Specific responsibilities of people who work in health and social care settings

Question 1

What is the care value base?

Answer 1

The care value base was established by the Care Sector Consortium in 1992. They set out the codes of practice of all health and care professionals.

Question 2

What 5 rules in the care value base ensure that policies and procedures are followed by service providers?

Answer 2

• promoting anti-discriminatory practice to ensure that care services meet the needs of all people regardless of their religion, culture, ethnic background, disability or other personal differences
• empowering individuals, enabling them to take control of their lives and the decisions that relate to their treatment and care
• ensuring the safety of staff, and of the people for whom they care
• maintaining confidentiality and privacy
• promoting good communication between carers, and between carers and their clients.

Question 3

Define “code of practice”

Answer 3

standards of behaviour and professional practice required of health and care practitioners, set and monitored by professional bodies such as the GMC, NMC or the HCPC.

Question 4

What is the GMC?

Answer 4

The General Medical Council - sets and monitors standards of behaviour for doctors

Question 5

What is the NMC?

Answer 5

The Nursing and Midwifery Council - sets and monitors standards of behaviour for nurses and midwives

Question 6

What is the HCPC?

Answer 6

Health and Care Professionals Council - recently formed and sets out and monitors standards of behaviour for social workers and a range of other health professions, such as paramedic and physiotherapist etc.

Question 7

What legislation exists to ensure vulnerable groups of people aren’t discriminated against?

Answer 7

The Equality Act 2010
The Human Rights Act 1998

Question 8

What does the The Equality Act 2010 do?

Answer 8

Prevents discrimination on the grounds of:
- age
- disability
- gender reassignment
- marriage and civil partnerships
- pregnancy and maternity
- race
- religion or belief
- sex
- sexual orientation

Question 9

What does the Human Rights Act 1998 do?

Answer 9

The Act guarantees rights to people cared for by ‘public authorities’ to be treated equally, with fairness, dignity and respect. Public authorities, or organisations, include hospitals, GP practices, social service departments, schools and colleges and many care and nursing homes.

Question 10

What does the The Human Rights Act 1998 guarantee?

Answer 10

Guarantees an individual the right to:
- access to education
- freedom of expression
- freedom from torture and inhuman or degrading treatment or punishment
- freedom from slavery, servitude and forced or compulsory labour
- liberty and security of person
- respect for a private and family life, home and correspondence
- freedom of thought, conscience and religion
- peaceful enjoyment of possessions and protection of property

Question 11

What must health and care workers do to promote anti-discriminatory practice?

Answer 11

• Address their own prejudices and adapt their behaviour to meet the clients’ needs regardless of their background
• actively challenge both intentional and unintentional discrimination against clients and patients
• ensure the setting is a welcoming and accessible environment for all
• compensate for the negative effects of discrimination in society
• celebrate the contribution that a wide and diverse range of people can bring to the setting and society
• understand and meet the individual needs of ALL service users

Question 12

How can adaptations be made to meet individual needs?

Answer 12

• to ensure wheelchair users have full access to and movement within the setting, ramps may be needed, doors widened, toilet faciliries adapted and
  kitchens and dining rooms arranged to allow for easy movement
• if a service user has a hearing impairment, written and visual communication may be necessary, quiet areas available for important conversations
  and meetings and a signer or interpreter should be employed ti ensure communication is clear
• in a multicultural setting, dietary requirements will need to be met and religious and cultural festivals respected and observed

Question 13

In what ways can service providers empower service users?

Answer 13

• putting the individual at the heart of service provision and promoting individualised
  care
• promoting and supporting individuals’ rights to dignity and independence
• providing active support consistent with beliefs, cultures and preferences of health and social care service users
• supporting individuals who need health and social care services to express their needs and preferences
• promoting the rights, choices and wellbeing of individuals who use health and social care services
• balancing individual rights to health and social care services with the rights of other service users and staff
• dealing with conflict in specific health and social care settings, to include GP surgeries, hospital wards, residential care homes for the elderly, residential care
  homes for vulnerable children and young adults, and domiciliary care settings.

