1.Working with person centred values means respecting individuality, allowing and supporting individuals to retain this or if required restore it. Person centred values should be at the very core of social care work, and infact is a legal requirement as many of it’s values are mimicked in acts such as the human rights act and the health and social care act, furthermore it should be present in your companies policy and codes of practice. If you are practicing proficient person centred values individuals should feel they are supported in accessing their rights, treated as an individual, supported to exercise choice, have privacy if they want it, are supported to be as independent as possible and are treated with individuality and respect. Clearly to ensure this is happening person centred values will have to be considered in every aspect of your work, making it much more effective and less invasive.
2. Identity, self image and self esteem all to a certain extent rely upon and effect each other. Identity is about people being themselves and being allowed to make their own independent choices as to what that is. There are many different forms of identity such as religious, cultural and personal things such as the way you dress or what colour you want your hair. This ties in with self image which is the way individuals envisage themselves in relation to abilities, appearance, and personality. If they are allowed to form their own identity this will generally create a healthier self image as they are in control of this and as they have been allowed to focus on what they appreciate and respect meening they will be more likely to appreciate and respect themselves, this in essence is self esteem. Self esteem is about self respect and the confidence in one’s own worth or abilities. Clearly if people make you doubt your identity or self image or try to change this it will belittle you knocking your confidence in your own worth and your self respect
3. There are many factors that will contribute to the well being of individuals, these include but are not limited to, spiritual factors that enrich lives and touch people and are uplifting on a deep level such as religion, music and art. Emotional factors e.g. close bonds with family and friends, happy memories, photographs, correspondence etc… Cultural factors that respect the individual’s likes choices and preferences and that give them a sense of what is normal to them. Religious factors such as attending church or mosque or visits from their local religious leaders, being able to and supported to celebrate religious celebrations, having an appropriate place to pray etc… Social factors such as opportunities to be with others, to communicate with others, to share in a group experience. Lastly Political factors such as being involved and having a say in what is happening or should happen in their environment and having their opinions respected.
4. 1- Individuals- this is the risks that individuals pose to themselves or others, examples include the risk of scolding whilst making tea, the risk of violence, the risk of falling down stairs, manual handling (TILE) etc… this relates to staff and service users. As far as service users risk assessments should be easily available and carried out and renewed regularly, generally with their support plans. 2- Environment- this refers to environmental dangers, for example the risks of trips and falls on carpets, the risks of fires, the risk of drowning (ponds, swimming pools) etc… This relates to all the possible risks in your environment and should be used as a tool to reduce these risks wherever possible and provide guidelines for dealing with consequences of these risks should they ever arise.
3- Dangerous substances- This is the risks of and dangerous substances in your work place, for example cleaning products, medication, DIY materials etc… These risks should be covers in COSHH training and ways to deal with the dangers should be available on COSHH sheets. Most premises will have to use some form of dangerous substance so you must weigh up the risks verses the benefits and apply suitable working practices. 4- Equipment- refers to the dangers that may arise from using equipment around the workplace, for example lifting equipment, cooking equipment, bathing equipment etc… these risks refer to using the equipment safely and appropriately, sometimes it may be deemed to much of a risk for a certain individual to use some equipment (forgetful due to an illness/medication, pregnant etc) so this must be documented and regulated.
5. Employers and companies have a responsibility to ensure people in their care (employees/ service users) are being safeguarded as much as possible and not unnecessarily being put in harms way, this is one of an individual’s most basic rights. However sometime’s risks will be a necessity so risk assessments are there to make sure this is done in the least dangerous and most appropriate way so as not to endanger anyones health and ensure individuals are fully aware of the risks involves so they know what they are doing and how to do it properly.
6. Assessments need to be regularly revisited because risks are liable to change, for example risks individuals impose on themselves or others can change regularly, this could be growing more unstable due to old age or becoming much more or less violent during times of ill mental health or other factors. Equipment could be upgraded and need to be used in a different way to be considered being used safely, the same goes for dangerous substances and changing environments. Things continually change so risk assessments should acknowledge and represent that if they are to be effective.
