Health and Social care Unit 2

What are the National Organisations in the Public Sector?

• NHS England
• HSC Northern Ireland
• NHS Scotland
• NHS Wales

What is the NHS Foundation Trust?

• It's funded by the government
• An independent organisation
• It moves decision-making from the NHS to local communities

What is the Mental Health Foundation Trust?

• It's provided by the GP
• Support may be needed from specialist service providers
• It's managed by the community

What is the Community Health Foundation Trust?

• They work with the GP and the local authority social department to provide HSC support
• Services they may provide, include: health visiting, school nursing, walk in/urgent care centres, adult and community nursing services, and end of life care

How are GP Practices funded?

• They are funded according to their workload
• They can receive further payment from the NHS, if they are deemed as giving high quality service, or by the seniority of their patients or the length of time that they have been at the practice

What are the range of services that the Public Sector can offer?

• Primary Healthcare. This is provided by GPs, Dentists, Opticians & Pharmacists. There services are accessed directly by the service user when needed
• Secondary Healthcare. This is normally accessed by the GP, as they make the referral to a Consultant or other healthcare specialist
• Tertiary Healthcare. This provides specialist and complex services; e.g. hospice support, or help at a specialist spinal injury unit

What is the Independent Sector?

• This is commonly referred to as Third Sector Services, and these provide social services by the voluntary sector
• Key features, include: the use of volunteers for their services; their independent management (managed by central government or local authorities); not being run for personal profit - any income made is used within the service for its development
• Organisations within this sector, are usually funded through charitable donations and any central or local government help

What is NACRO?

• National Association for the Care and Resettlement of Offenders
• This association changes lives by designing and delivering its service to equip people with the skills, advice and support to move on

Who are MENCAP?

• They improve the lives of people with learning disabilities, along with their families
  -MENtally handiCAPped - MENCAP

What is Shelter?

• Shelter helps the homeless and those who are badly housed and struggling, by providing advice, support and legal services

Who is the NCVO?

• National Council for Voluntary Organisations
• They support and promote work for the voluntary sector

Who are Barnados?

They transform the lives of vulnerable children through the provision of services, campaigning, and research expertise

What is the Private Sector? And how is it funded?

• This is the other side of the healthcare sector that is fee-paying
• There are different aspects of private care providers, including: private schools, nursery and pre-school services, hospitals, domiciliary day care, residential and nursing homes for the elderly, and mental health services
• They are funded through: the fees paid directly by service users; payments made by health insurance companies (BUPA - subscription scheme); and through grants and other payments from central and local governments for services provided on their behalf

Who are AXA?

They provide help for people to protect their possessions, themselves and their families - insurance

What is BUPA?

• It is a not-for-profit private healthcare company
• They provide a broad range of healthcare services, support and advice to people throughout their lives

What is Domiciliary Care?

Care provided in the client's home to enable some independence. This could include: support with domestic tasks, or intimate personal care

Who provides Hospice Care?

• ACORNS: They provide care for children 0-18 years old, with life limiting or life threatening conditions, as well as support for their families
• St. Mary's Hospice: They help and support families throughout a patient's illness and after their death

What are Day Care Centres/Units?

• They provide a friendly, stimulating and supportive environment for people who would be socially isolated
• They serve: the elderly; people with disabilities, learning difficulties, mental health problems and specific conditions (e.g. Dementia)
• Providers of the service, include: voluntary providers, statutory providers, and private providers

Who gives care in the workplace?

Occupational Health are supposed to keep workforce's fit and healthy. This helps them carry out the duties that they are employed for

What are the 2 types of Care Homes?

• Residential Care - Provides help with personal care
• Nursing Homes - Provides personal care

What are some of the issues that affect access to HSC services?

• Community Care Assessment: This is a professional assessment carried out by a local authority, to determine the individuals need for care
• National Eligibility Criteria: This is where a criteria is applied to decide whether an individual is entitled to (financial) support from the local authority's social services department
• Some barriers include: language, finance, the lack of resources, communication, and the inconvenient location of services

What are the 3 types of referrals?