Question 14

What is empowerment?

Answer 14

supporting people to take control of their lives and futures by taking a full part in discussions and decisions about their care and treatment.

Question 15

Why is empowerment so important?

Answer 15

• If service users are empowered, they will be fully involved in discussion about and planning of their care, and they will fully understand the options open to them. It will ensure individualised care, with the service user at the heart of the service.
• Their needs and preferences will be known and respectfully considered. As their rights to dignity and dependence are promoted, their self-esteem will be boosted.
• If a person’s cultural differences are ignored, they won’t feel respected. This means they won’t feel empowered so won’t contribute to the planning of their care.
• Not all service users will have the confidence or personal skills to participate fully in their care. They may need specific support e.g. translator, interpreter, signer, advocate. Translators + interpreters are essential for ensuring good communication. Signers play a key role in ensuring that people with hearing impairments can fully participate to communicate their care needs + preferences. Advocates and family and friends can often play a key role in ensuring that the service user’s needs are understood and met.

Question 16

How can the beliefs, cultures and preferences of service users present challenges for care providers?

Answer 16

• if service users speak little or no English, information will need to be presented in a range of languages, translators may be necessary and support may need to be given to access English lessons
• there may be a need to provide a wide range of foods for people with different religious requirements, for example Jews and Muslims do not eat pork, Hindus and Sikhs do not eat beef and many Buddhists are vegetarian
• religious observances may need to be considered, for example Muslims will need a prayer room and opportunity to pray up to five times a day, Roman Catholics may want to attend Mass on Sundays and other holy days, Jews may want to attend the synagogue on Saturdays.

Question 17

Give examples of conflicts in health care settings/services

Answer 17

There may be a conflict between:
- the equally valid preferences of one service user and that of another – for example conflicts arising from the choice of music or other leisure-time activities in the sitting room
- the client’s right to choice and protecting their personal safety – for example a person suffering from dementia may wish to live independently in their own home but if they are not able to use the cooker and the oven safely, this may pose fire risks and other dangers to themselves and others
- the different rights that service users have – for example the right to confidentiality and the right to protection from harm, if a service user discloses incidents of sexual or physical abuse
- the respect for the cultural or religious values of a service user and promoting their health and wellbeing – for example Jehovah’s Witnesses do not believe in blood transfusions, and a blood transfusion may be essential for their own or their children’s survival.

Question 18

What do care practitioners need to do when dealing with conflict?

Answer 18

• Never resort to aggressive behaviour
• Listen carefully
• stay calm
• try to see both sides of the argument or issue
• make sure that you know where the doors or other exit points are
• remove anything that could be used as a weapon
• allow the aggressor personal space, do not stand too close to them
• summon help as soon as possible, by using a panic alarm, shouting for help or by phoning the police or security.

Question 19

How can people who work in health and social care ensure safety for individuals and staff?

Answer 19

• use of risk assessments
• safeguarding and protecting individuals from abuse
• illness prevention measures, to include clean toilets, hand-washing facilities, safe drinking water
• control of substances harmful to health
• use of protective equipment and infection control
• reporting and recording accidents and incidents
• complaints procedures
• provision of first-aid facilities

Question 20

What must employers do to maintain a safe working environment for all?

Answer 20

• ensure that the organisation has a robust health and safety policy and that there is someone with official responsibility for health and safety at the setting
• undertake a risk assessment to identify the risks and hazards at the workplace, and take action to reduce the likeliness of harm or injury
• provide up-to-date information on health and safety issues
• provide health and safety equipment to carry out all procedures and treatments
• provide health and safety training
• keep a record of all accidents and incidents.

Question 21

What is a risk assessment?

Answer 21

identifying and evaluating the possible consequences of hazards and the level of risk that the hazard will cause harm. When employers carry out risk assessments, they examine all the procedures and activities that take place in their organisation and assess the level of risk involved.

