7.1 – Understand person-centred approaches in adult social care
1.1 – Describe person-centred approaches
The person-centred approach is about providing the care and support that is centred and focused around an individual’s needs. It encompasses not only their physical or mental needs but also their culture, ways in which the individual communicates, their family and professionals input. It also focuses on what their likes and dislikes are.
I have looked into this and have found that there are eight values that work to support the person-centred care approach. These are:
While some of these are obvious, some are not and had I not been working in the environment I work in now I would most probably not be aware of these.
Even twins with the same diagnosis must have the values of person-centred care applied to their care and support packages. They will have very different care packages as they have their own free will of choice. They will have their own individuality and independence.
1.2 – Explain why person-centred values must influence all aspects of social care work
It is essential that the person-centred values be adhered to when caring and supporting an individual. While many people like family, friends and professionals may know an individual very well, it is truly only the individual themselves that know what they like and dislike and how they wish to be cared for. It is also important that the individual knows what their rights are when they are faced with having someone else care or support them. This will help them make decisions and choices throughout the time they are being cared for.
The level of the care and support would also depend on the individual’s ability both physically and mentally. Although their abilities may affect their care packages they should still have the same freedom as other human beings to make their own decisions, treated with the equal respect and dignity and given the same rights of choice and privacy.
Another aspect to consider when caring or supporting for an individual is their financial situation and constrictions.
1.3 – Explain how person-centred values should influence all aspects of social care work
If we look at some of values of person-centred care, we can expand on them to reflect what should be considered when supporting or caring for an individual.
Individuality – An individual should be allowed and supported to make their own decisions with the care and support packages tailored to the individual’s specific needs. The individual should never be expected to mould their choices or decisions to suit a care provider or support worker. Assumptions should never be made about and individual and personal beliefs should always be respected.
Independence – No matter how small a task is an individual must always be given the appropriate level of support to be able to complete this task as best they can as long as their dignity is preserved.
Privacy – An individual must always have their privacy respected, some environments may offer different levels or challenges for privacy, for example in a care setting the privacy would be different from that in your own home.
Choice – As mentioned before each individual must be allowed and supported to make their own choices and decisions. During the support it is essential that the individual is thoroughly given the appropriate information to be able to make an informed choice. A support worker or carer should endeavour to not make a choice for an individual just because it is easier or faster or based on their own beliefs or preferences. The individual must be consoled during the decision making process when forming their care or support package.
Dignity – A sense of dignity is important to all individuals; it gives us a sense of our place or importance in the wider community. At all stages during an individual’s care dignity must be paramount, it what makes us feel respected. Something as simple as asking an individual how they wish to be addressed can go a long way to retaining an individual’s dignity. In a more traditional care setting like a nursing home the situation may arise where you are asked to help a resident bath or shower, in these circumstances it is important to cover the resident with a towel or similar to ensure they are not easily seen by yourself or other residents/staff.
Respect – always show an individual that you support them in what the feel or believe is important. Their age, culture gender, beliefs, or sexual orientation should always be taken into consideration.
7.2 – Understand how to implement a person-centred approach in an adult social care setting
2.1 – Explain how finding out the history, preferences, wishes and needs of an individual contributes to their care plan
The care plan is always based around an individual and is about their needs, preferences and wishes. Only by building a knowledge of an individual can a care plan focused on person-centred care can be efficient and contribute to successful care and support of an individual. The care plan should also be able to provide any new starters or other care homes, in the case of a transfer, the information required to provide consistent and equal care to an individual.
2.2 – Describe ways to put person-centred values into practice in a complex or sensitive situation
There are many situations that can be considered complex or sensitive, some are:
• Traumatic or distressing
• Communication complications or physical needs
• Threatening or frightening
• Result in serious implication of a personal nature
The care plan should always highlight if these situations may arise, whether it is through history or through a risk assessment. This will help to avoid the situations that can be avoided, some cannot.
