Positive Care environments

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Introduction

The purpose of this assignment is to investigate how clients gain access to health and social care services. In this report I will be discussing the barriers to accessing services, what legal rights service users have, the level of care given to service users and I will also be evaluating how legislation safeguards promote service users rights. I will examine the importance of a care value base in care settings and how it can help create positive care environments. Creating and maintaining a positive care environment requires care practitioners to be open minded as the values and beliefs of service users will differ from their own, therefore they need to have an understanding of the diverse society we live in.

In order for me to gain a better understanding of how health and social care services are accessed by clients, I spent 2 days in a private residential home. I interviewed a senior carer relating to creating positive care environments and also spoke to a couple of residents. Therefore I will be focusing on the care of older people. I will not be naming any of the residents I spoke to or the residential home for confidentiality reasons.

How Service Users Accessed the Residential Home

The residential home provides personal care and accommodation for up to 20 people who are 65 and over. Firstly the service user visits and gets information about the home to help them decide whether it’s the right residential home for them. Before service users move into the home, their needs are assessed to ensure that they can be met. Once the service users needs are assessed and the service user thinks that the home is suitable for him/her then they are given a written contract stating the terms and conditions with the home. Many of the residents I spoke to said that their children found the home for them because they were unable to look after them due to work commitments. This is known as a third party referral.

A client can gain access to health and social care services in different ways. Whichever way the client manages to make use of the service, it is known as a referral. There are three different types of referral:

  1. Self-referral: This is where people apply directly for access to care services. For example, if a service user phones a surgery themselves to make an appointment to see their GP.
  2. Third-party referral: This is when an individual applies for a care service on behalf of another individual. The individual applying on behalf of the other person is not a professional carer. It is normally a family member or friend. For example, a daughter may take her mum to the GP because she is concerned about her mother’s health.
  3. Professional referral: This is where a client is put in contact with the service by a professional. For example, a GP may send their patient to the hospital to have a blood test.

Most residential homes are part of the independent sector. This sector includes voluntary and private organisations. This sector has grown greatly. Much of the growth in provision has been in private homes for elderly people.

Many of the residents I spoke to said that they trusted the carers and had strong relationships with them. All the carers were female but the male residents said they felt comfortable with the female carers helping them. A few times a year the manager would organise day outs to places that interests the residents such as the theatre.  Having strong relationships with carers will help residents to feel secure, valued and comfortable in the care setting.

The residential home accommodates 20 residents. The fees for staying in the home range from £305 to £344 a week. The difference in fee relates to a resident’s care needs. If people are unable to afford the fees then the local authorities are able to provide funding towards the financial cost of the residential care. In the Community Care Act 1990 under the residential accommodation with nursing section, it states that “A local authority shall make such arrangements as they consider appropriate and adequate for the provision of suitable residential accommodation.” Therefore social services are required to carry out a care needs assessment and if residential care is found to be appropriate a financial assessment follows. The Services which the residential home provides are meals, laundry and personal care designed to meet individual needs. All bedrooms are on the first floor which is accessed via a star lift. The home has two televisions to keep the residents entertained and activities such as bingo and dominos are offered everyday. All residents get to choose what they want for diner and snacks such as crisps and chocolate are offered everyday.  By giving residents many choices it will make them feel empowered and independent.

In order to promote a positive care environment it is essential that carers are aware of the rights service users have and many rights are supported by legislations. Service users have the right to effective communication which is supported by the Code of Practice, therefore carers must ensure when speaking to clients they use language which service users understand and avoid using to much jargon. The Care Standards Act 2000 is a legislation which supports service users’ rights. It states that service users have the right to empowerment and choice therefore carers should not be making decisions for clients if they are capable of doing so themselves. The residential home I visited always gave the service users choices and this empowered the service users and one resident I spoke to said that they never felt that they weren’t in control of their lives and that carers allow them to make choice for themselves which makes them feel valued and respected. Another legislation which supports the rights service users have is the Community Care Act1990. This law states that organisations must publish a plan of its current services so that service users are aware of the service the organisation provides and this act also states that service users are entitled to an assessment.

