Introduction
In this assignment on principles of health and social care practice, I will explain how principles of support are applied to ensure the holistic care and safeguard of a service user as well as other staff members. I will highlight the benefits of person centred care and discuss the ethical issues and dilemmas that may arise when providing support and protection to users of healthcare services from a carer’s perspective. Whilst implementing the policies, legislations and regulations i will also indentify where these policies and procedures can be developed and evaluate its impact on organizational policy and practice. I will also incorporate the effectiveness of inter-professional working system from a personal perspective and make recommendations for development of organizational policies and implement these organizational policies.
Application of Support Principles
In order to understand what are principles of care one needs to understand what is meant by the term principles and the different types applied in health and social care. Principles may be defined as “A fundamental truth or proposition that serves as the foundation for a system of belief or behaviour or for a chain of reasoning” (Oxford Dictionary, 2013). There are many principles of support which are set by relevant authorities for healthcare providers and health workers which they must adhere to when providing care (Day and Wigens, 2006). ABC care home caters to the needs of vulnerable adults with neurological conditions. The principles of support that are strictly implemented in this care home are anti discriminatory practice which is working in accordance with the Equality act 2010 (NMC 2004). Staff are encouraged to promote equality and defy practices which involves discriminatory acts and procedures .Empowering clients to make informed choices by obtaining informed consent, is a common practice in this care home
(Hearnden 2008). Thus promoting independence and supporting service users in making an autonomous decision which is “The ability of the individual to exercise self determination; plan to their own actions and act on the plans without interference from other” (NMC 2004). For instance if a service user refuses to take their medication we have to accept their decision and make a coherent report or a record of such incidents in case of any complications as carers are accountable for their own actions and to avoid ambiguity. Individual rights and diversity are respected in this care home by care providers as they try their utmost to fulfill the religious and cultural needs of clients by offering praying rooms, various food options e.g. kosher, halal, vegetarian etc. The ABC staff is required to observe the confidentiality code of conduct when providing care (Day and Wigens, 2006). Staff in ABC are obliged to implement this and refrain from giving information to anyone unless actively part of care.
Protecting Clients from Harm
Safeguarding is a process of shielding vulnerable service users from any type of abuse or exploitation (Nolan Y, 2005). The key concepts of this principle are empowerment, protection, prevention, impartial responses, partnership and accountability. Abuse has been described as “The physical, psychological, emotional, financial or sexual maltreatment, or neglect of a vulnerable adult by another person. Health care staffs play a significant role in the protection of themselves, service users and other members of staff from harm and are responsible for ensuring that the support and services delivered is safe and of a high standard (Nolan Y, 2005). The most widespread prevention interventions for vulnerable adults include training and education of both the service users and staff on. Staff must adhere to the health and safety act 1974(HSE) in order to achieve this, which involves appropriate risk assessment tools e.g. waterlow score for the prevention of pressure sores in patients who are bed bound, control of Substances Hazardous to Health (COSHH regulation,2012), correct manual handling operations 1992, food and safety act regulations, 1990. The “No Secrets Guide” sets out a practice code that aims to protect vulnerable adults. This code explains how providers and commissioners of health care and social care should work in union to create and implement local procedures and policies. They should for instance; they should collaborate effectively with the public, private and voluntary sectors and should also make consultation with service users, their representatives or their carers. The local departments of social services should coordinate and oversee development of procedures and policies (Nolan Y, 2005).
In ABC staffs are expected to access information and indentify signs of harm which may put a service user or a collegue at risk of being harmed or abused hence why any incidents that take place within health care settings must be documented and reflected upon to prevent it from reoccurring in the future.
Person-Centered Approach Benefits
The person-centred approach essentially guides social care and health practice. It is a model of care that is based on Carl Rogers’ early therapeutic work and mainly emphasizes on protecting client’s individual rights as well as making decisions that are tailored to meet their unique needs (Edwards, 2012). While the term :person-centre approach” is widely used in other social care and other health systems, many of them find themselves actually relying on political and financial considerations when actually planning the type of healthcare to avail to clients (Moon, 2008). However, ABC being such a renowned care centre should give priority to clients by enacting various legislations that will protect the person centred approach. By doing this, it will be found that several benefits and advantages will be realized. Such benefits will include customer satisfaction, ability and capability to reach and serve individuals from a wide and diverse range of financial and ethnic backgrounds and finally there will the realization of more case outcomes that are more effective (Moon, 2008).
Effective communication is the foundation of healthcare, it’s been described as “Effective communication is a reciprocal, interactive process in which sender and recipient have responsibilities to ensure that a message has been received and understood” (Hugman, 2009, p.15). Communication is an important aspect of life and we as human beings use this process on a daily basis it may be direct or indirect. Effective communication is a critical element which determines the quality of care that is received by the service user, this is achieved by maintaining coherent and open communication between members of staff as well as the client. This idea is further supported by the NMC which states that “You must communicate effectively and share your knowledge, skills and expertise with other members of the team as required, for the benefit of the patient and clients” (NMC, 2004). Thus following these principles contribute to a Person centred approach (PCA) which is adopting various techniques to empower service users to plan their own expectations and receive services they require ( Tudor L, 2004).
