NAME; ADINA TOMA
QUALIFICATION; HSC DIPLOMA LEVEL 5
Unit ; HSC 53
resume writing service hampton roads
1. Understand diversity, equality and inclusion in own area of Responsibility
1.1 Explain models of practice that underpin equality, diversity and inclusion in own area of responsibility
In my role as manager I am responsible for ensuring that all individuals, their families, friends, carers and members of staff and those that I work in partnership with, are treated equally. Everyone should be treated with dignity and respect. There are many Legislations, Codes of practice and also my workplace policies which regulate equality diversity and inclusion within my area of responsibility. In my managerial role, I have to promote equality and uphold individuals equality of opportunity, individual rights and choice, their privacy, individuality, independence, dignity, respect, promote empowerment, equality of care, confidentiality and their wishes and needs. I must show how I respect diversity and accept other individual??™s differences. Some of the ways I can show this are:
??? Complaint procedure ??“When a resident wants to make a complaint I have to explain him the procedure, support him in how to complete one, give feedback about the result and maintain confidentiality.
EXAMPLE: The resident is complaining that one of the carers is rude to him every time that she comes in the morning to give him a shower and she don??™t mind the language. As a manager I explain him that the residential home has a complaint procedure and I will explain and help him in complete one. I also told him that the complaint is remain strictly confidential till will be resolved and he will get a feedback as soon the situation is resolved.
??? Consultation/participation ??“ Residents should have the right and be encouraged to actively participate in consultations regarding changes to the homes policies and procedures. When changes occur I have to involve the resident actively and have his permission in any changes.
EXAMPLE: Recently were some changes in the policies and procedures in using the lift. Because it was too old it was replaced with a new one. I organize a meeting in which I inform all the residents that in the new lift it can be used just for 4 persons not like before by 8. All the residents were actively involved to participate in asking questions and to opine about it.
??? Individual??™s care plans are regularly reviewed and updated to take into account any changes to the individuals health, needs and wishes.
EXAMPLE: One of the carer identify that one of the residents health has change, that the falls that he suffered in the last month it was because is losing the balance. I inform the doctor for a review in his medication, to run some tests and to be seen by physiotherapist. When the results comes it show up that he has a urine infection and the medication was too strong for him. I informed him that the care plan it will change and in till the infection is cured he has to walk with a Zimmer frame. His wish was that when in the home is ok for him to use the frame but when he goes out with the family to use just a stick.
??? Maintaining confidentiality ??“ Storing care plans securely
EXAMPLE: When the results of the urine infection of the service user come, it was logged in the care plan, known just by the doctor, nurse and the carers who help him with the care plan and the intake of the medication and the file was stored in the place under a key where is accessible just by them.
??? Various planned activities ??“ Activities which are inclusive and individual??™s choice
EXAMPLE: In the care home we organize all types of activities like dancing classes, bingo day, crafting, painting and many more. I made a planer of the week in which, I put it on a board in the dining room and living area so could be seen by all the residents and also every morning at the breakfast one of the carers remained them about the activity that will take place in that day.
??? Offering choices ??“ choice of meals, what to wear.
EXAMPLE: All the residents have the right to choose what to wear in that day so the carers have been instructed and trained to offered choice and help the resident to choose the cloths.
??? Promoting independence ??“ encouraging active support and empowerment of individuals.
EXAMPLE: Not all the residents in my home need support with the personal care, or to dress. Some of them for example can??™t close the zipper or the buttons but they could dress. The carers give encouragement and support for the service user to do as much is possible for them like brush teeth??™s, brush hair, put the scarf or to eat without help just with supervision from the carer.
??? All residents are allowed to practice their religious beliefs in the manner they wish.
EXAMPLE: In my care home I have various service users from different cultures. I provide them places for praying and celebrate with them their culture with the others residents like Festival of Dwaly in Indian culture
??? Respecting individual??™s privacy ??“ knocking on doors before entering.
??? Equipment needs ??“ readily available and in working order.
EXAMPLE: At the night time all the equipments are cheeked that are in order, all the batteries are put in charged, verify the due term for the next check-up, that the sleeves are not broke so when are used for the next day to be ready for use. The policy of the care home and the mandatory training give it to all carers is to check all the equipment before to use it.