The care plan means we can focus specifically on individual A’s needs as opposed a more ‘blanket’ style of care. The support plan focus’ on ‘ personal hygiene, bathing, appearance, shopping, cooking, kitchen management, budgeting, finance, fitness, mobility, domestic responsibility, enjoyment, achievement, education, employment, health, medication, social interaction, personal short term aspirations and long term aspirations.’ Clearly these factors are going to differ greatly with peoples individuals needs, so going through the care planning process allows us to identify individual A’s specific personal needs in these areas. Individual A will also be involved throughout the care planning process so that they can identify their own needs. In this way we can provide much more person centred care. Individual A suffers from enduring mental health issues, this is some cases can effect capacity however this individual has been seen to have full capacity.
Therefore it is up to staff to fully explain the benefits And downsides to choices and allow the individual the final decision. Often this may be seen as a negative choice but as the individual is fully informed and deemed able to make the choice the final decision is theirs. This is called informed consent, if staff withheld information this would no longer be the case as the individual has not been made fully aware of the repercussions of their actions. This is extremely bad practice and should be raised with management or a body such as the CQC if done continually or after the issue has been raised. If the individual is deemed unable to establish informed consent then you would have to have this recognised formally with a DoLS order (deprivation of liberty safeguards) This is done with a best interests assessment by The Court of Protection to ensure that the person is in fact lacking the ability to make informed consent and that it is in the individuals best interest to have their liberty’s deprived.
Someone who does not have capacity is deemed to be unable to one or more of the following; understand information given to them, retain that information long enough to be able to make a decision, weigh up and understand information given and the consequences of decisions, communicate their decisions by any possible means. Examples of appropriate deprivations of liberty include; medication being given against a person’s will and restraint. The DoLS order will be regularly reviewed to make sure individuals are still unable to make informed consent. Individual A has low motivation due to the nature of their illness, this can make active participation quite hard as they will often shy away from any participation. Due to this it is often quite small things, that alot of us would find an everyday task. Individual A has does not like leaving the house so would rather his shopping be done for him however he has shown he is capable so staff will make sure that he does participate in this, at first staff would help him write lists however as time has gone on he has become more able to make his own decisions once in the shops, this meens individual A is gaining skills and independence as apposed to being allowed to opt out.
The same goes for the individuals cooking, at first his skills were very low to the point he would ask staff to microwave ready meals for him. To help build these skills staff have slowly ensured he did more and more by asking him to come and watch the first time and then watching whilst he does it the next time then allowing him to do it himself, then moving on to the same process but with cooking meals from scratch such as Bolognese or curries, this learning curve is longer as there are clearly more processes to remember however it is worthwhile as it a allows the individual to gain valuable life skills and improve their diet. Other examples of active participation include taking part in house meetings, so the individual has a say in which the housed is run, taking part in communal cooking (Sunday roast) joining and engaging in social groups (writing groups, tea groups) the list goes on. Active participation can be a slow process and as i mentioned before may be what you would consider the smallest of things but it is important to have patience and stress the importance of this so that individuals can build the skills they need and gain more autonomy.
I would support the individual to challenge decisions made by others firstly by making sure they fully understood the meaning and repercussions of the decision made, once this is done they are in a greater position to decide whether they are happy with this decision. If they are not then i would explore the alternatives with them, this can be done either by letting them voice exactly what they want or if this is not appropriate or their decision is not possible by presenting them with the available alternatives and explaining the meaning and repercussions of these. Once that is done you can start the process of challenging the actual decision that has been made. This process will differ greatly depending on the nature of the decision, if it is quite simple such as meals being cooked for them then the process is quite easy, simply communicate the individuals wishes to other staff and management and monitor that this is being fulfilled and raise your concerns at a higher level if it continues be ignored.
Some decisions may be harder to challenge such as those regarding medication or CTO’s. To challenge these you would need to set up a meeting with groups of professionals such as psychiatrists and care co-ordinators, once the meeting is set i would support the individual to raise their concerns or if the individual was not confident doing this raise them for the individual with their permission, explaining why the individual feels this necessary and the possible benefits of the change. After this is done it will generally be left with these professionals to have the final say. If the individual is still unhappy and their discontent is valid then i would help them to dispute this and again take it to a higher level until the issue is resolved or deemed to be inappropriate to change.