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This report will explore the principles of safe practice in Health & Social Care by examining two case studies which are Merryvale Residence and Cherry Tree’s Children Centre.
(SCIE, 2018) Standard 5, Duty of Care defines duty of care simply as a legal obligation to:
- always act in the best interest of individuals and others
- not act or fail to act in a way that results in harm
- act within your competence and not take on anything you do not believe you can safely do.
The importance of duty of care is to prevent negligence, but also to ensure the service user is receiving the correct care for their health, safety and wellbeing.
Merryvale Residence is a care home which offers support 10 older women and men with varying degrees of mobility. All the residents are over the age of 75. Three of the residents in the home have a hearing impairment and two have dementia.
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In Merryvale Residence a Duty of care is not being met, the residence personal care is not attended to. The residents are left without a bath or shower due to less than the legal limit of care workers.
The Health & Social Care Act 2008, Regulation 2014: Regulation 18 says ‘’Sufficient numbers of suitably qualified, competent, skilled and experienced persons must be deployed’’ in order to meet this regulation in the Care Act 2014.
It is crucial that Health and Social Care settings have the correct staffing levels to ensure each individual in their setting are catered to and are receiving care that fits their needs. The correct residence to staff ratio whom are qualified, skilled and experienced guarantees the needs of the services users is met and also their Physical, Intellectual, Emotional and Social areas of development are supported.
In this scenario, the care workers are failing to meet the needs of their service users and also failing to provide suitable care for each individual due to the low staffing levels. This is an act of omission, residents have been left without a bath or shower for two- or three-days and as a result of this it has caused distress and worsening skin condition on some residents. In addition to the act of omission, they are also neglecting the residents for the reason that they have disregarded their personal hygiene and have not taken into consideration of the potential issues that have occurred because personal care was not followed through.
Furthermore, because there are no sufficient numbers of care workers, the impact of this means the service users that require additional support with their personal care or other needs are not receiving this.
The carers are not implicating person centred care, (PCC) means “Long-term care residents are supported in achieving the level of physical, mental and psychosocial well-being that is individually practicable. This goal honors the importance of keeping the person at the center of the care planning and decision-making process.”
Personal centred care should be implicated to achieve a good standard of duty of care and safe practice, the residence must receive the correct treatment.
Under the Health and Social Care Act 2014, regulation 9, it states “providers must work in partnership with the person, make any reasonable adjustments and provide support to help them understand and make informed decisions about their care and options”
If person centred care is not given it will have a negative impact on the residence as they are not made a priority. This could have an impact on their holistic development, physically the individual may feel they have no purpose in life due to being neglect, this could in fact lead to the residents not wanting to get up out of bed or be active. As a result of this, they start to develop health problems such as bone issues. Socially, residence might distant themselves from the staffs and other residence in the home, they may socially isolate themselves causing them to become emotionally unhappy, the unhappiness can lead to the resident making the choice of not wanting to see their family or be around other people.
All carers must ensure they promote safe practice, this includes following COSHH (Control of substances hazardous to health) to health regulations 2002. COSHH is defined under the Health and Safety at work Act 1974. This regulation states that employers must prevent or reduce exposure to substance that is hazardous to someone’s health. For example, the case study informs us that carer’s have taken upon domestic duties which they have not kept up on, leading to spilt food and drinks, often left on work surfaces. This is poor practice due to residents being in direct contact with the spilt food and drinks, the residents could accidentally spill the drinks further, this could cause injuries to other residents in the home such as falls or trips. If some residents have allergies this could affect them as they may accidentally touch the spilt food or drink that could have a specific ingredient which they cannot touch.
Currently in the home there are two female residents in the same-sex relationship, both females have experienced discrimination from one member of staff, they do not wish to open up about this nor cause any conflict. The couples wish to have a double room but are unsure what their legal rights are on this issue.
Same sex relationship is defined as ‘’a relationship between persons of the same sex and can take many forms, from romantic and sexual, to non-romantic homosocial-close relationships. The term is primarily associated with gay and lesbian relationships.’’
The Marriage (Same Sex Couples) Act 2013 was legalized in the UK 13 March 2014.
In relation to the two female’s relationship in Merryvale Residence case study, who are under the Care Quality Commission Act 2009, the act states that men and women should protected from discrimination on the grounds of sex and marital status.
All services users should receive the same impartial treatment as any other residence despite the grounds. All the discriminations are under the Care Quality Act therefore conveys that the couples are being discriminated for being in the same-sex relationship, which the staff are not abiding by the legal act and legislation and is a criminal offence.
