Unit 2 notes.pdf · version 1

Unit 2 Equality, diversity and rights in health and social care LO1: Understand the concepts of equality, diversity and rights and these are applied in the context of health, social care and child care environments  EQUALITY To give everybody the same opportunity regardl...

Unit 2 Equality, diversity and rights in health and social care LO1: Understand the concepts of equality, diversity and rights and these are applied in the context of health, social care and child care environments  EQUALITY To give everybody the same opportunity regardless of differences which means treating people according to their need. People should not be discriminated against because of their gender, age, ability or disability, race etc. IT IS NOT JUST ABOUT TREATING PEOPLE THE SAME  DIVERSITY Recognising and respecting individual differences ie race, religion, cultural differences, food, family structure, marriage, gender or gender re- assignment, age, sex or sexual orientation, language or social class etc  Empowerment Enabling individuals to be in control of their life process through which people gain greater control of their own life/ authority or power given to someone/a clear voice (1) over decisions and actions affecting their own health / the process of becoming stronger and more confident, especially in controlling one’s life(1)  P Rights R CHOICE E CONFIDENTIALITY PROTECTION FROM HARM/ABUSE C CONSULTATION RIGHT TO LIFE C EQUAL & FAIR TREATMENT C  Advocate PROCESS: Somebody who represents the views, preferences choices of somebody they are speaking on behalf of RESULT: SU can make an informed choice and take control of their life VALUES OF CARE Core principles which underpin the work of those providing health, social and child care services. Provide a way of working ensuring individual service users receive appropriate care and do not experience discriminatory attitudes, have their diversity valued and rights supported. Values of Care H&SC PROMOTING equality and diversity: Equality: access to care services provided for all ie ramps, hearing loops, information in various formats (braille, large font, languages) Diversity: choice of menus, choice of activities, Values of Care H&SC PROMOTING individuals rights and beliefs: Rights: mobility, dietary, communication needs are met, accessible to all, consulting with …….. Beliefs: cultural and dietary requirements met, ie halal and kosher, providing reading room, festivals Values of Care H&SC MAINTAINING confidentiality: Confidentiality: private information shared on a need to know basis only, GDPR regulations followed ie data stored securely and not shared with third parties, electronic data stored securely, not talking in corridors etc Values of Care - Childcare MAINTAINING confidentiality: Anti discriminatory practice: Working with other professionals: C a P Values of Care - Childcare ENCOURAGING learning & development: VALUING diversity: ENSURING equality of opportunity: E V E Values of Care - Childcare MAKING welfare of child paramount: KEEPING children safe and healthy: WORKING in partnership with M parents/guardians: K W Support Networks Advocacy Services (SEAP, Mencap, Empower Me, British Institute of Learning Disabilities) Support Groups (Mind, Age UK, Headway) Informal Support (friends, family, neighbours)  Unit 2 Equality, diversity and rights in health and social care LO2: Understand the impact of discriminatory practices on individuals in health, social care and child care environments Indirect Discrimination Indirect discrimination occurs where a policy/practices of an employer or organisation applies to everybody but results in people with certain protected characteristics (e.g., race or gender) being put at a disadvantage/ has an adverse impact disproportionately on one group. Can be intentional or unintentional Direct Discrimination Intentionally putting somebody at a disadvantage Abuse Physical abuse: physical pain or threatens physical pain, physical injuries Verbal abuse: name calling, insults, humiliating Psychological abuse: sometimes called emotional abuse, threats, constant criticism, undermining the individual, controlling behaviours Sexual abuse: any type of unwanted sexual contact whether victim is dressed or undressed Neglect: where the carer fails to care for somebody properly, ie basic needs for warmth, food, clean clothing etc are not met  Prejudice: where somebody has a negative attitude against an individual or group – based on ill-formed opinion. An eg may include not wanting to be alone with somebody who is gay/lesbian because they may ‘come on to you’ Stereotyping: making judgements about groups of people, ie those unemployed are lazy, girls are better behaved in class than boys Labelling: identifying people negatively, assuming all same ie old people are all frail Bullying: range of negative behaviours that intimidate an individual (physical, verbal) Who is affected Service users Friends and families of service users Practitioners How does it affect them? Disempowers them Lowers self-esteem Lowers self-confidence Poor health / well-being which could include (injuries, withdrawn, frightened, anxious, affect ability to work – loss of concentration, aggressive, sad,  Unit 2 Equality, diversity and rights in health and social care LO3:Understand how current legislation and national initiatives promote anti-discriminatory practice in health, social care and child care environments Legislation – protects both the service user and service provider. It states their responsibility in law.  