Unit 2 - Equality, diversity and rights in H+SC

Equality ensuring people are treated fairly and equally, everyone should be given the same choices and opportunities, regardless of their differences. 

Diversity recognising and valuing that everyone is different. It involves accepting and respecting differences. 

Examples of diversity:

• religion
• race 
• cultural differences
• gender / gender reassignment
• social class
• age
• disability
• language 

Rights are what everyone is legally entitled to. 

Examples of rights:

• choice - gives control over their own lives, as a result, promotes self esteem and independence 
• confidentitality - info should be shared on a need to know basis 
• protection from harm and abuse - safeguarding procedures should be in place to protect people
• equal and fair treatment - people should be treated in accordence to the law and their own needs 
• consultation - people in H+SC and childcare settings should be asked for their opinions and views on the care and activities they would like to participate in 
• right to life - no one is allowed to harm you, and you cannot harm others, everyones life should be valued and respected.

Values of care core principles that underpin care work. Aim to eliminate discrimination, reduce inequalities and help to ensure individuals care needs are met

Applying the values of care ensures that people using H+SC settings recieve:

• appropriate levels of care
• attention
• treatment
• equal opportunities
• free from discrimination
• diversity valued
• rights supported 

The values of care ensure that staff provide care effectively and provide staff with information about the legal requirements. 

Examples of how equality, diversity and rights can be applied in H+SC settings:

Promoting equality and diversity:

• Use non-discriminatory langage 
• Challenge discrimination 
• Care should meet individuals specific needs 
• Accessible e.g. when taking older people out of care home, ramps for wheelchairs and hearing loops 

Promoting individual rights and beliefs:

• Provide access to prayer rooms / transport to church 
• Giving pregnant women the choice whether they want to give birth in a hospital or at home
• Alternative meal options e.g. vegan, gluten free or kosher 

Maintaining confidentiality:

• Chat about patients in a private place and dont leave patient files around
• Documents to be filed away in a locked cabinet or password protected 
• Information to be shared on a need to know basis, and who are involoved in the care of the patient 

Examples of how equality, diversity and rights can be applied in child care settings:

Making the welfare of the child paramount:

• Child care environments shoudl use a child centred approach, where the childs need should come first 
• A child should never be humiliated by publically being told off or made fun of 
• Should never be verablly abused or smacked 

Keeping children safe and maintaining a healthy environment:

• Safeguarding procedures should be in place 
• All staff to be DBS checked 
• Lanyard ID should be worn 
• Health and safety procedures and legislation should be followed e.g regular fire drills, risk assessments and first aiders avaliable 
• Staff to child ratio 

Encouraging children's learning and development:

• Activities should be stimulating and interesting. They should suit their developmental progress

Valuing diversity:

• Displays, food and toys should reflect differenet cultures, beliefs and needs 
• Celebration of worldwide festivals with all the children e.g Diwali and Christmas 
• Meetimg individual communication or mobility needs 

Ensuring equality of opportunity:

• Meeting childrens needs e.g. cultural, religious, mobility, dietary
• Staff should know and follow the equal opportunites policy 
• Activities to be accessible for all 
• All areas accessible for all 
• All children treated fairly - no favourites 

Anti-discriminatory practice:

• Staff should be good role models 
• Staff shouldn't use discriminatory language
• Discriminatory comments or behaviour should be challenged 

Maintaining confidentiality:

• Information to be shared on a need to know basis
• Personal information to be stored in a locked cabinet or password protected file 
• Conversations about children should be done in private 

Working with other professionals:

• It might be necessary to work with other practitioners, in order to support a child
• Information should be shared openly but sensitively
• Examples include a school nurse, health worker or social worker 

Advocacy services:

Advocacy means getting support from another individual in order to express your own views and opinions to ensure your voice is heard.

Example is MENCAP. They work with people who have a learning disability and supports them to live the way they want to live.

Support groups these are groups or organisations which provide support to groups of people.

Example is Mind. They provide advice and support to empower those experiencing mental health problems. It campaigns to improve services, raise awareness and promote understanding.

Informal support is where individuals recieve support from people they know e.g. friends, family and neighbours. 

They help services like shopping, driving to appointments etc. 