The case study informs us that one of the women has discovered that her partner, who requires assistant with her personal care, has a range of bruises on her neck and arms which she states that she fell over, reason being why those bruises have developed.
Carer workers have the responsibility to uphold the rights and promote the interest of individuals experiencing abuse or neglect. It is important of care workers, being in a position of power understand that all services users are individuals and unique with their own needs and abilities, but also they must understand that the service user could lack the capacity to protect their own rights, in addition to this, the individual may be frightened to make the care staffs aware that a certain aspect of their needs are not being fully met or they may feel intimidated to do so. Under the role of care staffs, they have an obligation to follow duty of care and also personal care, if care staffs notice any signs of bruising on a service user it is extremely important that they follow the correct procedure and report this. They must ensure to complete an accident form immediately, records this in the individuals care plan and complete a body map to indicate where the body marks or bruising were. The reports should then be investigated and if there are any concerns that the investigation was not carried out correctly, you should report it to the CQC (Care Quality Commission) who will further the investigation of the report.
CQC are the regulators of health and adult social care service providers, who inspect all health and adult settings in England. It was established in 2009.
It is important that complaints are made to help ensure Health and Social Care settings improve and provide better care for their service users, also, settings are able to take up on the feedback and improve their practice. The complaint procedure ensures the complaint has been responded to and the people who have caused acts of omissions are held accountable, ensuring they learn from it.
Cherry Tree Children’s Centre
Cherry Tree Children’s Centre is a centre for children, the children who attended this centre have additional needs and also require medication. Since birth, Lisa, 3 year’s old, who has autism attends the centre with her mum Joanna twice a week. Several staff at the centre have recently left and the manager has allowed local people to act as volunteers until new staffs are recruited.
Abuse is defined as ‘’any action by another person – adult or child – that causes significant harm to a child. It can be physical, sexual or emotional, but can just as often be about a lack of love, care and attention.’’
Some children with autism have behavioural issues, Autism is defined as ‘’Autism spectrum disorder (ASD) that affects a person’s social interaction, communication, interest and behaviour.’’
Due to some children with autism having behavioural issues, the volunteers may not understand how to respond to their tantrums or meltdowns to solve the situation. Instead, they may harm the child by using the incorrect strategies that could trigger them further.
Duty of care is not being met in this, the children are not being safeguarded and in this case study also, legal requirements have not been followed.
The Children Act 2004 states ‘’that the interests of children and young people are paramount in all considerations of welfare and safeguarding and that safeguarding children is everyone’s responsibility.’’
Although it is everyone’s responsibility to safeguard children, the volunteers in this case study are inexperienced with no skills or qualifications, this convey that duty of care is not being met fully. For example, they have been allowed to lead unsupervised play sessions without no first aid training. First aid training is not compulsory nor essential, but in this case, the children who are being safeguarded require close attention, the volunteers have no specific training on supporting children with additional needs.
The manager has no information on the volunteers nor do the volunteers have a DBS, this puts the children at high risk. The Disclosure and Barring Service was established in 2012. The legislation ‘’ carries out the functions previously undertaken by the Criminal Records Bureau (CRB) and the Independent Safeguarding Authority (ISA). It helps to prevent unsuitable people from working with vulnerable groups, including children.’’
A DBS is a legal requirement in which employers must obtain before making employable decisions. DBS ensures the children are under the right care and their safety is protected. In this case, the children’s safety is not protected.
The case study mentions Joanna, Lisa’s mother, has informed her concerns on the volunteers leading unsupervised play sessions to the manger, in which the manager informs that it is only a temporary measure. Although this is a temporary measure, it is also a lack of duty of care and neglect. An example of this is, Lisa who has fallen of a climbing equipment and hurt her leg. This is a case of neglect, the volunteers who are supervising the play session have not taken any necessary actions upon her fall and have not followed the correct procedure for accidents. When accidents occur, a form should be done on the child as soon as possible after the accident has occurred, the exact time and date should be stated and also a body map of where the bruising is.