The Care Act 2014 Outlines the way in which Local Authorities (LA’s) should: Carry out carer’s assessments Carry out needs assessments Determine who is eligible for support Charge for residential and community care ALSO puts new obligations on LA’s The Care Act 2014 Duty on LA’s to promote an individual’s wellbeing: Personal dignity Protection from abuse and neglect Physical and mental health and emotional wellbeing Social and economic wellbeing Suitability of living accommodation and control by the individual over day-to-day life Where a LA make a decision about an adult they must promote that adult’s wellbeing The Care Act 2014 Continuity of care Must be provided if someone moves from one geographical area to another – there must be no gap in care/support The Care Act 2014 Duty on LA’s to carry out Child’s Needs Assessments (CNA) Where young people are likely to need care and support after they reach the age of 18 a CNA must be carried out The Care Act 2014 An independent advocate to be available to facilitate the involvement of an adult or carer who is the subject of an assessment, care or support planning or a review The Care Act 2014 Adult safeguarding – this includes responsibility for enquiries into cases of abuse and neglect, establishment of Safeguarding Adults Boards, responsibility to ensure information-sharing and inter- professional working The Care Act 2014 Local Authorities (LA’s) have to guarantee preventative services that could help reduce or delay the development of care and support needs, including carers’ support needs The Health & Care Act 2012 Intro Aim of improving the quality of health care provided and promoting individuals’ rights to a fair and inclusive service Abolishment of primary care trusts and introduction of clinical commissioning groups ENABLING SERVICE USERS TO HAVE MORE CONTROL GIVING MY POWER TO THOSE PROVIDING CARE TO COMMISSION CARE TO BEST MEET LOCAL NEEDS No decision about me without me To become guiding principle behind all treatment of service users Patients should be empowered to pick GP, consultant, treatment, hospital. This empowers the individual as they are consulted and involved in decisions being made Clinical Commissioning Groups Replaced primary care trusts GP led bodies responsible for commissioning the majority of health services in England (including: primacy care services: doctors, dentists, pharmacies and secondary care services: emergency care, hospital care, community and mental health care – ie provided by hospitals) Health and well-being boards NHS and local authorities became responsible for improving health and reducing inequalities The health and well-being boards made up of health and social care commissioners, councillors and a lay representative to bring together different sectors incuding NHS, public health, adult social care, children and young people’s services and encourage them to work together in partnership to deliver local services and tackle inequalities in peoples health and well-being Public Health Public Health England (PHE) – responsible for public health services Planned, delivered and monitored by local authorities with increased emphasis on prevention No longer part of NHS / now responsibility of local councils Focus on prevention, public health services and population health improvement (eg obesity, smoking, screening, vaccinations) Healthwatch Healthwatch England (HWE) to protect the interests of service users and provide information and advice to those who plan to deliver and monitor services Communicates the views of patients to commissioning bodies (CCGs) and regulators (CQC) A service user who moves to an area can ring Healthwatch to find out information about local services and options available  The Care Quality Commission (CQC) became responsible for monitoring quality of care. Independent regulator of adult social care in England. Providers of different services may ask for feedback on their performance. This can be used in CQC inspections Voluntary register for all health care support workers to sign up to – includes minimum training, knowledge and skills needed for job role – service user should therefore receive effective quality care by trained, high quality support staff  The Equality Act 2010 Makes it illegal to DIRECTLY or INDIRECTLY discriminate against somebody on the basis of a protected characteristic (9). Includes victimisation and harassment. Prohibits discrimination in education, employment, access to goods and services, housing  The Equality Act 2010 Age Disability Gender re-assignment Marriage and civil partnerships Pregnancy and maternity Race Religion or belief Sex Use of non- Sexual orientation discriminatory language  The Equality Act 2010 It states that reasonable adjustments have to be made by employers or providers of goods and services Women have a right to breastfeed in public places or and not treated less favourably Encourages POSITIVE ACTION – in order to represent under-represented areas. Offer guaranteed interview if all other selection criteria are met Pay secrecy clauses are illegal No discrimination by association (ie carer of somebody with one of nine protected characteristics Direct/indirect/victimisation/harassment Prohibits discrimination in education, employment, access to goods and services The Mental Capacity Act 2005 Making sure that the service user has the CAPACITY to make THAT decision at THAT time Every adult has the right to make their own decisions and carers must assume they are capable of this, unless it can be proved otherwise The Mental Capacity Act 2005 What are the five statutory principles of the Mental Capacity Act? Capacity Support (to make decisions) Unwise decisions Best interests Less restrictive option Capacity Has the service user the capacity (at that time) to make (that) decision? Must not make the assumption that they have not got the capacity because of a condition. Must carry out a ‘functional test of capacity’, can they demonstrate they understand the basics of the decision, retain it, weigh up options and communicate their decision? Support to make own decisions Service user must be given all the practical support they can to make the decisions Ie making the information available