With the passage of laws and legislations, organizations in the health and social care sector have adapted their policies and systems to ensure the service users’ rights. Increasing importance is being given to promoting and maximizing the empowerment of service users in residential cares. Factors affecting loss of independence, non-participation and social exclusion of service users are being addressed with greater importance. Organizations are adapting according to the needs of the users.

Case Study 1

Care plan:

Goals of need	Desired Outcomes	Ways of achieving it	Who is responsible	Time Scale
Employment	Improved self-respect	Partnership with day center	Care Manager	2 months
Entertainment	Decreased level of stress and boredom	Engaging in creative activities	Care Manager	2 months
Social Interaction and Emotional Needs	Increased level of belongingness and connecting to other residents	Engaging in group activities	Care Manager	4 months

During the last 20 years or so there have been many changes in the health and social caresystems. The catalyst for changes has been the legislations and laws to ensure and maximize the rights of service users. With the passage of such legislations organizations had to change their policies and practices. And thus the organizations had to follow a standard of service to sustain. These legislations have given increasing amount of rights and empowerment to the users. The NHS and community act of 1990 introduced a system of care which encouraged users to exercise their rights and make informed decisions about their health care. (Thomas, Mason, & Ford) The acceptance of these laws made service providers design their services centering on the needs of the individual. And therefore, has brought significant changes in company policies and practices. Another legislation promoting the rights of users is human rights act of 1998. (Thomas, Mason, & Ford) It has given the recourse to individuals within UK courts if they feel their rights have been infringed. It includes 16 rights including right to life, right to freedom, security and right to a fair trial. While making policies organizations have to be aware this act, and realize every person has the same right. The organization will need to make sure one person’s rights are not infringed while maintaining another person’s rights.

Participation and independence of users is vital to achieve the best possible outcome. Organizations promote service users’ participation by implementing an effective care planning system. A care plan is a written documentation of an individual’s fundamental needs and desired outcomes. It also includes how the desired outcomes will be attained.

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In managing the process, it is central to carefully consider the individual in the process. To promote participation of residents, the organization needs to reflect that it is planning a service around the agreed upon needs and desired outcomes of the user rather than fitting a person into the service it offers. The design and content of the care plan might vary. But it is important to correctly identify the desired outcomes. All aspects of daily living should be considered while preparing a care plan, and the process should start by gathering information from important sources. It is important to involve the user in the process. Involvement of the residents in the 6 stages of care planning is essential in order to provide better service. (Thomas, Mason, & Ford) Need Assessment: Involving the user by agreeing dates and times, explaining how it works and ensuring the staff will involve the user from the early stage of the care planning process.

Developing the care plan: The opinions, expectations and worries of the residents should be considered while developing the care plan. The staff will need to make sure the resident has clearly understood the process.

Intervention and support: Once the goals have been agreed upon, the staff will need to start on implementation of the plan. Ongoing negotiations with the user must be considered in achieving the best end result.

Monitoring and review: Encouraging the users to provide feedback is essential. It is also important to note the progress made and take into account any weaknesses.

Statutory review of the package: The residents view is important; it also involves the view of outside agencies.

Agreement on goal setting: The residents should be full involved in future goal setting process. The user should be encouraged to share what he has achieved.

The organization needs to reflect on these stages and clear understanding of the issues should be ensured. The process should have options to monitor progress and make changes accordingly. There should be the option of trying something different if the initial plan doesn’t work. This way the individual will be more involved.

Case Study 2

Question 1

Analyzing the presenting factors affecting decisions to self-medicate

Fast Relief from ailments: Self-medication gives the individual quick relief from ailments.

Identifying the ailment as trivial: When patients consider the ailment or sickness to be trivial that can be cured easily, they don’t go to the doctor. Rather they self-medicate themselves.

Perceived Medication Knowledge: If the individual perceives his/her medication knowledge to be sufficient, he/she decides to self-medicate.

Saving time and money: Going to the doctor means spending valuable time and money, self-medicating saves the hassle of going to the doctor and spending money.

More control in care: when an individual self-medicates, he/she is in full control of her treatment. This gives the person an independence of care.

Education Level: The education level and understanding of the risks might also affect the decision to self-medicate.

Easy availability of drugs without prescriptions: The ease of access to drugs without prescriptions is also a factor affecting the decision to self-medicate.