??? Workplace policies and procedures readily available to all
EXAMPLE: When new staff is employed, after the induction training, the organisation give them a full and detailed handbook with policies and procedures to be followed like Disciplinary Policy, Equal Opportunities Policy, Diversity, Data Protection etc.
??? Information ??“ readily available and in various formats appropriate to each individuals need. The organisation gives all the information about the service that provides in different forms like large print, Braille, different languages, email, leaflets and inclusive audio format.
??? EXAMPLE: One day I receive an email from a lady that she wants more information about the residential home. Because English is not her first language she asked if I could send one in French and in big format. I replay to her that the package It will received in 3 days at home in her native language and in the format that she wished.
1.2 Analyse the potential effects of barriers to equality and inclusion in own area of responsibility
Inclusion, equality of opportunity and anti-discrimination are central principles in social care. All activity needs to be planned on the basis that some people may need additional support to overcome the barriers they face.? Barriers are those things that prevent or make access to a service more difficult for certain groups and individuals. The barriers that I faced in my own workplace are various and these barriers could include:
??? gender or gender identity
??? disability ??“ physical or sensory impairment
??? faith, culture, beliefs
??? sexual orientation
??? no communication, literacy and language
Other barriers could include:
Structural,? where circumstances create or result in barriers – for example in access to a good education adequate housing, sufficient income to meet basic needs. Structural barriers are associated with poor life outcomes that can be observed in the significant disparities in health between areas of affluence and those associated with poverty.
Institutional,? where policies, processes, practices sustain an organisational or service culture that excludes certain people or groups; an obvious example being what has been called the glass ceiling, i.e. that while not visible, a ceiling exists beyond which women – find it very difficult to progress.
Cultural? barriers can prevent, for example, consideration of spiritual, relational? or dietary needs that do not conform with traditional expectations. For example? “it took 3 days to organize Halal food”.
Personal? barriers, for example where healthcare staff hold individual prejudices that influence their practice. These actions may be conscious, but as we have discussed, they can often be unconscious or unwitting.?
Attitudinal barriers? are not as easy to identify as physical barriers, but they can feel every bit as real to those who are exposed to them.
Some vulnerable and disadvantaged individuals need more support to ensure their voice is heard and they are able to have power in the decision making process. Remember that everyone is an individual.? People do not always like to be categorised as from a particular equalities group. And individuals within equalities groups will have vastly different experiences, views and opinions.
Below are some examples of how different barriers can affect individuals with mental illness:
The World Health Organisation (2002) describe? stigma? as: “??¦any process whereby certain individuals and groups are unjustly rendered shameful, excluded and discriminated against.” Historically, considerable stigma has been associated with mental illness.? “… a collection of negative attitudes, beliefs, thoughts and behaviours that influences the individual, or the general public to fear, reject, be prejudiced and discriminate against people with mental disorders.” The work of Howard Becker (1963) on stigma – explored through the experiences of people with mental health problems and working in the psychiatric system – has contributed much to our understanding of stigma and the social consequences of labelling. According to Becker, responses to perceived difference showed that when: Society labels the individual or group; they are then treated differently as a consequence of the label.
The cycle of oppression proposes a relationship between prevalent or prevailing attitudes and beliefs about mental illness and difficult and? uncomfortable feelings and thoughts. These feelings and thoughts then influence the ways we act and behave.
If the messages we receive about people and mental health problems / mental illness is that they are weak, cant cope with pressure, that we would be unsuitable as a teacher??¦we may feel inadequate, responsible, guilt or ashamed. Or we might be angry at being so misrepresented??¦The feelings might confirm that we do not want others to know? so we decide not to tell our colleagues, friends, family. We might withdraw socially to protect ourselves from others. After all, if we dont see people there wont be any awkward questions??¦We might decide to act out . After all, if people are frightened of us, they will stay away from us and we will feel safer??¦It is important to recognise that sometimes people can get caught in a negative cycle that, unchallenged, can feed and reinforce itself. This process has been described as internalised oppression? (Mason, 1990).