Ethical Dilemma and Conflicts
As seen from the case study, ABC provides care to people of various vulnerabilities. One group of these people is the elderly people. The elderly are a group that is particularly very hard to work with. The social care and health setting is rife with many potential conflicts and ethical dilemmas (Edwards, 2012). For instance, when dealing with elderly people, some potential ethical dilemmas include potential legal; violations by the client or by colleagues (McLean, 2010). For instance, a patient may be a chain smoker which may consequently result in lung cancer. In spite of doctor’s advice and recommendations, he may continue smoking. The patient then starts suffering from acute pains and the doctor prescribes some pain killers which ultimately fail to work. However, the doctor is faced with an ethical dilemma of prescribing stronger painkillers because he is wary of their adverse effects. The medical are at a dilemma because they cannot stand to see the elderly patient screaming in pain. Another potential ethical dilemma or conflict may involve an instance where a selection between two case alternatives that do not meet the needs of the clients is necessary. Another ethical dilemma that may be experienced may be reporting of illegal or unethical behavior on the client’s part. Finally, an ethical dilemma when working with the elderly patients may involve the negotiation of responsibilities and roles when working with such vulnerable clients. Since the health and social care field is very sensitive one, ABC should follow the ethical policies and guidelines that have been formulated by the relevant heath and social care authorities (NMC, 2004). This will greatly help in the avoidance of work related ethical dilemmas that may compromise the provision of quality care. One particular way through which ethical dilemmas and conflicts can be mitigated for pain related scenarios like the one explained above is through the availability of appropriate pain assessment techniques (McLean, 2010). The aspects of pain that each pain assessment tool should address include pain intensity, location, temporal pattern, treatment and relieving factors, pain history, beliefs and pain interference. In terms of monitoring pain intensity, it advisable to use simple visual analogue scales (McLean, 2010). Where patient communication is impaired, the pain assessment tools utilized should be ones that really on the observation of pain behaviour, for instance PAINAD and the Abbey pain scale and not on patient communication. I addition, the pain assessment tool utilized should be one that is in the patient’s language (McLean, 2010).
Policies, Codes, Regulations and Codes Implementation
Within the health and social care environment, relevant authorities continually evaluates the various policies, legislations as well as codes and regulations to ensure that they are relevant as well as specific to the different cultural, religious, financial and ethnic backgrounds of the clients (McLean, 2010). As shown earlier, this is hugely applicable as ABC extends it services to clients from various ethnic, religious and financial backgrounds. The Health and Social Care Act of 2012 serves as a legislation guide to many health and social acre providers. (Department of Health, 2012). This act maintains and applies polices and regulations on providers of social care and health, professional accountability and field organization (Department of Health, 2012). ABC has for a considerable length of time utilized the stipulations of this act and has implemented it across its structures. As a result, the implementation of the act has resulted in greater health and social care as well s increased efficiency of the two.
Local Policies and Procedures
Local policies and procedures are developed in accordance with national policy requirements.”Legislation determines the policy framework for health and social care organizations, professionals, carers, clients and patients or service users" (Richards, 2003 p.180).
The local policies and procedures may however vary according to the needs of the particular population. For instance, regions that have population of lower or higher economic status may vary their or adapt their social care and health policies accordingly (Department of Health, 2012). Since ABC serves a population exhibiting different financial statuses, it should develop local policies and procedures that cater for the different financial statuses of the population.. ABC should in no way try to enact local policies and procedures that contradict those set by national health authorities such as the Department of Health or the National Health Service. However, the setting up of local policies and procedures by ABC serve to inform the national policy by highlighting the local procedures and policies. By adapting the local procedures and policies, so as to satisfy community needs, the national health authorities are able to avail higher quality service on a national scale (Department of Health, 2012).
Impact of policy, legislation, regulation, and codes of practice on policies and practices of ABC Care Home
Policy, legislation and code reforms have a great impact on social and health care practise at ABC care home. The policy, legislation and code protect both practitioners and clients and also offers practical guidelines about the best practises in relation to social care and health care needs (Department of Health, 2012). The main aim of evaluating legislation, code and policy of practise is so as to make sure that the standards present are updated, relevant and clear to the practitioners and clients and also ensure that there is ethical and safe care of all people (NMC, 2004).
Theories that underpin work as a care worker in ABC Care Home
The importance of theory to the field of social care and health care practice cannot be overemphasized. Theory directs almost all practice. The general models and theories of care that are utilized in the healthcare setting dictate its policy reform and legislation (Department of Health, 2012). In addition, the deliverance of care that is based on theory helps in guiding future social care and healthcare research.
One of the major theories that underpin my work as a social care worker at ABC is the humanistic theory. This theory emphasizes mainly on each clients individual needs in formulating the nature of care services, the protection of the individual rights of the clients as well as their dignity and autonomy (Edwards, 2012). Additionally, the use of the theory places great value on effective client-practitioner-colleague communication and also in the establishment of efficient inter-professional working environments.
