PSYCH 103 UNIT 7 PRINCIPLES OF SAFE PRACTICE IN HEALTH & SOCIAL CARE,100% CORRECT

PSYCH 103 UNIT 7 PRINCIPLES OF SAFE PRACTICE IN HEALTH & SOCIAL CARE Inton, Maria Sophia Ernestine L3 Health and Social Care YR 2 Bryan Smikle Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (AP1) Explain the implications of a duty of care in a selected health and social care setting. Duty of Care is the legal obligation that you have when in the position to look after vulnerable individuals to protect them from harm and support them to lead a fulfilled life working to high standards and all legislations and policies. In the workplace, there are policies and procedures, agreed standards, codes of practice and other legislation a care worker should follow. In a care worker’s job role, you would be responsible for making sure the service users’ needs are met to the best of your ability as well as making sure the service user does not come to any harm and also making sure they are involved in their care plan. This include promoting service users’ choice and rights to the best of your ability. You would be responsible for assessing risks. You must remain professional throughout your role making sure you are adhering to confidentiality, keeping up to date and accurate records of the care you have or are providing to service users. Duty of care contributes to the safeguarding or protection of individuals by keeping individuals safe whether it is illness, abuse, harm or injury. This can be achieved by involving families, health care professionals and other external agencies into the individuals care plan. Duty of care is a legal requirement and there are policies, procedures, code of conduct and legislation around safeguarding and protecting your service users. Following this guidelines is showing that a setting is providing the best care possible. If you are doing activities with service user, you should always do risk assessments making sure that the service user is aware of any risks also. In childminding settings, the childminder is the key person. The key person should meet the needs of each child in their care and respond sensitively to their feelings, ideas and behaviour, talking to parents to make sure that the child is being cared for appropriately for each family. Duty of care is needed not only to the children, but also to their parents and families, who expect us to use our knowledge to care for their children. A high duty of care is needed for children because of their narrow ability to care for themselves as they are still learning, and the younger the child the higher the duty of care is. The consideration should be even greater if a child is known to have learning difficulties or is known to have a medical condition which may make them more vulnerable than the average child to foreseeable risk of harm. If duties and responsibilities are not being met, the childminders are fully responsible and be held accountable for following negligence to occur. The EYFS (Early Years Foundation Stage) is the statutory framework that ensures all parents and carers that their children will be kept safe and will help them to succeed. This also helps to achieve the five stages of every child matters. Since 2008, it is a legal requirement to use the EYFS to meet the learning and development of all children in all early years setting which complies with the welfare regulations. In addition to that, to ensure the safety and wellbeing of children and young people, childminders are expected to report assessments, receive advice and support from the appropriate people. (Here is an example on how a duty of care is performed in a childminding setting. The given setting is based on where I had my work experience for 17 weeks.) Maria’s Childcare Services Within our setting, we: 1. Carry out daily checks to ensure that the environment inside and outside is safe before the morning session at 8am. 2. Have a checklist of things to do (i.e. check all fire doors are unlocked, all gates outside are locked, no wet floors and all plugs have safety covers etc) and tick them off when they’re done. 3. Have daily rotas for change of nappies, dinners and lunches and vacuuming. 4. Contribute to ensure it is clean at the end of session and at the end of the day and before and after meals we disinfect tables chairs to stop the spread of infection. 5. Ensure that at least one member of staff in each room has been trained in first aid and that we have the right equipment. 6. To complete accident forms when an accident occurs and getting the parent/carer to sign to say there have been made aware. 7. Sign in and out every child that enters and leave the setting, we also have one at the main doors for staff and people that come to drop or collect children. How does the duty of care contribute to the safeguarding or protection of individuals? One part of my work is to always put the children and young people first, keep them safe and protect them from significant harm. We must follow the guidance of every child matters and promote safeguarding and the welfare of the children and young people. We should also ensure that the person caring for a child especially alone is suitable to do so and has a DBS check. Many things help us to provide the care to keep children and young people protected and safe, some of them are as follows: Risk Assessments - By doing risk assessments for all of the activities we do and for the playing areas ensures that if any risks concerning equipment, venues and activities will be found therefore reducing the risk of injury or harm to the children and young people. Also, spotting potential hazards and eliminating them. This includes germs and transferable diseases, we can minimise this just by cleaning surface and toys with an anti-bacterial to promote good health. Policies and Procedures - By having policies and procedures in the setting, it gives a good guidance of what is suitable in the setting from an adult or child that is at an age of understanding the rules and boundaries. Making observations and assessing children: By doing this, I am able to check to see if individual child or young person is progressing and developing at suitable rates. Also by doing observations, it will help us pick up on and recognise any signs of neglect or abuse so that these can be reported to the relevant third parties to protect the child or young person. Training and Development: I and all other childcare providers must keep up to date on compulsory training such as first aid and safeguarding. No one should be left to care for a child or young person alone if they do not have the appropriate training to care for a child. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (AP2) Discuss ways in which complaints and appeals procedures address failure in a duty of care in a selected health and social care setting. The Care Quality Commission monitors, inspects, and regulates hospitals, care homes, GP surgeries, dental practices, organisations and other care services related to health and social care to ensure they meet fundamental standards of quality and safety and publishes what it finds, including performance ratings to help people choose care. All organisations inspected and regulated by the CQC must have a complaints procedure and staff should be familiar with that procedure so they can assist people who wish to make a complaint. The care provider must investigate the complaint thoroughly and take action if problems are identified. Complaints may be made because of something done, an act committed, or they may be because of something that should have been done and was omitted. Some reasons for complaints against both NHS and Social Services may be: (1) Attitudes or behaviour of individual care workers, for example, rudeness, abuse or persistent lateness (2) Discrimination for example by not providing