Page 1 of 11 aspecmaps.free.fr/NVQ3/SHC34.pdf Principles for implementing duty of care in health, social care or children’s and young people’s settings by Gaël Romanet.

Principles for implementing duty of care in health, social care or children’s and young people’s settings

Page 2 of 11 aspecmaps.free.fr/NVQ3/SHC34.pdf Principles for implementing duty of care in health, social care or children’s and young people’s settings by Gaël Romanet.

Assignment task – SHC 34 - Principles for implementing duty of care in health, social care or children’s and young people’s settings

Unit purpose and aim This unit is aimed at those who are newly commencing or plan to work in health or social care settings with adults or children. It introduces ways to address the dilemmas, conflicts or complaints that may arise where there is a duty of care.

Author note Although I finished the SHC24 unit, I decided to answer to all the SHC34 questions, according to my senior care assistant position. I answered the questions of this unit as a senior care assistant working in a residential care home for individuals living with early dementia.

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Task 1 Understand how duty of care contributes to safe practice 1.1 Explain your understanding of the term a “Duty of Care” in your own work role; explain the legal obligations you have whilst maintaining a “Duty of Care” with individuals 1.2 Explain how Duty of Care contributes to the safeguarding and protection of vulnerable individuals

Task 2 Know how to address conflicts or dilemmas that may arise between an individual’s rights and the duty of care 2.1 Describe the potential conflicts and dilemmas that may arise whilst maintaining your Duty of Care towards individuals and respecting the right of individuals 2.2 Describe how risks associated with activities are managed, whilst respecting the individual’s rights and choices as far as possible 2.3 Explain the sources of advice and support available to you when help is needed in maintaining a Duty of Care

Task 3 Know how to respond to complaints 3.1 Explain the importance and benefits of promoting the complaints procedure in your place of work 3.2 Explain the role you have in responding to a complaint and the main procedural points to consider in handling a complaint as seen within your organisations complaints policy

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Assignment task – SHC34 Answers Task 1 Understand how duty of care contributes to safe practice 1.1 Explain your understanding of the term a “Duty of Care” in your own work role; explain the legal obligations you have whilst maintaining a “Duty of Care” with individuals

What is a “Duty of Care”? Duty of care is a moral or legal obligation to ensure the safety or wellbeing of others. For example, employers have a duty of care to their employees. The duty of care of a senior care assistant in health, social care or children’s and young people’s settings, is to act and to respect the best interest of the vulnerable service users by meeting good quality and standard of care. That means to ensure that the needs and wellbeing of the vulnerable service users are met.

As a senior care assistant working in a residential early dementia unit, my duty of care is to protect the vulnerable residents from any hazards by making them safe from harm and exploitation or abuse that may occurs in my workplace settings, and avoiding any acts that could result in injury or hospitalisation. Duty of care is also to work in a person-centred approach way that place the resident first in the centre of the care provided, to involve the resident in the decision making process of choices and decisions over care according to the resident's mental capacity. This will be ensured by an effective communication, respecting my residents and giving them choices. Duty of care means working in a way that underpins everything I do whilst providing care and support using the 8 Core Care Values. Regarding duty of care, my employer responsibility is to provide policies and procedures; support through training; equipment and guidance that will enables me to do my duty of care safely. Also, my legal obligations are to work within the law including; The National Care Standards Code of Practice – Standards 3, Organisations Policies and Procedures; The Mental Capacity Act 2005 Code of Practice; The Health and Social Care Act 2008 – The Essential Care Standards Regulation 9, outcome 4 demands that people experience effective, safe, appropriate care treatment and support that meets their individual needs and protects their rights; The Care Act 2014 - Central to the Care Act is the concept of wellbeing, council’s duty to consider the physical, mental and emotional, wellbeing of the individual needing care. A Person Centred Approach sets the structure of The Care Act 2014, care workers must involve the individuals in deciding what they need, how they can best be cared for and what they want to achieve; means reporting and recording information accurately, legibly and appropriately; means keeping my knowledge, skills and practice up to date; means maintain all confidentiality requirements as this is an essential legal obligation.

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What are the 8 Core Care Values? The 8 Core Care Values, also called the eight person centred values, are an agreed set of principles that are believed to be the foundation of all good care practice and provide care workers with an agreed set of principles and standards by which care workers benchmark their practice which ensures they conduct themselves in a way that embraces these principles. The 8 Core Care Values were intended to guide and inform the approach and practice required of all care workers. The 8 Core Care Values not only apply to the relationships developed with the individuals who require care or support within a care home, families and friends but to the working relationships with team members and colleagues; other professionals; advocates or others who are important to individuals. The 8 Core Care Values provides a set of principles that help to develop a better understanding of what constitutes good care practice which supports the continued care, safety and wellbeing of the individuals within a care home. These values and principles are now embedded in the National Care Standards Codes of practice for social care workers, and must be adhered to at by all social care workers. The 8 Core Care Values are the following: individuality; rights; choice; privacy; independence; dignity; respect; partnership. Individuals have a right to be treated as an individual; to be treated equally and not be discriminated against; to be respected; to have privacy; to be treated in a dignified way; to be protected from danger and harm; to be supported and cared for in a way that meets their needs, takes account of their choices and also protects them; to communicate using their preferred methods of communication and language; to access information about themselves.