- Care Act (2014) Care Quality Commission [Online] Available at https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-18-staffing#full-regulation Accessed on 29/10/18Definition of Personal Centred Care [Online] Available at https://www.nhqualitycampaign.org/goalDetail.aspx?g=PCCAccessed on 30/10/18SCIE (2018) Common Induction Standards [Online] Available at https://www.scie.org.uk/workforce/induction/standards/cis05_dutyofcare.asp Accessed on 31/10/18Definition of Autism [Online] Available at https://www.nhs.uk/conditions/autism/ Accessed on 30/10/18
- The Children Act 2004 [Online] Available http://www.cypp.powys.gov.uk/index.php?id=4658Accessed at 30/10/18Personal Centred Care [Online] Available at https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-9-person-centred-care#legislation-links Accessed at 30/10/18
- Definiton of Same-sex relationship [Online] Available at https://www.google.co.uk/search?rlz=1C1CHWA_enGB792GB792&ei=h8u4W4WuLo-ckgX9kovACQ&q=definition+of+same+sex+relationship&oq=definition+of+same+sex+rel&gs_l=psy-ab.3.0.35i39k1.2450.4185.0.54220.127.116.11.0.0.0.216.1673.5j7j1.13.0….0…1.1.64.psy-ab..3.13.1665…0j0i131i67k1j0i67k1j0i20i263k1j0i131k1j0i22i30k1.0.WhQVlUdGYggAccessed on 30/10/18
- DBS legislation states [Online] Available at https://www.gov.uk/government/organisations/disclosure-and-barring-service/abou Accessed at 30/10/18
- Definition of Abuse [Online] Available at https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/ Accessed on 31/10/18
In this report I will be justifying the effectiveness of health and safety legislations, policies and procedures and evaluating the importance of safe practice principles in maintaining and promoting the health, safety and welfare of service users in the selected health and social care settings.
Equality Act (2010)
This act protects people from discrimination in the work environment. This act has brought over 100 pieces of legislation in regards to discrimination, equality and diversity. There are nine protected characteristics and 4 Discrimination defined in the Equality act, which are: Age, Disability, Gender reassignment, Marriage or civil partnership, Pregnancy or maternity, Race, Religion or belief and Sexual Orientation (Citizens Advice 2018)
Care Act (2014)
The Care act protects vulnerable adults from mistreatment, it sets out in one place, local authorities’ duties in relation to assessing people’s needs and their eligibility for publicly funded care and support (SCIE 2018).
Care Standards Act (2000)
The Care Standards Act provides administration in a variety of care institution including children’s homes, independent hospitals and nursing homes. The Care Standards set outs legal practice which must be followed correctly and efficiently, it protects vulnerable adults from the risk of harm.
Care Quality Commission Standards
The Care Quality Commission Standards Act are the standards below which all care must never fail in, the fundamental standards are: Person centred care, dignity and respect, consent, safety and safeguarding from abuse.
Health and Safety at Work Act (1974)
The Health and Safety at Work Act provides wide-ranging duties on employers, employers have a duty to protect the health, safety and welfare at work of all of their employee’s.
The Food Hygiene Regulations (2006) Amended (2013)
The Food Hygiene Regulations places an obligation on all business, to make sure that their activities are carried out in a hygienic way, all business must provide food which are safe and not harmful to human health.
Disclosure and Barring Service Checks (DBS)
The DBS is a legal obligation that all individuals must obtain before working in care. It protects individuals in Health and social care settings from harm, DBS is required to show any criminal offence which helps employer’s make careful recruitments, any individual who has committed certain offences can never work in care.
Children’s Act 1989
Equality Act 2010
Legislations, policies and procedures are put in place to ensure that all service users are receiving the correct care, acceptable care and protection. An example of this is, the Equality Act 2010, this act stops discriminatory actions upon service users, it protects services users from discrimination under the 9 protected characteristics, ensuring staffs do not treat service user in an injustice way but treated fairly and equally in choices that are made, care that is given and support.
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In this case I will be discussing, Merryvale Residence, the Equality Act 2010 relates because the two females fall under one of the protected characteristics which is sexual orientation because they are in the same-sex relationship. If this act was not issued, the females would be mistreated for their personal choice on being in the same-sex relationship.
The equality act 2010 stops acts of mistreatment, without this act services users can easily be mistreated and staffs would not be accountable for any discrimination towards them.
The Food Hygiene Regulations 2006
This act requires employer’s to handle, cook and serve food following the correct procedures such as efficiently using the correct food temperature. The importance of following high standard of hygiene ensures that service users are not caused to become ill due to incorrect use of temperature, storing of foods or handling.
If this regulation is not followed, the food provided to service users may put them in danger of infections, illness or possibly even death. Not having the correct understanding of the different food hygiene procedures such as ensuring to wash hands in between handling meat to vegetables could lead to minor infections. Infections similar to salmonella caused by uncooked meat, this can have major impact on a vulnerable service user.
