Being person centred is to treat everyone as an individual that is felt valued and shown respect, by doing this you are supporting their choice and to respect their choices and privacy. You do this by promoting equality and diversity which supports their independence, furthermore you’re establishing an individual’s rights. The support that is involved is assessing, planning, developing and then implementing their care and support needs, this could involve individuals to help support the person by involving their families, advocates and GP’s in any decision making process. Why this is specifically used in general practice is to treat everyone as an individual and to address the individual with their preferred name. Ask the individual permission before carrying out any task for them, closing the door when personal care is provided which is giving them the privacy needed. Offer various options so they can make the informed choices which is best for them. Also to support them to make choices if they’re unable to do. Furthermore to include and support them with any decision making process that will cater the individual. 1
Care plans are important within general practice as it sets out how to deliver individualised care for an individual, in the care plan it informs us how care should be given to the individual following a person centred way. The care plans are made up from different parts which include a short history of the individual, medical history, choices, mobility plan, wishes, mental capacity assessment and risk assessment. By following these parts we are able to understand what level of support is needed to an individual and how the plan should be actioned and delivered. We are able to find out the individuals choices, wishes and preferences from a care plan, thus following a care plan it also informs us of any of factors that could take place such as a medical condition, risk and safety, abiding by the care plan will prevent us applying person centred values. A few examples of parts of a care plan are:
– We are able to obtain personal information from an individual such as their name, date of birth, profession, what activities and interests the individual likes, this can help us support their dignity, choices and their individuality.
– By noting down in a care plan the individual’s medical information it provides us of their past and present diagnosis, however this can restrict their personal choices.
Mobility care plan:
– This is able to help us to find out how mobile the individual is, this is best because this able to support the individual’s independence.
Nutritional care plan:
– A nutritional care plan is able to inform us what the individual likes to eat and drink, doing this allows us to help support the individual’s wishes and choices. 2
By treating people as individuals they give the resident a choice of what they want to eat, wear, wishes and desires, by taking account choices and where they want to be. This can be done by supporting people by giving them the information they are able to access their rights to what choices they have and also to helping them to understand. By treating people with dignity and respect what their decisions might be also by involving few members of staff during periods where it for when privacy is required, closing the curtains and doors and to knock on the door, this is recognising that working with people is a partnership rather than it being a relationship controlled by professionals.
Sources of information of the wishes and needs of an individual can be found by asking:
– The individual
– Other professionals such as nurses, social workers and GPs, which is referring to documents such as reports, records and care plans
– Friends. 3
Complex or sensitive situations that may be included are:
– Distressing or traumatic
– Frightening or threatening
– Likely to have consequences or serious implications
– Personal nature
Involving complex communication or cognitive needs if an individual is in a complex or sensitive situation which could be a results of an event i.e having received some bad news or the death of a relative or a close friend, there is little you do to stop the distress that the individual is going through. However the way you handle it is very important, you have to make sure that the individual keeps control and is able to make choices of what they want to do. When someone is in distress it is quite easy to take over, although you need to carefully check that you are following the choices that person has made. Furthermore you have to ensure that you do not pressure the person into discussing more that they intended to. However if they are reluctant to discuss their concerns with you ensure that you give the individual an option of talking to someone else i.e a member of staff, relative or family. Some situations may be complex due to family pressures, it can be that the views of the individual you are supporting could differ from those of the family. Furthermore when in a situation like this it is very important not to forget that your priority is to the individual that you are supporting. Finally you always must ensure that you are working to their choices and preferences, however it cannot be easy to deal with the responses from a strong minded family member who thinks that are acting for the individuals bests interests. 4
As an individual a care plan is created which is an agreement with the individuals consent to have personal information recorded which can include, family details, age, culture, mental health, health needs and circumstances. With this care plan it will be frequently reviewed, this could be due to changes to the individuals preferences or needs also any reviews that will also be signed and for the individual to agree with. By inputting personal values into their care plan you are ensuring that their preferences and needs are met.5
Identity and self- esteem are very similarly related, having a strong sense of identity and by developing self-esteem are very importing for good mental health. However your sense of identity is in regards to who you think you are and how you perceive yourself, defining yourself is identity. Furthermore Self-esteem is how you value yourself, this has to do with your sense of self-worth, which can both affect your mental health, and how you relate to other people and finally your behaviour.
