A care practitioner should support the right of a service user to choose their own lifestyle for example and help them accept their responsibilities.
- A service user has the right to eat unhealthy food, but care practitioners need to tell them about the health risks so they can take responsibility for their choice.
- A service user has the right to smoke, but they must accept their responsibilities to other people who do not wish to be affected by passive smoking.
Rights and responsibilities are laid down in codes of practise. As a care practitioner, they need to make sure that their service users are aware of their rights and responsibilities in care settings. Service users are also entitled to rights in the ward in which they are staying, in this case in ward B7 in the Queen Elizabeth Hospital is also entitled to the following rights:
Clients have a right to:
- Not to be discriminated against
- Confidentiality
- Their own beliefs and values
Clients have a responsibility:
- Not discriminate against others
- Respect the confidentiality of others
- Do no harm to others
Confidentiality
This means that any information the service user gives a care practitioner must be private and confidential, whether it is:
- Verbal
- Written
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Electronic (on a computer)
A care practitioner needs to be aware of what they say to other carers and clients and also who has access to client files.
Maintaining confidentiality of information is an important part in the health and social care field. Service users can expect from a care practitioner not to discuss their details with anyone else without their consent and they won’t trust or respect you if you do.
There are times when a care practitioner needs to share confidential information, for example when a client may be a danger to themselves or others. Whenever possible, health and social care practitioners must respect their client’s must respect their client’s right to keep certain information private.
There are also legal requirements to keep personal records confidential. The 1998 Data Protection Act sets rules for processing personal information and applies to some paper records as well as those held on computers. The Data Protection Act covers all data held in respect of any individual, including credit and financial information, membership of organisations, as well as medical, health and social service records. It states that data has to be secure, accurate and that it can only be used for limited purposes.
In 1997 the government published a report from a committee, known as the Caldecott Committee, which had reviewed service user identifiable information within the National Health Service and which made a series of recommendations as to how this information should be handled. The recommendations of the Caldecott Committee were that each organisation should appoint an individual who would be responsible for maintaining and protecting service user information. The Caldecott Committee recommended a series of Principles which apply to the handling of all service user identifiable information.
Methods of protection
There are several ways in which access to information can be restricted and controlled. Medical records about service users are kept in a special filling cabinet, which is kept in a locked room and the access to that is limited to specific personnel.
Information which is held electronically on computers requires each person to have an identifier number user ID for their own use. This ensures that all activities on the computer system can be limited to the individual responsible and their access restricted by a password. Each level of access has to be carefully considered to ensure that all the procedures are within the law and within the guidelines. For example, it is not necessary for somebody who requires access to files in order to file them to have access to the contents of those files. A finance manager may need to know the numbers of people receiving a particular drug or requiring a particular type of dressing, but not necessarily any information about the individuals concerned. These types of access restrictions are probably easier to achieve with an electronic system than they are with paper files, thus allowing access at various levels through the user ID and password systems.
There is also a policy in place in the Queen Elizabeth Hospital on who is authorised to update or make changes to records. This is to prevent information being altered or lost by accident.
Types of information kept on service users in the Queen Elizabeth Hospital include details such as:
- Identification (name, age, date of birth, address etc)
- Psychological
- Social
- Medical
Effective communication
Effective communication is needed by a care practitioner in order to improve a person’s quality of life by addressing a range of needs. Effective communication is also about communicating with relatives, colleagues and other care practitioner’s to create a safe, welcoming and valuing environment. Effective communication is needed if care workers are to foster people’s equality, diversity and rights.
A care practitioner needs to use verbal skills to talk to the service user and to be able to express understanding to them. This means language being used to communicate should not be patronising, and avoid use of any jargon. Complicated language that may not be understood should be avoided as the service user may feel embarrassed that they are unable of what it means and as a result will be confused.
Empathy one person’s awarness of the emotional state of another person and their ability to share an experience with them.
The client also needs to use verbal skills in the care setting because they need to tell the care practitioner if they are in pain or if there is anything wrong and also to express their thoughts and feelings on certain things.
Anti-discriminatory practice
Action taken to prevent discrimination against people on the grounds of race, class, gender, disability etc. Anti-discriminatory practice promotes equality by introducing anti-discrimination policies in the work place (i.e. the care settings). Anti-discrimination policy (often known as an equal opportunities or diversity policy) was put together as part of a framework for good practice in organisations. Designed to prevent discrimination against individuals on the basis of difference: for example, age, cognitive ability, class, culture, gender, health status, HIV status, martial status, mental health, offending background, physical ability, place of origin, political beliefs, race, religion, sensory ability and sexuality.
Empowerment
This is the way in which a health and social care worker encourages an individual to make decisions and take control of their own life. Empowerment is a process that builds a person’s self-esteem and confidence in their ability to make decisions. Disempowerment refers to the forcible denial by one person (or group) of the rights and choices are of another person (or group). Includes withholding relevant information and excluding them from decision-making about emotional, physical, intellectual, social, economic or cultural aspects of their lives.
Respect
Listening to and treating people considerably in day-to-day situations, trying to understand individual values, views, opinions and preferences.
Access to health and social care services
The way people gain access to care services are known as methods of referral. You should know about the different methods of referral that exist. These are:
- Self-referral: choose to ask for or go to the services by themselves.
- Professional referral: being put in contact with a service by a care practitioner such as a doctor, nurse or social worker for example.
- Third-party referral: being put in contact with a service by a friend, neighbour, relative or another person who is not employed as a care practitioner (for example, own employer or a teacher).
Self-referral
This is often the first route for most people receiving health and social care. In the health service this may be simply turning up at the GP’s or dentists surgery. The first point of contact may also be through a health visitor, for example.
Within social care, self referral may be a duty social worker in a local office or direct to a care facility, such as a day-care centre or a nursery.
In all cases the initiative is with the person requiring care or a friend or relative making the initial contact.
Professional referral
Unless admitted to hospital as an accident or emergency case, the only way that a person may voluntarily receive hospital treatment is by referral from another professional, normally a GP. Where a GP diagnoses, or suspects, ill health that requires specialist treatment, the patient is referred to an outpatient clinic or, in more urgent cases, direct admission to a ward may be arranged.
In social care, an example of referral by professionals might be when a teacher in a school suspects child abuse and refers the case to the social services duty social worker.
Another example might be through the police who have given a ‘warning’ to a child who has committed an offence and who they feel should be referred to social services.
Third-party referral
Some people may have no choice about whether or not they are referred for support or treatment. Severely mentally ill people can be referred, as can children who are at risk under the various childcare legislation.
Statutory sector
Agencies of central or local government (e.g. local authorities, health authorities).
Primary care
Treatment and care provided by family doctors, district nurses, therapists, local dentists, pharmacists, opticians and other community health professionals.
Secondary care
Hospital care resulting from a referral by a health practitioner in primary care.