Another theory that would have great in my work at ABC is the social learning theory. This particular theory underlines the significance of learning through observation and modeling. This is through adherence to a given care plan (Bandura, 1979). For instance, it is very likely that ABC has a specific care plan which every worker is supposed to abide by. By understanding the importance of this method of learning, I as a care giver can be able to empower clients and also avail the best care to all persons regardless of their backgrounds.
The final theory that would underline my work at ABC is the anti-oppressive theory coupled with anti-discriminatory practice (Bandura, 1979). The anti-oppressive theory relates to a certain professionalism style that emphasizes on social justice and the importance of individual rights. On the other-hand, anti-discriminatory practice relates to a type of social work that serves individuals from a diverse range of ethnic and social backgrounds and does not deny or limit service based on these characteristics (Bandura, 1979). Since, ABC serves a individuals from different backgrounds, the applicability of this theory is very clear.
How social processes impact on service users in ABC Care Home
Social processes can greatly impact social care and health care in variety of ways. For instance, at ABC, service user or client involvement is a key to all practises. Such practise has essentially promoted a care model that is more patient centred and that accounts for both the care givers and the patient perspectives. Research conducted has also revealed that user involvement improves services in areas such as cancer care amongst other disciplines within the health care and social care context (King's Fund, 2011). Here at ABC. I have found that forming partnerships with social care and health care professionals and users generally improves the inter-professional working environment and also reinforces the individual impact on both care and policy.
In addition, involving users and social processes accounting in directing policy in healthcare has essentially shifted the existent model from one that is more reactive oriented to one that is more proactive (Hearnden, 2008). By incorporating the service users at ABC, the management has for instance been able to anticipate various cultural changes and thus has been able to meet the need of an increasingly miscellaneous population. Use of the person centred care model and user involvement has helped to avoidance of social exclusion (King's Fund, 2011).
The effectiveness of inter-professional working for service users in ABC Care Home
Everywhere across the country, health care and social care has been increasingly trending towards an inter-professional working model. An inter-professional working model promotes worker and professional’s collaboration so as to effectively meet the needs of all clients (Trodd and Chivers, 2011). ABC has implemented this policy into its structure and has a result enacted care that helps in the fostering of working relationships with other similar professional working organisations. The effectiveness of this care model is very conspicuous as it has resulted in level of care that is relatively high (Nolan, 2005).
The inter-professional care model has been accompanied by the collaborative education model. Incorporating the inter-professional model into academic programmes has led to a more patient centred and holistic health care system (Department of Health, 2012). Knowledge sharing has essentially created more effective and efficient care plans. However, the inter-professional model has been most effective in the transcending the professional boundaries and therefore led to the creation of collaboration efforts that have resulted in more effective and efficient care model (Mendelstem, 2009).
Role, responsibilities, accountabilities and duties in resolving the failings mentioned by CQC
My roles, responsibilities, accountabilities and duties in resolving the failures mentioned by CQC would be several. First of all, I will be required to work within a team environment availed by the inter-professional model that would allow myself and other professionals to share knowledge and resources need to resolve some of the mentioned failings. I will also be required to maintain the professional standards and ethical codes that are related to social care and health care practise. I will also be responsible for demonstrating principles and values set forth by CQC in regards to professional practise. To effectively perform and fulfil these roles, responsibilities, duties and accountabilities, I will to have educated myself on such matters. (Nolan 2005 doing this will also require me to have effective non-verbal and verbal communication, respect other’s contributions as well as share professional duties and responsibilities (Nolan 2005).
Own contribution to the development and implementation of organisational policy in ABC Care Home to rectify the shortcomings pointed out by CQC
The report by CQC has established several failings and there is no doubt that a revamped organisation policy is required to solve these short comings. As a worker, my individual contribution to this policy is very well defined. First, I will be primarily responsible for the safeguarding the different vulnerable groups served by the ABC (Mendelstem, 2009). Therefore, I actively inspect the new policy to ensure that it indeed protects the service users. Another personal contribution in the course of protecting user’s rights will be obtaining some of the resources needed for the promotion of best standards of practise at ABC. My final contribution will be through my engagement in ethical practise where I will effectively manage the case loads and also continue increasing my professional knowledge so as to contribute to an improved overall organisation quality (Edwards, 2012).
Recommendations to develop own contributions to meeting good practice requirements in ABC care home in the future
The most vital aspect here is professional and educational development so as to meet effective practise requirements (Rushton, 2005). By receiving further training, both academic wise and professional wise, professionals such as me will be able to sharpen their skills and thus will be able to effectively meet changing needs of an increasingly diverse population (Rushton, 2005). In addition, integrating evidence based practise will facilitate the achievement of higher quality care. A combination of these measures or strategies will enable me together with other professionals to better safeguard the rights of vulnerable users and will also result in a working environment that is more collaborative and that adheres to the best standards of practise (Rushton, 2005).
References
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