in different formats Meeting with professionals Visits Unwise decisions People have the right to make might be regarded as an unwise or eccentric decision (providing they can prove they have the capacity to make the decision) They cannot be treated as lacking capacity for having a different belief Best Interests Where a service user lacks capacity any actions taken should be taken in the service users best interest They should firstly consider could the action be delayed until the service user has the capacity to make a decision They should try to involved the service user as much as possible and any actions must be in the service users best interest, descriptions as to why this action was taken must be recorded. Less restrictive options If the service user lacks capacity then any actions taken on their behalf should the least restrictive to their basic rights Writing it up Clear documentation is needed  The Children Act 2004 Aims to protect all children fat risk of harm and keep them safe Practitioners may need to remove a child from their home Practitioners who work with children MUST follow safeguarding procedures  The Children Act 2004 PROTECTING – children at risk, may need to remove child through emergency protection order or care order PARAMOUNTCY PRINCIPLE – child’s best interest and welfare is the first and foremost consideration, ie the child must come first, removing child to keep it safe might upset the parents but so be it. Children have the right to stay with wider family circle where possible. Issues have to be sorted as soon as possible  The Children Act 2004 CONSULTATION – child has a right to be consulted and if old enough/mature enough their decision should be taken into account. Gives the child the right to speak out and their opinions taken into account ie in a custody battle the view of which parent they would like to live with  The Children Act 2004 ADVOCATE – the child has a right to an advocate Children should be consulted and have their views taken into account  The Children Act 2004 EVERY CHILD MATTERS SHEEP – child has a right to: stay SAFE be HEALTHY ENJOY & achieve achieve ECONOMIC well-being make a POSITIVE contribution Puts duty on local authority to promote cooperation between practitioners  The Children Act 2004 ENCOURAGES PARTNERSHIP WORKING – ensure information is shared in order to keep children safe Care practitioners MUST follow safeguarding procedures To protect the child information MUST be shared with appropriate teams  The Children Act 2004 CREATED ROLES OF CHILDREN’S COMMISSIONERS – and set up local Children’s Safeguarding Boards (legal requirement), raises awareness of best interests of child. Reports to parliament Established the Children and Young Peoples Plan (CYPP) All of this gives children a voice and represents their interests The Data Protection Act 1998 Information commissioner Data controller Data user Data subject 8 principles On holding data on SU with their permission, sharing on a need to know basis Data must be: Processed fairly and lawfully Used only for specified purposes Adequate and relevant and not-excessive Accurate and up-to-date Kept for no longer than necessary Processed in line with rights of individual (SU has a right to know and have it put right or removed) Secure (restricted access, password protected, anti-virus, backup) Not transferred out of EU Rights Data subjects have a right to see information held on them They may have to pay to see the information – this should be a reasonable amount Once requested the information should be produced within a reasonable time frame Data subects have the right to see information about them, have it corrected if it is out of date, and have the right to have it removed if it is old data. The Children & Families Act 2014 The role of the Children’s Commissioner Parents who have a new child Family courts and justice SEND The role of the Children’s Commissioner Given the Children’s Commissioner stronger powers Commissioner’s role is not just represent the views of children but now includes ‘promoting and protecting’ the rights of children The Commissioner has to focus on the rights of ALL children inc: those in care or away from home Parents who have a new child Entitled to parental leave – mothers, fathers or adopters and can choose to share parental leave Fathers or mothers partner can have unpaid leave to attend up to two appointments Allows both parents time off to attend appointments before the baby is born Allows people who are going to adopt a child to have time off work to see the child and go to adoption meetings Family courts and justice Introduced 26 week deadline for the family court to rule on care proceedings (can if necessary be extended by a maximum 8 weeks) In cases where families are splitting up the courts should help parents do what is right for their child, not what the parents want Courts are to take the view that after separation both parents should be involved in their children’s lives, if it is safe and in the child’s best interests Removed contact and residence orders and introduced a single order called a child arrangement order  SEND – children with special education needs and disability Introduced EHC Plans – educational and health care plans Children’s needs are assessed in a holistic way with EHC plans Gives rights to a personal budget for children with an EHC plan When writing EHC plan, families have to be involved with discussion and decisions about the children’s care and education Young people and parents must be informed the local authority (LA) of support they are entitled to so that they know what is available Schools to be provided with more support for children with medical conditions in order to meet their needs. This extends the choice to allow children to attend mainstream schools if they want to The act aims to get education, health care and social care services