Unit 2 Working in Health and Social Care - PDF

# Working in Health and Social Care ## Unit 2: Getting to know your unit **Assessment** You will be assessed by a written exam set and marked by Pearson. **How you will be assessed** You will be assessed by a paper-based examination, lasting for 1 hour 30 minutes and worth 80 marks. The examinati...

# Working in Health and Social Care ## Unit 2: Getting to know your unit **Assessment** You will be assessed by a written exam set and marked by Pearson. **How you will be assessed** You will be assessed by a paper-based examination, lasting for 1 hour 30 minutes and worth 80 marks. The examination will consist of four sections: * Short- and long-answer questions. * The questions are intended to assess your understanding of how health and care services, and health and care practitioners can meet the needs of a range of service users who need professional support. * Each section will relate to a different service user group (e.g., the frail elderly, people with learning disabilities, people with mental health problems or people with long-term illnesses). * The questions will make connections between the organisations and professionals that contribute to care and provide opportunities to discuss the challenges associated with providing high-quality health and care provision. Throughout this unit, you will find assessment practices to help you to prepare for the exam. Completing each of these will give you an insight into the types of questions that may be asked and, importantly, how to answer them. Unit 2 has four assessment outcomes (AO), which will be included in the external examination. Each assessment outcome also has some 'command words' associated with it - see Table 2.1 for a list of what these command words are asking you to do. | Command Word | Definition - what it is asking you to do | |---|---| | Identify | State the key fact(s) about a topic. The word 'outline' is very similar. | | Describe | Give a full account of all the information available, including all the relevant details of any features, about a topic. | | Explain | Make an idea, situation or problem clear to your reader by describing it in detail, including any relevant data or facts. | | Discuss | Write about the topic in detail, taking into account different ideas and opinions. | **Essential Content** * The roles and responsibilities of people who work in the health and social care sector. * The roles of organisations in the health and social care sector. * Working with people with specific needs in the health and social care sector. ## Getting started Sheila is nearly 90 and is now quite frail. She lives alone in a ground floor flat and uses a wheelchair indoors. Sheila is on a very low income. Identify and list the health and care services that might be available locally to help her live independently. After completing this unit, see you can add more services to your list. ## The roles and responsibilities of people who work in the health and social care sector ### Key Terms * **General practitioner** - a doctor who does not specialise in a specific branch of medicine but provides ongoing treatment and preventative care in the community for a variety of medical problems that may be experienced by individuals of all ages. * **Preventative care** - care and education that aims to ensure people remain healthy, and are aware of factors that can lead to illness and poor health. It includes screening and vaccination programmes. ### Roles of people who work in health and social care settings #### Doctors When people are feeling unwell, their first (or primary) point of contact with the medical profession will normally be a general practitioner (GP). GPs provide ongoing care for people in the community. This includes: * Caring for people who are unwell, including carrying out simple surgical procedures. * Providing preventative care and health education for service users. GPs are increasingly based in local health centers, working with other doctors and a range of health and care professionals (e.g. nurses, health visitors and counsellors). GPs may refer people to hospital specialists (consultants) or other care professionals for further assessment and treatment, such as X-rays or blood tests, or to social workers for social care support. The principle responsibilities of doctors in treating illnesses are to: * Diagnose an individual's illnesses and ailments. * Discuss and agree an individual treatment plan. * Prescribe appropriate medication or treatment. * Monitor the impact of the agreed treatment. The preventative care and health education services provided include: * Vaccination programmes for people of all ages. * Health education and advice on issues such as smoking, alcohol consumption and healthy eating. **Research:** List the range of preventative care and health education services provided at your GP's surgery. Share this information with the other members of your group. Are there any significant differences in different areas? #### Nurses Nurses are the largest group of professionals working in the health services. There are many opportunities to specialise and to reach senior levels within the profession, including the role of nurse consultant or nurse practitioner. * **Adult nurses** work with adults of all ages, who may have a wide range of physical health conditions. They may be based in hospitals, clinics or GP practices, or work for specialist organisations such as the armed forces. Many adult nurses work with people in their own homes. Adult nurses will often plan individual care, carry out healthcare procedures and treatments and evaluate their effectiveness. They also work to promote good health by running clinics and health education programmes on topics such as giving up smoking or weight loss. * **Mental health nurses** are nurses who specialise in mental health work. These may include psychiatric units in hospitals, community healthcare centers, day care settings, residential homes and prisons. * **Children's nurses or paediatric