The risks most likely to occur

Incorrect diagnosis: The individual might incorrectly diagnose his/her illness, and incorrect medication can worsen the medical condition even more.

Delaying Medical help: Self-medication can provide temporary relief. However it can further worsen the situation if the individual delays to obtain medical help by temporarily relieving illness.

Adverse reactions: Medications might have severe re-actions that are not so frequent. And the same medication might have different reaction on different people. What works on most people might have a severe reaction on an individual. Self -medication can be dangerous in this respect.

Drug Interactions: If an individual on a prescribed meditation routine takes additional medications without consulting his/her doctor; the combined effect of the drugs can have severe impacts.

Wrong dosage: A drug that might be very effective and crucial in the relief of a particular ailment can have the opposite effect if taken in a wrong dosage.

Measures to minimize the risk

Since the practice of self-medication is unavoidable; authorities need to take measures to minimize the risks associated with it.

Health Education campaigns: Making people educated about the risks of self-medication can decrease the risks to a certain extent. Running health campaigns will develop the user’s skill in diagnosing oneself with trifling sicknesses, without asking a doctor. It will also help the patient to know the right drug, right dosage, right way of taking it and potential side-effects of a drug.

Implementation of legislations: Authorities should ensure that laws and legislations on providing drugs from pharmacies are strictly followed. Drugs that can cause life threatening situations should never be provided without prescriptions.

Clearly communication the crucial information: The drugs that are commonly takenforailments considered as self-recognizable; should contain the information on their packaging about how to take the drugs,how they react when taken with other drugs, the side-effects as and how tomonitor them, how long the drug can be taken, the dosage above which the drug can become dangerous etc.

Advantages and Disadvantages of Jean’s self-medication

Self-medication can be favorable for patients, healthcare specialists, and the pharmaceutical industry if the drugs are used in the proper way. However, it can create life threatening situations as well.

Advantages:

Self-medication givesJean greater independence and empowerment in making decisions about treatment of minor sicknesses.
It helps Jean to prevent ailments that do not require a doctor.
It helps her save precious time and money.

Disadvantages:

She has the risk of misdiagnosing a disease.
She might take drugs in the wrong doses.
The drugs can have side effects that might not be frequent and apparent at the beginning, but they might gradually develop life-threatening illnesses without showing any symptoms.
The drugs might have adverse reaction while taken with other drugs.
If she takes self-medications and temporarily treats ailments avoiding professional help when it is necessary, the ailment might become more severe. This might ultimately cause her to spend more money.

Should Jean be encouraged to self-medicate at this time

No, Jean shouldn’t be encouraged to self-medicate at this time. She has just been discharged from the hospital and she might not be fully recovered. The drugs that she took during her stay at the hospital might still have effects on her body and self-medication may have adverse reactions with those drugs. Also, before her admission at the hospital she had faced difficulty sleeping and had been forgetful. These could be signs of side-effects caused by self-medications which weren’t apparent at the beginning. But due to prolonged duration of self-medicating these problems have manifested over the years without showing prior symptoms. Continuing her self-medication at this time would be very risky because of these reasons.

Case Study 3

Question 2

When a person reaches adulthood his/ her nutritional needs reduce. Generally, adults need to eat a healthy diet containing carbohydrates such as bread, potatoes, rice or pasta, protein such as meat, eggs, cheese or ï¬sh, and fruit and vegetables. The intake of fatty and sugary foods should be little.To support Mr. H in meeting his dietary needs, it is essential to recognize if he has any deficits as well. With the help of a nutritionist, his dietary needs should be properly identified. A chart should be made listing the daily nutrients necessary for Mr. H and the foods that can meet these needs.

However, the care doesn’t end there. Good Nutritional care doesn’t only include providing safe and nutritious food according to the specific needs of the individual. It goes beyond that. Mr. H should be provided what he wants, when he wants, and where he wants it. And in doing so, maintain the safety of the Mr. H and others around him should be ensured. Moreover, it is fundamental in providing quality service to ensure that Mr. H’s choices are respected and heard, and his independence is promoted. Since Mr. H has mood swings, however; it might not be possible to listen to his every whim. But it should be made sure that he doesn’t feel frustrated. As he is forgetful, it is necessary to make sure he takes his food in time. And keeping a track of his food intake will also be useful. It is also necessary to make his meal times enjoyable. It might have greater and significant impact in his mental health. Dining with other members might also improve his learning abilities and social skills.