The importance of keeping up with efficient food hygiene is to keep service users health safe, especially services who have allergens and cannot be in contact or around certain foods and ingredients. Furthermore, the food hygiene regulation contributes to safe practice as you are ensuring that you are correctly handling all types of foods, this keeps all service users harm free, healthy and safe.
Different procedures promote safe practice, for example following the basics of hand wash and cleaning work surfaces areas before cooking ensures a lower risk of cross contamination. In addition to this, infection control such as using the correct cleaning produce on surface can reduce the likely hood of infecting service users.
The food hygiene regulation 2006 relates to the case study I have been discussing, Merryvale residence, as staff members within the setting have left spilt food and drinks have been left on tables and in the staff room. Poor food hygiene can lead to contamination, which, as a result of this, can put service users at risk of catching harmful germs, this my lead to an impact on their health and well-being.
Care Act 2014/Duty of Care
Duty of care also relates to this case study, duty of care is a legal obligation, it helps to maintain the safety of a service user and protects the service users from potential abuse. It is a legal obligation in which staffs must act in the best interest of the service users. They should only act in a way in which does not cause harm to them and their service users.
Duty of care ensures employee’s provide high quality care to the best of their ability, report any concerns regarding a services user’s safety and ensures service users are cared for and not neglected. Failing duty of care on a service user can lead to negligence therefore it is very important to take up duty of care, as all staffs are held accountable for any failures in not meeting the needs of an individual. Furthermore, the importance of duty of care means acknowledge that in order to avoid negligence, breaches or prosecutions they must follow duty of care correctly and keep the health, safety and welfare of their service users at a good standard by following policies, procedures efficiently.
Employees have responsibilities and duties to care for a service user, for example, ensuring they provide the health care specific for an individual. Protecting the health, safety and welfare of services users is important, if this is not followed through, it will mean the wellbeing of all services users are not protected. This results in services users being at a higher risk of abuse and due to this, it leads to them being distant and feeling less important. Not following duty of care on an individual but instead caring for them incorrectly, such as following the incorrect procedure for personal care can affect their health in which can lead to health issues and conditions.
In this case, Merryvale Residence, the two females being discriminated could potentially be affected emotionally, they may become socially withdrawn and less interactive. Implicating duty of care means these situations are avoided and allow services users to be safeguarded.
Care Quality Commissions Standards
Failing duty of care can lead to negligence which results in the Care Quality Commissions (CQC) inspections. The CQC ensures employees acknowledge and understand the consequences in failure to, provide efficient care to all service users or breaching legislations and regulations put in place to ensure the health, safety and wellbeing of each individuals. Without the Care Quality Commission, health services would not be kept up to a high standards, service users using the services provided for them would not be cared for properly.
The CQC contributes to safe practice because it has set requirements which health providers must apply and never fail in, in order to be rated adequate to inadequate, without the CQC providers would be providing insufficient care, services user dignity would not be protected and a number of acts and legislations would be breached. The Merryvale Residence case study relates to the CQC because they are not abiding by the some of the fundamental standards which are: Person Centred Care, Dignity, Respect and Safeguarding from abuse.
Disclosure and Barring Service Checks (DBS)
Disclosure and BarrIng Service Checks is a part of safe practice, it continues to protect vulnerable adults and children from danger. In this case, In the Cherry Tree Centre, the children are at a high risk of harm due to the recruitment of volunteers, inexperienced and have no qualifications regarding the care, safety, and wellbeing of the children with additional needs and autism.
DBS makes sure that the welfare of vulnerable adults and children are kept safe, without these they would be in contact with unsafe people. This can lead to an impact on their lives and safety, although these people may have not committed major offences but they could still have a huge impact on the development of the service users. For example, the service users could or may feel threatened, afraid or in danger, this can cause them to become emotionally distress, distant and withdrawn.
Health and Safety at Work Act 1974
The Health and Safety at Work Act 1974 protects the health, safety and welfare of their employees. If this wasn’t introduced in the work setting, the workers within the setting may become prone to abuse themselves from their service users, for example, verbal abuse. This means, if employees experience verbal abuse from service users or any type of abuse, it enables them to take precaution and take action and care for their safety or if another member see’s any type of abuse, they have the right to report their concerns. Plus, if this act wasn’t put in place, employees would not be kept safe from injuries or danger.
Children’s Act 1989
This act contributes to safe practice because it ensures
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