nurses** work with children. A children's nurse works closely with the child's parents or carers. This is to ensure that, as far as possible, the care provided meets their social, cultural and family needs, as well as addressing their health issues. Children's nurses may work in hospitals but also support children at home. * **Learning disability nurses** work mainly with individuals with learning disabilities living in the community rather than in hospitals. This may include supporting people in schools and workplaces, people living at home with their families and people who live in specialist residential settings. They aim to work with people with learning disabilities and their carers to maintain the person's physical and mental health, provide specialist healthcare and support them to live as fulfilling and independent a life as possible. * **District nurses** care for people of all ages, supporting them in their own homes or in residential homes. District nurses work closely with family members and other informal carers. They assess the patient's needs and also the care and support needs of their 'informal' carers. District nurses most commonly care for older people, people with disabilities and people recently discharged from hospital. * **Neonatal nurses** work with newborn babies, including babies who are born prematurely. They work in specialist hospital settings and in the community. The neonatal nurse works very closely with the baby's parents and actively encourages them to take a practical role in their child's care. ### Key Terms * **Consultant** - a senior doctor, normally based in a hospital, who provides specialist expert healthcare support in their area of expertise. * **Nurse practitioner** - provides expert consultancy service to patients and their carers. They contribute to the management and development of the care provision. They also undertake research and contribute to the education and training of other members of staff. #### Health Visitors Health visitors provide support for families in the early years of their children's life, normally from birth to the age of five. They offer support on health issues and minor illness, and advice on feeding and weaning. They carry out routine checks on the child's development and support parents in meeting the developmental needs of their children. Health visitors see the children and their carers in their homes, at clinics, at the GP practice and sometimes at a nursery or in other community settings. #### Practice Nurses Practice nurses work in GP practices. In small practices there may be only one practice nurse, but increasingly they are part of a larger team of practice nurses. Practice nurses' responsibilities vary according to the GP practice but will normally include taking blood samples, carrying out child immunisation programmes and administering vaccinations for people travelling abroad. Practice nurses often provide health screening for men and women, and family planning advice, if they are qualified to do so. #### School Nurses School nurses are usually employed by the NHS but may be employed directly by a school. They provide a variety of services, including developmental checks, administering immunisation programmes and providing health education programmes. #### Midwives Midwives play a central role in supporting women through all stages of pregnancy, providing both antenatal and postnatal care. This includes helping families prepare for parenthood and delivering babies in the maternity departments of hospitals and in patients' homes. Midwives may be based in hospital maternity units but an increasing number of midwives work in the community, providing support at local clinics in GP practices, in women's homes and children's centres. #### Healthcare Assistants Healthcare assistants are sometimes known as nursing assistants or auxiliary nurses. They work under the guidance and with the support of qualified healthcare professionals. They may work in GP practices, hospitals, nursing homes and other community healthcare settings. Most commonly, healthcare assistants work alongside qualified nurses, but they may also work with midwives in maternity services. Duties carried out by healthcare assistants include: * Taking and recording a patient's temperature and pulse. * Weighing patients, and recording the result. * Taking patients to the toilet. * Making beds. * Washing and dressing patients. * Serving meals and assisting with feeding when necessary. #### Social Workers Social workers provide help and support for people of all ages through difficult times in their lives. They aim to ensure that the most vulnerable people are safeguarded from harm and to help people live independent lives. Social workers support children, people with disabilities, people with mental health problems and the frail elderly. Increasingly, social workers specialise either in providing services for adults or in providing services for children and young people. * Adult services include services for older people; adults with disabilities, people with mental health problems and people who have learning difficulties. They support people living independently and those in residential care. They work very closely with the service users' families and carers. * The children and young people's services provide support for children and their families. They play a key role in ensuring that children are safe and protected from abuse. If children are at risk from harm, social workers take measures to ensure that the children are removed to a safe place. This may, in extreme circumstances, include removing them from their home and family. Social workers also work in residential children's settings and manage fostering and adoption procedures. They provide support for young people leaving care and young people at risk of being in trouble with the law. #### Occupational Therapists Occupational therapists work with people of all ages who are having difficulty in carrying out the practical routines of daily life (e.g. washing and