information in alternative formats for those with visual impairments (3) Poor delivery of services, such as not providing menu choices for vegetarians. Some complaints may relate to social care, for example: (1) the local authority refusing to assess a person’s need for adult social care, (2) unreasonable delays in assessing needs or providing services to meet assessed needs, (3) how the cost of a service is worked out if an individual has to pay. In the NHS, complaints should first be sent to the service provider. Many issues can be resolved locally and do not become full complaints. If the situation is not resolved then the complaints procedure is as follows: Stage One - Make a formal complaint to the service provider, for example, a GP, dentist, hospital or the organisation that commissioned their services, such as the local Clinical Commissioning Group or NHS England which purchases primary care services. CCGs oversee the commissioning of secondary carem such as hospital care and some community services. Stage Two - If you are not happy with the outcome of the complaint, you can refer the matter to the Parliamentary and Health Service Ombudsman, who is independent of the NHS and government. Complaints relating to social care should be made to the local authority providing the care but if a person privately arranges and pays for their own care, or uses a direct payment from the local authority to pay for the care that they themselves arrange, they must complain to the organisation that is providing the care who will have their own complaints procedure. If the problem is not sorted, the Local Government Ombudsman makes final decisions on complaints that have not been resolved by the NHS in England and UK government departments and other UK public organisations. On the other hand, here is a summed up options for complaints procedure: 1. Speak to the person providing the care, or their manager 2. Use the local authority complaints procedure or the complaints procedure of the care provider if this isn’t the local authority 3. Report your complaint to the Local Government Ombudsman 4. Take legal action, for example, for personal injury, negligence, discrimination or for breach of your human rights 5. Report concerns to a regulatory body 6. Report concerns to other bodies such as the Care Quality Commission or your local Healthwatch 7. Talk to your local councilor about your concerns All organisations should treat complaints seriously and with respect. Healthwatch, the consumer champion for health and social care say that people should have the right to have complaints and feedback taken seriously and acted upon when things go wrong. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (AP3) Describe the types and signs of abuse and neglect that may be experienced by different individuals. There are different types and signs of abuse and neglect. This can be experienced by anyone regardless of one’s age, gender, race and ethnic background. In this section, I will be describing the types and signs of abuse a child can experience. I am using children as my example as I have had my work experience in a childcare setting. The term ‘safeguarding’ means the process of protecting children from abuse or neglect, preventing impairment of their health and development, and ensuring they are growing up in circumstances consistent with the provision of safe and effective care that enables children to have optimum life chances and enter adulthood successfully. Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child either directly by inflicting harm, or indirectly, by failing to act to prevent harm. Children may be abused in a family or in an institutional or community setting; by those known to them; or, more rarely, by a stranger. They may be abused by an adult or adults, or another child or children. There are four types of child abuse. They are defined in the UK government guidance ‘Working Together to Safeguard Children’ 2010. Although bullying is not defined as abuse within Safeguarding 2010, there is enough evidence that is it abusive and can consist in at least one, if not all of the types of abuse. Emotional abuse includes actions or behaviour that have a harmful effect on the emotional health and development of a person at risk. Emotional abuse is the persistent emotional maltreatment of a child that causes persistent adverse effects on their emotional development. This is also termed as psychological abuse which combines emotional abuse and emotional neglect (Glaser, 2011). There can be two elements involved in emotional abuse, active and passive. Active abuse is a premeditated act, an individual scares, demeans or verbally abuses another. This includes terrorising, rejecting, exploiting or corrupting. Passive emotional abuse consists of depriving a child of the love or care needed to lead a happy healthy life. This can be as a result of the lack of knowledge, understanding or care that a parent or carer has about the child’s needs. It may involve seeing or hearing the ill-treatment of another. Emotional abuse can also involve serious bullying, including cyberbullying, causing children frequently to feel frightened or in danger. This abuse can be difficult to measure, as there are often no physical signs. There may be a developmental delay due to a failure to thrive and grow, although this will usually only be evident if the child puts on weight in other circumstances, for example when hospitalised or away from their parents’ care. However, children who appear well-cared for may nevertheless be emotionally abused. Some signs that maybe visible are: neurotic behaviour, for an instance, sulking, hair twisting, rocking, being unable to play, fear of making mistakes, sudden speech disorders, self-harm, fear of parent being approached regarding their behaviour. They can also be excessively withdrawn. Physical abuse involves physical harm or injury to the child. This maybe as a result of a deliberate attempt to hurt the child or severely discipline. The signs of physical abuse can be unexplained bruising, marks or injuries on any part of the body, multiple bruises- in clusters often on the upper arm, outside of the thighs, cigarette burns, human bite marks, broken bones, scalds with upward splash marks. The child can seem to be on alert, as if waiting for something bad to happen. Shies away from touch, seems reluctant to go home, flinches at sudden movement. The injuries a child has, appear as a pattern such as marks from a hand or belt. Sexual abuse includes sexual activity where the individual cannot give consent, and includes sexual harassment. It may be abuse which does not involve contact, but is still sexual abuse, for example inappropriate looking, sexual photography, indecent exposure, sexual teasing or innuendo, being forced to watch pornographic films or images, enforced witnessing of sexual acts or sexual media and sexual harassment. For cases involving children, sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse, this also includes via the internet. Sexual abuse is not solely perpetrated by adult males. Women and other children can also commit acts of sexual abuse. This type of abuse is usually committed by someone known to the victim not just by the sexual predators. It is important to remember that boys as well as girls can also be a victim of sexual abuse. Signs of sexual abuse may include physical signs such as bruising, bleeding, pain, itching, infections or discharges in the genital area, or sexually transmitted diseases (STDs), unusual difficulty in walking or sitting, foreign bodies in genital or rectal openings, wetting or soiling, torn, stained underclothing and pregnancy in a woman who is at risk or unable to consent to sexual intercourse. Behaviours may change and the person at risk may start to use explicit sexual language or may begin to