• Self-referral: This is when the individual contacts a care provider requesting help for themselves
• Third-Party referral: This is when someone you know contacts a HSC service on another person's behalf
• Professional referral: This is when a HCP contacts another service provider to request support for a service user - secondary health care

What are the responsibilities of organisations towards people who work in HSC settings?

• Meeting National Occupational Standards (NOS)
• Implementing Codes of Practice
• Supporting and safeguarding employees in HSC
• Undertaking continued professional development

What is the NOS?

• National Occupational Standards
• Standards of professional practice that are to be met in the workplace
• They underpin the Codes of Practice in care settings and curriculum for the training of practitioners standards, including the codes of practice for professional bodies

Why is it necessary to implement Codes of Practice?

• Health and Social Care Act (2008): This requires registered providers of care services to ensure that they have sufficient numbers that are qualified to meet the needs of its service users. The act also provides training and professional development to ensure that their staff carry out their role
• Social Care settings are required to complete an induction programme and meet the requirements of the Common Induction Standards (2010), in order to practice

What is the process for supporting and safeguarding HSC employees?

• Follow the protocols of regulatory bodies, such as the GMC - these provide protection for employees to ensure they meet the expected standards
• Internal and external complaints - Care organisations have professional organisations and inspection agencies to have formal procedures, in order to address complaints. Allegations of poor practice against staff are addressed by the organisation's internal disciplinary systems. More serious cases go to the regulatory bodies. In extreme situations, the police are informed
• Membership of trade unions/professional associations - these support staff, if they are accused of professional misconduct or if they are in a conflict in other ways with their employer

Why is it necessary for HSC staff to undertake continued professional development?

• It ensures everyone is following the best practices and the most up-to-date procedures
• It is the responsibility of care managers to ensure that support staff, that are not necessarily members, are also regularly updated, so that they can extend their skills

What policies are followed to prevent discrimination?

• Health and Safety
• Equality and Diversity
• Medication
• Safeguarding
• Disclosing and Barring Service (DBS) referral policy
• Death of a Resident procedure
• Complaints

What does the Human Rights Act 1998 guarantee?

The right to:

• Access to an education
• Life
• Freedom from torture and inhuman or degrading treatment or punishment
• Freedom from slavery, servitude, and forced or compulsory labour
• Liberty and security of person
• Respect for a private and family life, home and correspondence
• Freedom of thought, conscience and religion
• Freedom of expression
• Marry and found a family
• Peaceful enjoyment of possessions and protection of property

What does the Equality Act 2010 prevent discrimination of?

• Age
• Disability
• Gender reassignment
• Marriage and civil partnerships
• Pregnancy and maternity
• Race
• Religion or belief (including lack of belief)
• Sex
• Sexual orientation

Information on following policies and procedures in HSC

• Provide to meet the service users' needs
• Aim to ensure that all staff work within the law and to the highest professional standards possible
• Always apply the care values and principles
• Promote anti-discriminatory practice ~ a care service that meets the needs of all individuals
• Keep everyone safe
• Maintain confidentiality and privacy
• Have a value system that underpins the care practice
• Have good communication between the provider and the service user
• Empower individuals ~ enable them to take control of their own lives and decisions, related to their care

How does personal care differ between religions?

• Muslims - Prefer to use bidet, over paper and shower in running water. Strongly prefer to be treated and supported by the same sex. They don't eat pork. However, they do eat halal products
• Hindus - Prefer to use bidet, over paper and shower in running water. Strongly prefer to be treated and supported by the same sex. Don't eat beef
• Sikhs - Don't normally cut their hair. Don't eat beef
• Jews - They don't eat pork. However, they do eat Kosher foods
• Rastafarian's - Don't normally cut their hair

Who can prescribe medication?