bathing; housework; cooking or getting to the shops). These problems may be the result of a disability, physical or psychological illness, an accident or the frailty of older age. The occupational therapist will agree specific activities with an individual that will help them to overcome their barriers to living an independent life. Occupational therapists may work in people's homes, GP practices, residential and nursing homes, prisons, social services and other council departments and in hospitals. #### Youth Workers Youth workers generally work with young people between the ages of 11 and 25. They aim to support young people to reach their full potential and to become responsible members of society. They work in a range of settings, including youth centres, schools and colleges. They may be employed by the local council but youth workers are also employed by a range of religious and other voluntary organisations. Youth workers are not always based in a particular building, especially if they are working with young people on the streets. ### Key Term * **Supported housing** - shelter, support and care provided for vulnerable people, to help them live as independently as possible in the community. #### Care Assistants Care assistants provide practical help and support for people who have difficulties with daily activities. This may include supporting older people and their families, children and young people, people with physical or learning disabilities or people with mental health problems. Care assistants work in a wide range of settings (e.g. in clients' homes; at day care settings; in residential and nursing homes and in supported or sheltered housing complexes). Their exact duties will vary according to the needs of the clients, but could include: * Helping with personal daily care (e.g. washing, dressing, using the toilet and feeding). * General household tasks (e.g. cleaning, doing laundry and shopping). * Paying bills and writing letters. * Liaising with other health and care professionals. Sometimes care assistants will work with only one person, providing intensive support to enable them to manage everyday life. #### Care Managers Care managers have a key leadership role within residential care settings. They manage the provision of residential care for: * Adults and young adults with learning difficulties. * Older people in residential care or nursing homes. * People in supported housing. * People receiving hospice care. Care managers are responsible for the routine running of the residential care setting, including appointing suitable staff and managing staff teams, managing the budget, and ensuring that the quality of care meets the standards required by the sector. Care managers will manage and supervise the duties of the care assistants working in their setting. #### Support Workers The support worker role is closely linked to the healthcare or nursing assistant role discussed earlier. Support workers, however, may work under the supervision of a range of health and care professionals (e.g. physiotherapists, occupational therapists and social workers). Family support workers, for example work with and support social workers. Once the social worker has identified what is needed, the support worker may work closely with the family to help implement the plan. They may provide support with parenting skills, financial management or domestic skills. **Reflect:** Consider the range of health and care workers who support people at your work placement. There may be professionals or volunteers who are not included in this unit. The list is not exhaustive! Can you think of other professionals who might promote your clients' or patients' health and wellbeing further? Keep a list to help you prepare for the exam. ## Case Study: Caring for Imran Imran has multiple sclerosis. He uses a wheelchair both at home and when he goes out. Imran has a very caring family who are determined that they should look after him at home. He needs help with washing and dressing, he cannot feed himself any longer and he is incontinent. **Check your knowledge** 1. Identify the range of care professionals who might support Imran and his family in caring for him at home. 2. Briefly describe the contribution that each of the healthcare professionals you have identified may make to Imran's care and comfort. 3. Discuss your work with other members of your group. Have you missed anything? 4. Present your work in a table. **This will help you prepare for your exam. ** ## Responsibilities of people who work in health and social care settings ### Key Terms * **Policies** - detailed descriptions of the approach, and often the specific procedures that should be followed, in caring for clients. * **Procedures** - written instructions that outline the expected and required routines that care staff must follow in specific situations (e.g. reporting accidents or administering medicines) - to implement agreed policies. * **Safeguarding** - policies to ensure that children and vulnerable adults are protected from harm, abuse and neglect and that their health and wellbeing is promoted. In this section, you will consider the day-to-day responsibilities of people working in health and social care settings. You will examine the strategies that are in place to ensure that the care services promote the health and wellbeing of service users and meet the standards required by the health and care sector. ### Following policies and procedures in health and social care settings Health and social care organisations have guidelines that describe the working procedures that should be followed to ensure that the care provided meets service users' needs. Policies and procedures aim to ensure that all staff and volunteers work within the law and to the highest professional standards. The specific policies in place in a care setting will vary according to the client groups served and the particular function of the setting. These policies may include: * Health and safety policy. * Equality and diversity policy. * Medication