Discriminatory practice involoves treating someone unfairl or less favourably compared to others. 

Examples of discriminatory practice includes:

• excluding someone from activities
• verbal or physical abuse 

Discriminatory practice develops from uninformed attitudes and beliefs that result in unfair treatment of certain individuals or groups. 

Discrimination can be due to many factors:

• race
• culture
• disability
• age
• gender
• sexual orientation
• religion 

Race: 

Group considered to have distinct characteristics, e.g. skin colour, nationality or origin. People are asked to classify themselves, which can be used to see the number of people from different backgrounds use particular services.RACISM

Culture: 

Refers to a group of people in society who share the same customs, language, dress, beliefs and values. Some groups are percieved differently, so are often victims of discrimination.

Disability:

Defined as a physical or mental inpairment that has negative effects on someones life. It has a long term effect on their ability to do everyday tasks. DISABILISM

Social class:

Defined by people being 'grouped' according to their economic or educational status. Some people judge others because of their social class. 

Age:

Some people are discriminated against because of their age. This could be due to society having negative perceptions about that group of people. AGEISM

Gender: 

Refers to whether someone is male, female or transgender. SEXISM

Sexual orientation:

Discrimination due to someones sexuality, if they are bisexual, gay or lesbian is known as HOMOPHOBIA 

Religion:

Is a system of beliefs and values individuals may have. Everyone may follow different religions and will influence their way of life. Religious discrimination can involove peoples religious needs not being met. e.g Kosher food not avaliable for a Jewish patient. 

Direct discrimination involves intentionally putting someone at a disadvantage by treating the unfairly, based on their differences. 

An example is:

Women not being allowed to take a job becuase she is female, and might be a victim of sex discrimination. 

Indirect discrimination when a policy, procedure or a rule applies to everyone, but it has a  detrimental effect on some people. The discrimination is accidental. 

An example is:

Male workers must be clean shaven, however this might be against some relgious rules.

Abuse range of negative and harmful ways of behaving.

Types of abuse:

• PHYSICAL - causing pain or threats to hurt an individual. 
• VERBAL - name calling, insults or swearing. This could humiliate someone or reduce their dignity or security. 
• PSYCHOLOGICAL (EMOTIONAL) - threats and constant criticism. The aim is to undermine and control the person being abused.
• SEXUAL - any type of unwanted sexual contact, dressed or undressed.
• NEGLECT - carer failing to look after someone properly. Not providing the essentials. 

Prejudice having a negative attitude towards an individual or group. It is often based on ill-informed opinion or inaccurate infromation. 

Stereotyping making judgements about groups or individuals assuming that people with certain characteristics are the same. 

Labelling identify people negatively as part of a particular group, the assumption is that they are all the same. 

Bullying range of negative behaviours that can intimidate or harm others. It happens more than once, and can be carried out by anyone. 

Discriminatory practice can affect anyone using H+S and child care services. However, there are 3 main groups, with a few examples: 

• Individuals who require care and support
  • patients
  • people with disabilities
  • babies and children
  • adults
• Family, friends, relatives of the individual
  • parents / grandparents 
  • sons and daughters
  • best friends
  • neighbours 
• Practitioners 
  • nurse / GP
  • health visitor
  • social worker
  • nursery assisstant 

Dicrimination can affects peoples physical, intellectual, emotional and social wellbeing, which can lead to health problems.

Disempowerment feel lack of control in their life.

Low self-esteem / confidence not feeling good about yourself, or not believing you can do something.

Being discriminated against can make the person feel withdrawn and isolate themselves. They might also feel frightened aboout being discriminated against again. This can lead to health problems like high blood pressure and anxiety. 

Legislation provides individuals with rights to which they are entitled through laws passed by parliament. Law is upheld through the courts. 

Legislation protects the rights of both individuals recieving care and the providers of care and support. It also states their responsibilities in society. 

