Working in Health and Social Care

Physical Therapy: Helps maintain, recover or improve physical ability following a medical condition of injury

Occupational Therapy: Adapting the individual's living environment and providing equipment to maintain and ensure independence 

Speech and Language Therapy: Support with development of language and regaining language skills following injury or illness.

Assistive Technologies: Offering latest technological adavnces to support individuals with long-term movement and communication differences in order to maintain independence

Cognitive Therapy: Focuses on thinking, behaviour and current communication skills

Respiratory Therapies:Treating infections/conditions of cardiopulmonary system e.g. lung cancer

Neuropsychology: Treating illness and injuries of the brain to minimise the effect on cognitive function and behaviour

Examples of Personal Care:

• Using the toilet 
• Getting dressed 
• Cooking 
• Brushing teeth
• Working
• Morning Routines 

Religion/Beliefs - e.g. Kosher (Judaism)

Physical Conditions - e.g. Allergies, IBS, Diabetes

Personal References - e.g. Vegan, Vegetarian

Assessing People's Needs:

The extent of the need, what type of help should be provided, observation, contact GP (personal care notes/medical records) and professional discussions.

Care Plans May Need To Be Changed If:

• If the individual has progressed, they may be less needed
• If health deteriorates 
• If the individual requires extra care
• If a specific care plan isn't right for the individual
• If change in discussion or medical records
• If the individual needs improvement, then more may need to be added
• If there is a complaint

The Care Planning Cycle

(Diagram)

1. Assessing the care needs of service users

2. Writing and agreeing a care plan which promotes an individuals health, wellbeing and independence

3. Monitoringand reviewing the effectiveness of the care provided

Changing Care Plans:

Changes inservice user needs, changes in service user's social circumstances, availability of resources, expertise of staff, access to other professionals, role of informal carers.

Care Plans Should: Assess service users' needs and agree appropriate care with the service user and family members, involve informal carers in the review of care plans, suggest alternative interventions to promote independence and holistic approach

Professionalism: Good knowledge and understanding, and expertise within a job role.

Qualities and Attributes of Professionalism:

• Good knowledge and understanding
• Skills/abilities
• Decision making
• Team work
• Follow policies and procedures
• Good communication skills

Care Values: Range of standards with HSC, guiding professionals to give best and most appropriate care.

Care Value Base 7 Principles:

Promotion of anti-discriminatory practice, Promotion and support of dignity, independence and safeguarding, respect and acknowledgement of personal beliefs and individual identity, Maintenence of confidentiality, Provision of personal care, Protecting individuals from abuse and effective communication/relationships.

Care Settings:

1. Anti-discriminatory practice (allowing everyone to share ideas and have a say on a regular basis)

2. Empowering individuals

3. Health, Safety and Safeguarding 

4. Confidentiality

5. Communication

Codes of Practice in Health and Social Care:

Confidentiality, Safeguarding, Communication, Equality, Collaborative Working

Discrimination: The unjust or prejudicial treatment of different categories of people, especially on the grounds of race, age, sex, or disability.

• Harassment
• Racism etc.
• Victimisation
• Abuse 
• Direct/Indirect

Harasssment: Agressive pressure or intimidation

Victimisation:The action of singling someone out for cruel or unjust treatment.

Direct: Direct discrimination is the legal term that applies if you treat someone less favourably than someone else has been treated (or would be treated) because the person belongs to one of the protected groups.

Indirect: Indirect discrimination is when you treat an employee the same as everybody else, but it has a negative effect on them. Say you have a practice, policy or rule that applies to every employee in the same way.

Empowerment: The process of becoming stronger and more confident, especially in controlling one's life and claiming one's rights.

How to Empower Individuals (Service Users):

• Independence
• Opportunities
• Treat them with respect
• Patience and compassion
• Guidance and support

Strategies for Empowerment:

• Individualised care
• Promote and support
• Supporting individuals
• Promoting rights
• Providing consistent support e.g.beliefs 

Health and Safety at Work Act 1974

Governs the requirements to ensure a safe working environment for all in every workplace

Sets out responsibilities for employers/employees

Law underpins the policy and procedures for risk assessments in care settings

Risk: likelihood, high or low, that a person will be harmed by a hazard

Hazards: anything that has the potential to cause harm to an individual

Risk Assessment: identifying and evaluating the possible consequences of hazards and the level of risk that the hazard could cause harm

Responsibilities

Employer:

• Ensure there is health and safety policy
• Undertake a risk assessment of the workplace
• Provide information on health and safety issues
• Provide equipment
• Provide health and safety training
• Keep record of accidents

Employee:

• Take reasonable care of own health and safety and that of others
• Co-operate with health and safety policies and procedures
• Use equipment safely 
• Attend health and safety training
• Report workplace accidents

Purposes of Risk Assessments:

• Examine level of risk involved in all tasks in the care setting
• Raise awareness of hazard and risk
• Reduce health and safety risks for sewrvice users, visitors and staff
• Communicate safety information/procedures to staff
• Demonstrate compliance with the law

Carrying out a Risk Assessment:

1. Identify hazards in setting, or carrying out the activity

2.Identify those at risk, including service users, staff and visitors

3. Identify strategies to minimise the risk

4. Evaluate level of risk

5. Review measure taken to minimise the risk

Safeguarding: Protect from harm and damage with an appropriate measure.

