Assessing needs would be the third step of the care planning. This is where the patient is looked at in a holistic approach, which means looking at the person as a whole and assessing what their physical, intellectual and emotional needs are. In Jenifer’s case, her husband took her to the doctors who then spoke to her about her going into hospital for a while, until she got better. Jenifer has a physical need for shelter and somewhere where she can feel safe. Also she would need a place where she can recover mentally and emotionally from her past experiences whilst she was working. Therefore, the doctor asked her if she would want to go and spend some time in a hospital or whether she wanted someone, such as a nurse, to care for her at home, Jenifer agreed to being admitted to hospital, as she is desperate to get better and get back to her lifestyle. This fits in with the empowerment principle, because Jenifer was involved in her own care planning, by having a choice to say how she felt about each option that was suggested for her. However it could have been dangerous if Jenifer had refused care, because there is a chance she could put herself and her children at risk, due to her being absent-minded and confused. For example, she forget to pick her children up from school or she could take her children out to the parks and forget she had them with her and left the park to go home without them, or leave something on the stove which could catch fire.
The next step would be to record plans to meet the needs. At this point, a doctor (from the hospital), Jenifer and her husband all have a meeting about what is going to happen next and set up a care plan for Jenifer. This again refers to the empowerment principle, because Jenifer is getting included in her own care plan and care is not getting forced onto her. This also ties in with the ‘needs’ and the ‘choice’ principles, because Jenifer’s needs are taken into consideration and she also has a choice about what is going to happen next. Her husband could also be used as and advocate, due to her condition, Jenifer may forget about or become slightly confused about her treatment, so her husband could be used as some sort of back-up and knowing her well speak up for what she wants, if she is unable to express it herself.
Implementing the care plan is the next step in the process. In this process, Jenifer’s care plan is put into effect. She has medication prescribed to her, which will help to keep her settled and help her mental state. She would also be put on constant 1:1 observations, to help monitor how she is doing and how she is reacting to the new setting, the medication and ensure that she does not endanger herself. Other staff within the hospital will also be given a briefing on her, so they know what to expect of her and to make sure that they are aware of her situation. This process fits in with the values principle, because even though she is a mental health patient, she is being treated with respect and her past experience with people picking on her is taken into consideration. Things are not just done to her, but procedures are explained to her and she is not patronised.
The next step is monitoring. As part of her care plan, Jenifer was put on constant 1:1 observations, by the doctor within the hospital, to see whether she settles in well and her reaction to the medication that has been prescribed to her. This was also put in place to sort any problems that may occur.
Reviewing and evaluating the care plan is the final step in the care process. In this stage, the doctor who is up-to-date with Jenifer’s notes and records and the monitoring that has gone on, has another meeting with Jenifer and her husband (which is where the acting as an advocate principle comes back into place). Her husband could then say whether he feels the treatment is working, and whether Jenifer is happy and also mention any concerns he may have. Jenifer’s progress is fully evaluated, along with whether she is getting on well in the hospital and whether she needs different medication. This is where the doctor decided that she is well enough to come off her constant 1:1 observation and is put on regular, 15 minutes checkups instead. She is also assessed to see if she could cope with visitors. These actions tie in with the values and rights principles, as Jenifer can explain her views and talk about any concerns she could possibly have and they are fully listened to by the doctor. Her husband is also present and is able to raise concerns and represent Jenifer’s views which Jenifer due to her condition is unable to make for herself.
M1- Explain care planning principles
In this assignment I am going to be explain the different care planning principles that have been put in place by the government, to ensure that service users from all kinds of different care (such as nursing homes, hospitals and nurseries) are treated fairly when it comes to their own personal care.
Care planning is an essential part of healthcare. A care plan ensures that no issues are neglected and it provides a map to guide the health and social care worker into providing adequate care for the service user. To be effective and comprehensive, the care planning process must involve all disciplines that are involved in the care of the patient. The ultimate purpose of the care plan is to guide all who are involved in the care of this person to provide the appropriate treatment it needs accordingly to its physical, intellectual, social and emotional requirements. A care work unfamiliar with the patient/resident should be able to find all the information needed to care for this person in the care plan. This process is never truly completed until the patient is discharged from the current care setting or decreased.
Empowerment of service user
One of the main principles of care, us that the service user should be given the power by having a chance to have their say on what they want and also a chance to explain how they feel about the care that is being given to them. It is crucial that care isn’t just given to someone without having a say in the matter, it is better that the service user is involved in the planning of their care. (M.Crittenden, 2007)
At my work placement this principle was carried out with each patient. I worked at a hospital in the mental health department. Each patient had to undergo a meeting with a doctor and either their own care worker or a close relative, such as the parents, to have a discussion about the care that the hospital was going to provide for them. This included a discussion about their medication and whether they needed on-going support (for example being put on 1:1 observations, which means a staff member was always at hand supporting that particular patient).
Needs & Choice
This principle was also carried out by my work placement. During the meeting with the doctor, the patient’s needs were discussed. It is very important for the patient’s needs to be discussed as it helps reassure the patient that they are being listened to and that everything is being done to support them no matter what kind of needs they have. (M.Crittenden, 2007)
Whenever it is possible, service users should be given a choice. For example, when patients were admitted into the hospital, staff gave them a choice of what kind of room they would like, such as if they would like a room by itself with just a sink or whether they want a en-suite bathroom with a shower and a toilet. Patients are also given a choice of what kind of foods they would prefer at meal times. This kind of choice may help the patient to settle in more quickly and develop a stable routine which could potentially help with their recovery process. (M.Crittenden, 2007)
Confidentiality & Rights
Another principle of care planning is confidentiality. Every service user has the right of confidentiality; they have the right to know who is accessing their personal information and also the right to say who they want to share it with. Therefore those who were involved in patient’s care (such as family or their care worker) at my work placement were asked not to discuss that patient’s personal life and situation with those who do not have the right to the information. However, if the patient wanted to tell people, such as friends or other family members then they had the right to do that, but the care workers wouldn’t be able to disclose that kind of information. (M.Crittenden, 2007)
Values
The values underpinning care are respect for the client as an individual with individual needs. The service must promote anti-discriminatory practice, offering a confidential service which promotes and supports individual rights. At my work placement, the staff acknowledged individual personal beliefs and personalities and offered this kind of service through effective communication. (M.Crittenden, 2007)
Potential use of advocates
If the service users are unable to speak for themselves, they have the right to have someone, such as an advocate, to speak on their behalf. For example, while I was at my work placement, there was a patient who understood little English and could only speak Bengali. Therefore, a staff member always booked an advocate or an interpreter when doctors had to speak to her so that she fully understood what was being said to her. (M.Crittenden, 2007)
Cycle of assessment/planning
A care plan has to be written for each service user at my work placement. Each care plan would meet the patient’s needs and ensure that during their stay at the hospital, they were safe. The care plan would be reviewed with each patient, a doctor or nurse and either a social or care worker or a member of the patient’s family. The patient’s views and needs would be heard and the further needs would be assessed and the care plan would be updated regular ( at my work placement, each care plan was updated every 72 hours). This cycle of assessment, planning and review would continue until the patient left the hospital. (M.Crittenden, 2007)
Service user at the centre of the process
It is a principle of care planning that the service user is at the centre of their care planning process and fully involved with and aware of what decisions are made and why they are made. (M.Crittenden, 2007)