💡💡✅Important Questions Bristol

Question 1

What did the care quality commission do to check the quality of care provided at Winterbourne view?

Answer 1

1. We asked 10 people who lived at Winterbourne View for their views.
2. We watched to see how staff treated people
3. We read some records and notes about people who lived there
4. We asked staff for their views and talked to the managers.

Question 2

What did the care quality commission find out about winterbourne view?

Answer 2

1. The managers did not tell us about important things that happened at the service, like people getting injured/ when some people left the house without permission
2. systems used to check the quality of care were not good enough
3. The managers were not able to deal with any problems that could affect the health and safety of people who used the service. (included people being abused)
4. They did not reply to some of the complaints made by people who used the service. (included complaints about abuse)
5. When managers looked into the poor behaviour of staff, they did not do this carefully enough to keep people safe.
6. Staff held people down in a way that is not legal
7. Service did not manage staff properly/give them the right sort of training/check they were qualified

Question 3

What actions did the care quality commission take against the service at Winterbourne View to make things better for people

Answer 3

1. We stopped any more people coming to stay at the service
2. We worked with the council and the NHS to make sure that people were kept safe until they went to live in a new place
3. Because we were still so concerned about what we found, we stopped the owner from running any more services at Winterbourne View.

Question 4

What was winterbourne view?

Answer 4

Winterbourne View was an independent provider of health care and support for adults who have learning disabilities and other needs. They may also have been kept in care by a law called the Mental Health Act.

Question 5

Name the act relevant to social care

Answer 5

The Health and Social Care Act 2008 established the Care Quality Commission as the regulator of all health and adult social care services in England

Question 6

Duties of a candor (honest professional within a healthcare setting)

Answer 6

When a service is meeting the duty of candour patients should expect:

1) A culture within the service that is open and honest at all levels.
2) To be told in a timely manner when certain safety incidents have happened.
3) To receive a written and truthful account of the incident and an explanation about any enquiries and investigations that the service will make.
4) To receive an apology in writing.
5) Reasonable support if they were directly affected by the incident.

Question 7

Fact about charges of staff in winterbourne view carehome

Answer 7

9 support workers and 2 nurses were admitted 38 charges of neglect/ill treatment of people with severe learning difficulties

Question 8

Nurse verbally abuses a mentally handicapped resident, doesn’t let her go to toilet until she soils herself, what are the ethical issues of this

Answer 8

1. Patient autonomy -patients choice what to do with her body
2. Capacity -as she’s handicapped she may not be able to understand the magnitude of the situation and :: goes unreported, May happen to other residents.
3. Beneficence -not acting in best interests of patient, emotional abuse, physical abuse, embarrassment, holistic approach. As she’s mentally handicapped she’s more vulnerable to bullying.
4. Non Maleficence -clearly causing harm to the patient, goes against duty signed in Hippocratic oath, clear lack of judgement
5. Justice -treating all people equally despite handicap, clearly targeting those vulnerable

Question 9

You witness member of staff verbally abuse someone with learning difficulties by not giving them their evening meal what do you do?

Answer 9

1. Quickly Raise attention of the situation to another member of staff if at all possible (they have more experience and know what aid the patient requires)
2. Ask the other member of staff their opinion and clearly state your belief that they should be prohibited from seeing another patient until an investigation is carried out -(send her home and get emergency cover if needed)
3. Document everything that you as a volunteer have witnessed and report this to the appropriate senior colleague
4. Ensure that the nurse in question is okay, act compassionately to prevent further confrontation and offer support if needed.
5. Check that the complaint has been acted on/taken seriously, if not report to the quality of care commission for them to audit
6. If possible speak to the handicapped individual about their treatment, offer suitable support if possible as a volunteer. If the patient isn’t competent ask members of staff to inform patients family of issue/solutions
7. Example: winterbourne view care-home

Question 10

Somebody has broken their leg which departments are involved after being admitted to A&E?

Answer 10

1. Radiographers
2. Orthopaedics
3. Physical therapist
4. Occupational therapist
5. Nutritionist
6. Surgical team (if required)

(Tibia thicker than fibular)

Question 11

What are the qualities of a doctor?