Question 22

Explain how a risk assessment would be carried out in a care home

Answer 22

In a care home, for example this will range from risks associated with routine care procedures to organising social events and taking service users on outings. The responsibility for carrying out the risk assessment will often be delegated to a senior member of staff or a supervisor, for example a senior care assistant in a residential
home may have responsibility for assessing the risks associated with the bathing of a new resident. It is the responsibility of the care home manager to ensure that the senior care assistant
has had the training to carry out this task.

Question 23

What should you do if a child or vulnerable adult shares information that raises concerns about their personal safety / abuse?

Answer 23

Follow the setting’s safeguarding policies.
- Listen carefully to the service user and avoid asking them questions, let them tell you in their own way and words.
- Explain to the service user that the information must be shared with someone more senior.
- All care settings will have a designated safeguarding officer who will take over responsibility for investigating the claim or accusation.
- The safeguarding officer will ask you to provide a written record of what you have been told.

Question 24

How can service users, staff and volunteers be protected from infection?

Answer 24

Following policies and procedures at your setting to minimise infections, such as:
- Washing your hands before you start work and before you leave work, before eating, after using the toilet and after coughing or sneezing and before and after you carry out any personal care, particularly if this involves contact with body fluids, clinical waste or dirty linen.
- Safe handling and disposal of sharp articles such as needles and syringes to avoid needle-stick injuries and to ensure that infection is not passed on through viruses carried in the blood or bacteria.
- Keeping all soiled linen in the designated laundry bags, or bin, and not leaving it on the floor. When handling soiled laundry a protective apron and gloves should be worn. Hands must be thoroughly washed after handling soiled linen. Separate trolleys should be used for soiled and clean laundry to avoid cross-contamination and the spread of disease.
- Wearing protective disposable gloves and aprons when you have contact with body fluids, or when you are caring for someone with open wounds, rashes or pressure ulcers, for example.
- Cleaning all equipment according to the agreed procedures of your setting.
- Wearing protective clothing for any activities that involve close personal care or contact with body fluids.

Question 25

How should you control and dispose of substances harmful to death?

Answer 25

Ensure that hazardous waste is disposed of properly. This includes disposing of protective clothing, syringes, soiled dressings, nappies, incontinence pads and bodily fluids. In care settings, different coloured bags are often used to ensure the safe and efficient disposal of hazardous waste. The Control of Substances Hazardous to Health (COSHH) Regulations (2002) provide guidance approved by the Health and Safety Executive for the safe disposal of hazardous waste.

Question 26

Explain the importance of reporting and recording accidents and incidents

Answer 26

‘notifiable deaths, injuries or diseases’ must be officially reported and are are covered by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) (2013). Notifiable illnesses include diphtheria, food poisoning, rubella (German measles), tuberculosis (TB) and notifiable incidents occurring at work include broken bones, serious burns and death. Less serious accidents must also be recorded regardless of if there is an injury. Providers of health and care services use an accident form to report the details of all accidents and incidents, which are then recorded in an accident book. These reports are required by law and are checked when care settings are inspected.

Question 27

Explain the provision of first aid in health and care settings

Answer 27

The provision of first aid in health and care settings is governed by the Health and Safety (First-Aid) Regulations (1981). Provision for first aid should be ‘adequate and appropriate’. All first-aid incidents occurring in care settings must be recorded, either in the accident book or by completing the setting’s accident form. The report should include:
▸▸the name of the casualty
▸▸the nature of the incident/injury
▸▸the date, time and location of the incident
▸▸a record of the treatment given.
These records must be truthful and accurate.
They may be used in courts of law, particularly if the casualty is claiming compensation for injury, or if there is an accusation of criminal negligence.

Question 28

Explain complaints procedures

Answer 28

All care organisations must have complaints procedures and these are also checked when the setting is inspected. Complaints should be regarded as a source of information that will help improve the service. Complaints procedures vary in different organisations but will follow a very similar format. If a service user, a member of staff or a volunteer complains, they have a right to:
▸▸have their complaint dealt with swiftly and efficiently
▸▸have a proper and careful investigation of their concerns
▸▸know the outcomes of those investigations
▸▸have a judicial review of the facts, if they think the action or the decision is unlawful
▸▸receive compensation if they have been harmed either physically or psychologically as a result of the situation about which they are complaining.

