unit 2 learning aim C

• a multi-disciplinary approach is usual and normally essential.
• When people are supported by health and care professionals, it is not at all unusual that the service user has a range of concerns in addition to the one first presented.
• care professionals, whatever their speciality, aim to take a holistic approach to meet the needs of the whole person.
• People with mental health problems often have associated physical ill health.
• Poor physical health can lead to serious anxiety and depression.
• It is the care professional’s role to judge when it is necessary to work professionally with other specialists to ensure that the service user’s needs are fully met.
• Mental illness is difficult to define and, therefore, difficult to monitor. What is regarded as normal and acceptable behaviour varies from one society to another, and at different times in history. 
• Mind, the charity that works with and supports people with mental health problems, estimates that one in four people experience a mental health problem each year.

• MENCAP, the organisation that supports people with learning disabilities, defines a learning disability as ‘a reduced intellectual ability and difficulty with everyday activities… which affects someone for their whole life’.
• This may include difficulties with regular household tasks, shopping, using public transport or managing their money.
• Many people with learning difficulties also have other health needs, for example people with Down’s syndrome, a common condition that leads to learning difficulties, often have heart problems and sight and hearing impairments.
• Research by The Foundation for People with Learning Difficulties has found that between 25 per cent and 40 per cent of people with learning difficulties also suffer from mental health problems.
• dementia is much higher amongst older adults with learning difficulties compared to the general population.
• However, the Community Care Act (1990) increased the number of people with learning disabilities who were cared for and supported in the community rather than in large institutions.
• Importantly, the Disability Discrimination Act (1995) provided legal protection from discrimination in employment, access to public buildings and in renting of accommodation. H
• owever, MENCAP (2015) reports that despite recent progress, just 7% of adults with a learning disability are in paid employment, yet 65% want to work and, more importantly, have the capability to work.
• Of those people with a learning disability that do work, most only work part-time and are in low paid employment. Additionally, only a third of people with a learning disability take part in some form of education or training.

• Prior to the Community Care Act (1990), many people with physical and sensory disabilities and impairments also lived in hospitals and other large institutions in which the focus was predominantly concerned with their physical care. 
• Less awareness of the need for a holistic approach.
• People with disabilities tended to be segregated from the community 
• A sensory impairment refers to a condition where a person’s sensory organs, for example their eyesight or hearing, function abnormally poorly, which limits their ability to perform day-to-day activities.

• a person with an impairment may only be disabled if adaptions and services are not in place to ensure they are able to perform their daily routines and other activities of daily life independently.
• A disabling environment describes a situation where appropriate adaptions and services are not in place to support people with impairments. For example, a person with a hearing impairment is only disabled if they do not have access to a hearing aid. Or a person with a visual impairment does not have access to information in Braille, if this is the system of communication they prefer.

• may not regard themselves as mentally ill
• may not want to admit it 
• may be frightened to seek medical help, worried that being diagnosed will affect employment prospects, have the highest rate of enemployment amonst people with a disability 
• its the health practitioners role to be aware of the changes in both the service users mental and physical wellbeing 

address a patient/ clients P.I.E.S and spiritual health, attempting to meet the needs of the whole person rather than single issues or problems 

• poverty for adults with a disability is twice that for adults without 
• disability is a main reason for poverty 
• people with a disability have extra costs e.g. hearing aids 

• 1 communication and language 
• 2 physical development 
• 3 personal, social and emotional development 
• 4 literacy 
• 5 mathematics 
• 6 understanding the world 
• 7 expressive arts and design.

• the ageing process usually begins in adulthood e.g. deterioration of eyesight 
• women experience menopause 
• changes occur in the brain - slows down, power memory 
• physical changes in sleep patterns deadline in stamina/strength & their immune system is not as strong

• CNO launched their vision for nurses and midwives, called Compassion in Practice, back in December. It outlines the values every nurse or midwife should work to, known as the 'six Cs'

• 3 year strategy set up in december 2012

• Courage - to always do the right thing for service users and speak up when there are concerns, particularly about poor practice

• Care - is at the heart and core of thee health and care professions, ensuring that the care provided is right for the client throughout their lifespan

• Commitment - means that this vision for service users can be realised, and the needs of service users are consistently met

• Competence - means ensuring that staff are able to understand their service users’ needs, and have the up-to-date expertise and knowledge to deliver effective care and support

• Compassion - for service users and their carers must be based on empathy, respect and dignity

• Communication - is central central to the caring relationship, particularly the users. The motto to guide practice should be ‘no decision about me without me’

• Any adult aged 18 or over who is eligible for and requires services from the Local Authority has the right to a full assessment of their needs and the services provided should be individually tailored to meet those assessed needs.