policy. * Safeguarding policy. * Disclosing and Barring Service (DBS) referral policy. * Death of a resident procedures. * Complaints policy. **Research** When you are on work placement, ask your supervisor for a copy of one of their policies. Summarise the policy and explain to the rest of your group how it is used to promote the health and wellbeing of the people you support. Make notes during other people's presentations in order to gather information about as many policies as possible. **Reflect:** Think about the range of policies in place at your work placement setting. Are all staff familiar with them? Are the policies always implemented? What action is taken if staff or volunteers do not follow the official procedures? Make a note of your answers to help you with your revision. ### Healing and supporting recovery for people who are ill There are clearly many different strategies that may be used to support the recovery of people who are ill. The precise support needed will depend on the service user's condition and also their wider social and personal needs. The range of treatments and care procedures used in healthcare settings may include: * **Prescribing medication** - this has traditionally been the doctor's role. However, some nurses have undergone additional training and taken on the role of nurse prescriber. Some other healthcare practitioners (e.g. dentists, chiropodists and physiotherapists) may prescribe some medications in certain circumstances. * **Surgery** - which may play a significant part in supporting an individual's recovery from illness and other physical disorders. For example, cancerous tumors (e.g. breast lumps) may be removed by surgery if cancer is diagnosed at an early stage. Older people may require joint replacement surgery (e.g. hip or knee joints). Health and care workers in the community have an increasingly important role in supporting people recovering from surgery. This may include visits from the district nurse to monitor progress and provide specific treatments (e.g. changing dressings). Physiotherapists and occupational therapists, where necessary, support mobility and promote independence in carrying out daily living activities. Social workers may provide additional emotional support and ensure that the patient is accessing the services available. Home care workers may provide practical help in the home (e.g. preparing meals) where this is seen as necessary. A patient's recovery will continue after discharge from hospital. Community support is particularly necessary as there is a trend to discharge people as soon as possible following surgery. * **Radiotherapy** - is treatment using high-energy radiation. Treatment is planned by skilled radiotherapists working alongside a team that includes radiographers and specially trained nurses. Although radiotherapy is often used to treat cancer, it can be used to treat non-cancerous tumors or other conditions (e.g. diseases of the thyroid gland and some blood disorders). Patients may need support from their GP on completion of the treatment to ensure full healing. Common side effects of some forms of radiotherapy include itchiness and peeling or blistering of the skin. * **Organ transplant** - involves either moving a body part or organ from one person's body to another's (known as an allograft) or from one part of a person's body to another location in their own body (known as an autograft). The purpose of the transplant is to replace the patient's damaged or absent organ. Organs that can be transplanted include the heart, kidneys, liver, lungs, pancreas and intestines. The most commonly performed transplants are the kidneys followed by the liver and the heart. A living donor can give one kidney, part of their liver and some other tissues, such as bone marrow. However, other transplants come from donors who have recently died, so in the recovery period following surgery the person receiving the transplant may need the support of a counsellor. Highly skilled surgeons and their teams will carry out the transplant. However, many more care professionals will be involved in preparing the individual physically and mentally for surgery and caring for the person following their transplant. For example, specialist nurses, physiotherapists, occupational therapists, counsellors and social workers may provide post-operative support. * **Support for lifestyle changes** - changing the pattern of daily routines and habits that are damaging to health can be very challenging, but may be very important in improving a person's health. Counselling and the support of self-help groups may be crucial in implementing and sustaining lifestyle changes. For example, introducing a more healthy diet, taking more exercise, reducing the amount of alcohol consumed and stopping smoking. Healthcare professionals (e.g. GPs, practice nurses and district nurses) can assist individuals to set up self-help groups, for example by allowing them to meet in a room in a GP practice. ### Key Terms * **Self-help groups** - groups formed by people who share a common issue that they wish to address. The members provide advice, support and care for each other. For example, Alcoholics Anonymous is a self-help group for recovering alcoholics. #### Accessing support from specialist agencies Many specialist agencies support and promote the health and wellbeing of service users, especially those who have specific illnesses or disorders. Healthcare professionals can inform their service users about these agencies, some examples include: * **Age UK** - provides services and support to promote the health and wellbeing of older people. * **Mind** - provides advice and support for people with mental health problems and campaigns to raise awareness and improve services for people with mental illnesses. * **YoungMind** - is committed to improving the mental health of children and young people, through individual support and through campaigning for improved services. * **The Royal National Institute of Blind People (RNIB)** - supports