However it is important to understand how we can develop self-esteem, with our sense of identity, this is because a poor sense or low self-esteem can contribute too many different problems within our lives, finally it is very important to know and understands what steps you can take if you need help in these areas.6
An individual’s health and wellbeing can be affected by a number of different factors. The individual should know about the factors to positively contribute to health and wellbeing such as:
– Rest and Sleep – refreshes the body and mind, restores energy and improved concentration
– Education, leisure activity and stimulating work – feel valued and improve mental ability
– Balanced diet – Feeling Healthy, controlling weight and improved immunity.
– Supportive relationships – family, friends, professionals, improved self-worth and self-esteem.
– Financial resources – benefits, free prescriptions, free diners, social security benefits.
– Pension – mobility allowance
– Regular exercise – weight control, mobility, circulation and improved fitness. 7
To be able to support individuals with well-being and health, we have to promote their self-esteem, self-image and identity, by promoting these three factors we are ensuring that their psychological and physical needs are met and also can be improved. Furthermore it also helps to provide the individual with dignity. An individual’s self-esteem gains when their cultures and values, views and beliefs are being respected. Self-esteem is important as part of their well-being and health. As a result this helps the individual to protect them from potential abuse and harm. However individuals with low self-esteem are more than likely to become the victim of abuse and harm, low self-esteem can be responsible for self-neglect and this can contributes to other mental health issues. Furthermore by promoting self-image, self-esteem and identity we are able to support the individual’s longevity, well-being and Health. 8
The environment is one of the main factors that promotes an individual’s well-being, the individual that is living in a safe, supportive and lively environment is able to enjoy all the aspects of their life. An individual needs to enjoy these aspects in order to gain self-esteem and feel valued which is plays an important part of their well-being. There are ways we can contribute to an environment that is able to promote well-being by-
– Providing equipment that is able to assist with accessibility and mobility
– Using marks and signs for instructions and directions
– Promoting person centred values
– Following health and safety legislations and rules, furthermore supporting others to follow the instructions and rules.
– Promoting diversity and equality
– Encouraging all to take part in activities
– Being able to provide secure, safe and easy entrances and exits facility
– To provide 24 hours assistance and support
– Arranging different entertainments for residents, this could be bingo, board games, day trips, quizzes, cooking, knitting, religious services, theatre and arts etc. 9
Health and safety risk assessments covers almost 85% of potential risks that relate to health and social care setting. These include:
– Electrical appliances
– Moving and handling
– Accident and incident
– Lifting equipment
– COSHH (Control of substances hazard to health) risk assessment.
The Moving and handling risk assessment is created because if there is any issue with the individual and the object. Fire risk assessment is created so if there is any potential risk of fire or what can disrupt the evacuation plan.
Furthermore a risk is assessment is carried out for medicine management. This risk assessment involves any risks that could be for administering, storing and dispensing medications.
Finally a risk assessment is carried out for nutrition, in this risk assessment involves the risks that could be due to eating and drinking such as (choking, assisting with drinking and eating and swallowing difficulties). 10
Each individual has a right to be safe from any danger and harm. One of our responsibilities is to make sure that we keep individuals from harm and danger. To do this we carry out a risk assessment that can eliminate risks so that the individual is able to keep safe from danger and harm which supports their rights. However if any individual is caused harm due to a risk assessment not being carried when a risk has been identified then this becomes a safeguarding issue. Which as a result is investigated with regulators, this could be either the local safe guarding authority or the CQC. Furthermore it is isn’t also the individuals service user to be safe from danger and harm but also the rights and responsibilities of other users and social care workers. 11
It is important to review and make any changes to a risk assessment this can be down to every day changes that happens in any workplace, few of these workplaces stay the same, but however sooner or later new equipment, procedures and substances will be brought into the workplace that could lead to new hazard. So the best cause of action will be to review what you are doing on a regular basis. 12
Each member who is involved in the care plan has to carry out assigned tasks within the care plan when it has been generated by the practice or wider team, this is to ensure that care is divided equally also to make sure care is being provided, each staff member who makes changes to the care plan to audit it so that for the next member.
You support the members involved within the implementation of the care plans by doing:
– Understand the roles and responsibilities when carrying out a specific activities
– Work holistically, inclusively and effectively to be able to provide support for the individual who the care plan is for and the key people who implement the care plans activities.