Care Value Base

The care value base was developed to improve clients’ quality of life by setting standards in care settings. It states the basic principles and values for carers and clients in care settings. It also outlines how quality in care might be understood and how carers need to act in certain situations to create a positive care environment. In care settings the care value base needs to take into consideration:

  1. Confidentiality

Maintaining confidentiality of information is an important part of caring. It means that any information clients give must be kept private and confidential. Carers need to think carefully when talking about clients or other colleagues. The couple of residents I spoke to when visiting the residential home said that they expect carers not to discuss their personal details with anyone else without their consent first and if they did their trust in the carers would go. This suggests that if carers do not maintain confidentiality then it could result in clients becoming less confident around others as well as lowering their self-esteem. Carers maintaining confidentiality is one of the main factors needed to form a strong relationship with clients.

There are also legal requirements to keep personal information confidential. The 1998 Data Protection Act states that information has to be:

  • Fairly and lawfully processed
  • Processed for limited purposes
  • Adequate, relevant and not excessive
  • Accurate
  • Not kept longer than necessary
  • Processed in accordance with rights
  • Kept secure
  • Not transferred abroad without adequate protection.

           The above information was taken from the website:      

           

Therefore, wherever possible employees in care settings must respect their client’s   right   to keep certain information private. However there may be times where they do need to    share confidential information. For example when a client may be a danger to themselves or others.

  1. Effective Communication

Effective communication will allow carers to build supportive relationships with the individuals they are caring for. Good communication skills are essential for developing strong relationships with clients. Carers need to have the skills to communicate effectively and be aware of non-verbal behaviour. Non-verbal behaviour is very important in social interactions and as suggested by Argyle in 1975 it can be “Four times as powerful and effective as verbal communication” (Philip Banyard, 2002, Page 20). When talking to clients, carers need to be aware of things like their body posture, facial expressions and muscle tension, but they also need to be able to read the service users non-verbal behaviour.  Argyle (Philip Banyard, 2002, Page 21) stated that there are four major uses for non-verbal behaviour:

  • To assist speech
  • As replacement for speech
  • To signal attitudes
  • To signal emotional states

Carers also need to be aware of the words they use when talking to service users. If they use complex terms then it’s very likely that clients won’t understand them. For example Taylor (1995) suggested that “Doctors may use jargon-filled language to stop the patient asking too many questions.” (Anthony James Curtis, 1999, Page 74) This would therefore prevent effective communication. Listening skills are also very important for effective communication to take place. Listening will indicate to the service user that their views are being understood and as Goldsmith indicated “Such skills are particularly vital in establishing a relationship with a person with dementia” (Mark Lymbery, 2005, Page 142).

In the residential home I visited there was an Italian woman who spoke a little English, therefore when the carers had to communicate to her they would often make gestures with their arms and hands but they also used this communication technique with other residents who had hearing difficulties. However when the carers have to communicate something important to the Italian women then they would contact her daughter to act as an interpreter, therefore health and care organisations may need to employ a translator or interpreter when there are language differences in order for effective communication to take place.

  1. Empowerment

This refers to giving someone the ability to do something for themselves. Carers can empower clients by promoting certain values. For example, supporting individual choices, understanding individuals’ beliefs and culture, providing individualised care. This would encourage clients to feel valued and respected. If carers encourage individual choice then they will empower clients to make decisions about their care. For example, the residential home I visited always asked residents what they would like for dinner the next day. This shows that they empower service users by giving them a choice. Therefore carers should help clients to stay in control of their lives.

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  1. Respect for individual choice, identity, culture and beliefs

All service users of health and social care services have a right to maintain their own beliefs in relation to things like religion, ethics, culture etc. They also have the right to confidentiality and not to be discriminated against. Carers should support the right of a client to choose their own lifestyle and help them to accept their responsibilities. For example, clients have the responsibility to not discriminate others and respect the confidentiality of others. Showing respect for an individual’s beliefs also shows that you have respect ...

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