1.3 Analyse the impact of legislation and policy initiatives on the promotion of equality, diversity and inclusion in own area of responsibility
The legislation relating to equality, diversity and inclusion, stems both from the UK government and the European Union. It offers protection from discrimination on grounds of age, disability, gender, race and ethnic origin, religious faith or belief and sexual orientation. The legislation has implications on all workplaces, in terms of employment practice and in terms of the services provided. Compliance with the legislation must be embedded in your Equality, Diversity and Inclusion policies. You will need to adopt a very broad-based approach to ensure that all relevant legislative requirements are addressed and take full responsibility for actions in your sphere of responsibility. As a manager you will be responsible for ensuring ongoing appropriate staff development and training to support all staff in promoting inclusiveness and meeting legislation requirements. In addition meet with staff to give appropriate updates on relevant events and legislation and to discuss appropriate issues. Health and social care providers are obliged to incorporate legislation relating to equality, diversity and discrimination into their policies and procedures. Workplace procedures dictate best practice regarding how work activities must be carried out, and they must be followed. Anything else would be a contravention of the law, and be breaching an individual??™s rights.
Some of the legislations which may impact on your area of responsibility could include:
??? The NHS and Community Care Act 1980. This protects the rights of older and disabled people to receive care at home and in the community in ways that take account of their choices.
??? The Residential Care and Nursing Homes Regulations 2002. This protects the rights of people living in care homes.
??? The Children Act 2004. This protects children??™s rights by requiring local authorities to be ?exible in meeting children??™s needs.
??? Health and Social Care Act 2008. This Act established the Care Quality Commission (CQC), whose remit is to protect and promote the right of people using health and social care services in England to quality care and to regulate its provision. CQC took over the roles of the Healthcare Commission, Commission for Social Care Inspection and and the Mental Health Act Commission in March 2009
These pieces of legislation have helped us move forward on equality, but in 2009, women were still earning, on average, 23% less per hour than men; less able but better-off children were overtaking more able, poorer children at school by the age of six; people with disabilities were still more than twice as likely to be out of work than able-bodied people; and one in ?ve older people was unsuccessful in getting quotations for motor insurance, travel insurance and car hire. This prompted the government to bring into force The Equality Act which brought different types of discrimination within one piece of legislation. It provides understandable, practical guidance for employers, service providers and public bodies to ensure that rights to fair treatment are promoted for everyone.
Equality Act 2010 is the law which bans unfair treatment and helps achieve equal opportunities in the workplace and in wider society. The act replaced previous anti-discrimination laws with a single act to make the law simpler and to remove inconsistencies. This makes the law easier for people to understand and comply with. The? act also strengthened protection in some situations. The? act covers nine protected characteristics, which cannot be used as a reason to treat people unfairly.? Every person has one or more of the protected characteristics, so the? act protects everyone against unfair treatment.? They protected characteristics? are:
??? gender reassignment
??? marriage and civil partnership
??? pregnancy and maternity
??? religion or belief
??? sexual orientation
The Equality Act sets out the different ways in which it is unlawful to treat someone, such as direct and indirect discrimination, harassment, victimisation and failing to make a reasonable adjustment for a disabled person. The? act prohibits unfair treatment in the workplace, when providing goods, facilities and services, when exercising public functions, in the disposal and management of premises, in education and by associations (such as private clubs). The equality act will for instance impact on your role as manager with regards recruitment. You will need to ensure that your job specification does not discriminate against particular groups of applicants. When processing applications you should concentrate on an individual??™s abilities to do the job, not their disabilities. Make adaptations to accommodate individual??™s differences e.g. working hours, special equipment needs etc.
Codes of Practice
In England and Wales, the General Social Care Council (GSCC) is responsible for ensuring that standards within the social care sector are of the highest quality. It has developed Codes of Practice for all care workers that include information on how to protect and promote the rights of individuals using the service. The Codes of Practice provide a guide to best practice and set out the standards of conduct that workers are expected to meet. They are also recommended reading for examining your own practice and seeking out areas in which you can improve. As a social care worker, you must protect the rights and promote the interests of individuals and their carers. This includes ???Promoting equal opportunities for service users and carers??™ (1.5) and ???Respecting diversity and different cultures and values??™ (1.6). Health care workers also have an obligation to protect the rights and promote the interests of patients. For example, the Nursing and Midwifery Council (NMC) code or Standards of conduct, performance and ethics for nurses and midwives states that, ???You must not discriminate in any way against those in your care.