– To able to understand and to ensure the best methods for changing the care plan to meet the individuals preferences and needs
– To report and record any changes and any discomfort the individual might be in when doing activities. 13
The monitoring of a care plan can be carried in a number of different ways, this is including any or all the following ways: face to face, over the phone, family or client contacts, written or verbal reports from various services providers. However monitoring of the care plan could involve both non-scheduled and scheduled contacts, furthermore the frequency of monitoring of the care plan can vary depending of the care of the client needs and the types of services that are being provided. 14
After a new change of the care plan has been implemented then you must collate with other agreed sources to ensure that that the changes are known so that the agreed sources are able to ensure that the further care has been carried out. You must record any changes that could affect the delivery of the care that’s needed to the individual making sure that the members are aware of details of the programme in order to make sure that the care is being delivered. 15
You yourself as a member will identify and agree the responsibilities, roles and the criteria for whom will be judging the effectiveness and quality of the care plan with all members involved. By doing this you participate, contribute in and also run meetings that will discuss and agree the changes towards the care plans, that’s also taking in account of the benefits and risks towards the individual. You ensure this by the review meeting are set and made sure to run in ways that will promote the full participation of the key people and the individuals. 16
By having these review meetings we are able to receive feedback from the individual but also the members who are involved to be able to discuss how the plan is working, any timescales that need to be completed. By using either verbal or written communication to ensure that the individual has a say in the review meeting.
However the individual and the members are also able to express any concern if they feel the plan is not working and able to note down how they think the care plan can be improved. By using feedback we are able to see if the objectives are being met, by monitoring the care plan we are able to include a variety of measurements which will enable you to report about any activities that have been took place. 16
By working with the individual and others we should attempt to gain as many views of the members who are involved with the care of the individual, the plan of care is an important factor with the individual, Having a holistic approach with the individual will allow us to know the service user and so by doing this we able to support the individual as we obtain relevant information such as his religious and cultural background, circumstances and health state. We can obtain more information by contacting relatives and friends. Etc.17
When a decision has been made following a review meeting and that a revision is necessary, the key member should inform the person, or a person who is acting on behalf of the decision, if there isn’t any family or friends to help the individual to engage then an independent person or an advocate must be involved, when there is a new change or they are revising the plan they should follow the process used in the assessment and also in the care planning stages. 18
The roles and responsibilities of an employee must take safe measure in order to prevent and to control the spread of infection within the workplace, this includes working safely to protect yourself, visitors, staff and other individuals from infections. There are regulations and legislations that are associated with the control and prevention of infection. These are COSSH (control of substances that are hazardous to health), Health and safety work act (HASAWA) and when reporting a risk that is reporting the injury, disease, dangerous occurrences regulations (RIDDOR). It is very crucial that employee have knowledge of these regulations and legislations, as a result everyone can work safely. Every work place has to have a requirement of information that is provided in the health safety and COSHH file.
As an employee we must ensure that we attend essential trainings that our employer offer to do with infection control and prevention. Also to have the competence and have the confidence to spot bad or abuse practices and know who you must report to. Each employee has a duty of care to ensure safe ways of working and to put that into practice, i.e by effective hand washing, not to wear jewellery in order not to have cross-contamination, not coming into the workplace ill because as a result you’ll be putting vulnerable patients at risk. When it is areas where bacteria and viruses can thrive PPE must be worn in order for the employee to protect themselves and not to cause a risk to others, this can be in regards to giving personal care, handling or preparing food. 19
To help the providers of healthcare, others and adult social care, they plan and implement how they can prevent and control possible infections. The CQC includes criteria so that they can take into account when they are assessing with the registration requirement, also assessing compliance on the cleanliness and infection control.
The regulators, legislation and guidance that govern the control and infection prevention:
– Food Safety Act 1990
– COSHH 2001
– Health and safety at work act 1974
– RIDDOR 1995
– The environmental protection regulation 1991
– Health protecting agency bill
– The public health of infection diseases regulation 1988
– Hazardous waste regulations 2005
– NICE ( the national institute for health and clinical excellence)
The local and organisational policies that are relevant towards the prevention and control of infection are the public health (control of diseases) act 1984, the NICE guidelines, social care act, furthermore any other company procedures and polices that relate to the infection control and prevention. 20
The systems and procedures that are relevant towards the prevention of infection following the companies procedure and policy in which it relates to the correct hand washing procedure, cleaning equipment when have to clean equipment surfaces, equipment when cleaning equipment
The outbreak of any infection can be very fatal if care is not stopped and the infection has been prevented. For i.e if there is an outbreak of MRSA, that can be drug resistant to most antibiotics which can be fatal. When there is an outbreak of an infection it has consequences for staff member, individuals and to the organisation. Furthermore an outbreak can cause ill health to that all who are concerned, also this can impact emotionally because people who acquire infection relate it to being dirty, also some infection may require some people to be isolated from other people for a period of time, this is so the infection is reduced spreading. By having an infection outbreak the organisation could lose money if the majority of the work staff need to be off due to be sick which as a result the employer will need to employ more staff, however as well as paying for the new staff they are also paying the staff who are sick. Finally the organisation could be fined by not following the law and furthermore could damage the reputation. 21
The word risk means the exposure to the chance of loss or injury, a dangerous chance or a hazard, the hazard or chance of loss is the degree of probability of such loss, an individual with a reference to the hazard that is involved insuring him/her, the term risk means the likelihood of an activity becoming an hazard or causing harm.