Providing quality service entails giving the service user independence and empowerment. Because of this, it is important to support Mr. H to cook his meal. It will make him feel empowered and give control. Also, not giving him the chance to cook might make him frustrated which might cause him to do something harmful to others and himself. Since he is semi-independent, it is necessary to appoint a supervisor to make sure he doesn’t harm himself or others. The materials used to cook or cut the ingredients should be safeguarded. He should be under constant supervision the whole time.

Question 3

Risk taking can be petrifying, for the individual concerned as well as the family members. According to the National Minimum Standard relating to risk states that service users should be supported to take risks as they are free to lead an independent lifestyle. By following a system and identifying how risks can be analyzed and lessened, calculated risks can be taken. There can be various benefits of risk management for the service users including learning new skills, amplified independence, self-esteem and participation. (Thomas, Mason, & Ford)The risk management systems and policies should include recording recommendations and actions. A good risk assessment tool should be used, one that is not too lengthy but user friendly. Finally, review is also a crucial point in risk management. Putting all the policies at work, more responsible risks can be taken.

Question 4

The management of medication is perhaps one of the most precarious tasks of a care worker. Regulation13 of theHealthandSocialCareAct2008talks about the management of medication in a residential care.

It mentions that the registered individual is supposed to protect users against the associated risks resulting from unsafe use of medications, by different means of necessary arrangements for obtaining, recording, using, safe keeping, safe administration and disposal of medicines used for the purpose of the regulated activity. (The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010)

People who follow this regulation will managemedicinescarefullyandappropriately,make surethatmedicinesareprescribedandgivenbypeoplesafely,maintain the guidanceonusing medication in a safe way.

The management of medication follows a standard procedure including receipt, recording, storage, handling, administration and disposal. (Thomas, Mason, & Ford). Receipt involves identifying what is required for each service user and attaining those medications. A clear ordering system should be maintained in order to ensuring effectiveness of the process. Clear records should be kept about medications of individuals, taking into account the confidentiality issues. Medications are personal information and should be kept confidential. The record should be in accordance with data protection act and National Minimum Standards. Planning storage of medication is very important. All medications should be under lock and key. Medicines should be taken out of the locked cabinet only when required and should be put back in it immediately after using.

Question 5

Effective communication is the basis for involving service users in the decision-making process. For data to be valuable, it requires to be in a format that is understandable, reachable to people who need it. The communication procedures of an organization must consider the needs of service users and staff.

a) Feedback:Creating an effective feedback mechanism can develop effective communication. By considering constant feedback from users, the organization can make sure the rights of the users are maintained.

b) To promote and maximize the rights of service users the organization can create an effective information and communication strategy, suited accordingly to the needs of service users and staff.

c) To make sure information is readily available, an integrated information technology system can be introduced which will enhance the quality of care and delivery of services.

d) The organization should have clear communication principles including: transparency and honesty, use of apt language and variety in approaches of communication; compassion and understanding; effective listening.

e) The organization should provide training for staff on how to communicate with users and care workers.

f) It should develop efficient procedures for obtaining valid consent for examination, treatment and/or care;

h) The organization canpublish a range of updated information about services, situations, and treatment, care and support options available.

Question 6

Viewing people in residential cares as passive recipients of care, who are incapable to make choice and take control, contributes to loss of independence. Perceiving service users as powerless suggests that they cannot have both care and empowerment. Society’s negative view and attitude towards people who require social care services can also cause loss of independence. Lack of acceptance and dignity can also cause social exclusion and non-participation. When a service user feels he/she is not being listened to or being cared with dignity, the individual tends to participate less. When the individual thinks he/she has a choice and control over his/her health care decisions, the person is naturally encouraged to participate more. Above all, the general mindset of people who are around about people in residential care can significantly impact participation and independence of service users. Viewing them as incapable, powerless, and showing gestures that suggests they are different can cause non-participation and social exclusion.

Conclusion

Empowering individuals in health and social care is vital to their treatment and wellbeing. However, organizations might face barriers and difficulties in doing so. The organization can achieve the best possible outcomes through careful planning, policy making, risk assessment, management of medication, providing what the service users wants and involving them in the decision making process.

Bibliography

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. (n.d.). Retrieved from http://www.legislation.gov.uk/ukdsi/2010/9780111491942

Thomas, A., Mason, L., & Ford, S. Care Management in Practice for the Registered Manager Award NVQ 4.