• Doctors
• Nurse Prescribers
• Dentists
• Chiropodists and Physiotherapists (in certain circumstances)

What staff are involved in general post-operative care?

• District Nurses monitor progress and provide specific treatment
• Physiotherapists and Occupational Therapists (OTs) support mobility and promote independence in daily living

Who are involved in organ transplant post-operative care?

• Specialist Nurses
• Physiotherapists
• Occupational Therapists
• Counsellors
• Social Workers, etc.

What goes into rehabilitation?

The specific programme will vary according to the individual's:

• Physical and psychological needs
• Home
• Family circumstances
• Level of support from their family, friends and carers
• Support from medicinal background, e.g. Physiotherapists, Occupational Therapists, Counsellors, and Psychotherapists

What are some of the equipment and adaptations that individuals may need to increase their independence?

• Walking sticks
• Walking frames, e.g. Tripods and Tetrapods
• Wheelchairs
• Adapted shopping trolleys
• Stair lifts
• Adapted cars
• Walk-in baths and showers
• Bath and shower seats
• Raised toilet seats for service users who find it difficult to sit down and stand up again
• Hand rails
• Non-slip bathmats
• Adapted taps
• Special cutlery - for those with Arthritis
• Feeding cups
• Angled straws
• Egg cups and plates with suctioned bottoms
• Special gadgets to help people who can only use one hand to take the lids off jars and tins, and others to help with peeling potatoes and buttering bread, kettles on tipping stands and adapted plugs to help with using electrical appliances
• Special dining chairs and armchairs adapted to meet individual's needs
• Kettle tipping device + Water level alarm in cups
• Computers for the visually impaired & blind
• Wheelchair access to all learning spaces and additional time in exams for those with dyslexia - supports educational achievements

What needs have to be supported in daily life?

• Physical
• Intellectual
• Emotional
• Social (PIES)
• Plus, educational and spiritual

What client information do HCPs have to be aware of?

• Their work
• The community in which the client lives in
• Family circumstances
• Their financial position
• Their interests
• Their hobbies
• Their aspirations

What is Informal Care?

This is the care and support provided by relatives and friends. It is normally unpaid and in addition to any care provided by HCPs

What is the Care Plan Cycle?

1. ASSESS the client's needs
2. PLAN and, where possible, AGREE the most appropriate care
3. IMPLEMENT the care plan
4. MONITOR the effectiveness of the plan
5. REVIEW and EVALUATE the effectiveness of the plan
6. AMEND the plan as necessary
7. REPEAT all 6 steps

What is an Occupational Therapist?

They provide support and equipment for people who are having difficulties carrying out practical activities in everyday life

What is a Social Worker?

They provide support for people through difficult times in their lives

• In the Children + Young People's Service, they ensure that individuals are safe and protected from abuse
• In the Adult Services, they support individuals to live independently or in residential care

What is a Care Assistant's role and responsibilities?

Role: To provide support for people who have difficulties with everyday tasks in a range of settings (clients' homes, day care centres, residential or nursing homes, and supported or sheltered housing complexes)

Responsibilities:

• Helping with general household tasks
• Helping with personal care
• Communicating with other HCPs

What is a Youth Worker's role and responsibilities?

Role: To support young people (11-25 year olds) to reach their full potential and to become responsible for members of society

Responsibilities:

• Running programmes, e.g. smoking awareness
• Running sports teams

They may be employed by the local council but youth workers are also employed by a range of religious and other voluntary organisations

What is a Doctor's role and responsibilities?

Role: To provide specialist medical care

• Consultants (senior) - Specialise in a particular field of medicine
• GPs - Provides care for people in the community

Responsibilities:

• Discuss and agree treatment plans for individuals
• Diagnose illnesses
• Monitor the impact of treatment

What is a Support Worker's role and responsibilities?