Information should be provided to support workers or carers that help to calm or de-escalate an individual facing these types of situations. Again this should be developed and formed with individual when building their care or support plan. After all they will know what is best for them in this kind of situation. If an individual suffers from a cognitive or speech problem, then professionals or family may also be consulted as they will also know the individual very well.
2.3 – Evaluate the use of care plans in applying person-centred values
A care plan should contain a lot of information for an individual:
• Family contacts
• Risk assessments
• Medical history
• Medications lists
Mainly the care plan will summarise the wishes and needs for an individual and the way that they wish for their care and support to be carried out. The care plan is the main document that will assist in the day to day care of an individual and should be considered one of the greatest tools for a support worker or carer to have to refer to.
2.4 – Explain the importance of monitoring an individual’s changing needs or preferences
One true fact of life is that people change, we very rarely always have the same needs and desires. I have noticed since working in Mental Health care that this statement could not be truer. An individual may one day prefer to be seen by one specific member of staff and the next it may be very different. This can mainly be contributed to that individual’s mental health, but not in all circumstances. Another example is tastes, an individual may have a specific desire for a particular type of food or fashion, this can change very quickly or over time. I have found that sometimes medication can even have an effect on this also.
It is important to recognise these changes no matter how small, the individuals care plan should be updated to support this. At Kemps place we have daily progress notes, this is the perfect opportunity to update other staff of any changes in an individual’s preferences or desires. We as carers have a responsibility to take down this information and to make sure that we are up to date regularly so we can continue to provide the care that is required.
Sometimes an individual may change their mind frequently, for example one of our residents at Kemps Place may inform us regularly that she no longer wishes to have any member of her family put through to her phone in her flat, this always depends on any recent conversations that she has had with them. Due to her mental illness this can change quite often throughout the day. Although we may not understand why this is we must take these requests serious as not doing so may have a detrimental effect on her mental health and will also affect her relationship with staff.
Other examples of changes in an individual’s preferences or needs that can affect their care plan may include:
• Social interaction
7.3 – Understand the importance of establishing consent when providing care or support
3.1 – Describe factors that influence the capacity of an individual to express consent
Factors that may influence the capacity of an individual are:
• Level of engagement or participation
• Choice awareness
• Mental health state or capacity
• Physical condition or communication
3.2 – Explain how to establish consent for an activity or action
Legally consent must be given before an activity or treatment can be carried out. Not only does this ensure the individual is being respected it also protects both the individual and staff member. It also goes a long way to developing trust between an individual and staff.
The individual is more likely to take part in an activity or less likely to refuse treatment if they feel that they are being taken seriously and that their wishes are being respected. The individual must always be given all the information they need to be able to make the choice whether or not they wish to consent to such an activity or treatment that they are consenting to.
3.3 – Explain what steps to take if consent cannot be readily established
We must always ensure that we understand the individual’s needs, preferences, ability to make decisions, health condition and try and make sure that we have the relevant information to hand that the individual can understand and that we ourselves understand this information.
7.4 – Understand how to implement and promote active participation
4.1 – Explain the principles of active participation
An individual is regarded as an active partner in their own care and support. They are not to be considered as a passive recipient. We must recognise the individuals rights to participate in the activities and relationships of day to day life as independently as possible.
4.2 – Explain how the holistic needs of an individual can be addressed by active participation
When building a care plan it is essential the individual gets the opportunity to choose ways they wish to live their life and in ways that are important to them. They should be able to choose their own lifestyle and to choose activities that they want to participate in. In doing so their care plan will be extremely effective and gives a better understanding of an individual.
4.3 – Explain how to work with an individual and others to agree how active participation will be implemented
Working with an individual is essential, active participation can be implemented in the following ways:
• Providing information and choice
• Discussing the activity and encourage the individual – highlight benefits
• Ensure the activity is appropriate
• Using appropriate persuasion techniques
• Use peer group or family to help encourage
4.4 – Explain how to promote the understanding and use of active participation
At Kemps Place we have a list of activities for each day of the week, we always consider an individual’s physical, mental and even financial constraints when considering an activity. Some activities are in house like baking or arts and crafts and others are outside like seaside walks or some sports activities in a local park.