• The two main requirements are:

• Everyone who requires services has the right to a full assessment of their needs and to be fully involved in that assessment.

• Everyone assessed who is eligible has the right to expect that the services they receive are tailored to meet their needs where reasonably practicable.

• Increased the number of people with learning difficulties who were cared for and supported in the community rather than large institutions.

• Provided legal protection from discrimination in employment, access to public buildings and in renting of accommodation.

• DDA defines disability as “a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities”. This includes significant sight loss.

• The types of discrimination it can help you challenge are:

• direct discrimination (such as a ban on employing blind people)

• disability related discrimination (for example, a taxi driver refusing to take a blind passenger because they have a guide dog)

• failure by an organisation to make a reasonable adjustment to allow you access to goods, facilities and services

• victimisation

• harassment.

• The DDA covers key areas of life such as employment and training; education; goods, facilities and services; premises and transport.

• empower people to understand their condition and the choices available to them through:

• their Info line which offers callers confidential help for the price of a local call

• their Legal Line which provides information on mental health related law to the public, service users, family members/carers, mental health professionals and mental health advocates

• their award-winning publications and website, now certified by the Information Standard.

• they provide advice and support to empower anyone experiencing a mental health problem

• Supports people with learning disabilities

• They define a learning disability as a ‘reduced intellectual ability and difficulty with everyday activities… which affects someone's whole life’

• They give advice and support for both the person with the illness and their family, as well as where the best support can be got from.

• Hey also help parents to set up wills/trusts for there families

• Victoria Climbié was abused, and finally died, while living with her guardians in the Borough of Haringey, London, in February 2000.

• Victoria was born in the Ivory Coast, West Africa, and came to live in London with her great aunt and her great aunt’s boyfriend.

• They claimed to be able to offer her a better life. In January 2001, the great aunt and her boyfriend were convicted of Victoria’s murder.

• This included the police, social workers from four different local authorities, two housing authorities, the National Health Service, the National Society for the Prevention of Cruelty to Children (NSPCC) and local churches.

• Lord Laming investigation identified countless examples of poor practice within these services and organisations; and very poor levels of communication between them. The report by Lord Laming led to the government taking the following steps.

The five outcomes to achieve for all children are for them to:  stay safe  be healthy  enjoy and achieve make a positive contribution  achieve economic wellbeing. 

• The Children Act (2004), which led to the:   
• appointment of a Director of Children’s Services in every local authority, who has responsibility for the care and education of children in their area  
• duty to cooperate’ for all services concerned with the care and safeguarding of children

• In August 2002 two primary school children, Jessica Chapman and Holly Wells, were reported missing from their home.
• Less than two weeks later, their bodies were found.
• The girls had been sexually abused and murdered by their school caretaker.
• It emerged during the investigations that the caretaker had been investigated in the past for sexual offences and burglary, but he had still been appointed to work in a school.
• An enquiry, led by Sir Michael Bichard, was set up to investigate this tragedy. One of the key recommendations of the Bichard Report was that there should be a statutory agency with responsibility for vetting all individuals wanting to work with children or vulnerable adults, whether as a paid member of staff or as a volunteer.
• This was initially the responsibility of the Criminal Records Bureau (CRB) set up in 2002. In 2012, the responsibility for vetting staff and volunteers was given to the newly created Disclosure and Barring Service (DBS).

In 2008, seventeen-month old Peter Connelly, still often referred to as Baby P, died after suffering serious physical and psychological abuse over a nine-month period. Just as in the case of Victoria Climbié, he had been seen by numerous health and care professionals during this period, but they failed to intervene and avert the tragedy. Further, just like Victoria Climbié, Baby P was also living in the Borough of Haringey. Lord Laming conducted a review to establish why, despite the changes in legislation, the tragedy had occurred. He found that yet again communication had been poor,

practice unprofessional and the standards of care inadequate. As part of his review, Lord Laming recommended that there should be: 

▸ a review of the recruitment, training and supervision of social workers to ensure that they received better child protection training  ▸ improved safeguarding training for staff with a responsibility for the care of children.