Role: To provide support with financial management (a personal budget) and domestic skills

Responsibilities:

• Helping with general household tasks
• Filling in and sending off cheques and letters

What is a Midwife's role and responsibilities?

Role: To support women through and after pregnancy (antenatal care and postnatal care)

Responsibilities:

• To teach mothers how to feed and bathe their babies
• Identify high risk pregnancies

What is a Healthcare Assistant's role and responsibilities?

Role: To provide support for people that have difficulties with everyday tasks

Responsibilities:

• Taking and recording patients' temperature, pulse and weight
• Washing and dressing patients
• Serving meals and assisting with feeding if needed

They are sometimes known as nursing assistants or auxiliary nurse

What is a Health Visitor's role and responsibilities?

Role: Working with children (0-5 year olds) to ensure they get the best start in life

Responsibilities: Assessing: parenting skills; home and family situation; and the development needs for the child

What is a Care Manager?

They are a key leadership role in residential settings, and they manage residential care for:

• Adults with learning disabilities
• People in supported housing

What is a District Nurse's role and responsibilities?

Role: To visit patients at home, providing both support and advice

Responsibilities:

• Assessing the needs of the patient
• Monitoring the quality of care that the patients receive
• They commonly care for the elderly

What is a Neonatal Nurse's role and responsibilities?

Role: To care for newborn babies that are premature or sick

Responsibilities:

• Managing a baby's fluids
• Preparing and checking medications
• Recording observations and documenting a baby's care

What is a Mental Health Nurse's role and responsibilities?

Role: To support individuals in their recovery

Responsibilities: Planning and providing medical care to people who are suffering from mental health illnesses

What is a Children's Nurse's role and responsibilities?

Role: To provide care and support for the child and their family

Responsibilities:

• Treating wounds
• Providing pre-operative and post-operative care
• Playing with the children

What is a Nurse Practitioner's role and responsibilities?

Also known as a Practice Nurse

Role: To look after the patients

Responsibilities:

• Prescribe medication
• Treat illnesses
• Administer physical exams

What is an Adult Nurse's role and responsibilities?

Role: To provide care for adults

Responsibilities:

• Writing care plans and records
• Dealing with medical emergencies

What is a School Nurse's role and responsibilities?

Role:

• To prevent illness
• To promote a healthy lifestyle

Responsibilities:

• Carrying our health assessments
• Advising schools on their public health agendas

They are usually employed by the NHS but may be employed directly by a school

How to ensure safety is upheld in HSC settings?

• Have a robust health and safety policy
• Have someone with official responsibility for health and safety at the setting
• Undertake a risk assessment
• Take action to reduce the likeliness of harm or injury at the setting
• Provide up-to-date information on health and safety issues
• Provide health and safety equipment to carry out all procedures and treatments
• Provide health and safety training
• Keeping a record of all accidents and incidents that have taken place at the setting
• Have the relevant safeguarding policies in place to protect all individuals
• Ensure employers look out for their own and their staffs safety and wellbeing
• Getting staff to work together to provide the best care of the patient
• Not intentionally damaging equipment, e.g. lifts
• Washing hands before and after any contact with equipment or individuals
• Wearing an apron and gloves, in case of contact with bodily fluids
• Safely handling and disposing of sharp articles - yellow sharps box!

What are the Care Value Base's 3 main standards for health and social care?

1. Fostering equality and diversity
2. Fostering people's rights and responsibilities
3. Maintaining the confidentiality of information

What does the Data Protection Act 1998 state?

That data must:

• Be accurate and up-to-date
• Be collected and used honestly and fairly
• Be used only for the reasons it has been given
• Be sufficient to meet the needs of the organisation
• Not be passed on to other organisations without permission
• Not be kept longer than is necessary
• Be kept safe and secure
• Not be passed to countries without data protection laws

The Data Protection Act 1998 dictates the rules of holding and processing personal information, both in electronic and paper records.
A modern feature of this was in 2016/2018 with the GDPR changes - General Data Protection Regulation (GDPR)

How does someone deal with conflict in a HSC setting?