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What is The National Care Standards Code of Practice – Standards 3? The National Care Standards Code of Practice – Standards 3, is related to duty of care and underpins promoting the independence of service users while protecting them as far as possible from danger or harm, this include: 3.1 promote the independence of service users and assist them to understand and exercise their rights 3.2 use established processes and procedures to challenge and report dangerous, abusive, discriminatory or exploitative behaviour and practice 3.3 follow agreed practice and procedures designed to keep you and other people safe from violent and abusive behaviour at work 3.4 bring to the attention of your employer or the appropriate authority any resource or operational difficulties e.g. not enough staff on duty, that might get in the way of the delivery of safe care practices 3.5 inform your employer or an appropriate authority where the practice of colleagues may be unsafe or adversely affect standards and quality of care 3.6 comply with employers’ health and safety policies including those relating to substance abuse 3.7 help service users and carers to make complaints, take complaints seriously and respond to them or pass them onto the appropriate person 3.8 recognise and use responsibly the power that comes from working with all service users and carers. 1.2 Explain how Duty of Care contributes to the safeguarding and protection of vulnerable individuals

Duty of care contributes to the safeguarding or protection of individuals by ensuring the staff follow safe working procedures to ensure the residents are protected from any hazards, harm or abuse that may occurs in my workplace settings, and are kept safe from abuse by other members of staff, other residents, resident's family, resident's friends and other professionals people, e.g. district nurses, social workers, general practitioners, dietitians, speech and language therapists, literally every persons that are involved in the resident's care planning process. In my work place, I have received specific training regarding safeguarding policies and procedures, and this makes it clear that my duty of care as a senior care assistant is to report and record all relevant information related to unprofessional conduct or behaviour that may contribute for a resident to be abused. The Whistleblowing policy in my workplace makes it clear to me and to staff that it is staff’s responsibility to report any suspicions regarding any form of abuses. This is important to remember that: abusers can be any person that are living and involved in the resident's care planning process.

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Task 2 Know how to address conflicts or dilemmas that may arise between an individual’s rights and the duty of care 2.1 Describe the potential conflicts and dilemmas that may arise whilst maintaining your Duty of Care towards individuals and respecting the right of individuals

I am working as a senior care assistant for individual living with early dementia in a residential early dementia unit, and my role as a senior care assistant is to ensure that the residents living with early dementia are receiving the same right as anyone else when deciding in their daily life, according to their mental capacity. For example a resident living with early dementia may refuse an important medication such as Warfarin. My duty of care is to encourage and to explain to the resident that the Warfarin medication is very important to stops blood from clotting. I will try later again for the resident to take his Warfarin, but if the resident refuse again, my duty of care is to document on the resident's Medication Administration Record sheet, that the resident refused to take the Warfarin medication as prescribed. My duty of care is also to inform the GP, social worker and next of kin about that. My duty of care is to check that everything is alright by taking the resident's vital signs although the resident missed the Warfarin medication. It is the resident’s right to refuse to take medications if they want to. It is my duty of care to ensure that the residents are supported accordingly and when they refuse a service that I record and report this according to my workplace guidelines and policies. I make sure everything has been documented properly; resident’s daily life, resident’s family and other professionals informed. I will communicate this information to the night staff during the handover time. In a health and social care settings, communication is very important to ensure good quality cares and peace of mind regarding the duty of care. Another example could be a resident who is a smoker and insist on smoking in the community area where the other residents are sitting. The smoker resident may ignore all advice from staffs who are concerned about the safety of everyone.

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The dilemma of balancing Rights and Risks Risk taking is a part of everyday life. Taking responsible risks helps to learn more about own self, own potential and helps to develop own life opportunities, confidence and self-esteem. Working within the health and social care sector means staff must learn to find a balance in maintaining an individual’s health, wellbeing and safety, whilst respecting the right and choices of the individual when making positive choices involving varying degrees of risk. Duty of staff to have a legal responsibility to promote a service users rights and choices and enable them to maintain their independence and be free to undertake activities of their choice however eccentric or extreme they may seem to be. (The Mental Capacity Act 2005 – Principle 3) The dilemma, conflict and tension staff often face whilst promoting individual choice involving risk whilst maintaining a duty of care in keeping individuals safe is a challenge that all staff have to face and manage effectively. A dilemma arises when there are two or more alternative courses of action which may not entirely meet all needs. This is when advice and support is needed to resolve a situation in the best interests of the individual. The dilemma that may arise between a duty of care and an individual’s rights through the five principles that are contained within the Mental Capacity Act 2005 as explained below. The main function of the Mental Capacity Act 2005 is to provide a statutory framework to empower and protect vulnerable people who are not able to make their own decisions e.g. individuals living with dementia that lack mental capacity. It makes it clear who can take decisions, in which situations and how they should go about this. It enables people to plan ahead for a time when they may lose capacity. Human rights don’t stop when dementia comes. Guidance on the Act will be provided in a Code of Practice. People who are placed under a duty to have regard to the Code include those working in a professional capacity e.g. doctors and social workers. The five principles that are contained within the Mental Capacity Act 2005 are; A presumption of capacity – every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise; The right for individuals to be supported to make their own decisions – people must be given all appropriate help before anyone concludes that they cannot make their own decisions: That individuals must retain the right to make what might be seen as eccentric or unwise decisions; Best interests – anything done for or on behalf of people without capacity must be in their best interests; Least restrictive intervention – anything done for or on behalf of people without capacity should be the least restrictive of their basic right and freedoms.