2 Be able to champion diversity, equality and inclusion
2.1 Promote equality, diversity and inclusion in policy and practice
It is your role and responsibility to ensure that all staff promote equality, diversity and inclusion, whether dealing with service users directly or indirectly. This can be done in the following ways:
Dignity and respect ??“ respect individual??™s need for privacy and dignity in the way that service is provided and the way that information is handled. Treat service users with tolerance and have a non-judgemental attitude
Information and Communication ??“ providing information in different formats for example large print, Braille, video, tape, total communication, other languages, providing an interpreter.
Value the contribution – that each individual can make. Create a productive
environment in which everybody feels valued, their talents are fully utilised and services meet the requirements of diverse service users.
Embrace difference as a way of attracting and retaining staff and improving customer satisfaction. Provide relevant and appropriate access for the participation, development and advancement of all individuals and groups.
Remove physical barriers – overcome physical features by removing them, altering them, avoiding them or providing access to work or service by an alternative method.
Stereotypes, assumptions and bias ??“ avoid using negative or offensive language and images which convey stereotypes. Avoid making assumptions about people??™s ability to do things or not do things, their attitudes and their persona; circumstances. Don??™t assume that you understand their needs and requirements. Don??™t allow bias to affect decisions you make about recruitment, training, policies or procedures.
Tailor services to needs – Provide auxiliary aids such as an induction loop, prayer room.
It is important that staff attend relevant training meetings and supervision so they are aware of their role and accountability with regards equality and diversity. Here they are able to learn the principles of good practice and keep up to date with new developments and changes to relevant legislations. During supervision you should ensure staff are fully aware of the complaints procedure and they should be encouraged to report any issues they feel need to be challenged regarding discrimination.
2.2 Challenge discrimination and exclusion in policy and practice
Adult social care is a complex world of diverse organisations, dispersed responsibilities and growing user empowerment. As a provider of care and support you will need to ensure that you understand the legal framework regarding equality, diversity, discrimination and rights and be able to relate this to your everyday role. Managers at all levels and in all settings, should be seeking to ensure equality and eliminate discrimination by:
??? engage people using services and their families in shaping future support,
??? present staff with a vision of a fair and equal service,
??? create cultures which support equality and challenge discrimination,
??? capture the commitment of the workforce and raise their awareness of the
importance of equality
??? equip them through training, standards and supervision to recognise and
tackle discrimination, and enhance equality.
??? work across boundaries with other agencies and services to raise the profile of equality and promote informed debate and commitment to change
It is also about challenging others if necessary and speaking up for the individuals you support when they cannot speak up for themselves. It can be di?cult to challenge discrimination, particularly if it is institutional or practised by a colleague, so it is important that you consider how to deal with di?erent and often di?cult situations. To be able to challenge discrimination you require knowledge of policy, procedures and practice. If you feel con?dent about what is good practice, you will be able to deal more e?ectively with incidents that arise. When discrimination happens it may be intentional, but it can also be because of ignorance and lack of understanding. It is not easy to change the views of others but you must challenge discriminatory comments and actions. It is important to learn assertiveness strategies that can help when you recognise discrimination. When challenging discrimination, you should:
1. explain what has happened or what has been said that is discriminatory
2. state the e?ect of this on the individual, group and others
3. suggest or model ways to ensure anti-discriminatory practice.
In your job role, you have a duty of care to challenge discrimination in a positive way and promote inclusion. When you are concerned about anti-discriminatory practice, whether by sta? or by service users, you should challenge it effectively so that future incidents of discrimination can be prevented. This will also empower individuals to understand their rights. When you are concerned about anti-discriminatory practice, whether by sta? or by service users, you should:
??? Always act fairly and try to see things from the other person??™s point of view.