We actively help individuals locate and discover activities that might appeal to their interests. We also help them enrol on discount schemes so we can try and eliminate any financial constraints that they may have, in some cases we have paid for an individual as we may feel that a particular activity might really bring them enjoyment and thus benefit their mental health. We have also encouraged individuals to think of their own groups or activities and will support them in any that they may wish to run in house.
Once we have a list of activities we always ensure that we explain in full what the individual might expect to achieve or get from such an activity.
7.5 – Understand how to support an individual’s right to make choices
5.1 – Describe different approaches to support an individual to make informed choices
To support an individual in making informed choices we can discuss that possible choices and outcomes or risks, if any, of a decision they are able to make. If relevant we can provide any information that we can get hold of to inform them in full of their choices. We can also suggest that an individual speaks to their friends, family and professionals as they may also have further information. Sometimes and advocate or external support service might be asked to speak with an individual so they know they are getting impartial information.
Sometimes this can be difficult. For example, I was a key worker to a resident, he was given up as a baby many years ago and had just recently made contact with his biological brothers and sisters. I was not aware of this at the time but they were discussing with him the possibility of meeting his biological mother. At this stage had I known I would have made several suggestions. I would have first of all suggested that he discussed this with his social worker and care team. He had a long history of severe mental health problems and was doing very well at Kemps Place.
My thinking behind this was that he was a delicate, humble person. I knew that his mother had giving him up as a baby was something that he struggled with throughout his younger years and in many ways was the reason for him becoming mentally ill.
Sadly, this did not happen and he met his mother. From what he told me it was very awkward and he felt angry at the time but did well to hide this. He wasn’t able to have a decent conversation with her as a result. Had a professional from his tem been made aware they could have arranged for a more neutral environment and mediation to take place. Hopefully this would have made it easier for him to converse with his mother and a stronger relationship could have been formed from that day forward.
This is an example where consulting with family only may not have been the best thing to do.
5.2 – Describe how to support an individual to question or challenge decisions concerning them that are made by others
Sometimes people are involved in the decisions that are made for others, they may include:
• Social workers
• General Practitioner
• Health Professional or specialists (Occupational Therapists, Nurse etc.)
• Family and carers
The decisions made by these people may not always be correct or as per their individual wishes. It is our duty as carers and support workers to ensure the individual is encouraged to ask questions and make comments freely. We must make sure we are prepared to speak with a senior member of staff if we are not sure and also refer the individual to them if we are not able to help them. We should always listen to their concerns no matter how trivial as it is still their right to have concerns or comments regarding decisions made that may affect their care.
Sometimes an individual may want to ask for a second opinion, which is well within their rights, we must make sure we can help them obtain a second opinion when and where possible.
5.3 – Explain the consequences of allowing the personal views of others to influence an individual’s choices
If an individual’s preferences, needs and wishes are not taken into consideration it can lead to stress, low self-esteem, low motivation, lack of choices and even abuse.
There needs may also not be met.
7.6 – Understand how to promote an individual’s well-being
6.1 – Explain the links between identity, self-image and self-esteem
An identity is who we are to ourselves, others around us and our peers. An individual’s identity is formed depending on the relationship with significant others like parents, close friends and even from popular media. In this modern day it can also be influenced by others on social media.
This can tie in with our self-image or the view of ourselves and who we want to be or want others to see us as. Self-image usually encapsulates the external factors, for example our weight, height, gender and hair colour. Very often we make decision on whether we are attractive or not often not taking into account the thoughts of others or even disregarding them.
Linking in with self-image the self-esteem is often a self-evaluation of ourselves and comparing this to how we want to be or how we want to look to how we look. Self-esteem is often how we think others think about us. Our worthiness is often evaluated by ourselves and depending on the results of such a self-evaluation can have an effect on our
6.2 – Explain factors that contribute to the well-being of an individual
Being healthy, happy and comfortable is regarded as well-being. As discussed in this unit so far the possible factors that contribute to this are:
• Being able to make our own choices
• Great communication
• Active Participation
• Being treated like an individual
• Being treated like others with respect and dignity
• Being able to lead a healthy life
6.3 – Explain the importance of supporting an individual in a way that promotes their sense of identity, self-image and self-esteem
Identity, self-image and self-esteem is who we are, how we see ourselves and how we feel about ourselves. When combined makes the individual who they are as a person and separates us as individuals from others.
