HEALTH AND SOCIAL UNIT 2

Doctors(GPs):                                                                                                                       

• provides medical care for patients 
• They work mainly in surgeries and local communities.

They:

• diagnose, treat, monitor and prevent illness 
• provides prescriptions for treatment and arrange preventation care, such as  fluimmunisation 
• refer patients to other health professionals, such as specialist doctors and therapistS

Nurses:

• Trained to carry out medical duties at thier level of seniority and specialism, mainly in , suguries and hospitals, clinics and homes 
• Specialisms include hopsitals critical care nursing, cardiac nursing, surgical care, and oncology nursing 

They:

• monitor and care for the daily chronic and acute medical needs of patients 
• Support doctors in giving treatment and prescribed drugs 
• Work to restore health and wellbeing

Occupational therapist:

• facilitate recovery and overcome practical barriers 
• They work mainly in hospitalss, clinics,residentail  care and homes

They;

• identify issues people may have in everyday life, such as with dressing, shopping, or working 
• Help people  to work out pratical solutions.

Midwives:

• diagnose, monitor and examine pregnnt women
• provide anenatal care
• assist during labour
• supervise pain management

They:

• prepare and review patient care plans
• arrange or provide parenting health education
• support and advice on care of newborns
• support and advice following miscarriage, termination or neonatal death

Care manager:

• day to day running of residential care settings
• supervising work of care assistants
• ensuring quality of care meets standards and adheres to relevant legislation
• ensuring suitable staff are available 

They:

• creat and maintain relationships of trusts with residents
• maintain accurate records
• observe, listen and repsond to concerns
• maintain confidentiality

Care assistants:

• provide appropriate daily personal care
• carrying out general household tasks
• carrying out other routine roles as required
• liasing with other health and care porfessionals

They:

• work indifferent care settings
• observ and report changes in health and wellbeing of service users
• make service users feel at ease
• maintain confidentiality

Social workers:

• mange a designated case loads
• maintain professional registration
• working within regulatory guidelines
• keeping informed of changes in policy and procedure
• liasing with other agencies

They:

• preparing and reviewing case files of clients
• taking difficult descions
• working with a vriety of service users of different ages
• ensuring continutiy of care

Youth workers:

• demonstrating vlaues which underpin youth work
• completeing a background check with the disclosure and barring service
• continuing professional development
• acting as a member to young people

They:

• working across different sectors - care, cirminal justice and in public, private and voluntary sector organisations 
• developing projects with schools and other organisations
• offering advice on topics like sexual health using language which is accessible to young people

Home:

• easy access to all rooms
• facilities are within reach and not at floor level
• hoists are available

school:

• access class rooms and labs
• access to play and exercise facilities
• curriculum is adapted to their needs - i.e. language

work:

• awareness training
• support worker
• extra time

Identifying:

• treated unfairly/unequal
• i.e. not accessible signange, leaflets in one language, no access to buildings, no extra time, no anti bullying policies etc

Action against:

• equality act 2010 - age, gender, pregnancy, religion, marital status, disability, race, sexual orientation
• protected against employers, health and care providers, schools, transport services, public bodies

Types:

• direct - treating someone worse, conscoiusly
• indirect - policies and procedures put someone at a disadvantage, unconsciously 

Traveller - enable access to GP services at new locations, no hostile language

Transgender people - appropriate gender terms, associated mental health issues

Person with hearing impairment - hearing loops in GP surgeries,  use BSL

Asylum seeker - translation services, recognise cultural preferences

Child with emotionsl and bheavioural differences - peer mediation and mentoring. nurture groups

Person with physical disabilities - accessible rooms, support participation in sport and exercise

Challenge discrimination:

• doctors should check records to see preferences i.e. language and treatment
• nurses - prefer male or female
• social worker - advise on actions to avoid discrimination i.e. reporting it
• occupational therapist - help live independently by ensuring appropriate kitchen equipment for different cultures i.e. wok and chopsticks 

Means giving individuals information and support to make informed decisions and make choices about their lives to live independently

Empowerment:

• individualised care
• promoting dignity
• delaing with conflict
• enable them to express needs and preferences
• promote independence
• provide support that is consistent with user's beliefs cultures and preferences
• promote users rights choices and wellbeing
• balnacing the rights of individuals with those of other service users and staff
• putting users at the heart of service provision

Rights:

• dignity, independence, privacy, safety and security, equality, free from discrimnation, express needs and preferences

Examples of rights being used in practice:

Dignity - privacy in the bathroom

Independence - allowing them to make choices on their living arrangements

Needs and preferences - support choices about food clothing and religious practice etc

Safety and security - ban on smoking in public places, providing clear training, applying policies

Equality - fair allocation of budgets, accountability through local authoirty representatives

Freedom from discrimination - registering complaints, investigating abuse, making sure services are available area (postocde lottery)

Possible risks:

• abuse
• inadequare supervision of facilities
• inadequate supervision of support staff
• lack of illness prevention measures
• infection 
• inadequate control of harmful substances
• lack of first-aid facilities 

Managing risks:

• use risk assessments
• staff training
• clear codes of practice
• ensuring all staff have a DBS
• regular checks of facilities
• protective equipment available
• reporting and recording accidents incidents and complaints

• detect incident or accident
• record it
• report to relevent person
• classify acording to type and severity
• prioritise issues for appropriate actions
• propose preventative measures
• implement changes to working practice
• monitor effectiveness of changes in preventing future incidents

Barriers to incident reporting:

• seen as not important at the time
• dont know how to fill out the form
• have other stuff to do
• dont know about the procedures
• difficult to access the person who needs to recieve the report
• pressured by managers not to report it 

Controls how personal information is used by organisations, businesses or the government. the data must be:

• used fairly and lawfully
• used for limited stated purposes
• used in a way that is adequate, relevant and not excessive
• accurate
• kept for no longer than necessary
• handled correctly
• kept safe and secure

Can keep this information:

• address, birth date, gender, emergency contact details, education and qualifications, employment history and work experience, national insurance number, tax code, details of known diabilities, name

Data storage:

• computers, tablets, mobile phones, social media, written/paper records, photogrpahs (i.e. CCTV)

How is confidentiality ensured:

• applying requirments of the data protection act 1998
• adhering to legal and workplace requirements specified by codes of practice in health and social care settings
• securely recording, storing and retrieving medical or personal information
• maintaining confidentiality to safe guard service users
• following appropriate procedures where disclosure is leglly required
• respecting the rights of service users where they request non-disclosure or limited disclosure of their personal information

Maintaining confidentiality is part of the safeguarding practice so clients are protected form harm and abuse 

Examples of professional bodies:

• the nursing and midwifery council
• royal college of nursing
• the helath and care professions council
• the general medical council 
• care council for wlaes
• the northern ireland social care council

Regulation of workers:

• must follow codes of professional conduct
• must be familar with and able to apply current codes of practice
• must ensure tht revalidation procedures are followed
• must follow procedures for raising concerns 

Workers who do not follow regulations might be disciplined by their employer, organisations, the government or even the police

Children:

• protect from maltreatment
• follow organisations policies for protecting children and actions to take if child discloses abuse
• prevent impairment of childrens health and development
• protect from infection
• ensure they grow up in circumstances that are consistent with the provision of safe and effective care
• take action to enable children to have the best outcomes

Local safeguarding children board - the children act 2004 requires every loca authority to have a local safeguarding children board 

Adults - can be safeguarded too in the same ways, protected under the care act 2014

Why is it important:

• imporves lives of vulnerable adults and children
• dont have to give out information to different people
• improves information sharing
• improves the efficency of care sysem as a whole
• coordinates the way in which care is provided
• helps the service user feel that they are being treated as a whole person
• improves the planning and commissioning of care

Difficulties of partnerships:

• failure to comunicate 
• lack of coordination 
• delayed discharges from hospital
• health and social care providers with different IT systems 
• cuts in funding that prevent effective partnership working 

Looks at wider problems and needs and aims to meet thes to promote health and wellbeing

Advantages:

• more personalised
• other issues like stress etc are identified
• viewed as a whole person

Disadvantages:

• most people only want their illness or symptom treated
• doctors do not look for other issues during diagnosis
• health and social care workers are not skilled to manage all aspects of individuals needs

Advocacy allows people to :

• express views or concerns so they are taken seriously
• access information and services and explore choices and options
• defend and promote thier rights and responsibilities

Internal monitors ensure that health and social care workers are following the codes of practice and policies in the settings where they work

Internal monitor roles:

• lead nurses/senior nurses
• doctors
• matrons
• ward sister/charge nurse
• nurse specialists
• healthcare assistants

Whistleblowing:

• a member of staff might raise concerns about patient care etc, the concerns are reported to the relevant staff in the hospital such as a senior nurse, a doctor or one of the hospital managers