self-harm. They may develop overt sexual behaviour and inappropriate attitudes towards others, copying the behaviour that was used towards them by the abuser. They may become withdrawn, have poor concentration and disturbed sleep, develop fear of relationships, and show fear of staff or other carers offering help with dressing, bathing, and become reluctant to be alone with a specific individual. Neglect happens when there is a failure to provide care, for example, putting food in front of a person but failing to check whether they can feed themselves. Neglect can be deliberate withholding of, or failure to provide necessary care and support. An act of omission is when a health or social care professional fails to meet the standards required of them by their professional code of conduct, for example, a nurse failing to give medication to a patient, or a social worker failing to check on a child at risk. Child Neglect can be a difficult form of abuse to recognise, yet can have some of the most lasting and damaging effects on children. Some of the signs can be: constant hunger, sometimes stealing food for other children, constantly dirty or ‘smelly’, loss of weight, or being constantly underweight, inappropriate clothing for the conditions. Changes in behaviour which can also indicate neglect may include: complaining of being tired all the time, not requesting medical assistance and/or failing to attend appointments, having few friends, mentioning being left alone or unsupervised. Bullying can be defined as a deliberately hurtful behaviour, usually repeated over a period of time, where it is difficult for those bullied to defend themselves. It can take many forms, but the three main types are physical (e.g. hitting, kicking, theft), verbal (e.g. racist or homophobic remarks, threats, name calling) and emotional (e.g. isolating an individual from activities and social acceptance of their peer group). Bullying can cause considerable distress to children to the extent that it affects their health and development or, at the extreme, cause them significant harm. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (BP4) Explain the factors that may contribute to and reduce the likelihood of abuse and neglect for service users in health and social care. Abuse continues to happen unfortunately and anyone can be a victim of it. Conversely, anyone can be an abuser. We will now tackle the factors that contribute to an individual becoming vulnerable to both abuse and to neglect. People may see themselves as isolated and alone but they often belong to certain groups which are vulnerable. Babies, children, and some older people are seen as more likely to be abused because they are seen as powerless because of their age and ability and because they have no one to defend their best interests. Children with increased vulnerability include those under one year, those with disabilities, looked-after children, and those who witness domestic violence. Adults in need of care and support are vulnerable, especially those who lack mental capacity, have communication difficulties, or are socially isolated. Children and adults who are vulnerable may suffer neglect or abuse if their caregiver abuses substances. Physical vulnerability - this may come from having physical disabilities. A wheelchair user who cannot get away from taunting bullies is vulnerable. A child with a chronic medical condition such as asthma may not be able to get away from the school bully who steals their lunch. A deaf eight-year-old resident may not hear the cruel comments carers make when she rings the bell yet again for the toilet. Cognitive impairment - this can make people vulnerable. An older person with a type of dementia such as Alzheimer’s disease may be out on their own and get confused by their surroundings then ask a stranger to take them home. A young person with special educational needs may not understand when a carer behaves inappropriately. A child with a speech impairment may have difficulty expressing themselves and their views might be neglected by social workers keen to place them with a foster family. Emotional vulnerability - this includes depression, anxiety, and phobias. Relationships that involve influence or power have the potential for abuse. Someone who is depressed and has low self-esteem may easily be intimidated by a stronger partner in a relationship, or by a forceful carer who makes their decisions for them. People with anxiety and phobias are especially vulnerable, if someone deliberately tries to coerce them into making decisions in their favour. One elderly lady who lived alone received a telephone call supposedly from her bank, saying her account had been hacked. In order to prove they were genuine and not a scam, the fraudsters asked her to ring the bank back using the phone number printed on the back of her bank card. However, the fraudster kept the telephone line open so even though the person called the bank, the call did not go through. Instead she is unknowingly connected straight back to the fraudster. The fraudster then pretends to be from the bank and asks the lady to provide her full bank card details and key in her PIN so that their existing card can ‘cancelled’ and the new one ‘activated’ or ‘authorised’. They explained she would have to return her bank cards at once and they would send a courier to collect them. She gives her cards to the courier. The next day she finds her bank account has been emptied. Her anxiety made her emotionally vulnerable to financial abuse. Social vulnerability - this is an increasing problem in our ageing society, where older people live in social isolation and are lonely. One elderly lady answered the door to find two strangers who said they had just moved in next door and had brought her some cakes. She invited them in, made a cup of tea and was chatting to them when one asked to go to the toilet. He was some time. When he came back downstairs, the couple left. A few minutes later, the elderly lady found her handbag had been emptied of the hundred pounds she had withdrawn earlier that afternoon from the bank. Socially vulnerable people are susceptible to controlling and institutionalised behaviour – forcibly showered and soaked in water to make her stop spitting at carers. People who abuse others look for those who are vulnerable. Those who work in health and social care can reduce the likelihood of abuse by supporting vulnerable individuals by: Identifying people at risk of abuse and neglect and the importance of observation - Health and social care workers play an important role in identifying those at risk of abuse or neglect because as part of their work, they observe people. Case Scenario Peter Connolly, Baby P 1 March 2006 Baby P, Peter Connolly was born. December 2006: His mother was arrested after bruises were spotted on the boy’s face and chest by the GP. April 2007: Baby P was admitted to North Middlesex hospital with bruises, two black eyes and swelling on the left side of his head. May 2007: After seeing marks on the boy’s face, a social worker sent Baby P to the North Middlesex where 12 areas of bruises and scratches were found. His mother Tracey Connolly was re-arrested. July 2007: Injuries to Baby P’s face and hands were missed by a social worker after the boy was deliberately smeared with chocolate to hide them. 3 August 2007: Baby P was found dead in his cot. In the case of Baby P, a GP and a social worker both identified Peter as at risk of abuse and neglect. His mother was arrested each time. Perhaps if others around had been more observant, he might not have died. Awareness raising, providing information, advice and advocacy - Incidents of abuse and neglect are distressing to read about, but even more distressing for those suffering the abuse. By raising awareness and providing advice and information, people are more able to protect vulnerable individuals. It is important to have knowledge and understanding of the policies, legislation and regulation to reduce and help prevent abuse. If people know what to do and how to report suspected abuse, they are more likely to do so. It is also important that in a health and social care workplace, staff are provided the adequate training and given the continual professional development. This is to ensure they are aware of their legal and professional duty to be observant and report neglect and abuse. In addition, promoting empowerment and choice for service users contribute massively to reducing the possibilities of being at risk of abuse. Promoting empowerment and choice for service users, for example, through the personalisation of care brought in by the Care Act 2014, will help strengthen vulnerable people, giving them confidence, making them more assertive and less likely to be abused. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (CP5) Explain how to respond to concerns about abuse and neglect in the selected health and social care setting. Safeguarding means protecting and adult’s right to live in safety, free from abuse and neglect. To prevent neglect and abuse from happening, it is necessary to know how to respond and what actions to take. This includes following safeguarding policies and procedures. According to the Care Act 2014, the aims of adult safeguarding are to stop abuse or neglect wherever possible, prevent harm and reduce the risk of abuse or neglect to adults with care and support needs, safeguard adults in a way that supports them in making choices and having control about how they want to live, promote an approach that concentrates on improving life for the adults concerned, raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect, provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult and address what has caused the abuse or neglect. Procedures in safeguarding may include a statement of purpose relating to promoting well-being, preventing harm and responding effectively if concerns are raised, a statement of specific roles and responsibility, authority and accountability so that all staff and volunteers understand their role and limitations, a statement of the procedures for dealing with allegations of abuse, including those for dealing with emergencies by ensuring immediate safety, the processes for initially assessing abuse and neglect and deciding when intervention is appropriate, and the arrangements for reporting to the police, urgently when necessary and a list of all services which might offer access to support or redress. When safeguarding children, Sections 11 and 12 of the Children Act 2004 place a statutory duty on agencies to cooperate to safeguard and promote the welfare of children. The statutory guidance ‘Working together to Safeguard Children - A guide to inter-agency working to safeguard and promote the welfare of children’ (2015) focuses on a child-centred and coordinated approach to safeguarding. It says that everyone has a responsibility to keep children safe. Concerns about the children SHOULD NEVER BE IGNORED. After immediately responding to disclosure of abuse, the incident must be reported within the same day. If a criminal offence has or is likely to occur, the police must be notified at once and then the incident reported to the local lead agency. If no criminal offence is involved, the incident must be reported immediately to the local lead agency, which is likely to be local social services. Whistle-blowing is disclosure by an individual to the public, or those in authority, of mismanagement, corruption, illegality, or some other form of wrongdoing in the workplace. The law protecting whistleblowers is the Public Interest Disclosure Act 1998 (PIDA). The usual steps are first, check your employer’s whistle-blowing policy and follow the steps set out in it. The policy should give details of the contact person for raising concerns within your organisation. Raise concerns internally with the line manager so issues can be addressed at a local level. You should be kept informed about the action taken to deal with it. If nothing happens, escalate your concerns internally with the higher management. If nothing happens after raising concerns with the higher management, escalate your concerns externally with a prescribed regulator. If there is concern about the health, behaviour, or practice of another professional, raise your concerns internally and also notify the appropriate regulator for their profession. In Maria’s Childcare Services, staff and healthcare professionals, whether paid or voluntary, in all agencies and organisations, where they come in to contact with children and young people, or similarly, all those who work in some way with adults, who may be parents or carers are expected to be alert to potential indicators of abuse or neglect, be alert to the risks which individual abusers or potential abusers, may pose to children, be alert to the impact on the child of any concerns of abuse or maltreatment, be able to gather and analyse information as part of an assessment of the child’s needs. Professional and Agency Response - In our setting, we have our child protection procedures in place to support and provide information about how and what action to take when there are concerns about a child. Those child protection procedures will include information about how to: 1. Identify potential or actual harm to children; 2. Discuss and record concerns with a first line manager/in supervision; 3. Analyse concerns by completing an assessment 4. Discuss concerns with the agency’s designated safeguarding children advisor Hearing and Observing the Child - Whenever a child reports that they are suffering or have suffered significant harm through abuse or neglect, or have caused or are causing physical or sexual harm to others, the initial response from all professionals should be to listen carefully to what the child says and to observe the child’s behaviour and circumstances to: 1. Clarify the concerns; 2. Offer reassurance about how the child will be kept safe; 3. Explain what action will be taken and within what timeframe. The child must not be pressed for information, led or cross-examined or given false assurances of absolute confidentiality, as this could prejudice police investigations, especially of sexual abuse. It should be explained to the child that whilst their view will be taken into account, the professional has a responsibility to take whatever action is required to ensure the child’s safety of other children. Parental Consultation - Concerns which have been raised, should, where practicable, be discussed with the parent and agreement sought for a referral to Maria’s Childcare Services unless seeking agreement is likely to place the child at risk of significant harm through delay or from the parent's actions or reactions; For example in circumstances where there are concerns or suspicions that a serious crime such as sexual abuse, domestic violence or induced illness has taken place. Making a Referral - Referrals should be made to Maria’s Childcare Services for the area where the child is living or is found. If the child is known to have an allocated social worker, the referral should be made to them or in their absence to the social worker's manager or a duty children's social worker. In all other circumstances referrals should be made to the duty officer. The referred should confirm verbal and telephone referrals in writing, within 48 hours. Where an assessment has been completed prior to referral, these details should also be conveyed at the point of referral. Maria’s Childcare Services should within one working day of receiving the referral make a decision about the type of response that will be required to meet the needs of the child, and feedback the decision to the referrer. If this does not occur within three working days, the referrer should contact these services again and, if necessary, ask to speak to a line manager to establish progress. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (CP6) Compare the influence of different health and safety laws and policies on health and social care practice in a selected setting. Employers have a duty of to ensure a safe working environment for their employees. Maintaining health and safety is essential in any area of work but especially in health and social care where staff and members of the public may be at risk. The Care Quality Commission is the lead inspection and enforcement body under the Health and Social Care Act 2008 for safety and quality of treatment and care matters involving patients and service users receiving a health or adult social care service from a provider registered with CQC. The Care Quality Commission took the lead role for patient and service user health and safety in health and adult social care in England in April 2015. The Health and Safety Executive and local authorities are the lead inspection and enforcement bodies for health and safety matters involving patients and service users receiving health or care service from providers not registered with CQC. They are also the lead inspection and enforcement bodies for health and safety matters involving workers, visitors and contractors, irrespective of registration. Health and Safety at Work Act (1974) - This act requires everyone to have a responsibility for health and safety. Employees must take reasonable care for the health and safety of themselves and others who may be affected by the employee’s acts or omissions at work. A care worker spills water on the floor. They are responsible for making sure the water is dried or if they cannot do it immediately, they must warn others and ensure no one can slip. Employers must provide personal protective equipment and aprons but it is the employee’s responsibility to use them to prevent cross infection. Employers should regularly risk assess tasks and reduce the risk of injury from slips, trips, and falls. Employers must display the Health and Safety law poster or provide each worker with a copy of the equivalent pocket card. The Manual Handling Operations and Regulations (2002) - This manual was originally published in 1992 and applies to many different manual handling activities such as lifting, lowering, pushing, pulling or carrying animate loads which may move unpredictably, such as a person, or inanimate ones, such as a box or a trolley. Incorrect manual handling can cause injury. Employers must consider the risks to employees, consult and involve employees in reducing risks. The Food Hygiene Regulations (2006) - This regulation apply throughout the UK and consolidated and simplified previous EU hygiene legislation. They control throughout the food chain, from primary production to sale or supply to the final consumer, focus or public health protection and clarify that it is primary responsibility of food business operators to produce food safety. Control of Substances Hazardous to Health (COSHH) 2002 - Substances that are hazardous to health must be controlled in the workplace. Exposure to hazardous substances can be prevented or reduced by finding out what the health hazards are, for example, risk of harm from cleaning chemicals, or from body fluids for care workers, deciding how to prevent harm to health (risk assessment), providing information, instructions and training, providing monitoring and health surveillance in appropriate cases, planning for emergencies. Data Protection Act (1989) - Information sharing has proved a barrier to effective joint working but is permitted where it is of vital interest – a term used in the Data Protection Act (PIDA) 1998 to permit sharing of information where it is critical to prevent serious harm or distress, or in life-threatening situations. The Equality Act (2010) - This Act brought together previous laws into one discrimination law which protects individuals from unfair treatment and promotes a fair and more equal society. Under this Act, you are protected from discrimination in the workplace, when using public services like health care or education, when using businesses and other organisations that provide services and goods, when using transport, joining a club or association (e.g. your local football club); and when you have contact with public bodies such as the local council or government departments. The Care Act (2014) - This Act brought in some of the biggest changes for 60 years to the way care is delivered. It placed a duty on local authorities to promote well-being, to focus on preventing, reducing or delaying needs, to provide information and advice to service users and change from a service led system to a person-centred one that focuses on outcomes for service users. Local authorities have a legal duty to assess needs and eligibility and provide independent advocacy. Disclosure and Barring Service (DBS) checks - This prevents unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CBR) and Independent Safeguarding Authority (ISA). Safeguarding regulations include information about the Disclosure and Barring Service and are part of the Protection of Freedoms Act 2012. Legislations and policies improve services. Monitor, the sector regulator for health services in England, and the NHS Trust Development Authority publish quarterly reports on NHS performance. Safeguarding policies and legislation influence practice by clarifying what to do, who should be involved in safeguarding, and have emphasised training for staff around their responsibilities in this area. Protection from accidents, injuries and illness, including infection control, food preparation, hazardous substances - national minimum standards have clear guidelines for employers and employees meaning more people are aware of what good care is and what is not. Staff and service users are protected by this legislations. Managing risk assessments and maintaining a safe working environment, including safe moving and handling - managing risk assessments and maintaining a safe working environment, including safe moving and handling has become everyone’s business. Staff are trained to risk assess situations and have safe practice, including the storage and handling of medication. Promoting health and well-being - promoting health and well-being is emphasised and the shift from cure to prevention has influenced practice as more funding is directed into maintaining health. Better care, a joint initiative between local authorities and CCGs aims to reduce the number of hospital admissions. Legislation - legislation provides confidence and reassurance for families and other carers. The Care Act 2014 brought together different laws and put the patient at the heart of care, focusing on outcomes for them as a measure of the service. Meet legal and regulatory requirements, including record keeping. Legislation and policy clarify requirements for record keeping according to the Data protection Act and the Care Act. Self-assessment involves the person at the heart of the care. Personal budgets and direct payments involved record keeping on the part of the budget holder and give a tighter control on finances. Recruitment of staff in health and social care - this remains an issue. Agency staff maintain many services where there are insufficient permanent staff. Disclosure and Barring Service checks help to ensure that the many thousands of staff employed in health and care have clear criminal records. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (DP7) Explain how different procedures maintain health and safety in a selected health and social care setting. Procedures are ways of doing something, so procedures to maintain health and safety are ways of ensuring a healthy and safe environment. Keeping children of all ages safe and healthy is one of the most important tasks of child care providers. Whether children are in centre-based or home-based care, providers are responsible for ensuring safety both inside and outside their child care setting. Health and safety are major concerns for child care providers when transporting children. They should be prepared to prevent injuries and illnesses to handle emergencies. Maria’s Childcare Services’ Health and Safety Procedures Infection Control and Prevention - Infections and diseases spread rapidly when hygiene is poor. Infections are less of a threat to healthy people but in some health care settings where people may have less resistance to organisms, infections can be deadly. In our setting, keeping the child care environment clean is one of the best ways to help ensure that children stay healthy. Dirty toys, bedding, linens, eating utensils, and surfaces can carry and spread germs. Regular disinfecting should be a part of the routine in a child care setting.This can be done through washing the item with soap and water or through disinfecting them by using bleach. For carers and workers, hands should be decontaminated immediately by using hand rub or soap and water before and after every episode of direct contact or care even when they wear gloves. Bathroom Safety - As children begin to use the toilet, bathroom safety becomes especially important. Because there are many potential safety hazards in the bathroom, child care providers need to supervise bathroom use carefully. As children reach the preschool years and beyond, child care providers can also help children stay safe in the bathroom by teaching them how to identify and avoid risks. The bathroom has many areas and materials that could be risky to young children. To maintain the health and safety of the children, you should be aware of the following risks like drowning, hazardous chemicals, burns and shocks, falls and plan ways to eliminate or reduce them. This means a carer should never allow a toddler a child or a young person to go to the bathroom alone as most of them are not developmentally ready to be left in a bathroom because they do not have the sufficient self-control and judgment to avoid risks. Food Safety - Safe storing, preparing, and serving of foods is just as important in child care programs as serving a balanced diet. Many children and adults get sick from eating foods that are not properly handled. It's important to follow food safety guidelines carefully whenever you buy, store, prepare, or serve food. Guidelines for food safety begin with food purchasing and continue through storing, preparing, serving, and cleaning up afterwards. Handwashing - Keeping all children healthy is an important goal of child care programs, and washing hands carefully and thoroughly can help children and child care providers prevent the spread of germs that cause illness. Thorough hand washing can remove as much as 90 percent of the virus-containing particles and bacteria on your skin. That's a lot of protection from infection for the amount of time and effort it takes. Child care providers and children should wash their hands regularly during the day. Outdoor Safety - Children love to play outdoors. It is a wonderful place to test one's physical abilities and to just have fun. Keeping children safe outdoors requires some special precautions. Here are some tips for keeping children in your child care program safe outdoors. It is important to never leave children to play or wander alone outside, teach the children not to play near the street, and check the outdoor play routinely. Remove trash, sharp objects, tools, lawn equipment and any object that can possibly harm a child. Ensuring that the playground area is safe requires careful planning and monitoring. Remember that infants and toddlers (ages 0 - 2), preschool-age children (ages 3 – 5), and school-age children (ages 5 – 12) have different developmental needs and abilities, and may need developmentally different. Different age groups may need different playground equipment in areas separated by fences to ensure that playgrounds are safe and fun for everyone. Preventing Illness - Because children in child care spend so much time together, it's not unusual for germs to spread. Child care providers can reduce the spread of common illnesses by using simple precautions like thorough hand washing and keeping surfaces and toys clean. Child care programs can also help prevent the spread of illnesses by requiring immunizations and by developing rules to exclude children with specific symptoms. Preventing Injuries - Injuries are the leading cause of death and disability for young children. Young children are at higher risk of injuries overall, and certain injuries are more probable at different ages. Toddlers are most susceptible to poisoning, preschoolers to drowning, and school-aged children to pedestrian accidents. Children are more likely to be injured when they are not under appropriate adult supervision. The vast majority of childhood injuries are preventable. Child care providers need to take specific steps to prevent injury in the child care setting. This includes indoor and outdoor safety where children must be protected and looked-after seriously. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (DP8) Explain the health and safety responsibilities of employers, employees and others in a selected health and social care setting. Both employers and employees are obliged under the Workplace Health and Safety Act 1995 to reduce workplace hazards. Failure to meet these obligations may not only cause personal suffering and financial losses, but may also result in legal action. Duty of care refers to the responsibility of each person to do everything within their power to ensure a safe and healthy environment. Duty of care places into a legal form a moral duty to anticipate possible causes of injury and illness and to everything reasonably practicable to remove or minimise these possible causes of harm. This duty of care is written into the Workplace Health and Safety Act 1995 as obligations. All adults in a workplace are legally responsible for workplace health and safety issues. Duty of care cannot be delegated. That means you cannot pass on that responsibility to anyone else. Employer’s responsibilities - Employers have an obligation to provide a work environment free from hazards and to ensure the health and safety of themselves, their workers and other people affected by the workplace. They meet this obligation by complying with the relevant workplace health and safety regulations that govern their type of business and by following the Advisory Standard or adopting an equally effective way of managing exposure to risks. Employers who do not meet their obligations under the Act may face severe penalties (fines, imprisonment, lawsuits). Employees’ responsibilities - Responsibilities of employees include taking reasonable care of their own and others’ health and safety, following guidance from health and safety training, identifying potential hazards in the setting and participating in training and updates provided. Maria’s Childcare Services Responsibilities as a Childcare Worker As a parent, you rely on childcare workers to care for your children and keep them safe when you are not around. Childcare workers may care for your children at your home or in a childcare center. Each state has laws and regulations in place to ensure that all children enjoy a safe environment when their parents are not around. Education and Certification - Childcare workers must meet the education and certification requirements in their area. Some areas do not have any education requirements, while others require a high school diploma or a degree in childhood education. Safety - The primary legal responsibility of a childcare worker ensures the safety of the children. You must comply with state regulations, which may include first aid and CPR certification and plans for emergencies, such as fires or tornadoes. In addition, the home or center must meet sanitary and fire regulations, including smoke detectors and fire extinguishers. Workers must know each child's relevant medical history and be prepared to prevent and provide first aid for any resulting health issues. This includes conditions such as asthma or diabetes and allergies to food, medication or bee stings. In addition, if the childcare worker transports children, the car must contain appropriate car and booster seats. If driving is one of the workers responsibilities, the childcare center or family may check the worker's driving. Sick Children - In most cases, childcare workers are not legally responsible to accept the care of sick children. However, if a child becomes ill or the worker accepts the care of a sick child, the worker is responsible for providing appropriate medical care. This may include providing a place for the child to rest, administering medications or calling 999 for emergency medical care, if necessary. Abuse - Childcare workers must report all suspected cases of child abuse or neglect to law enforcement even if they do not have concrete proof of abuse. Some physical signs of abuse include frequent or unexplained bruising, dental trauma or broken bones. In addition, the child may show behavioral signs such as being fearful of adults or reluctant to go home, and aggressive or destructive behavior. Childcare workers should also look for signs of emotional or psychological abuse which include speech disorders, eating disorders or ulcers and withdrawing from social interaction. Failure to report suspected abuse may result in fines or criminal charges depending on state law. In addition, childcare workers may not abuse children in their care. Some examples of abusive behavior include grabbing, yelling and screaming and forcing hugs and kisses. Responsibilities of others in the setting, such as visitors, includes following health and safety guidance and emergency procedures if required, and abiding by relevant regulations, policies, and procedures such as signing in and out if required. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (AM1) Assess the importance of balancing individual rights with a duty of care in a selected health and social care setting. Having duty of care means that the individuals are protected by having risk assessments these outline the risk of the activities we do in work place and rate the chance of this happening. This reduces the chance of harm and we also have policies and procedures that give you clear rules and boundaries ensures that staff know how to act within the work environment, this means not behaving in ways that could cause distress or harm to individuals. Sometimes care workers may feel that there is a conflict between their duty of care and the wishes of the person using the service. Best interest decisions can only be made for individuals who cannot decide matters for themselves at the time a particular decision needs to be taken. So before starting to think about best interests, you need to be certain that the person doesn’t have the capacity to make this decision. For example in a care home, Mr. Wanda has decided that he will go and collect his pension at the bank himself. You don’t feel this is wise as he has to cross a busy road and his sight and hearing are not good, but he is perfectly capable of making a decision. A statement comes from the Department of Health (DH) that clearly explains about the balance of risk: “Supporting people to make informed choices - most of the choices that people make in life naturally involve some element of risk, and the decisions made by people using health and social care are no different. Avoiding risks altogether would constrain their choices and opportunities. Risk is a concept that tends to have negative connotations but people take considered risks all of the time and gain many positive benefits. As new health and social care choices and opportunities arise, they are likely to involve the consideration of taking risks. To be able to carefully think about Mr. Wanda’s situation, we have to look at the The Mental Capacity Act (MCA) which provides a framework to empower and protect people who may lack capacity. Considering the decision by Mr. Wanda to collect his own pension, it is important that as a care worker, you know his capability to make such decision and to be able to provide an evidence that he may lack capacity or an unwise decision with capacity. The law states that you cannot assume that a person cannot make their own decisions simply because of their condition (in this case, a sight and hearing impairment). Mr. Wanda may, for example, know that a school crossing patrol officer will help him across bas he always does. If his behaviour or history suggests that he may lack capacity to make this decision, then a staff must carry out a capacity assessment. This capacity assessment may require a two stage process: Is there an impairment or disturbance in the functioning of the mind or brain? Does this prevent Mr. Wanda from making this decision? The MCA Code of Practice provides guidance about how to assess capacity. The Codes of Practice state that we must assume people have capacity unless there is evidence to suggest otherwise, do all we can to maximise someone’s capacity to make their own decisions, not assume that someone who makes an unwise decision lacks capacity, act in a person’s best interests, and apply the least intrusive intervention. As a responsible care worker, you need to do all you can to support Mr. Wanda to understand the risks and your concerns. A duty of care does not mean that you have the automatic right to override Mr. Wanda’s wishes. Working within this process may sometimes create an uncomfortable situation, when you think a person is planning, with mental capacity, to take a risk that you may consider ‘unwise’. Discuss your concerns with the person and explain your worries. If the risk seems great, you could discuss the matter with other involved professionals, such as the commissioners, medical practitioners and the local safeguarding team. It is important to let people make their own decisions whenever possible as people can become depressed, demotivated and more dependent if they are not allowed to make their own decisions and take risks especially for a setting like in a care home where older people are most likely to be considered as people who doesn’t have the inability to do things independently due to their age. We must understand our responsibilities as care workers to protect and ensure individual’s safety but we must also balance our duties and responsibilities with the individual’s rights to make their own decisions and let them live their lives independently. Maria Sophia Aludo Inton L3 Health and Social Care YR 2 UNIT 7 - Principles of Safe Practice in Health and Social Care Bryan Smikle (BM2) Assess the importance of recognising and responding to evidence or concerns about different types of abuse and neglect in health and social care setting. Cruelty to children and young people is a criminal offence and child abuse and neglect can have serious adverse health and social consequences for children and young people. These include: effects on growth and physical development, impaired language development and behaviour, impaired ability to socialise, play and learn, increased likelihood of being involved in anti-social behaviour, increased likelihood of suicidal thoughts and attempts during adolescence. These negative consequences can persist into adulthood. Adult survivors of childhood abuse are more likely to misuse