people affected by sight loss, both people who are partially-sighted and those who are blind. * **Alzheimer's Society** - provides information and support for people living with dementia, their families and their carers. It also funds research and promotes awareness of this condition. **Research** Investigate one specialist organisation or agency that provides specific advice and support for the people cared for at your work placement setting. Write a short report of the aims, objectives and key activities of the organisation. Email this to other members of your group. ### Enabling rehabilitation The purpose of a rehabilitation programme is to enable a person to recover from an accident or serious illness and to live, as far as possible, an independent and fulfilling life. These programmes are particularly important after someone has a heart attack or a stroke, or following an accident that has significantly reduced their mobility or their reaction speed. Rehabilitation programmes may also be a central part of treatment for people who have a mental illness. The specific programme will vary according to the person's physical and psychological needs and their home and family circumstances, including the level of support from their family, friends and carers. Rehabilitation may include support from physiotherapists, occupational therapists, counsellors or psychotherapists. ### Key Terms * **Rehabilitation** - the process of restoring a person to good health following surgery, an accident or other illness, including recovery from addiction. * **Psychotherapy** - type of therapy used to treat emotional and mental health conditions, usually by talking to a trained therapist one-to-one or in a group. <start_of_image> It may also include using complementary therapies. Complementary therapies are not considered conventional medical treatment, and so may not be available as part of an individual's NHS care. **Discussion** Consider the range of support that may assist the rehabilitation of an elderly woman who lives alone and has not left her house since she had a burglary. Which health and care professionals might support her to live a more fulfilling life? What strategies could they use? ### Providing equipment and adaptions to support people in being more independent A vast range of equipment is available to support people to remain independent when carrying out their routine daily activities. There are many reasons for people needing temporary or permanent assistance with mobility or other activities of daily life and their needs are usually assessed by a physiotherapist or occupational therapist. Other healthcare professionals (e.g. doctors or nurses) may refer a service user to a physiotherapist or occupational therapist for assessment. Care assistants and health care assistants often provide ongoing support in using equipment effectively and adaptions to increase a service user's independence. #### Equipment to increase mobility At the simplest level, mobility appliances allow people to be more physically active and more independent in carrying out daily routines. For example, people with arthritis, people who have broken a limb or are recovering from surgery or a stroke, or who have a progressive disease (e.g. multiple sclerosis, motor neurone disease or muscular dystrophy) or are simply ageing and have less strength in their bones and muscles. Mobility aids include: * Walking sticks. * Walking frames (including tripods and tetrapods). * Wheelchairs (manual or electric). * Adapted shopping trolleys. * Stairlifts. * Adapted cars, or other motorised transport. #### Appliances that support daily living activities Individuals may need a range of other appliances to support daily living activities and to promote their independence. These could include: * Special cutlery with thick, light handles that are easy to hold for people with arthritis. * Feeding cups or angled straws for drinks. * Egg cups and plates with suctioned bottoms. * Special gadgets to help people who can only use one hand to take the lids off jars and tins, and others to help with peeling potatoes and buttering bread, kettles on tipping stands and adapted plugs to help with using electrical appliances. * Special dining chairs and armchairs adapted to meet individual needs. * Bathing aids such as walk-in baths and showers, bath and shower seats. * Raised toilet seats for service users who find it difficult to sit down and stand up again. #### Key Terms * **Assistive technology** - any tool or strategy used to help people with disabilities complete their studies successfully and reach their potential. * **Domiciliary care** - care provided in the service user's own home. This may include district nurses, home care workers and health visitors. #### Adapted computer keyboards Adapted computer keyboards and, where necessary, screens to support people with a range of physical conditions (e.g. epilepsy, arthritis and visual impairments). Some people with chronic conditions may need highly sophisticated equipment in their home to manage an independent life. For example, people with chronic bronchitis, emphysema or a coronary heart condition may need oxygen cylinders at home and people with kidney failure may need dialysis equipment. #### Technology and other resources that support educational achievement Assistive technology and a very wide range of other resources are available to support people with disabilities and other illnesses to meet their educational potential. These include: * Adapted computers to meet the needs of visually impaired and blind people. * Availability of signers and other communicators for hearing-impaired and profoundly deaf people. * Ensuring wheelchair access to all learning spaces. * Additional time in examinations for learners who are dyslexic. * Enlarged text for people with poor vision. **Research** Investigate the range of adaptive equipment available to support someone: * With arthritis in their hands and fingers. * Who uses a wheelchair. * Who has a degenerative eye