All of these factors, when combined positively lead to a healthier well-being. So therefore it is obvious that as a carer or support worker we must promote these factors and support an individual in achieving their positive image of themselves. We must respect that everyone is different and treat them with the dignity that they deserve and where possible help them to achieve their goals that may lead to this.
Any negative factors will have a knock on effect with the others thus leading to a less healthier well-being, in some circumstances this can be dangerous also for example: self-harm, aggression etc.
6.4 – Describe ways to contribute to an environment that promotes well-being
When thinking of the environments surrounding an individual I can think of mainly two. The physical environment, for example an individual’s living area: Bedroom, flat or house, furniture and personal affects.
Also their social environment for example: relationships, personal space or boundaries and feelings.
We can support an individual with their physical and social environment by supporting them with things like: cleaning, ensuring furniture is in good condition, protection from abuse of any nature, they are treated with respect, given privacy, encourage them in active participation, good communication, help them to maintain their current relationships and form new ones and many others, the list is almost endless.
7.7 – Understand the role of risk assessment in enabling a person-centred approach
7.1 – Compare different uses of risk assessment in adult social care settings
Risk assessments in adult social care are used in many areas and are essential. They are used for many reasons, some being: to meet legal requirements, prevent injury by accident or deliberate to service users and care workers and to outline steps and procedures.
A risk assessment can be carried out on an individual when considering their mobility, personal hygiene, challenging or difficult behaviours, personal habits like walking around with no shoes and socks and when taking them on outings or arranging an activity of any nature.
7.2 – Explain how risk assessment relates to rights and responsibilities
As mentioned before, risk assessments are a legal requirement and relates to the rights and responsibilities of people in the care environment. For example, the manager of a care home or person in charge of an individual’s care must acknowledge the risks that are associated with caring for a specific individual and that steps are taken to reduce them where possible.
Risk assessments can also be used to prevent harm or danger to an individual, not only a service user but also care workers. Factors such as mobility, personal hygiene behaviour can have a major effect on the way that an individual’s care is provided. This can then be used to prevent further harm to an individual.
Another possible and popular use for risk assessments is to give instruction and give clear outlines. As the risk assessment highlights the risks it can also be used to ascertain any solutions in handling the associated risk and allow the clear guidance to be formulated as a result.
7.3 – Explain how risk-taking relates to rights and responsibilities
Risk taking is linked in with rights and responsibilities in several ways. For example, am individual may enjoy a fry-up every morning and eat lots of sugary foods and drinks throughout their day, if the individual is already obese and suffering from diabetes as a result, they still have the right to make the choice to continue to live this lifestyle because of their freedom of choice. The same can be said for smoking.
Independence is also another right that an individual has. If a service user decides that they want to carry out a risky task like find their own way to a city centre without staff input then they can, despite the high possibility that they may get confused and lost and become vulnerable as result. We only have the responsibility to advise them, we cannot stop them from doing so.
7.4 – Explain why risk assessments need to be regularly revised
Risk assessments must be regularly revised to ensure that they are up to date, risks are not always permanent and can change entirely or even in their severity depending on needs, preferences or ability. New risks may also be highlighted. Not to mention a person’s environment may change resulting in a potentially significant change in risk.
7.5 – Explain the importance of using agreed risk assessment processes to support choice
It is our responsibilities as carers to ensure the individual has choice. Risk assessments should be used to support a care worker in providing the information necessary for an individual to make informed choices in a safe way.
If an individual decides to take on a high risk decision or choice, we can ask then to sign a risk assessment surrounding that activity so it can show that we have highlighted the risk to them and that they have decided to go ahead regardless.
This provides care companies and professionals with due diligence and significant degree of protection should something go wrong.