There are 6 pieces of legislation:

• The Care Act 2014
• The Health and Social Care Act 2012
• The Equality Act 2010
• The Mental Capacity Act 2005
• The Children Act 2004
• The Data Protection Act 1998

This act relates to those being assessed or recieving social care and their carers. Key information includes:

• Duty on locla authorities to promote an individuals wellbeing when making a decision about the individual 
• Continuity of care must be provided to ensure no gap in care or support  - moving from one area to another
• Local authroity to carry out child's needs assessments for people who might need care and support after they reach the age of 18 
• Independent advocate availiable to facilitate the involvement of an adult carer who is the subject of an assessment, care or support planning or a review
• Adult safeguarding 
• Local authorities to guarentee preventative services which could help reduce or delay the development of care and support needs

2 main principles:

1. Enabling patients to have more control over the care they recieve 

2. Those responsible for patient care have the freedom and power to commission care that meets local needs

• No decision about me, without me - patient to choose
• Clincial Commissioning Groups are GP led bodies that commisson most health services. 
• Health and wellbeing boards bring together health and social care commissioners, councillors and a lay representative to promote joint working and takle inequalities in peoples health and wellbeing
• Public health - focus on prevention, quit smoking, screening, obesity and vaccinations 
• Healthwatch - aim to protect the interests of the people using the H+SC services. Role is to communicate the views of patients to governing bodies 

• Made direct and indirect discrimination illegal 
• Prohibits discrimination in education, employment, access to goods, services and housing 
• Covers victimisation and harrassment on the basis of a protected characteristic 
• Adaptions have been made for people with disabilities e.g. ramps in workplaces
• Women have the right to breastfeed in public places 
• The act encourages positive action - encouraging and training people to work in jobs which are under-represented due to protected characteristics 
• Pay secrecy is now illegal 

Protected characteristics:

• Age                                                         Race
• Gender reassignment                             Sex
• Disability                                                 Sexual orientation 
• Marriage / civil partnership
• Pregnancy / maternity
• Race
• Religion

Capacity ability to make decisions 

This act has 5 key principles:

1. A presumption of capacity - every adult has the right to make their own decision unless it is proved otherwise. Assumptions may not be made 

2. Support to make own decisions - all practicable help must be given before anyone treats them as not being able to make their own decisions

3. Unwise decisions - people have the right to make unwise decisions, as everyone has their own preferences. They cannot be treated as lacking capacity for thinking differently 

4. Best interests - if a decision has to be made for someone lacking capacity, it should be done it their best interests. They should involve the person as much as possible

5. Less restrictive option - anything done/decided for someone who lacks capacity should be the least restrictive of their basic rights and freedoms. 

• Protecting children at risk - may involve taking children away from their family
• Childs needs to come first, so children have the right to stay within their wider family circle wherever possible 
• Child has the right to be consulted 
• Children have a right to an advocate 
• Staying safe, beign healthy, enjoying and achieving, amking a positive contribution and economic wellbeing are all universal ambitions for every child. 
• Encourages partnership working 
• To represent childrens interests, they set up the Childrens Commissioner and childrens safeguarding boards

The act states that data should:

• processed fairly and lawfully - shared on a need to know basis 
• use for the intended purposes 
• adequate and relevant, but not excessive
• accurate and kept up to date 
• kept for no longer than necessary 
• processed in line with the rights of the individual 
• secured
• not transferred to other countries

The Care Certificate:

Consists of a set of standars that H+SC workers must follow everyday. It shows other workers and patients that the worker has been assessed against a set of standards and has demonstrated they have the skills, knowledge and behaviour to provide high quality care and support. 

Quality assurance:

External bodies are involoved in regulating and inspecting the quality of H+SC environments, here are a few examples:

• Care Quality Commisson (CQC) - registers, monitors and licenses H+SC services to ensure they meet safety and quality standards.
• OFSTED - inspects and regulates services that care for children. Publishes a report showing good practices and areas for improvement 
• Equality and Human Rights Commission (EHRC) - provides info to people so that they know their rights. Also provides organisations info about their responsibilities under equality law
• NICE - improves outcomes for individuals using NHS and other H+SC services. NICE consider whether a treatment benefits the patient and help NHS meet its target. 

Person-centred approach to care and provision and individual needs met 

Legislation and antional initiatives are focused on promoting and protecting the rights and needs of individuals. Values of care embed person-centred practice and ways of working to meet individual needs. This means the people using H+SC services can say what is important to them, gives more control and improves quality of life. 