condition and is partially sighted. Which healthcare professionals might be able to help them find the adaptive equipment they need? How might the equipment be paid for? Would they have to buy it themselves? ### Providing personal care - including washing, toileting and feeding Keeping clean, enjoying a meal and using the toilet when needed are tasks and activities that most people are able to take for granted and do for themselves. However, when people become either physically or mentally ill, or they have a disability, these everyday activities become a challenge. There are clearly important reasons, in terms of physical wellbeing, why people should be clean, eat well and be able to use the toilet when necessary. Dealing with these very personal areas of life has an impact on self-esteem and general confidence. It cannot be overemphasised how important it is for health and care workers to approach these intimate areas of a person's daily life with thoughtfulness and sensitivity. Carers must discuss usual routines and preferences in terms of personal hygiene and diet with clients. For example, when washing the client may prefer a bath to a shower, or a thorough wash to either of these. Most people would prefer to take personal responsibility for these tasks and wash in private. Independence should be encouraged, but where specific help is needed the client's dignity and privacy should be preserved. Toilet and bathroom doors should be closed and shower curtains drawn. You should follow the policies and procedures of your setting to ensure the safety and dignity of your service user while carrying out these intimate tasks. Domiciliary care workers, who provide support for people living in their own homes, will often provide personal care of this type. In a residential home care assistants will provide this support and in hospitals it will be a regular task for health care assistants working on the ward. A wide range of equipment is available to extend the independence of people in terms of their personal hygiene and to support carers providing personal care. Equipment includes: * Walk-in baths. * Showers suitable for the use of wheelchair users. * Non-slip bathmats. * Bath and shower seats. * Hand rails. * Bath lifts and hoists. * Adapted taps. * Bedpans and commodes. * Female and male urinals. Healthcare professionals must also be aware of and respect religious and cultural differences related to personal cleanliness, for example: * Muslims and Hindus normally prefer to wash in running water rather than have a bath. * Muslims and Hindus often prefer to use a bidet rather than use paper after using the toilet. * Sikhs and Rastafarians do not normally cut their hair. * Hindus and Muslims would strongly prefer to be treated and supported by someone of the same sex. Eating and drinking is vital for life itself, but meal times are also a social activity and ideally an enjoyable occasion. Dining areas should be clean and a pleasing environment. Most people in care settings are able to feed themselves. However, there will be clients who experience difficulties because of their physical condition, because they are confused, or because they are emotionally unsettled. They may be depressed or unhappy in the setting and find it difficult to eat. Some people will be capable of feeding themselves with minimal assistance and often using specially designed eating and drinking equipment (e.g. those referred to earlier in the unit) will allow them independence. Many people have specific dietary requirements. This will sometimes be related to religious belief, sometimes to physical disorders and sometimes to personal choice, for example: * Vegetarians do not eat fish, meat or meat-based products - this could include jelly. * Vegans do not eat meat or any animal-related products, including eggs, cheese, cow's or goat's milk. * Muslim and Jewish people do not eat pork and they require their meat to be killed and prepared for consumption in a particular way. Muslims eat halal products and Jews kosher foods. * Hindus and Sikhs do not eat beef. * People with coeliac disease require a gluten-free diet. * Other people have specific allergic reactions to particular foods - allergic reactions to nuts, strawberries, dairy products and shell fish are particularly common. **Reflect:** Use a catalogue or the internet to see the wide range of adaptions and equipment available to support people to wash, use the toilet and eat and enjoy their meals. Think about the people at your placement. Would these adaptions help them? Make notes so that you can describe key equipment and its purpose. You may need to do this in your final assessment. ### Supporting routines of service users in the context of their day-to-day family life, education, employment and leisure activities Earlier in this unit, the specialist support provided by a wide range of health and care professionals was discussed. Although many health and care staff have expert knowledge and high-level skills in particular areas, they will also try to address the wider personal needs that may emerge while working with their service users. This could include, for example a nurse not just attending to a service user's physical needs but also being aware of their wider social, emotional, spiritual and educational needs. Addressing these may be just as important for a speedy and successful recovery as the medical interventions and physical care that needs to be delivered and monitored. In attending to the needs of the 'whole' person, health and care professionals will want to support clients in developing and maintaining a fulfilling and satisfying daily life. This will involve being aware of the community in which their client lives, their work, their family circumstances, their general financial position and their interests, hobbies and aspirations. It also includes being aware of the support provided by family, friends and neighbours, who are often referred to as informal carers. These wider considerations can be as important to a person's recovery