Answer 11

1. Empathy/compassion (Velindre oncology tertiary centre)
2. Good communication (with patients with fellow doctors, (stroke ward)
3. Resilience (deal with uncertainty, optimistic, patience) (peer mentoring)
4. Respect patients (confidentiality, active listener, Beneficence) (Monday Club)
5. Interest in learning (Wilson F2 doctor in llandough)

Question 12

Describe how you’d obtain consent from a deaf individual

Answer 12

1. Visual information (symbols/pictures/diagrams)
2. Develop consent forms/ information packs that’s are clear and readable at a low level)
3. Provide real situations and examples to explain abstract concepts
4. Operationalise key terms (anything scientific/unfamiliar)
5. Videotapes that show the process or performance of treatment
6. Make sign language available (either whilst doctor is speaking/ video is playing for those who prefer this)
7. Use interpreters (priority places in finding the most direct communication)
8. Must be delivered by suitably qualified/experienced staff

Question 13

How to assess capacity of deaf patient

Answer 13

1. As soon as patient arrives/ before admission staff check the patient has nah aids of equipment they need
2. Staff introduce themselves
3. Staff ask questions with interpreter present (if found/preferred by patient) to assess capacity
4. If they have career/social worker communicate with them about capacity (As long as inferred consent is given)

Question 14

What skills do you need to work in a team?

Answer 14

Link to H&W week

Good communication

active listening/reasoning skills

Accountability/responsibility

Organisational skills

Conflict resolution skills

Reflection skills

Question 15

Characteristic that would make it hard to become a doctor

Answer 15

Too high expectations of myself- how I’ve improved from this

Question 16

A boy is being bullied in school and posts on social media “what is the point of going on” what do you do?

Answer 16

1. recognise bullying (lack attendance, post big clue, isolation etc)
2. Reach out to the child, be a friend/crutch to lean on, let them know it won’t last forever/tell them the bullying isn’t their fault (and their a likeable person)/offer your immediate help to sort it out (go over their house if accessible, meet for coffee etc).
3. If your not close to the child see if he has any close friends, if not reach out yourself
4. If you can’t personally reach out call the Samaritans on 116 123 and they will anonymously reach out to them
5. Immediate danger call 999
6. Encourage them to speak (call Samaritans themselves) 116 123
7. Talk to the school report the bullying, encourage them to talk to the school
8. Report/record every incident of bullying report to school if it doesn’t stop
9. Communicate with bullies, tell them the seriousness of the impact that they’re having
10. If it still continues contact educational department/ seek legal advice/ tell police

Question 17

Who could you tell about the bullying??

Answer 17

1. Councillor
2. Head of pastoral care in school
3. Family of the child being bullied
4. Encourage them to tell Samaritans/childline

Question 18

Role play: giving advice to an alcoholic who’s grieving

Answer 18

1. Introduce myself calmly, with reassuring ora
2. Small talk
3. Ask them how long their alcoholism has affected them (should see correlation with mothers death)
4. Tell them that alcohol is often part of the greiveing process and that their not alone
5. Explain to the different modes of treatment accessible to them for the alcoholism (medications, counselling, rehabilitation, AA etc)
6. Alcoholism will decrease with better management of grieving, offer him a councillor dedicated to listen to his needs, actively listen to him, silence is okay.

Question 19

How do you deal with a situation that you’ve made a mistake in patient care?

Answer 19

1. Recognise error and own up to it (integrity and honesty)
2. Take immediate steps to correct it if possible
3. Involve the right people to advise and help out (teamwork and communication)
4. Communication to patients is vital, be honest about what has happened, APOLOGISE, and discuss with them ideas on how to further manage their care, where to go next, they can get a second opinion if faith in doctor is decreased etc etc
5. Analyse situation and draw lessons from it (willingness to improve)
6. Apply lessons and ensure others don’t make the same mistakes

Question 20

How should we deal with staff who make mistakes?

Answer 20

Matters more about the action after the mistake is made.
If they recognise the mistake immediately, follow procedures and show remorse then the doctor should be cared for
Is it an accident or negligence/how often does mistake occur/was it anticipate e.g in complicated surgery or simple task gone wrong
Does the patient (plaintiff want to take legal action) if so then hospital pays out
if gross negligence is detected doctor removed if liscence
Most mistake corrected immediately however and doctor remains working, just maybe for a different patient/hospital
Doctor learns from mistakes

Question 21

How to deal with medical priorities questions

Answer 21

1. Unwell patients always come first (clinical need/ Nye Bevan)
2. Think of physical effects of surgery
3. Think of social effects of surgery

Question 22

What are the roles of a leader

Answer 22

1- delegate tasks 
2- clear communication 
3- involve the opinions of all
4- resolve conflict 
5- responsibility and accountability
6- organisational/keep members informed

Question 23

How do you deal with conflict within a team?

Answer 23

1. Recognise conflict and know that it’s expected
2. Set ground rules at first meeting to address preocedure when there’s conflict
3. Stop conflict when it happens before it grows (discuss as a team what’s best) but don’t fall into suppressing people’s views
4. Get the whole story (talk to each party if needed)
5. Make compromise, propose alternative but understand that you can’t change their opinion but help them accept the opinion by telling pros and cons of both ideas

Question 24

What observations can you infer from a picture?