substances and to experience mental health problems and physical ill health. Recognising and responding to child abuse and neglect, or its early signs, is complex. Key challenges practitioners may face include: Knowing ‘when to be worried’ that a child or young person is being abused or neglected and how serious a cause for concern different indicators may be. Assessing levels of risk and need in relation to child abuse and neglect. Knowing what early help interventions are effective when there are early signs of child abuse and neglect. Knowing what interventions are effective in helping children and young people to recover following child abuse and neglect, and to support families in which there has been child abuse and neglect. For somewhat reasons, children and young people who are being abused or neglected might have a difficulty with telling someone about their experience and as a responsible and sensitive care worker, it is important that you recognise whenever a child feels such way. This is due to the following reasons: (1) they may have feelings of confusion, shame, guilt and of being stigmatised, (2) they may not recognise their own experiences as abusive or neglectful, (3) they may be being coerced by (or may be attached to) the person or people abusing or neglecting them, (4) they may fear the consequences of telling someone, for example that no one will believe them, the abuse or neglect might get worse, their family will be split up or excluded by their community, or they will go into care, they may have communication difficulties or may not speak English fluently. Recognise that children and young people may communicate their abuse or neglect indirectly through their behaviour and appearance. Take into account that when children and young people communicate their abuse or neglect (either directly or indirectly), it may refer to non-recent abuse or neglect. Explore your concerns with children and young people in a non-leading way, for example by using open questions, if you are worried that they may be being abused or neglected. If a child or young person tells you they have been abused or neglected, make a referral to children’s social care using your local procedures. Explain to the child or young person who you will need to tell, and discuss what will happen next and when. Senior managers should ensure staff working in community settings, including education can recognise and respond to child abuse and neglect and are aware of child safeguarding guidance relevant to their profession, for example, the Department of Education’s “Keeping children safe in education”. Consider child abuse and neglect if a child or young person displays or is reported to display a marked change in behaviour or emotional state (see examples below) that is a departure from what would be expected for their age and developmental stage and is not fully explained by a known stressful situation that is not part of child abuse and neglect (for example, bereavement or parental separation) or medical cause. Examples include: recurrent nightmares containing similar themes extreme distress markedly oppositional behaviour withdrawal of communication Consider child abuse and neglect if a child's behaviour or emotional state is not consistent with their age and developmental stage or cannot be fully explained by medical causes, neurodevelopmental disorders (for example, attention deficit hyperactivity disorder [ADHD], autism spectrum disorders) or other stressful situation that is not part of child abuse or neglect (for example, bereavement or parental separation). Examples of behaviour or emotional states that may fit this description include: Emotional states: fearful, withdrawn, low self-esteem Behaviour: aggressive, oppositional Consider current or past child abuse or neglect if children or young people are showing any of the following behaviours: substance or alcohol misuse self-harm eating disorders suicidal behaviours bullying or being bullied Sexual behavioural alerting features: Suspect current or past child abuse and neglect if a child or young person's sexual behaviour is indiscriminate, precocious or coercive. Suspect child abuse and neglect, and in particular sexual abuse, if a prepubertal child displays or is reported to display repeated or coercive sexualised behaviours or preoccupation (for example, sexual talk associated with knowledge, emulating sexual activity with another child). Physical neglect alerting features: Suspect neglect if you repeatedly observe or hear reports of any of the following in the home that is in the parents or carers' control: a poor standard of hygiene that affects a child's health, inadequate provision of food, a living environment that is unsafe for the child's developmental stage. Be aware that it may be difficult to distinguish between neglect and material poverty. However, care should be taken to balance recognition of the constraints on the parents’ or carers' ability to meet their children's needs for food, clothing and shelter with an appreciation of how people in similar circumstances have been able to meet those needs. Suspect neglect if a child is persistently smelly and dirty. Take into account that children often become dirty and smelly during the course of the day. Use judgement to determine if persistent lack of provision or care is a possibility. Examples include: child seen at times of the day when it is unlikely that they would have had an opportunity to become dirty or smelly (for example, an early morning visit), if the dirtiness is ingrained. Consider neglect if a child has severe and persistent infestations, such as scabies or head lice. Consider neglect if a child's clothing or footwear is consistently inappropriate (for example, for the weather or the child's size). Take into account that instances of inadequate clothing that have a suitable explanation (for example, a sudden change in the weather, slippers worn because they were closest to hand when leaving the house in a rush) or resulting from behaviour associated with neurodevelopmental disorders such as autism would not be alerting features for possible neglect. Alerting features relating to interactions between children and young people and parents or carers: Consider neglect or physical abuse if a child’s behaviour towards their parent or carer shows any of the following, particularly if they are not observed in the child’s other interactions: dislike or lack of cooperation, lack of interest or low responsiveness, high levels of anger or annoyance, seeming passive or withdrawn. Consider emotional abuse if there is concern that parent– or carer–child interactions may be harmful. Examples include: Negativity or hostility towards a child or young person. Rejection or scapegoating of a child or young person. Developmentally inappropriate expectations of or interactions with a child, including inappropriate threats or methods of disciplining. Exposure to frightening or traumatic experiences. Using the child for the fulfilment of the adult's needs (for example, in marital disputes). Failure to promote the child's appropriate socialisation (for example, involving children in unlawful activities, isolation, not providing stimulation or education). Suspect emotional abuse if the interactions observed are persistent. Consider emotional neglect if there is emotional unavailability and unresponsiveness from the parent or carer towards a child or young person and in particular towards an infant. Suspect emotional neglect if the interaction observed is persistent. Consider child abuse and neglect if parents or carers are seen or reported to punish a child for wetting or soiling despite practitioner advice that the symptom is involuntary. Consider child abuse and neglect if a parent or carer refuses to allow a child or young person to speak to a practitioner on their own wh