working together The Human Rights Act 1998  Rights: Right to life – (need to access food/water, medicine, care, can’t automatically turn off life support – permission needed from courts) Right to respect, privacy and family life – (not discussing information where others can hear – taking family to quiet area, putting curtain around, putting support in place to allow somebody with physical/mental disability to live independently) Right to liberty and security – individuals cannot be detained unless committed a serious crime or sectioned under the Mental Health Act as being a danger to themselves or others  Right to freedom from discrimination – rights are supported by The Equality Act 2010 Right to freedom of expression – individuals have a right to their own opinions and have a right (within legislation) to express these. For examples H&SC service users have a right to consultation and choice Right to freedom of thought, conscience and religion – each individual has a right to their own faith and religion and beliefs, which should be respected. Schools/care homes etc should not just support Christmas but should also support Diwali, Hanukkah etc National Initiatives Care Certificate 2014 Sets out minimum standards that should be covered in induction training Is for ‘unregulated’ jobs in H&SC sector 15 standards of care  Think about how these are Care Certificate 2014 implemented in an organisation Understand your job role Safeguarding adults Your personal development Safeguarding children Basic life support Duty of care Health and safety attend course, Equality and diversity man handling, COSHH Work in a person centred way Handling information, need to Communication know Privacy and dignity –knocking on door etc Infection control Fluids and nutrition Awareness: mental health, dementia, and learning disabilities Think about benefits to service users, service providers and organisations OFSTED – Office For Standards in EDucation Carries out inspections that rate child care settings (childminders, nurseries, residential settings, schools, colleges etc). Rates them OUTSTANDING, GOOD, REQUIRES IMPROVEMENT, INADEQUATE. Inspects 5 areas: Effectiveness of leadership and management; Personal development, learning and behaviour; Quality of teaching, learning and assessment; Outcomes for children and learners; Effectiveness of safeguarding Produces a report. Identifies areas of good practice and areas of improvement OFSTED Puts failing schools into special measures, re-inspects to monitor progress Reports available on line for all identifies area of good practice and areas to improve Raises standards in education sets expected targets, guidelines so practitioners know what to do/is expected Ensures person centred approach to learning keeps children safe and ensures legislation is followed Makes sure individual needs are met identifies training needs Identifies if educational setting offers value for money Graded: OUTSTANDING, GOOD, REQUIRES IMPROVEMENT, INADEQUATE  CQC – Care Quality Commission Regulator of H&SC in England (not UK) It registers and licences care services to ensure essential standards of quality and safety are met (inc care homes, doctors, hospitals, walk-in centres etc) Carries out on the sport inspections of providers to monitor care Publishes inspection reports – available to all, report identifies areas of good practice, areas to improve Care settings are rated: OUTSTANDING, GOOD, REQUIRES IMPROVEMENT, INADEQUATE Ratings should be displayed, warning notices and fines can be issued if standards are not met Can be re-inspected quickly if not up to standard, can withdraw licence and close down CQC – Care Quality Commission Should improve quality of care Report available to service users and family can read it and make informed decisions EHRC – Equality & Human Rights Commission Has a website with information, advice and guidance on discrimination Provides details of a support-service helpline Provides factsheets about discrimination (based on 9 protected characteristics) Suggest ways to sort out situations Provides advice on how to make a discrimination complaint Provides information on how to take a case to court NICE – National Institute for Health & Care Excellence Assess new drugs and treatments as they become available (safety/value for money/suitability) Provide evidence based guidelines on how particular conditions should be treated Provide guidelines on how public H&SC services can best support people Provide information services for those managing and providing H&SC Improve outcomes for those people using NHS and other public H&SC services NICE Will consider if a drug / treatment will: Benefit patient Will help NHS meet its targets Offers best value for money / cost effective Should be available on NHS Helps NHS meet targets Impacts of legislation and initiatives Person- centred Raises approach to care Individual standards needs of care met Impacts of Guidelines Legislation for and national Empower- practitioners initiatives ment System of Accessible redress services Person centred approach to care Legislation and national initiatives and values of care all focus on person centred approach Service users can say what is important to them and this must be listened to. This empowers them and improves their quality of life Individual needs are met Empowerment Accessible services Reasonable adjustments must be made by employers, education providers, providers of goods and services etc All contribute to making goods and services accessible to all Giving all an equality of opportunity Provides a system of redress The rights that individuals have to have something put right that is wrong / the process of putting right a wrong IE How to make a complaint Eg under data protection could have information removed (if out of date) or put right if wrong. How to take legal action/ under some legislation you