Confidentiality is maintained as only the information that the client wishes to share is disclosed, the information that is in the life books is done so with the client, their family or advocate.
Effective communication is improved, in Wendy’s case her limited verbal communication could lead to frustration if she was unable to make herself understood. The life-story book mean’t that I was able to ask questions about things I knew interested her. I was also able to carry out actives with her that I knew she would enjoy and I didn’t upset her by saying or doing this that I was aware she didn’t like.
By being aware of, an individuals likes and dislike anti-discriminatory practice should be prevented. Each client is treated as an individual their likes dislikes are acknowledge. The life book gives the client control because the carer as knowledge about the things that the client, likes to do the way they like to dress etc.
I felt that the life books helped to empower the client. Some of the service users had aphasia but were able to show new staff their books this mean’t that their individual needs could still be met.
The staff that I observe supporting Wendy knew her well and were able to respect her individual choice, identity culture and beliefs, for me as a volunteer only spending a short amount of time with her, I felt that the life book had given me a good insight to her needs, likes and dislikes which mean’s that I too was able to offer her choices that I knew she would enjoy.
The nursing home in which I worked was run by an organisation called New Era their philosophy states that the following principles govern the service that they provide to their service users.
1. People with a learning disability have the same rights as any other individual and should have equal access to community services.
2. Relationships are valued by society as a whole, and the service places emphasis on facilitating the development of relationships for all services users, between services users, staff and the community.
3. Services users are encouraged and supported to make informed choices, promoting increased control over their lives.
4. Promoting self-reliance the service will encourage and support individuals in their attempts to acquire everyday living skill.
5. Service delivery will at all times respect a tenant’s dignity and right to privacy.
The service users that I met participated in a wide range of activities. For example, going shopping, swimming, riding, hill walking, painting, keep fit, Lunch clubs, snoezelen, gardening and many other activities geared to meet their individual needs.
I personally felt that a positive care value base was being achieved, I also developed a questionnaire to give to the staff to ascertain who they felt they created a positive care environment, see over page.
Whenever a person is receiving care there can be a tendency for the carer to take over and make decisions for the client. There is also a tendency to assume that the needs of the care organisation take precedence over the needs of the client. Carers can ignore the client and ask the relatives questions that could be answered by the client. The health and safety of clients is a key area where there is a shared responsibility between the client and the carer. Where a client is highly dependent on the carer for support, then the carer also takes on more responsibility for health and safety. However, where a client is able to take responsibilities she/he should be encouraged to do so.
The recognition of rights and choice is important.
It is important to encourage individuals to express their needs and wishes.
Individuals should be encouraged to be as self-managing as possible.
In the care home I witness clients been actively involved in all aspects of their daily life. From choosing whether to wash in a morning, what to wear the food they eat and the activities they took part in. However most of these clients had communication problems. The care workers actively sort ways to overcome the barriers that lack of verbal communication might cause. The use of sigh language, body language, in particular facial expression and sound, where used. By not acknowledging a individuals wishes the carer can cause loss of self esteem and disempowerment for the client, and have the effect of increasing client dependence on the carer. They also cause physiological changes leading to increased risk of illness and depression, the carer can help to prevent this by:
Challenging discrimination whenever and wherever it occurs.
Strive is maintain client dignity.
Promote client independence.
Maximise client choice and assist them to speak up for themselves
Maintain client confidentiality and promote trust.
Work to ensure and maintain a safe environment.
Maintaining confidentiality
If a care worker is to be trusted by the client then the person will expect information not to be passed on to others. This area creates some professional conflicts because the information given by the client may mean that the client or someone else is at risk. In most cases it is essential that the client knows what you intend to do with any information before it is passed on to you. Each individual agency will have its own specific policies. Most agencies have a code of practice which says that confidentiality could not be maintained if what the clients says is deemed a danger to the client or to another person.
Confidentiality is important.
An individual’s choice regarding confidentiality should be respected as far as possible.
Who will have access to information should be established at the first meeting.
Legislation
Legislation relating to confidentiality:
The Data Protection Act 1989
The Access to Personal Files Act 1987
The Access to Health Record Act 1990
Brief
I am a first year a level student. As part of my course you an required to conduct some research into care values and how they are achieved in care settings. I would be very grateful if you could take the time to fill in my questionnaire. There is no need to state your name as confidentiality will be maintained, thank you.
