone who can help them express their needs and preferences. All this is essential to keep the person informed about what is happening to them and what is going to happen to them, and to ensure that they can express their needs and preferences. Dealing with conflicts
Dealing with conflicts is crucial in health and social care. Individuals may become aggressive and tensions may build up if the care they are receiving is not meeting their needs. As a health care provider you should be trained enough to deal with conflicts. Conflicts can be between health and social care staff when several different services are needed to care for an individual. When dealing with conflicts service providers have to be professional and positive, this means that they have to always support the service user and reassure them. You will require a range of skills, including: Seeing both sides of the argument
Being willing to listen
Not taking sides
Being good at quick thinking
Looking for solutions and not getting bogged down in personal issues In other words the service provider has to be neutral and should be able to solve the problem and come up with ways to avoid the same incident from happening again.
Personal beliefs and value systems
We behave as individuals because of our personal beliefs and value system these develop as we grow each day and shapes our behaviors. As an individual if you look at the way your personal beliefs and values affect you will help in understanding the way in which other people may behave. Influence on culture
Some people may have a strong cultural background or none at all. It depends on the people around you and how they influenced your culture as you were growing up as an individual. Some people may have developed a strong cultural link as they grew older. This influences the way you communicate with others. No one can ever convince another person to take another culture unless they are willing. This means that they have to respect the other person’s culture and it also applies to care providers and their colleagues. They have to respect each other’s values and beliefs. At Magic Nursery they believe in respecting every child’s culture and they show that they value each culture by making sure that they celebrate the special festivals with the children, for example they recently celebrated the Chinese New year and they ate Chinese food on that day. They even have multi-cultural toys. Influences on beliefs
An individual’s beliefs may have been influenced by the adults they lived with in the process of growing up. For some people it is different as they may have grown up with no one to look up to. Beliefs will influence the way in which you feel about yourself. For example if you were raised with Buddhist beliefs you understand and perception of the world will different from those who hold other beliefs. Physiotherapist believe that a person is shaped by how they view themselves. If they view themselves as not good at anything, they may react in a negative way towards others and not have any confidence in themselves. It is very important to respect the beliefs of others in health and social care. Past events
Things that may have happened in an individual’s life in the past may either have negative or positive influences. For example, if you experienced something awful in hospital as a child you may find that as soon as you enter or smell a hospital those negative feelings come back. And this can make hospital checkups difficult. Past events have an influence in our lives so it is very important for care providers to be aware of these events in the people they are caring for. It is their duty to try and make the service users feel comfortable in situations like that for example by giving them a different experience in the hospital than they had before in order for them to gain new and better memories. Health and well- being
Our health and well-being influence the way we develop, how we are seen by others, and how we feel about ourselves. If a person is extremely ill during their childhood, this could disrupt their education and also possibly the way they socialise. It may affect a person’s career path later on and also how they communicate and feel about themselves. People who are disabled may fail to see themselves as disabled. But they may feel that others only see the as a disabled person rather than individuals in their own right. Labelling people is not helpful in health and social care. Noone should be labeled that is why the service providers are asked to see every patient as an individual and not their differences. Service providers usually ask patience how they would like to be addressed so that respect them the way they want. Careful use of language
A carer’s use of language forms part of the core value base which lies at the center of health and social care. It is important to be aware of people’s languages and to know how to communicate with them as they need to understand what you are saying. If someone does not understand what you have said, that means you have not clearly explained yourself. Always be aware of communicating with people in the right way using the right method of communication they prefer. If there are language barriers to communication it will be very helpful to get an interpreter. It is very important to know that each person understands what is happening to them and what they need to do to ensure that their health is properly looked after. Choice of words can affect the relationship between a care provider, colleagues and service users, so it is very good to think before you speak. Some people may not prefer to be referred to as “dear” because they feel as though they are too vulnerable. It’s always polite to ask before calling someone by a title they do not like. These are the things that help in promoting anti-discriminatory practice. Every individual deceives to be valued, respected and dignified so it is our duty as service providers to make a safe and equal environment for all the individuals and accept the diversity in Britain.
Bibliography
Links
http://timabrown.blogspot.co.uk/ http://www.humanrightscommission.vic.gov.au/index.php/the-law/equal-opportunity-act https://www.gov.uk/equality-act-2010-guidance https://www.improvinghealthandlives.org.uk/publications/1221/Health_Charter_for_Social_Care_Providers http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx http://www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/nice.aspx http://www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-common-bioethical-principles/Beneficence-and-non-maleficence www.nhsemployers.org/pages/home.aspx
Data Protection Act www.legislation.org.uk
Books
Stretch.B, Whitehouse M,(2010) Health and Social Care Level 3,A Pearson Company Richards.J, Ford.S (2010) A-Z Handbook 3rd Edition Health and Social Care , Philip Allan updates
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