Empowerment 

This is how a carer encourages an individual to make informed choices and decisions so that they can take control of their own life. 

Accessible services 

Acording to the Equality act, reasonable adpations must be made for disabled users. The use of ramps, autopmatic doors, lifts, Braille, info provided in large print etc all are useful. 

Provides a system of redress 

The legislations outline clearly what is expected, and if they are not followed, the law can be enforced by taking legal action. If the law is broken, a fine or imprisionment make be considered.

Clear guidelines for practitioners to follow 

An exampl of clear guidelines is the Mental Capacity Act. It states clearly who can make the decisions, in what situations and how they should go about making them. 

Rasies standards of care 

An example is OFSTED. They: promote improvements in order to raise standards, ensures the service focuses on interests of their users, identifies good practice, areas for improvement, ensures servie is effective and efficient and ensures that the service promotes value for money. 

Staff selection and interview procedures must comply wth the Equality Act

The Eqaulity Act has had an impact on the selection and interview process. Adverts must not discriminate against any group, and the same with the questions at the interview. The interview pannel should be trained in equality and diversity to avoid any bias or discriminatory practice. Interviews should take place in an accessible place for all. 

Organisational policies

There are lots of benefits of having policies. They say how the environment will provide the best quality care in a way that promotes equality and supports individuals rights. Some benefits are below:

Key aspects of best practice include:

• being non-judgmental
• respecting the views, choices and decisions of individuals 
• anti-discriminatory practice
• valuing diversity 
• using effective communication
• following agreed ways of working
• training and professional development opportunities for staff
• mentoring, monitoring and performance management of staff
• attending staff meetings to discuss issues/practice 

Understanding and raising awareness of best interests can be done through a variety of methods:

• Skill audit 
• Reflection on own practice
• Create a personl development plan
• Sharing experiences - what went well and what didn't
• Mentoring for inexperienced staff members to gain experience 

Best practice providing the care that is required to meet the needs of individuals. This can help in turn by:

• Improving the individuals slef-esteem 
• Making them feel valued 
• Enables trust and confidence in worker 
• Improves individuals wellbeing + quality of life
• Maintains individuals independence

As a H+SC worker, you should be able to identify the basis of discrimination and the form it takes. You should also be able to indetify the effect it will have on the individual and potentially, the effect on the family. 

It is the H+SC workers job to identify and respond with appropriate action. 

Examples of discriminatory practice:

• Prejudice - treating a group of children differnetly because they come from a 'common' area
• Inadequate care - childminder sitting a child in front of the TV all day to keep the quiet 
• Abuse and neglect - care assistants causing individuals bruises due to handling patients roughly 
• Breach of health and safety - equipment not regulary checked for damage 

Appropriate action may involove:

• reporting an incident to the relevant authorities 
• reporting to mangement
• reflecting on your own attitudes 
• changing your own practice or encouraging others

In some situations, the issue can be easily resolved without the need of authroities

Some other appropraite actions are:

• methods of challenging discrimination
• whistleblowing
• providing information about complaints procedures and advocay services
• dealing with conflict 

Challenge at the time

Tell the person how they are discriminating, to raise their awareness of what they are doing. They might not be aware that they are doing it.

Challenge afterwards through procedures 

Tell the person to read the organisations policies. Senior staff could help approach the issue. In serious cases, disciplinary actions could be taken. 

Challenge afterwards through long-term campaigns 

Awareness sessions could be provide for staff. This is a professional development opportunity that helps to improve understanding of correct ways of working. 

This involoves alerting a more senior member of staff e.g. manager of an issue. 

Managers should listen and act upon the issue in order to make improvements for staff and individuals using their services. 

In some cases, a staff member might need to whistleblow to outside authroities e.g. OFSTED. 

This enables a member of staff or someone who uses the H+SC services to take action about poor treatment. 

Here is an example:

People using the service should know who to complain to, or to make an internal complaint or involove an outside agency. 

Some people are unable to speak for themselves. Having support from an advocate can enable them to obtain their rights and have their care needs met. 

Ways to resolve a conflict:

• Active listening
• Remaining calm
• Being objective
• Being sympathetic

It is important to see both sides of an arguement.