Questionnaire
- How is confidentially maintained in your work place?
- How do you achieve effective communication when most of your clients have language barriers?
- Do you feel anti-discriminatory practice is achieved in your work of place and how?
- How do you empower your clients?
- Do you belief that each individual is able to have individual choice and that their identity, culture and beliefs are met?
AO2
The potential barriers experienced by service users when accessing services, and the effects of these barriers
There are many barriers that can prevent people accessing services, these include:
Geographical factors
Financial constraints
Physiological factors
Physical problems
Resources
Language and communication
The effect of such barriers may include:
Reduced life chances
Discrimination
Disempowerment
Marginalisation
Oppression
Low self esteem
For the purpose of this unit I have decided to look at the effects of financial constraints, language barriers and geographical and physical barriers.
As I worked in a primary school for one of my placements I decided to look at the effects of poverty on young children and their families. The school in which I worked was a Church of England School and as such did not have a ‘Catchment area’.
A child’s early years of life could be said to be one of the most physiological, psychological and emotional susceptible stages of their development. It is at this stage that the effects of poverty on issues such as, health, social well-being, education, family life and housing conditions have an ever-lasting influence on the child. “Problems during childhood cast long shadows into adulthood” (Acheson1999).
At the time of writing their as been much in the media about the growing number of young children in the UK living in poverty, but what is poverty? Townsend 1979 says “Persons are beset by poverty when, resources are so small as to exclude them from the minimum acceptable way of life of the Member State in which they live. Townsend’s definition implies to the reader that it is the members of the state, which define or set the parameters of poverty, it is not they who set the ‘minimum acceptable way of life’ But what of the child, who sets the parameters for them, or is it the circumstances that they are born into that, exemplifies their status?.
So what expectations do parents have for their children? A good education for many parents is in all probability a priority. But evidence shows that for the poorest of the population this is not being attained. ‘Sure start’ is a government initiative aimed at selected areas of recognised underachievement and poverty with proposal to prevent learning difficulties in the first place by focusing on children from birth to three. However do are families stigmatised by living in a ‘sure start’ area, is this admitting to living in an area of poverty and disadvantage and as a result are such family likely to take advantages of the facilities on offer?
The health of a family is seriously affected by poverty, poor housing can impact on a child’s health, cold damp housing can result in respiratory problems. A healthy diet is difficult to achieve as ‘healthier’ food items cost more. There is considerable evidence that, meals supplied by parents from low income families is not offered due to lack of knowledge of a healthier diet, but mainly due to cost and the consideration of wastages. The consequences of an inadequate diet can have severe affects on the growth and development of young children that in later life can be linked to coronary heart disease.
Shopping, considered by some as a pleasurable family experience, can become a nightmare for these families. Young children accompanying parents on shopping trips demanding toys and sweets can put a substantial burden on the parents. Considerable social and psychological pressure is also felt by parents for not providing what could be seen as the ‘normal’ young child’s wants and demands leading to potential detrimental affects on the family unit.
Communicate is the thing that the majority of us do continually throughout our waking hours. So how would we feel if we were unable to communicate our needs, couldn’t make our selves understood?
Isolated, angry, helpless, paranoid, confused, inadequate, ignored are a few words to describe how we may feel. The people in the care setting in which I worked had very restricted communication skills and I guess some of the words I have listed above must describe some of their feelings on a daily basis. So it is not surprising that many people with learning disabilities either give up communicating and are then described as withdrawn, uncooperative or develop behaviours which are regarded as difficult or challenging. These may be simply a response to the frustration of having limited communication skills, or the challenging behaviour may be the only effective way the person has of making sure they are’ listened to’. Communication is a central factor in almost everything we do in life. If for any reason we cannot communicate effectively, it is a barrier to:
Making relationships;
Learning new skills;
Having our needs met;
Making choices;
Projecting our own identity and personality;
Taking part in family, community, leisure pursuits;
Making sense of the world;
For these reasons, developing a person’s communication skills should be a priority, and will almost certainly be done most effectively in their everyday environment, with care staff and family members they are familiar with. In the care setting in which I worked I witness the use of sign language in the form of makaton been used, British sign language and body language to communicate between the clients and carers. One client also had an object board whereby he would point to the things he wanted, these included listening to music, having a bath, brushing his hair, stroking the cat, it appeared obvious that every attempt was made to help the client’s to be able to communicate their needs.