How to respond if a service user discloses abuse:

DOS

Support and respect individual, Reassure them, listen carefully to information given, report it.

DON'TS

Keep it to yourself, Don't panic, Don't push for any other information, judge or make assumptions.

Four Purposes of Safeguarding:

• Promoting health and wellbeing
• Protection from harm and abuse
• Honouring individuals rights
• Empowering individuals to make their own decisions 

The 6C's:

Compassiom - Based on empathy, dignity and respect for service users and their carers

Commitment - Your vision for service users to be recognized and the needs of individuals are met constantly

Communication - Central to the caring relationship, carers need the ability to listen to service users. No decision should be made about the service user without their involvement

Competency - Staff are able to understand the needs of service users and have up-to-date expertise and knowledge to deliver effective care and support

Courage - Always do the right thing for service users, speak up about concerns about poor practice

Care - At the heart of services, ensuring that quality care is given throughout the lifespan

The Cavendish Report 2015:

Ensured that social care services joined health care services in implementing the 6C's into day-to-day practice.

Came about as a result of the Mid-Staffordshire Hospital Case.

Recommended that the 6C's are included in the introductory Care Certificate which all social care workers complete as part of their workplace induction.

The Care Certificate:

Agreed set of standards defining knowledge, skills and behavious expected in health and social care job roles.

You need to complete before you can work unsupervised 

Demonstrating what the new emoyess knows and how they demonstrate the standards in practice

Set out fundamental skills you need to work on competently 

Made up of 15 minimum standards

You need to complete if you are "new to care"  part of a comprehensive induction programme

Jointly between Skills for Health, Skills for Care and Health Education England

CQC are responsible for ensuring that the Care Certificate is effectively delivered and completed within the first 12 weeks of employment. 

Policies, procedures, codes of practice and conduct for the caring professions have become more specific since 2010.

They are more understandable to service users and more rigorously implemented 

CQC has a specific responsibility to monitor standards in all settings and to request immediate action where significant failings are identified.

The Mid-Staffordshire NHS Trust 2013

Concerns were raised in 2007 by the Healthcare Commision about the high death rate.

Investigation found the provision inadequate, but there were serious failings identified with quality of care:

Significant staff shortages, patients left in soiled bedding, inadequate access to food and water, failure in leadership and managemnt, standards of care discouraged by managers.

CQC (Care Quality Commission) requires all care providers to register with them before offering care services.

Before registration, the CQC check to ensure:

• Appropriate standardsof safety are met
• Resources are available to maintain quality of care
• Once registered, each service is continually monitored, this includes regular inspection

Inspectors make Judgements by strong evidence on:                      (23 Fundamental Standards)

1. Quality of Service

2. Safety in the Service

3. Is the service caring?

4. Does the service effectuvely carry out its purpose?

5. Leadership and management of the service

Multi-Disciplinary Team: Different care professionals often work together to promote the health and wellbeing of other service users. These teams may include both other health and social care professionals, but also practioners from other organisations such as the police and education providers.

Why communication is important between professionals:

• Better understanding of situation
• Assess and review situation on regular basis
• Teamwork
• Share thoughts/ideas to potentially help and support individual for future in long-term
• Different perspectives

• Health and Social Care services are managed by a range of organisations
• Some are directly funded and delivered by the government or local councils - NHS
• Many others are charities
• Services are also provided by a growing number of private companies, profit making businesses which provide care.                                      

The Public Sector:                                                                             Voluntary Sector (Charities)

Adult Social Care, GP practices, NHS Foundation Hospitals, Children's Services

Financed and directly managed by government, funded through taxation and National Insurance contributions, mostly free to service when needed, but are paid for by all working individuals through tax and NI.

The Private Sector:

BUPA, Private Residential Care Homes, Priory Group Hospitals

Managed by commercial companies, need to make profit to stay in buisness, provide services for government, paid by service users themselves, medical insurance or government grants.

Types of Barriers:

• Language barriers e.g English is an additional language
• Communication barriers e.g. Breakdowns of communication
• Location e.g. Remote locations with poor public transport links
• Financial barriers e.g. Loss of potential wages/low income
• Resource barriers e.g. Demand for elderly care

Physical and Mental Health Needs

• Individuals present with very complex additional needs as well as their original need.
• Care professionals take a holistic approach to meet the needs of the whole person.
• People with mental health often have associated physical health needs.
• Physical health needs can lead to anxiety and depression.
• Mental health is difficult to defrine and monitor - varies across different societies and social groups.
• A quarter of people will experience a mental health issue each year.
• As professionals, we need  to be aware of changes to service users' physical and mental health as this may not always be disclosed.

NICE - National Institute for Health and Care Excellence.

Publishes guidance, research and advice

Public Health England:

Set up in 2013 as a result of Health and Social Care Act 2012

Improve health and wellbeing in England 

Provide information and strategies