Answer 24

Gender of person 
Age of person 
Ethnicity of person 
Abnormalities in photo
Sign and date notes

Question 25

What forms of abuse are there?

Answer 25

Physical abuse 
Emotional abuse 
Financial abuse 
Domestic abuse
Sexual abuse 
Psychological abuse 
Child abuse (link to above)

Question 26

Who’s in a surgical team?

Answer 26

1. Surgeon
2. Anesthetiser
3. Operating room nurse (helps surgeon during surgery)
4. Surgical tech (set up sterile operating room)
5. Resident or medical student
6. Physician assistant (practise medicine under supervision of a doctor, close incisions with stitches or staples)

Question 27

Why is teamwork important in healthcare?

Answer 27

1)Teamwork reduces medical error and increases patient safty
2)Teamwork reduced doctor burnout
No one person is responsible for a patients health (MDT)
3)One condition may require aid from multiple specialities and :: communication is essential to solve health problems
4)Teams used to communicate to diverse communities to instil disease prevention behaviours amongst patients
5)Learn off one another in a team, collecting and expanding knowledge

Question 28

Define informed consent

Answer 28

The process by which a patient learn and understands the purpose, benefits, risks of a medical or surgical intervention, including clinical trials and then agrees to receive treatment
Can only be given by someone who is competent

Question 29

Time where I’ve made a mistake

Answer 29

In ems care, I was distressed and confused the first time she collapsed and had a panic attack, became upset and left her alone for a couple of minutes, how I’ve learnt from this and how I’m no longer intimidated

Question 30

What challenges do you expect to face in a medical career

Answer 30

1. Work life balance
2. Breaking bad news
3. Extreme value of learning needed (stress)
4. Managing resources
5. Making mistakes

Question 31

Ethical issues associated with man refusing blood transfusion

Answer 31

1. Patient autonomy (patient entitled it make own decisions even if it defies doctors best interests)
2. Should have gained consent for any possible secondary interventions associated with surgery (including blood transfusion)
3. Beneficence (make decision with full knowledge of facts and they understand consequences of not having blood transfusion.
4. Consent -is the patient competent to make this decision if not act in best interests or turn to living will made when competent
5. If he was a child then parents would have to be involved as in England children don’t have the right to refuse treatment deamed in their best interests.

Question 32

What would you do if someone refused a blood transfusion?

Answer 32

1. Reassure the patient it’s in their best interests, if they’re worried about the procedure, ask why patient is unwilling to give consent for procedure
2. If she’s nervous about infection tell them about how blood is screened so it’s safe
3. May involve senior colleague often helps patients nerves
4. If religious reasons e.g Jehovah’s Witness then act beneficence and explain all the information they require for informed consent. Is it the only option? Support groups? Have to accept final verdict
5. If a patient is a child in England/wales they can’t refuse the procedure even if competent and :: consult parents and act in best interests
6. Check for competency and if not competent act in best interests

Question 33

How to handle stress?

Answer 33

1) Recognise -become aware of stress
2) Recruit Info- step back to analyse
3) Resolve
- organise better
- delegate tasks to others
- breaks/turn off
- anticipate further problems
- seek advice from friends/colleagues
- healthy lifestyle, hobbies and activities
4) Reflect -get perspective

Question 34

Should doctors be role models for patients?

Answer 34

Yes: increase doctor credibility
No: doctor autonomy (they have Their own choice over their body), define good example, following all health advice to the letter would place extreme pressure on doctors life, as long as they only perform certain acts in moderation then fine.
Patients should take responsibility for their own health.

Question 35

How do doctors keep their hood health?

Answer 35

1. Aware of consequences of bad health :: motivated to have good health
2. Maintain good work/life balance and :: frequently work on their health outside of the practise (basketball)
3. Consume a healthy diet
4. Ensure they practise safe sexual activity
5. Ask for advice from colleagues if necessary (not afraid to ask for health)
6. Relive stress boosts mental health

Question 36

What are the difference between university and school life?

Answer 36

1. Spoon fed vs self directed learning
2. School = compulsory uni= choice and :: need motivation
3. School = many broad subjects uni= one subject branch in detail
4. School= one location uni= integrated in city with academic hubs, changing environments
5. School= class of 30 lecture style, uni= large lectures 100+, small group work (CBL 11 students) and clinical skills
6. School= same friendship group for extended years uni= new friends made frequently
7. School= live at home uni= life on campus/ in city, social living and maturity etc

Question 37

Where would a doctor get information if he doesn’t know about something?

Answer 37

1. Get feedback from others
2. Speak to specialists in the field of research
3. Read books
4. Search online