as medicines and other clinical interventions. **Link:** You can find out more about caring for the whole person, or holistic care, in the section on Holistic approaches, and also in Unit 10: Sociological Perspectives. **Discussion** Consider how far the care provided at your placement, or at any other care setting with which you are familiar, supports routines that develop good links with families, and promotes opportunities for extending education, employment and leisure activities. Discuss your thoughts, knowledge and experience with other members of your group. ## Assessment and care and support planning, involving service users and their families As was discussed earlier in this unit, health and care professionals' skills are wide ranging and cover many specialities. However, despite the differences in skills, experience and specialist knowledge, all health and care professionals are likely to take a similar approach to planning and evaluating care. Often referred to as the care planning cycle (see Figure 2.1), this approach involves: * Assessing the individual healthcare needs of their service users. * Agreeing a care plan that promotes the service user's health and wellbeing. * Evaluating the effectiveness of the care implemented. <start_of_image> Schematic of care planning cycle: * Assess the client's need * Plan and, where possible, agree the most appropriate care * Monitor the effectiveness of the plan * Implement the care plan **Figure 2.1 The care planning cycle** The process is cyclical, interventions and changes may be introduced at any point in the process. Adjustments may be necessary; for example, in response to changes in the client's health or social circumstances, the resources that are available, the specific expertise of the staff or multi-disciplinary team or changing levels of support from informal carers. **Research** Read a care plan for a service user at your work placement setting. How closely does the process at your setting match the care planning cycle presented in this unit? Did the planning and review involve informal carers or other members of the service user's family? ## Specific responsibilities of people who work in health and social care settings **Key Terms** * **Code of practice** - standards of behaviour and professional practice required of health and care practitioners, set and monitored by professional bodies such as the GMC, NMC or the HCPC. * **Anti-discriminatory practice** - care practice that ensures that individual and different needs of clients and patients are met regardless of their race, ethnicity, age, disability, sex or sexual orientation, and that prejudices and unfair discrimination are challenged. * **Prejudice** - preconceived opinions or fixed attitudes about a social group that are not based on reason or evidence. Prejudicial attitudes may lead to active discrimination. People working in health and care settings are required to work to high professional standards. They are required to follow agreed policies and procedures and actively promote the health and wellbeing of those in their care. This is underpinned by a value system, which includes commitments to: * Promoting anti-discriminatory practice to ensure that care services meet the needs of all people, regardless of their religion, culture, ethnic background, disability or other personal differences. * Empowering individuals, enabling them to take control of their lives and the decisions that relate to their treatment and care. * Ensuring the safety of staff, and of the people for whom they care. * Maintaining confidentiality and privacy. * Promoting good communication between carers, and between carers and their clients. These principles of good practice are the care value base, established by the Care Sector Consortium in 1992. They are found in the code of practice of all health and care professions (e.g. The General Medical Council (GMC) sets and monitors standards of behaviour for doctors. The Nursing & Midwifery Council (NMC) sets and monitors standards of behaviour for nurses and midwives. The recently formed Health and Care Professions Council (HCPC) sets and monitors standards of behaviour for social workers and for a range of other health professions, including physiotherapists, occupational therapists, paramedics and speech therapists). ### Implementing codes of practice and policies that identify and challenge discrimination in specific health and social care settings **Anti-discriminatory practice** is a core value and principle that guides the work of health and care professionals. It is based on legal requirements as outlined in the Equality Act 2010. It underpins the policies and practices of care settings, and in the codes of practice of all care professionals. Anti-discriminatory practice aims to ensure that the care needs of service users are met regardless of differences in race, ethnicity, age, disability or sexual orientation, and that the prejudices of staff or other service users are appropriately challenged. Legislation exists (see Figure 2.2) to ensure that vulnerable groups of people are not discriminated against. **Figure 2.2 The Equality Act 2010** All citizens in Great Britain (England, Wales and Scotland) have legal protection through the courts. In Northern Ireland, the main legislation protecting workers against discrimination is the Employment Equality (Age) Regulations (NI) 2006 and there is separate legislation for each area of discrimination: * Employment Equality (Age) (Amendment) Regulations (NI) 2006 * Employment Equality (Age) (Amendment No.2) Regulations (NI) 2006 * Employment Equality (Age) (Amendment) Regulations (NI) 2009 * Employment Equality (Age) (Repeal of Retirement Age Provisions) Regulations (NI) 2011. The Human Rights Act (1998) applies to all parts of the United Kingdom (England, Scotland, Wales and Northern Ireland). The Act guarantees rights to people cared for by 'public authorities' to be treated equally, with fairness, dignity and respect. Public authorities, or organisations, include