Organisations that are external to care settings use codes of practice and regulations to govern how health and social care workers carry out their role

Inspections:

• analysis of internal data and trends
• investigate complaints
• observe service delivery
• collect service-user feedback 
• interview staff

Criminal investigation:

• when sexual, physical financial or emotional abuse is suspected
• take account of safeguarding
• follow referrals to the police from care providers, clinical commissioning groups and specialised care settings such as prisons
• follow referrals from individuals who suspect that a crime has been committed
• may lead to the suspension or dismissal of care workers

Public bodies:

• health - NHS foundation trusts or GP services
• social - local authorities are public sector organisations which provide social care services i.e. help in the home, support for carers, financial support, equipment to enhance independence

Commissioning:

• planning service specification, agreeing service procurement, monitoring delivery

Primary care:

• first point of contact, gives access to day-to-day services for patients and refers them to relevant specialists where needed

Private:

• services are provided by businesses, which are usually run for profit, services which are often paid for by the person who uses them
• boots, BUPA, virgin healthcare, private sector doctors
• residential care homes, nursing homes, counselling services, some home-help services

Public:

• non-profit making organisations which provide services alongside those provided by public and private sector organisations, usually charities with paid staff as well as volunteers
• hospices, macmillan cancer support nurses, marie curie nurses, marie stopes, sexual health services

Hospitals - people with specialised health needs are referred to hospitals by their GPs, hospitals provide emergency care via A&E, people who need health services have a right to choose which hospitals they attend , which team of specialist doctors they see  and to be involved in decisions about their treatment 

Day care units - surgery and other medical procedures may be carried out in daycare units, they usually provide services which meet the health needs of older people, people with mental ill health or people with learning disabilities and can also provide respite care, day care units can be a part of the NHS but some are privately run or are provided by charities

Secondary care and specialists:

• provided to referred patients by medical specialists
• usually centralised and takes place in hospitals 
• i.e. cardiologists, urologists, orthopaedic surgeons, radiologists

Hospice staff:

• take care of people's physical, intellectual, emotional and social needs
• aim to control the pain and other symptoms experienced by the patient through palliative care
• support carers, family members and close friends through a person's illness and during bereavment 

Palliative care:

• end of their life care
• multidisciplinary approach to specialised medicl care for people with serious illnesses
• active and holistic
• focuses on providing patients with relief from symptoms and pain and the physical and mental stress of serious illness
• regards as paramount the management of pain and other symptoms and provision of psychological, social and spiritual support

The goal of palliative care is to achieve the best quality of life for patients and their families

Residential care settings offer a service to people who are unable to look after themselves and who dont have family mebers to look after them at home

Most people in residential care recieve personal care but some also need health care

Personal care:

• people who live in residential care homes recieve social care or personal care from care assistants or support workers 
• meets day-to-day needs - meals, bathing, going to the toilet and taking medication

Nursing care:

• people in nursing homes recieve healthcare from trained medical staff such as nurses
• i.e. using hoists etc

Care at home is called domiciliary care

Types of domiciliary care:

• formal - provided by paid staff
• informal - provided by family members, relatives or friends, who are not paid
• voluntary sector - both formal and informal care is often provided by people and services within the voluntary sector

Young carers - care for parents or older relatives, often miss out on schooling, grow up fast as they take on the adult role within the family

Respite care:

• gives an informal carer a break away from caring for someone
• care act 2013 sets out the rights of adults who provide care
• includes home care, residential care or nursing care for a short period so the informal carer can have a break i.e. overnight care so the informal carer can catch up on sleep

Some people find it hard to access services after going through the process of 'referral, assessment, eligibility criteria'

• people with learning and physical disabilities
• people with mental ill health
• older people
• children
• refugees - language barrier
• people transitioning from one sex to another
• people with religious or cultural beliefs may reject some medicines
• people who exercise their right to be treated in a local hospital
• women who prefer to get care from other women
• people with terminal illness refusing to have treatment
• people with mental health may be unable to make decisions for themselves
• an older person who wants to remain independent
• financial barriers
• social - homeless people are unlikely to get health and social care they need
• geographical - people in certain areas dont have certain facilities

Charities - set up to represent people with specific needs and provide help and support

• NSPCC - end child abuse
• Mental health foundation 
• Shelter - reduce homelessness
• Stonewall - awareness of LGBT

What they do:

• represent interests to the government - carry out research - provide advice and services - raise money - work in partnerships - change public attitudes - challenge prejudice - prevent discrimination 