• Tension and conflict between service users, and between service users and their carers, is sadly very common
• Conflict may erupt in any care setting
• If you are a HCP and work alone, there should be a lone workers' policy in place with specific guidance for dealing with any situation where you feel vulnerable, such as dealing with conflict and aggressive behaviour.
  Challenging behaviour is seen as a risk, as it can hurt anyone.
• Listen carefully
• Stay calm
• Try to see both sides of the argument/issue
• Never resort to aggressive behaviour

If a situation gets violent… make sure you know where the doors/exits are; remove anything that can be used as a weapon; and call for help!

How do you empower individuals?

• Promote and support their rights to dignity and independence - this can boost their self-esteem
• Promote individualised care - care that meets the specific needs of each patient
• Provide support with their beliefs and cultures, as HSC is a multi-cultural society. Specific needs must be met, in regards to: languages, traditions, beliefs, and diets. There may be challenges from this however, including: patients speaking little/no English; the provision of a wide range of foods; and religious observances

How do you promote anti-discriminatory practice?

Ensure the patients care is provided, regardless of:

• Race
• Ethnicity
• Age
• Disability
• Sexual Orientation
• The prejudices of staff or other service users are appropriately challenged
  ^ The Equality Act 2010

Anti-discrimination involves the promotion of equal opportunities and challenging discrimination in the workplace

What are HSC workers required to do?

• Address their own prejudices and adapt their behaviour
• Understand and meet the patients' needs
• Actively challenge any discrimination against patients
• Ensure the setting is welcoming and accessible
• Celebrate the contribution of a wide range of peoples
• Compensate for the negative effects of discrimination in society

What is Multidisciplinary Care?

The combination or involvement of several academic disciplines or professional specialisations in an approach to a topic or problem. Partnership working would include:

• The need for joined-up working with other service providers
• The ways service users, carers and advocates are involved in planning, decision-making and support with other service providers
• Holistic approaches

What is the Holistic Approach?

• Looking at the whole being; both inside and out
• Critical information that needs to be passed on in order to provide emergency care for the wellbeing of the service
• When HCPs must consider PIES (+ spiritual) while planning

What are the GMC Codes of Practice?

GMC - General Medical Council (for Doctors)

• To help to protect patients
• To improve medical education and practice across the UK

How they deliver the role:

• By setting the standards for doctors
• By overseeing doctors education and training
• By managing the UK's medical register
• By investigating and acting upon concerns about doctors
• By helping to raise standards through revalidation

What are the NMC Codes of Practice?

NMC - Nursing and Midwifery Council (for Nurses and Midwives)

A set of standards that patients and members of the public tell the council what they expect from healthcare professionals. They are:

• To respect people's right to privacy and confidentiality
• To treat people as individuals and uphold their dignity
• To listen to people and respond to their preferences and concerns

What are the general Codes of Conduct in HSC?

• To set the standards for social workers
• To help workers provide high quality, safe and compassionate care and support
• To outline the correct behaviour and attitude ~ for those who use care and support should rightly expect
• It is mandatory

What is the Care Certificate?

It was introduced for HSC workers who did not fall under or were members of the specific regulated professional bodies.

• It sets the standards for HSC workers in their daily working life
• It's not a statutory requirement to join

What is Whistleblowing?

It is the situation in which an employee reports poor or dangerous practice at their workplace to the press or to another organisation outside of their setting
For example, the BBC Panorama case at Winterbourne View Care Home

What is the positive behind Service User Feedback?

It enables the service to improve their facilities for patients, so that they can get the best care possible

When are Criminal Investigations necessary?

In the most EXTREME circumstances! E.g. physical, sexual, emotional, or financial abuse

What is the Line Management responsible for?

Managing the work of individuals and addressing any issues with staff, by taking appropriate action