Within the workplace the supporting individuals that have personal care activities and with sharing facilities that others can come into contact with bodily fluids that contain pathogens for infections. These can be:
– Cleaning areas in the workplace such as bathroom that are dirty also where bodily fluids are present may be more potentially contaminated with pathogens.
– Handling of disposing of clinical waste and emptying waste container, which can also be potentially carrying infected pathogens.
– Providing personal care and activities that have to require being close to the individual
– Handling bodily fluids increases the chance of the infections spreading
However sometimes support works can be exposed to high risk situations where the risk of infection with significantly higher when in the individuals home attending personal care.
The reason why we carry out a risk assessment is to make sure we are aware of the risks that are involved in any given activity and know how to remove or reduce the risk. Furthermore it also protects the organisations reputations as the risk assessment identifies what the risks in the work place is and how to put the measures in place to be controlled or to remove suck risks. Because of this risk assessments are crucial in the work place as they reduce the risks of accidents and the ill health of each employee and patient. When we create a risk assessment there are 5 main stages to be carried out in a risk assessment:
– Identify he hazard – this is what the hazards are and finding out what harm is caused from observing, also by speaking to visitors, individuals and staff.
– Evaluate the risks – this step involves in deciding who might be harmed also how and who is involved considering each person in the work place to individuals, visitors and staff
– Take precautions – this is to ensure what precautions are to be in place so that they can reduce, avoid and remove the hazards i.e wearing the correct PPE.
– Review the risks – the precautions that are effective in place should be checked routinely to ensure that they are correct and sufficient
– Record and report the outcome – this is to find out the risk assessment is to be recorded so that all who are involved need to know information on how the risks can be controlled or prevented.
The main reasons risk assessments are carried out is to make sure that no one can become ill or get hurt, injuries and ill health can ruin lives, and furthermore it can also affect the business if there is no output, when machinery or equipment is damaged. By carrying out these risk assessments we are creating and implementing a statement regarding safety, by keeping them both up to date however will not prevent accidents nor ill health but however they will be crucial part in reducing the likelihood of a risk.
Managers, supervisors and employees should make sure that all workplace practices can reflect the safety statements and risk assessments. The way in which everybody works they must reflect the safe working practices that are laid down. Supervisory audits and checks are to be carried out so that they can determine how the aims that are set down are being achieved. Any corrective action should be taken when it is required. Furthermore if a work place is provided for user by other users, the safety statement must also ensure the safe working practices are relevant to them, finally is it important that a risk assessment is to be carried out in preparation of a safety statement for:
– Legal reasons
– Moral and ethical reasons
– Financial reasons 22
It is a known fact that each individual’s mental health is unique, there will always different views how mental health can be perceived such as diet/fitness.
However whilst this and that is working for some it may not work for others, however there is a basic that we can used called skeleton form, which by using this we are able to build up what is best for the individual.
Mental well- being can be unstable and can be set off at any given time by excitement or trauma.
Influencing factors that can contribute to mental health:
– Family break ups or loss
– Difficult behaviours
– Physical ill health
– Abuse 23
Childhood and teenage hood are crucial parts of our lives, it makes who we are and makes our beliefs. Whether we choose to like it or not our whole life compares new problems and outcomes that is based on our past.
– Family that have divided and grown up
– Social beliefs i.e religions or other
– The community or state that you live in and how they accept you
– People who you socialise with, and how they see you ( health or drug orientated groups)
– Any health problems that run in family that can be in the present or in the path.
– Poor nutrition
– Drug abuse
– Taking toxins into the body
– Injuries that are not related to family history
– Ongoing psych illness
– Loss of a loved one
– Lack of self esteem