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2.2 Describe how risks associated with activities are managed, whilst respecting the individual’s rights and choices as far as possible

The best way to manage risks associated with activities, whilst respecting the individual’s rights and choices is to ensure the documentation and communication are recorded and reported according to the workplace guidelines and policies e.g. staff refers to standards, policies and procedures, carry out risk assessments, working in a way that promote partnership through inclusion, liaise with others and seek our advice. Communication between the day staff and the night staff during the handover time is very important and helps to ensure the continuity of the resident’s needs. In a health and social care settings, communication is very important to ensure good quality cares and peace of mind regarding the duty of care. A good example is a proper handover and communication between staffs and professional involved in the resident's cares ensure the best interest of the residents by meeting good quality and standard of care to ensure that the needs and wellbeing of the residents are met.

What are the five steps to Risk Assessment?

Qualitative risk assessment involves making a formal judgement on the consequence and probability using: Risk = Likelihood x Severity (on a scale of 10). The result will be 10 x 10 = 100

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2.3 Explain the sources of advice and support available to you when help is needed in maintaining a Duty of Care

In my workplace setting, I can get additional support and advice about conflicts and dilemmas, from training, from one on one supervision, from my line manager, from my workplace policies and guidelines, from the internet, and of course from other professionals involved in the resident's life, such as other members of staff, district nurses, social workers, general practitioners, dietitians, speech and language therapists, literally every persons that are involved in the resident's care planning process. Also I can additional sources of advice and support available regarding a duty of care, from other supportive organisations e.g. Skills Councils, Skills for Care, Skills for Health, from Professional Bodies e.g. The Association of Health Care Professionals (AHCP), from Care Quality Commission (CQC).

Task 3 Know how to respond to complaints 3.1 Explain the importance and benefits of promoting the complaints procedure in your place of work

All complaints must be taken seriously and handled in a formal manner. The Care Quality Commission (CQC) requires my employer to keep reports of complaints. This process of keeping reports of complaints helps to improve services within my working place. Individual's family have a right to make complaints. Senior care assistants duty to handle complaints by responding professionally following the three basic steps, which are; recognize the complaint; being aware of differing views of what happened; having a complaint handling process already in place. Duty of care regarding complaints towards service users helps; to protect legal rights of adults; to prevent bad practice and abuse; to raise awareness with manager/regulatory bodies of issues; to improve the quality of health and care services for self and other users.

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3.2 Explain the role you have in responding to a complaint and the main procedural points to consider in handling a complaint as seen within your organisations complaints policy

My duty of care is also to ensure the families of the residents have easy access to make complaints using the correct complain forms. I will ensure that when handling a complaint from a family, that complaint is taken seriously and that the family feel listened. Complaints open the opportunity to learn, to adapt, to improve and to provide better services. Failure to listen to the complaints will lead to an aggravation of the problems. All verbal complaints, no matter how seemingly insignificant, must be taken seriously. If the senior care staffs receive a verbal complaint, they should document it and they should inform the line manager that complaints has been received. In my workplace setting, the line manager is responsible for conducting the investigation when a complaint is received and a written letter is sent out to the resident's family to inform them that the complaint is being dealt with and timescales are given to them for a response. General points to remember when handling complaints are the following: Complaints should be treated with respect; It is important to keep records of all complaints; A complaint should be used to identify what went wrong and what improvements can be made to improve the quality of the service; Respond to the complainant within agreed timescales. This is important to know that all local authorities, NHS organisations and care services have a duty to; make sure that the complaints procedure is publicised well through publications, mailshots, and websites, advocacy and information services; to offer to discuss complaints as soon as they are received; to investigate complaints thoroughly and efficiently; to write to the person who made the complaint, explaining how it has been investigated and the outcome; to remind people of their rights to refer complaints to the relevant Ombudsman if they are not satisfied with the outcome. The Ombudsman is an official, usually appointed by the government or by parliament charged with representing the interests of the public by investigating and addressing complaints reported by individuals.