??? Consider that there could be different pressures, needs and cultures.
??? Always use positive language and never use words or phrases that could be disrespectful towards another person.
??? Do not allow prejudices and stereotyping to influence you and do not accept any type of discriminatory behaviour.
2.3 Provide others with information about:
??? the effects of discrimination
As a manager the best way to provide staff with information about the effects of discrimination is to ensure they regularly attend the appropriate equality, diversity and inclusion training. You could also discuss this area during team meetings, supervision and appraisal. You should ensure all staff are aware of the procedures to follow if they suspect discrimination is taking place or they are themselves the subject of any form of discrimination. All staff and service users should be aware of their rights. An easily accessible complaints procedure should be in use which can be accessed if they feel their rights are not being observed.
Studies have found that discrimination, racism and harassment may have significant mental and physical health consequences such as frustration, stress, anxiety, depression, possible nervous breakdown, or high blood pressure that can cause heart attacks.
Negative effects of discrimination physically and emotionally:
??? Loss of self-esteem
??? Feeling stressed or unable to cope
The long-term effects could include:
??? Loss of motivation
??? Reduced individual rights
??? Restricted opportunities
??? Limited access to services
??? Mental illness caused by stress
??? the impact of inclusion
Research has suggested that the feeling of inclusion is a critical factor in bridging individuals??™ differences in age, race and gender in the workplace. In terms of the workforce, inclusion may lead to the feeling of acceptance in an organization which links to satisfaction with the organization and commitment to it. This in turn leads to increased productivity and more effective team and partnership working. In respect of the service users, by considering their needs and then designing the services to meet those needs inclusion can be attained. By enabling people to access services and informing and supporting them, developing their self-help skills and developing meaningful services. This improves health and wellbeing, reduces discrimination and increases inclusion in mainstream services.
??? the value of diversity
Having a diverse group of workers and service users simply means recognizing that all the people are unique in their own way. Their differences could consist of their athletic ability, cultural background, personality, religious beliefs, and the list goes on. There has always been diversity in the workplace, but in today society it is important to value and embrace it and make positive use of it. When people value diversity, they recognize and respect the fact that people are different and that these differences is generally a good thing. For example, when attempting to solve a problem, it is better to assemble a diverse team with many skills and many different ways of approaching the problem than it is to assemble a team that has all their strength concentrated in one area. This in turn will not only benefit both your organisation and the team as a whole but also the service users who use your services.
2.4 Support others to challenge discrimination and exclusion
In your role as Manager one of your most important responsibility, with regards discriminations and exclusion is to ensure all staff have attended the respective training and are fully aware of the workplace policies and procedures in this area. By ensuring staff have this information, knowledge and skills they will then be more able to identify situations where discrimination is taking place and will be aware of the correct procedures to follow in the event. Supporting both staff and service users to challenge discrimination and make a complaint will also be part of your responsibility. Service users should also be supported and encouraged to complain if they feel discriminated against or excluded. By providing service users with details of where they can seek further support and advice regarding discrimination, will allow them to feel they have more choice and control over their lives. Every workplace should have the following in place to aid both service users and staff to complain;
??? Whistle blowing policy
??? Complaint procedure
??? Appeals procedure
Once a complaint has been made it is important to monitor and review the situation periodically to ensure no reoccurrence happens. Some complaints may result in a review of practice and a change to the workplace policies which you would need to oversee. This would ensure that there is a clear directive for future similar events, should they occur.
3 Understand how to develop systems and processes that promote diversity, equality and inclusion
3.1 Analyse how systems and processes can promote equality and inclusion or reinforce discrimination and exclusion
Many care/residential homes have a mission statement which sets out the commitment of the home toward diversity, inclusion and equality. There must also be written policies, designed to re?ect the rights and responsibilities of those living within the homes environment. Policies should also provide guidance for sta? and visitors to the home on ways to ensure inclusive? practice. Policies are developed in response to legislation, codes of practice and statutory frameworks. By having these systems and processes in place it ensures that any acts of discrimination are dealt with in the correct way and according to your workplace practices therby ensuring all individuals are treated in a fair and equal manner.