could seek financial compensation, fines for breaking the law etc Clear guidelines Ie in Mental Capacity Act - stages that must be follow Or for some legislation a company will have its own policy which will state how the company will meet the law. Guide to staff of what is expected/how to work. Staff know their responsibilities, could protect staff if things go wrong. This would give the service user clear guidelines on what is expected of them, an agreed way of working This should ensure consistency of care, build trust between SU/SP Provides a system of redress Raises standards of care OFSTED Promotes improvements / raises standards / publish reports Identifies good practice / identifies areas for improvements Ensures services offer value for money, are efficient and effective CQC Registers and monitors services Regulates services such as hospitals, GP, walk in centres, care homes Sets standards / checks services meets standards / publish reports Award ratings – must be displayed Staff selection and interview procedures Asking same questions of each Scoring system Interview staff should be trained in equality Should be policy on equality Interview must take place where accessible for all Can take positive action Organisational Policies Benefits to staff Know what they are doing Ensures good practice Helps protect them from accusations Benefits to service user Consistency of care Should all be treated fairly and according to their needs Should help them feel safe Benefits to organisation Benefits to organisation Provide quality service Organisation run smoothly, protected from complains, prosecution  Applying best practice in health, social care or child care environments Being non-judgemental Think about Eric, he looked old, tired, unkept The nurse used effective communication skills Made no assumptions about Eric Used empathy, time and patience She was open minded, accepting of when he wanted to talk/eat yet encouraging Respectful of his feelings, experiences and values Respecting views, choices and decisions of individuals who require care and support Allowed to make wrong choice (Mental capacity act) Empower to take control and make own decisions Provide person centred care Provide care that meets individual needs Make SU feel valued and supported Anti-discriminatory practice No favourites All treated fairly Challenging discrimination Role models Making things inclusive for all Valuing diversity Recognising and valuing that everybody is different Non-judgemental Offering choice (food/toys/trips/festivals/prayer)  Not enough to just say EFFECTIVE COMMUNICATION Using effective communication was used – link to examples Think about Eric – used simple language, used whiteboards so adapted communication, was an active listener Think about community nurse with lady in Mental Capacity Act video – worked with SU to enabled informed choice be made about chair and bed, making sure she had the information she needed to be able to make decision, used images on phone to help, Think about the young man with the carer who needed an endoscopy – how they worked to try to make the information accessible to him ACTIVE LISTENING / ADAPTING / VOCAB / SPECIALIST METHODS Following agreed ways of working Ie 5 steps in the Mental Capacity Act Policies and procedures Consistent care / care within the law is given / improves quality of care / provides support / everybody knows how to work or what is expected of them Training and professional development opportunities for all staff Ensure all staff are up to date with latest legislation, skills and knowledge to do their job Provide CPD Promotion opportunities Work shadowing Performance management targets Meetings / workshops The Care Certificate Mentoring, monitoring and performance management of staff and attending staff meetings MENTORING - A system where a more junior member of staff is partnered up with a more senior/experienced member of staff to share their knowledge or skills. The more experienced staff member can offer support and guidance MONITORING – involves checking the progress/process through observation or asking questions/monitoring surveys or complaints over a period of time PERFORMANCE MANAGEMENT – staff are given targets or areas to improve, monitored/observer STAFF MEETINGS – share good practice or concerns, review policies, updates, solve problems Discriminatory Practice in Health, Social Care and Child Care environments Direct discrimination (against one of nine protected characteristics) Indirect discrimination Discriminatory Practice: Stereotyping labelling prejudice inadequate care abuse and neglect breach of health and safety being patronising Choosing appropriate action/response to promote equality, diversity and rights in health, social care or child care environments https://www.scie.org.uk/contact/concerns/whistleblowingvideo Reporting an incident to the relevant authorities (Ofsted, CQC) Reporting to management (internal) Reflecting on your own attitudes Changing your practice or encouraging this is in others Choosing appropriate action/response to promote equality, diversity and rights in health, social care or child care environments Methods of challenging discrimination – challenge at the time: discuss with person, supervision, challenge afterwards: direct them to company policies, consult senior staff, disciplinary action, long term campaigns/training Whistleblowing – raising concerns with line managers, senior managers, outside authorities such as OfSted/CQC Providing information – company complaints procedure, advocacy services, Choosing appropriate action/response to promote equality, diversity and rights in health, social care or child care environments Active listening Remaining calm/objective/empathetic See both sides of argument / look for positive solution Applying values of care Implementing policies/codes of practice Mentoring / observation