Formal policies on equality, diversity and rights include legislation, such as the following: Mental Health act, Race Relations, Disability Discrimination act, Sex Discrimination act and the Human Rights act. The government issues Codes of Practice and Guidance alongside the legislation to tell care organisations and individual professionals how laws should be implemented. All care organisations should have formal policies on equality of access and service user rights which is incorporated into all their procedures. All care workers are bound by the law and the Care Value Base. But workers in particular services will also be bound by Codes of Practice and Charters. Health service workers must comply with the Patient’s Charter which promotes equal rights by stating patients’ rights and the standards that they can expect from services. The Community Care Charter fulfils a similar role for social services workers.
The role of work practises in promoting service users rights is particularly important. Services should be provided in a way that respects’ the privacy and dignity of service users. A few examples of these appropriate work practises include service users being able to protect their private space, to lock the door to their room, and expect staff to ask permission before entering. All service users should have the choice over what to eat, what to wear, what activities they participate in, how they are addressed by staff and workers, as well as when to get up, have meals and even when to bathe. But above all of these suggested and appropriate work practises, dignity and privacy must be a particular consideration when helping service users with intimate care tasks. Care should be offered in a way that maximises independence and should also be encouraged to do things for themselves, rather than the worker taking over to save time. All care and work practises must be approached with a great degree of tact and support, as all service users are valued and important.
To have choice, individuals must be able to understand what is available and express an opinion. Some individuals cannot do either of these things. Advocacy is the process by which they can be helped to do so. Sometimes an advocate may make decisions in their interests and on their behalf. The dictionary defines an advocate as someone who pleads, intercedes or speaks for another. Service users may be unable to exercise choice for many reasons, for instance: people with learning disabilities may be unable to fully understand their circumstances and older people may be confused or have a memory problem which calls into question the validity of the choices they make. Other reasons an advocate may be contacted include: people from different cultural backgrounds not understanding systems and processes for securing their rights and for a number of reasons service users may lack knowledge or confidence to deal with officials. Many of these people will have friends or family to advocate on their behalf. If they do not, then they risk becoming disempowered and marginalised unless they have an independent person to support them. This personal advocacy may take two forms, professional advocacy and citizen advocacy. Professional advocates are people such as lawyers or other professionals representing a person in court, or any other formal hearing. Citizen advocacy, however, is when an independent volunteer acts on behalf of a service user with a service provider.
Advocacy is a way of challenging discriminatory practices in health and social care settings as it allows service users of all abilities, languages and classes to communicate at the same levels.
My last example on ways of reflecting on and challenging discriminatory issues in health and social care is complaints procedures. If service users do not have the right to complain, they have no way of standing up for their rights. An accessible and easily understood complaints system is a basic part of any organisations policy on equal opportunities. With most complaints procedures there are around 4 main stages. In the first instance, to speak with the member of staff concerned or their manager to see if the issue can be resolved informally, would be sufficient. However, if that does not resolve the issue the procedure would be to make a complaint to a senior manager of the department. The third stage, if the matter is still not resolved, is to request the matter to be referred to a review panel, which would have lay members as well as the representatives from the department in question. If the complainant is still not sufficiently satisfied then they have the right to refer the matter to the Local Government Ombudsman.
Overall there are a variety of different ways to reflect on and challenge discriminatory issues in health and social care settings. The examples I have explained are formal and organisational policies, education and training, work practices, advocacy and complaints procedures. All of these examples ensure that services are provided in such a way that all service users get equal benefit and no one is discriminated against.
References
Moonie, Neil (2003). BTEC national care. Oxford, Heinemann Education Publishers
Sophie Louise Kelly – Page