The di?erent ways in which homes promote the rights and equality of opportunity for individuals must be included in their policies. Policies which promote equality and inclusion give out a positive message and encourage an atmosphere of mutual respect. There also needs to be systems in place for effective monitoring, reviewing and reporting on progress in relation to equality of opportunity, diversity and inclusion. Methods of monitoring can include, providing service users and their families with questionnaire??™s to complete. Also by having a complaints procedure in place and ensuring everyone is aware of the procedure, individuals are able to voice their opinions and report any discrimination or inequalities they have experienced and access support. All complaints should be carefully monitored and acted upon. As a member of the team, you share responsibility with your staff, to ensure that anti-discriminatory practice is promoted and also recognise when discrimination is happening.
Organisations can sometimes discriminate unwittingly through policies and procedures that lead to disadvantage for certain groups. This is known as institutional discrimination and can occur when attitudes such as ???we??™ve always done it this way??? are commonplace. To eliminate institutional discrimination, all public authorities have a responsibility to look at all their services, policies and procedures regularly to identify and remove any potential discrimination. This process is known as Equality Impact Assessment and is a legal requirement. The result of doing an Equality Impact Assessment should be to identify where we can improve our services or employment practices to meet the needs of individuals or groups.
3.2 Evaluate the effectiveness of systems and processes in promoting equality, diversity and inclusion in own area of responsibility
It is important to evaluate the effectiveness of the systems and processes, as this enables you to reflect on your current practice, celebrate your strengths and achievements and also to ensure any gaps or shortfalls are addressed. This can be done by carrying out regular reviewing, monitoring and evaluating the effectiveness of your systems and processes. It will also provide opportunities to gather the views of colleagues, service users and their families. Using self-evaluation in this way builds up the morale of the setting and reassures all involved that your setting is working to improve the quality and its effectiveness. Your evaluation should include:
??? How effective your current systems and processes are at addressing issues
??? Do your policies and procedures cover all current legislations
??? Is there an effective communication system in place for reporting/registering complaints
??? Are service users happy with the service you provide
??? Is staff morale good
3.3 Propose improvements to address gaps or shortfalls in systems and processes
After evaluating your workplace in terms of equality and inclusion, the next stage is to decide upon the action you will take to address gaps and shortfalls in systems and processes and produce a report. Set out the key changes you would like to make as a result of your evaluation. The report should contain detailed recommendations and proposed changes or policy reforms. It should also detail how improvements will be made and a timescale for any proposed changes to take place, should be agreed. All team members should be aware of their own role and responsibility regarding the implementation of the plan. Prioritise changes to help you decide where to start. Some measures you may wish to consider as part of your action plan are:
Actively involve all employees
??? Consultation and participation.
??? Encourage employees to take part in monitoring, and promote the reasons for doing so.
??? Extra measures and adjustments.
Build a culture of inclusion and respect
??? Ensure the organisation??™s core values include a commitment to equality, human rights and inclusive working.
??? Create, extend or improve policies on equality and human rights and make sure other policies are equality proofed.
??? Take immediate action to address and tackle discrimination, harassment and bullying.
??? Training for all staff on inclusive working, human rights and equality.
??? Make inclusion a key management approach.
??? Encourage and appoint equality and human rights champions.
??? Encourage employee networks and forums.
??? Promote culture-changing initiatives.
How can I create an inclusive workplace
There are five stages in this process:
??? Consider what you want to achieve and what the benefits will be.
??? Undertake an inclusion review of your workplace.
??? Decide where work is needed and create an action plan.
??? Communicate the plan with staff and put the plan into action.
??? Review, monitor and evaluate the plans impact and use what you find to plan future action.