NHS organisations must involve the public in decisions

Clinical commissioning gorups have patient groups that represent the interests of people with particular health needs, provide feedback on NHS services, provide volunteers, take part in research 

• express the vies and concerns of a person 
• let them access information about services
• defend and promote their rights and wellbeing
• explore choices and options

People that need them:

• mental health - learn disabilities - speech difficulties - people who dont speak english - children 

Peer advocacy - people support someone with similar problems

Statutory advocacy - where someone is entitled to advocacy under the law

Self advocacy - be ones own advocate 

Friends and family can act as an advocate

How inspectors carry out inspections:

• identify the scope and purpose of the inspection
• gather views of service users
• gather information from staff
• observe service delivery
• review records
• look at documents and policies
• feed back at a meeting with the inspection team and senior staff
• publish findings
• take action to improve services where needed

After the inspection:

• service is graded
• requirements or warning notices may be given
• organisations and individuals may be asked to implement policy or practice changes
• a provider might be required to limit the range of service or to face criminal prosecution

The care quality commission:

• register care providers - moitor inspect and rate - protect service users - be an independent voice
• they ask five questions - is it safe - is it effective - is it caring - is it responsive - is it well led 

The national insitute for health and care excellence:

• provides national guidance - produce evidence based guidance and advice - develop quality standards - provide a range of information services 
• provides guidance about conditions and diseases - lifestyle and wellbeing - population groups - service delivery - settings 

OFSTED:

• Inspect childcare, adoption and fostering agencies and initial teacher training, and early years and childrens social care services

The care and social services inspectorate wales

Healthcare inspectorate wales

The national institute for health and care excellence

Her majestys inspectorate for education and training in wales

- dont think you really need to know about this - more the england ones -

The regulation and quality improvement authority

Public health agency

The national institute for health care excellence

Education and training inspectorate

- dont think you really need to know about this - more the England ones - 

The nursing and midwifery council:

• regulates nurses and midwives - have the right qualifications - set standards - making them challenge discrimnation

The royal college of nursing:

• represents nurses, midwives and health care assistants - set out principles of nursing practice, roles and responsibilities - ensure accountability of practitioners - support diversity

The health and care professions council:

• protects the public - keeps record of professionals that meet their standards in conduct and ethics - performance and efficency - character and health - education and training

The general medical council:

• protects patients and improves medical education and practice - decides what doctors are qualified - sets the standards doctors need to follow - prevents doctors from putting patients at risk

Wales:

• care council for wales

Northern ireland:

• the norhtern ireland social care council

National occupational standards:

• describe best practice to apply in all settings - underpin codes of practice

Examples of standards:

• recieving visitors
• providing advice and information to people who ask about services
• contributing to social care during emergency situations
• supporting individuals to use medication in social care settings
• monitoring and maintaining health, safety and security of self and others
• minimising the risk of spreading infection by cleaning, disinfection and storing care equipment

Performance criteria for meeting visitors:

• talk to them - provide support to rhe visitor - ensure that the info is accurate - maintain confidentiality - seek help if unable to help - ensure the visiting area is safe

Code of practice:

• set of guidelines - health and safety - data protection - confidentiality - professional conduct - end of life care - safe guarding 

Why do we need:

• best practice - informar practitioners of rights and repsonsibilities - outline bhevaiours and attitudes - help achieve high quality safe compassionate care and support - enabple safety for the people who use the services and people who work in them

Training:

• before - gain qualifications
• undertake training whilst on post
• trained by other more experienced professionals
• access training provided by their regulatory bodies
• nurses have to be revalidated every 3 years - 35 hours of CPD
• CPD is mandatory for social workers who wish to renew their registration

• the british medical association is the trades union and professionals association for doctors and medical students
• trades union and professional association for nurses is the Royal college of nurses and for midwives it is the royal college for midwives
• the unions unite and unison protect people who work in all occupations across healthcare

How are they safeguarded:

• complaints is made against employee - employee has the right  to be accompanied by a trades union representative or work colleague - employee continues to work whilst complint is investigated - employee should not experience any direct or indirect discrimnation - informal resolution - formal resolution 

Whistleblowing:

• if an employee is concerned about unsafe work practice or lack of care by other professionals they have a duty to raise concerns 

Where care is given:

• hospitals - GP surgery - hospice - residential and nursing homes - at home - the workplace

Who provides the care:

• doctors - nurses - midwives - healthcare assistants

Nurses role:

• follow correct admission procedures - assess specific needs - provide correct info when answering questions from patients and family members - use appropriate language - ensure patient preferences are respected and specific needs catered for - provide and administer correct dosages of mediction - ensure notes are complete and accurate - prepare patient for surgery where needed - monitor recovery - prepare care plans that are appropriate for specific needs, with clear support in place - ensure patient discharge forms are correctly completed

Types of mental health:

• anorexia - bipolar - dementia - OCD - PTSD - postnatal depression - psychosis - schizophrenia - self harm - alzheimers

Care providers:

• family/friends/NHS/ charities/ private sector organisations

Legislation:

• people cn be detained under the mental health act 1983
• detained and treated without their consent 
• police can be involved 

Preventing mental health:

• talking about feelings - active - eat well - drink sensibly - keep in touch with friends and loved ones - ask for help - take a break - doing things youre good at - accept for who they are 

4 key care prorities:

• choices - care in the community with personalised support - innovative services - early intensive support

4 main providers:

• family and friends - psychologists - support workers - social workers

Carers role:

• preserve independence - use language that can be understood - ensure preferences are respected - empathise - dignity - confidentiality - facilitate social activities - support them to access appropriate health care - report risk - care meets their needs 

Types:

• sesnory - neuorlogical - spinal cord injury - amputation 

Provided by:

• family and friends - support workers. - phsyiotherapists - specialist medical teams

The carers role:

• help the person deal with the diagnosis - support family members when theyre told about the diagnosis - ensure care reflects needs and preferences - help access care they need - help the perosn obtain suitable equipment - arrange for necessary adaptions to settings - support the person with self-care programmes and care of equipment - help access benefits - ensure that respite is available - help family to cope with adjustments to normal living

Specfic childrens needs:

• learning disability - phsyical disability - challenging behaviour - severe illness - victims of abuse or neglect
• care through parents, family, friends, teachers etc, specialist support workers, specialist medical staff

Carers role:

• keep them safe, healthy environment, accessible learning environment, encourage learning development and play, let them make contributions, welfare is paramount, confidentiality, working with parents or carers, make sure they dont experience discrimintion, not judegemental, promoting children's rights

Childrens entitlements:

• entitled to learning and development in these reas:
• communication and language, physical development, personal social and emotional development, literacy, maths, understanding the world, expressive arts and designs

Rights:

• choose their GP, equal and fair treatment, consulted about the care they need, consulted about their preferences, be protected from harm and risk, access to complaints procedures, access to advocacy and empowerment

Carers role:

• keep them safe - help live independently - access benefits - ensure confidentiality - work in partnerships with different personal care providers - ensure thye dont experience discrimination - promote their rights - provide mediation - prevent self-neglect - prevent abuse

Purpose:

• needs and interests are respected - human rights are respected - interventions and responses are appropriate - all decision and action are in line with legislation

Regulations:

• laws issued by the government

Policies:

• a service providers statements of intent followed by a description of procedures to be followed to ensure that codes of practice and regulations are adhered to

Procedures:

• step-by-step instructions that employees must follow when completing a particular task to the standard required by an organisation

Five goals of the NHS outcomes framework:

• prevent people from dyeing prematurely - enhancing quality of life for people with long-term conditions - helping people to recover from episodes of illness or following injury - ensuring people habe a positive experience of care - treating and caring for people in a safe environment and protecting them from avoidable harm

Principles of nursing practice:

• a - treat everyone with dignity and humanity
• b - take responsibility for the care they provide and answer for their own judgements and actions
• c - manage risk, are vigilant about risk, and help keep everyone safe
• d - provide and promote care that puts people at the centre
• e - heart of the communication process - assess, record and report on treatment and care
• f - up-to-dte knowledge and skills and use these
• g - work closely with their own team and other professionals
• h - lead by example, develop themselves and other staff and influence the way care is given 

4 aspects of rights that should be given to everyone:

• privacy, dignity and self esteem - have their own private space, choose their dress, food, when they sleep etc, decide how to be addressed
• independence, choice and control - how they spend their time, how they participate in the home, how they maintain relationships, opportunities for emotional and sexual expression, access to external advice, representation and advocacy
• diversity and individuality - feel their needs will be responded to by staff, opportunities to express and pursue religious and political beliefs, be able to attend places of worship 
• balancing safety anf risk - not be discouraged from certain activities on the grounds that there is an element of risk, live in a cintext where responsible risk taking is regarded as normal and important in maintaining autonomy and indpeendence