Question 29

How can service users trust that their information is safe?

Answer 29

The Data Protection Act 1998

Question 30

What does the Data Protection Act 1998 do?

Answer 30

sets out the rules governing the processing and use of personal information in health and social care settings and in many other organisations that hold information about their members. The act covers information stored electronically on computers, mobile phones and on social media sites. It also covers most paper-based personal information. It is against the law to have photographs of service users without their permission.

Question 31

What are the 8 key principles of the Data Protection Act 1998?

Answer 31

Data must:
- not be passed to countries without data protection laws
- be accurate and up to date
- be collected and used honestly and fairly
- be kept safe and secure
- be used only for reasons it has been given
- not be kept longer than is necessary
- not be passed on to other organisations without permission
- be sufficient to meet the needs of the organisation

Question 32

What does the Data Protection Act cover?

Answer 32

The Act covers the policies, procedures and systems for:
▸▸Storing information – confidential information should be stored in locked filing cabinets, in a locked room. Information held electronically should be protected by a secure password.
▸▸Accessing information – members of staff in the organisation who are allowed access to this information should be clearly identified. Staff should never have access to personal information that they do not need to know. Where information is stored electronically, only the relevant staff should have personal access passwords.
▸▸Sharing information – information should only be shared with other professionals who have a need and a right to know it.

Question 33

How are employees accountable to professional bodies?

Answer 33

• following codes of professional conduct
• being familiar with/applying current codes of practice
• ensuring that revalidation procedures are followed
• following safeguarding regulations
• following procedures for raising concerns/whistleblowing.

Question 34

What does each professional organisation monitor?

Answer 34

▸▸level and content of the initial education and training of members of their profession
▸▸ongoing professional development and the requirement to keep up to date, and to complete further training – often called continuing professional development (CPD)
▸▸standards of professional practice in their everyday work
▸▸standards of personal conduct, both at work and in leisure time.

Question 35

Describe codes of professional conduct

Answer 35

Professional organisations publish codes of practice for members which must be followed. If a member is accused of failing to meet the standards set, this will be investigated and, in extreme circumstances, the member can be removed from the professional register and barred from professional practice.

Question 36

Explain how professional bodies use revalidation procedures

Answer 36

Each of the professional bodies requires its members to complete regular CPD in order to remain on the register.
This may include, for example:
▸▸training on the use of new procedures or new treatments
▸▸training on the use of new equipment
▸▸providing evidence that a registered person reviews and learns from their own practice.

Question 37

What is whistleblowing?

Answer 37

a situation in which an employee reports poor or dangerous practice at their workplace to the press or to another organisation outside of their work setting, for example the GMC, NMC or HCPC, in order to bring about change for the better.

Question 38

What is the care certificate?

Answer 38

Care certificate was introduced in 2015 for newly appointed health and social care workers who are not members of the regulated professional bodies (NMC, GMC, HCSC).
It is voluntary and provides an identified set of standards that hsc workers should follow in their daily working life.

Question 39

What does the code of conduct in the new certificate require?

Answer 39

The code of conduct in the new certificate requires that hsc workers are:
▸▸are accountable, by making sure they can answer for their actions or omissions
▸▸promote and uphold the privacy, dignity, rights, health and wellbeing of people who use health and care services, and that of their carers, at all times
▸▸work in collaboration with colleagues to ensure they deliver high-quality, safe and compassionate healthcare, care and support
▸▸communicate in an open and effective way to promote the health, safety and wellbeing of people who use health and care services, and of their carers
▸▸respect a person’s right to confidentiality
▸▸strive to improve the quality of healthcare, care and support through CPD
▸▸uphold and promote equality, diversity and inclusion.