4 Be able to manage the risks presented when balancing individual rights and professional duty of care
4.1 Describe ethical dilemmas that may arise in own area of responsibility when balancing individual rights and duty of care
When working in a health or social care environment, professional practitioners are quite often faced with
situations involving moral dilemmas. Therefore, it is very important that you have a clear understanding of morality and the meaning of moral decisions and how they are linked to health and social practice. You also need to have a good understanding of their legal position, and the morals and ethics that form the basis of their professional code of practice. This is very important when a person refuses medical treatment or decides to take a course of action that might not be in their best interests. In such situations legislation and professional codes of practice can provide valuable guidance. You also needs to consider the following ethical points when dealing with moral dilemmas:
When working with vulnerable individuals, all health and social care practitioners have a duty of care to
protect their rights. If a proposed course of action or a proposed treatment could be harmful to the individual,
practitioners have to weigh up the advantages and disadvantages. For example, cancer patients are quite
often advised to undergo a course of chemotherapy or radiotherapy. Both treatments involve some harmful
side effects, but the benefits should outweigh the harm caused by the treatment.
Social care providers should ensure that environments safeguard vulnerable individuals. This involves recruiting new staff and providing resources to ensure that individuals??™ needs are met. However, there are times when the behaviour or actions of one individual could harm other people within the organisation. This could be an individual with mental health problems who might become violent towards other people. If this is the case then the social care professional must follow the organisation??™s policies and procedures and if the behaviour of an individual is likely to result in significant harm to themselves or other people then the individual has to be restrained. Section 5 of the Mental Capacity Act 2005 provides guidelines for the social care professional, relating to the degree of harm that is likely to be suffered by a person if he or she is not restrained.
Beneficence refers to actions that promote the wellbeing of others. In the medical context, this means taking actions that serve the best interests of patients. Social care professionals have a duty to act in an individual??™s best interest at all times. This can involve balancing the benefits of medical treatment against the risks and costs. Health care professionals quite often have to weigh up arguments over cost, the effectiveness of treatment and the benefit that patients gain from the proposed course of action. For example, the cancer drug Herceptin could cost ?30,000 for one person ??“ would this money be better spent on saving multiple heart attack victims
Empowerment and autonomy of the individual
Empowering an individual means ensuring that they know enough to make an informed choice about decisions that could affect the quality of their life. This helps individuals to have control over their own lives. Vulnerable people who receive health and social care services rely on professional carers to ensure their independence. It is important that care workers empower individuals and don??™t use benevolent oppression to make decisions for individuals in their care, especially when it might seem that risky behaviour is involved. While staff might appear to be acting in ???the best interest??™ of individuals, they could in fact be denying a person??™s right to act as an independent individual and control their own life. Examples of benevolent oppression include:
??? not allowing relationships to develop between consenting adults
??? limiting alcohol intake of individuals
??? leaving the bathroom door open; not ???allowing??™ an individual to take a bath/shower in private
??? preventing individuals with physical/learning disabilities from going out alone
??? choosing activities that are thought to be suitable, but are not the choice of the individual
??? not providing resources to encourage independence and autonomy.
Legislation, policies and codes of practice provide clear guidelines as to the rights and responsibilities of care workers and these should be adhered to at all times. The duties of the care worker are clearly laid out in such documents, as well as in their contract of employment. In most situations a care worker??™s duties are clear and there is no conflict of interest. However, at times there can be a conflict of rights and ethical principles to consider. For example, the rights of one person may clash with the rights of others. For instance, in a supported housing project there may be a resident who likes to play music late into the evening, while another resident likes to retire early and get up early. In other cases, one person may have two rights that conflict with each other. For example, in certain situations an individual??™s right to privacy and confidentiality may clash with the right to be protected from harm. Cultural or religious values may also conflict with the right to be protected from harm. For example, a Jehovah??™s Witness (who does not agree with blood transfusions) may find themselves in hospital with a medical condition where a blood transfusion offers the only means of saving their life. In these situations the rights and duties of the care workers may also conflict with those of the individual using the service, and a decision will have to be taken as to which is the best course of action.
4.2 Explain the principle of informed choice
Over the past two decades the concept of choice has become important to the health and social care professions, and to the government departments that make policies affecting these sectors. It is now widely accepted that service users should be able to make informed choices about the services they receive and the most suitable treatments for themselves. Health and social care professionals should treat service users in ways that enhance their capacity to choose, and should not undermine their capacity (e.g. by withholding necessary information or presenting alternative options in a negatively biased manner). Informed choice means that service users are empowered to consider a range of options, that they own decisions, and share responsibility for the outcomes. Your role is to give unbiased adequate and accurate advice and information regarding options available, which relates directly to the service user choosing and pursuing realistic objectives and enabling them to make an informed decision based on that information.
|Terms/Definition |? |
|Informed choice |One that is informed, consistent with the decision makers values, and behaviourally |
| |implemented |
|Informed decision |One where a reasoned choice is made by a reasonable individual using relevant |
| |information about the advantages and disadvantages of all the possible courses of |
| |action, in accord with the individuals beliefs |
|Autonomous choice |One which occurs when people act (1) intentionally, (2) with understanding, and (3) |
| |without controlling influences that determine their actions |
|Evidence based |The use of evidence based information as a way of enhancing peoples choices when |
|patient choice |these people are patients |
You will need to ensure that the service users values and culture are taken into consideration, with the information you provide. An informed consent can be said to have been given based upon a clear appreciation and understanding of the facts, implications, and future consequences of an action.
4.3 Explain how issues of individual capacity may affect informed choice
For a service users consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are explained below.
??? Voluntary:? the decision to consent or not consent to treatment must be made alone, and must not be due to pressure by medical staff, friends or family.
??? Informed:? the person must be given full information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead.
??? Capacity:? the person must be capable of giving consent, which means that they understand the information given to them, and they can use it to make an informed decision.
There may be several reasons why an individual is unable to make an informed choice and decisions can be made on behalf of the service user without consent, if decisions are made in the person??™s best interests This reasons could be because they have mental health or physical issues where they are unable to communicate their wishes and lack the ability to understand and use information. This would apply where an individual has some levels of learning disability or dementia or diminished cognitive ability, or when an individual is under the influence of drugs. In these situations, judging competence can be very difficult. Factors that professionals can bear in mind when making an assessment include the individual??™s abilities to:
??? communicate a preference
??? understand the purpose
??? understand any potential risks and/or benefits to themselves and others in the future
??? understand the rights to refuse consent or withdraw consent
??? understand confidentiality and its limits
??? retain these understandings throughout the course of participation
The Mental Capacity Act (MCA) has been in force since 2007 and applies to England and Wales. The primary purpose of the MCA is to promote and safeguard decision-making within a legal framework. It does this in two ways:
??? By empowering people to make decisions for themselves wherever possible and by protecting people who lack capacity by providing a flexible framework that places individuals at the heart of the decision making process
??? By allowing people to plan ahead for a time in the future when they might lack the capacity for any number of reasons
Every adult has the right to make his or her own decisions and it must be assumed they can unless it is proved otherwise. Also, a person must be given all reasonable help before anyone treats them as though they are unable to make their own decisions. Just because someone makes what might be seen as a poor decision, it should not be assumed that they are unable to make any decisions. Any decision made for a person who is unable to so for themselves must be done in their best interests. Any decisions made for someone else should not restrict their basic rights and freedoms.
4.4 Propose a strategy to manage risks when balancing individual rights and duty of care in own area of responsibility
You will need to show your assessor how you manage risks when balancing an individual??™s rights and duty of care. This may involve carrying out risk assessments which allow the individual to undertake positive risk taking, whilst protecting and safeguarding vulnerable adults. Positive risk taking is about weighing up the potential benefits and harms of exercising one choice of action over another. Identifying the potential risks involved, and developing plans and actions that reflect the positive potentials and stated priorities of the service user. It involves using available resources and support to achieve the desired outcomes, and to minimise the potential harmful outcomes. It is not negligent ignorance of the potential risk, it is a very carefully thought out strategy for managing a specific situation or set of circumstances. This is done by:
??? Balance risk of harm with the benefits of independence and choice
??? Enable people to make informed choices
??? Support people to manage risks
??? Mutual accountability in choices and decisions
??? Keep people informed ??“ before during and after assessment and
??? support planning
??? Be flexible and innovative in risk management
??? Regular monitoring and reviewing situation through team meetings and partnership working with service users family and friends
Consider what you want to achieve
Do an inclusion review
Create an action plan
Communicate the plan and put it into action
Review and monitor the plan??™s impact